3rd Engrossment - 83rd Legislature (2003 - 2004) Posted on 12/15/2009 12:00am
1.1 A bill for an act 1.2 relating to state government; making changes to public 1.3 assistance programs, health care programs, long-term 1.4 care, continuing care for persons with disabilities, 1.5 human services licensing, county initiatives, and 1.6 children's services; establishing the Community 1.7 Services Act; changing estate recovery provisions for 1.8 medical assistance; changing health department 1.9 provisions; modifying local public health grants; 1.10 changing child care provisions; making forecast 1.11 adjustments; appropriating money; amending Minnesota 1.12 Statutes 2002, sections 16A.724; 61A.072, subdivision 1.13 6; 62A.315; 62A.48, by adding a subdivision; 62A.49, 1.14 by adding a subdivision; 62A.65, subdivision 7; 1.15 62D.095, subdivision 2, by adding a subdivision; 1.16 62J.692, subdivision 4, by adding a subdivision; 1.17 62Q.19, subdivision 1; 62S.22, subdivision 1; 69.021, 1.18 subdivision 11; 119B.011, subdivisions 5, 6, 15, 19, 1.19 21, by adding subdivisions; 119B.02, subdivision 1; 1.20 119B.03, subdivision 9; 119B.05, subdivision 1; 1.21 119B.08, subdivision 3; 119B.09, subdivisions 1, 2, 7, 1.22 by adding subdivisions; 119B.11, subdivision 2a; 1.23 119B.12, subdivision 2; 119B.13, subdivisions 1, 2, 6, 1.24 by adding subdivisions; 119B.16, subdivision 2, by 1.25 adding subdivisions; 119B.19, subdivision 7; 119B.21, 1.26 subdivision 11; 119B.23, subdivision 3; 124D.23, 1.27 subdivision 2; 144.1222, by adding a subdivision; 1.28 144.125; 144.128; 144.1483; 144.1488, subdivision 4; 1.29 144.1491, subdivision 1; 144.1502, subdivision 4; 1.30 144.551, subdivision 1; 144A.04, subdivision 3, by 1.31 adding a subdivision; 144A.071, subdivision 4a; 1.32 144A.10, by adding a subdivision; 144A.4605, 1.33 subdivision 4; 144E.11, subdivision 6; 145.88; 1.34 145.881, subdivision 2; 145.882, subdivisions 1, 2, 3, 1.35 7, by adding a subdivision; 145.883, subdivisions 1, 1.36 9; 145A.02, subdivisions 5, 6, 7; 145A.06, subdivision 1.37 1; 145A.09, subdivisions 2, 4, 7; 145A.10, 1.38 subdivisions 2, 10, by adding a subdivision; 145A.11, 1.39 subdivisions 2, 4; 145A.12, subdivisions 1, 2, by 1.40 adding a subdivision; 145A.13, by adding a 1.41 subdivision; 145A.14, subdivision 2, by adding a 1.42 subdivision; 147A.08; 148.5194, subdivisions 1, 2, 3, 1.43 by adding a subdivision; 148.6445, subdivision 7; 1.44 153A.17; 174.30, subdivision 1; 179A.03, subdivision 1.45 7; 245.4932, subdivision 1; 245A.035, subdivision 3; 1.46 245A.04, subdivisions 3, 3b, 3d; 245A.09, subdivision 2.1 7; 245A.10; 245A.11, subdivisions 2a, 2b, by adding a 2.2 subdivision; 245B.03, subdivision 2, by adding a 2.3 subdivision; 245B.04, subdivision 2; 245B.06, 2.4 subdivisions 2, 5, 8; 245B.07, subdivisions 6, 9, 11; 2.5 245B.08, subdivision 1; 246.54; 252.27, subdivision 2.6 2a; 252.32, subdivisions 1, 1a, 3, 3c; 252.41, 2.7 subdivision 3; 252.46, subdivision 1; 253B.04, 2.8 subdivision 1; 253B.05, subdivision 3; 256.01, 2.9 subdivision 2; 256.012; 256.046, subdivision 1; 2.10 256.0471, subdivision 1; 256.476, subdivisions 3, 4, 2.11 5; 256.482, subdivision 8; 256.935, subdivision 1; 2.12 256.955, subdivisions 2a, 3, by adding a subdivision; 2.13 256.9657, subdivisions 1, 4, by adding a subdivision; 2.14 256.969, subdivisions 2b, 3a; 256.975, by adding a 2.15 subdivision; 256.9754, subdivisions 2, 3, 4, 5; 2.16 256.98, subdivisions 3, 4, 8; 256.984, subdivision 1; 2.17 256B.055, by adding a subdivision; 256B.056, 2.18 subdivisions 1a, 1c, 6; 256B.057, subdivisions 1, 2, 2.19 3b, 9, 10; 256B.0595, subdivisions 1, 2, by adding 2.20 subdivisions; 256B.06, subdivision 4; 256B.061; 2.21 256B.0621, subdivision 4; 256B.0623, subdivisions 2, 2.22 4, 5, 6, 8; 256B.0625, subdivisions 5a, 9, 13, 17, 2.23 18a, 19c, 20, 23, by adding subdivisions; 256B.0627, 2.24 subdivisions 1, 4, 9; 256B.0635, subdivisions 1, 2; 2.25 256B.064, subdivision 2; 256B.0911, subdivisions 3, 2.26 4d; 256B.0913, subdivisions 2, 4, 5, 6, 7, 8, 10, 12; 2.27 256B.0915, subdivision 3, by adding a subdivision; 2.28 256B.092, subdivisions 1a, 5; 256B.0945, subdivisions 2.29 2, 4; 256B.095; 256B.0951, subdivisions 1, 2, 3, 5, 7, 2.30 9; 256B.0952, subdivision 1; 256B.0953, subdivision 2; 2.31 256B.0955; 256B.15, subdivisions 1, 1a, 2, 3, 4, by 2.32 adding subdivisions; 256B.19, subdivision 1; 256B.195, 2.33 subdivisions 1, 3, 4, 5; 256B.31; 256B.32, subdivision 2.34 1; 256B.431, subdivisions 2r, 32, 36, by adding 2.35 subdivisions; 256B.434, subdivisions 4, 10; 256B.47, 2.36 subdivision 2; 256B.48, subdivision 1; 256B.501, 2.37 subdivision 1, by adding a subdivision; 256B.5012, by 2.38 adding a subdivision; 256B.5013, subdivision 4; 2.39 256B.5015; 256B.69, subdivisions 2, 4, 5a, 5c, by 2.40 adding subdivisions; 256B.75; 256B.76; 256B.761; 2.41 256B.82; 256D.03, subdivisions 3, 3a, 4; 256D.06, 2.42 subdivision 2; 256D.44, subdivision 5; 256D.46, 2.43 subdivisions 1, 3; 256D.48, subdivision 1; 256F.10, 2.44 subdivision 6; 256F.13, subdivisions 1, 2; 256G.05, 2.45 subdivision 2; 256I.02; 256I.04, subdivision 3; 2.46 256I.05, subdivisions 1, 1a, 7c; 256J.01, subdivision 2.47 5; 256J.02, subdivision 2; 256J.021; 256J.08, 2.48 subdivisions 35, 65, 82, 85, by adding subdivisions; 2.49 256J.09, subdivisions 2, 3, 3a, 3b, 8, 10; 256J.14; 2.50 256J.20, subdivision 3; 256J.21, subdivisions 1, 2; 2.51 256J.24, subdivisions 3, 5, 6, 7, 10; 256J.30, 2.52 subdivision 9; 256J.32, subdivisions 2, 4, 5a, by 2.53 adding a subdivision; 256J.37, subdivision 9, by 2.54 adding subdivisions; 256J.38, subdivisions 3, 4; 2.55 256J.40; 256J.42, subdivisions 4, 5, 6; 256J.425, 2.56 subdivisions 1, 1a, 2, 3, 4, 6, 7; 256J.45, 2.57 subdivision 2; 256J.46, subdivisions 1, 2, 2a; 2.58 256J.49, subdivisions 4, 5, 9, 13, by adding 2.59 subdivisions; 256J.50, subdivisions 1, 8, 9, 10; 2.60 256J.51, subdivisions 1, 2, 3, 4; 256J.53, 2.61 subdivisions 1, 2, 5; 256J.54, subdivisions 1, 2, 3, 2.62 5; 256J.55, subdivisions 1, 2; 256J.56; 256J.57; 2.63 256J.62, subdivision 9; 256J.645, subdivision 3; 2.64 256J.66, subdivision 2; 256J.67, subdivisions 1, 3; 2.65 256J.69, subdivision 2; 256J.75, subdivision 3; 2.66 256J.751, subdivisions 1, 2, 5; 256L.02, by adding a 2.67 subdivision; 256L.03, subdivisions 1, 3, 5; 256L.04, 2.68 subdivision 1; 256L.05, subdivisions 1, 3, 3a, 3c, 4; 2.69 256L.06, subdivision 3; 256L.07, subdivisions 1, 2, 3; 2.70 256L.09, subdivision 4; 256L.12, subdivisions 6, 9, by 2.71 adding subdivisions; 256L.15, subdivisions 1, 2, 3; 3.1 256L.17, subdivision 2; 257.05; 259.67, subdivision 4; 3.2 260C.141, subdivision 2; 261.035; 261.063; 295.55, 3.3 subdivision 2; 295.58; 326.42; 393.07, subdivisions 1, 3.4 5, 10; 466.03, subdivision 6d; 514.981, subdivision 6; 3.5 518.167, subdivision 1; 518.551, subdivision 7; 3.6 518.6111, subdivisions 2, 3, 4, 16; 524.3-805; 3.7 626.559, subdivision 5; Laws 1997, chapter 203, 3.8 article 9, section 21, as amended; proposing coding 3.9 for new law as Minnesota Statutes, chapter 256M; 3.10 proposing coding for new law in Minnesota Statutes, 3.11 chapters 62S; 119B; 144; 144A; 145; 145A; 148C; 151; 3.12 256; 256B; 256D; 256I; 256J; 514; repealing Minnesota 3.13 Statutes 2002, sections 16A.151, subdivision 5; 3.14 16A.87; 62J.17; 62J.66; 62J.68; 62J.694; 119B.061; 3.15 144.126; 144.1484; 144.1494; 144.1495; 144.1496; 3.16 144.1497; 144.395; 144.396; 144.401; 144.9507, 3.17 subdivision 3; 144A.071, subdivision 5; 144A.35; 3.18 144A.36; 144A.38; 145.56, subdivision 2; 145.882, 3.19 subdivisions 4, 5, 6, 8; 145.883, subdivisions 4, 7; 3.20 145.884; 145.885; 145.886; 145.888; 145.889; 145.890; 3.21 145.9266, subdivisions 2, 4, 5, 6, 7; 145.928, 3.22 subdivision 9; 145A.02, subdivisions 9, 10, 11, 12, 3.23 13, 14; 145A.09, subdivision 6; 145A.10, subdivisions 3.24 5, 6, 8; 145A.11, subdivision 3; 145A.12, subdivisions 3.25 3, 4, 5; 145A.14, subdivisions 3, 4; 145A.17, 3.26 subdivisions 2, 9; 148.5194, subdivision 3a; 148.6445, 3.27 subdivision 9; 245.4712, subdivision 2; 245.478; 3.28 245.4886; 245.4888; 245.496; 245.714; 252.32, 3.29 subdivision 2; 254A.17; 256.955, subdivision 8; 3.30 256.973; 256.9772; 256B.055, subdivision 10a; 3.31 256B.056, subdivision 3c; 256B.057, subdivision 1b; 3.32 256B.0625, subdivisions 35, 36; 256B.0928; 256B.0945, 3.33 subdivisions 6, 7, 8, 9, 10; 256B.095; 256B.0951; 3.34 256B.0952; 256B.0953; 256B.0954; 256B.0955; 256B.195, 3.35 subdivision 5; 256B.437, subdivision 2; 256B.83; 3.36 256E.01; 256E.02; 256E.03; 256E.04; 256E.05; 256E.06; 3.37 256E.07; 256E.08; 256E.081; 256E.09; 256E.10; 256E.11; 3.38 256E.115; 256E.13; 256E.14; 256E.15; 256F.01; 256F.02; 3.39 256F.03; 256F.04; 256F.05; 256F.06; 256F.07; 256F.08; 3.40 256F.10, subdivision 7; 256F.11; 256F.12; 256F.14; 3.41 256J.02, subdivision 3; 256J.08, subdivisions 28, 70; 3.42 256J.24, subdivision 8; 256J.30, subdivision 10; 3.43 256J.462; 256J.47; 256J.48; 256J.49, subdivisions 1a, 3.44 2, 6, 7; 256J.50, subdivisions 2, 3, 3a, 5, 7; 3.45 256J.52; 256J.62, subdivisions 1, 2a, 4, 6, 7, 8; 3.46 256J.625; 256J.655; 256J.74, subdivision 3; 256J.751, 3.47 subdivisions 3, 4; 256J.76; 256K.30; 256L.02, 3.48 subdivision 3; 256L.04, subdivision 9; 257.075; 3.49 257.81; 260.152; 626.562; Laws 1998, chapter 407, 3.50 article 4, section 63; Laws 2000, chapter 488, article 3.51 10, section 29; Laws 2001, First Special Session 3.52 chapter 3, article 1, section 16; Laws 2001, First 3.53 Special Session chapter 9, article 13, section 24; 3.54 Laws 2002, chapter 374, article 9, section 8; 3.55 Minnesota Rules, parts 4705.0100; 4705.0200; 3.56 4705.0300; 4705.0400; 4705.0500; 4705.0600; 4705.0700; 3.57 4705.0800; 4705.0900; 4705.1000; 4705.1100; 4705.1200; 3.58 4705.1300; 4705.1400; 4705.1500; 4705.1600; 4736.0010; 3.59 4736.0020; 4736.0030; 4736.0040; 4736.0050; 4736.0060; 3.60 4736.0070; 4736.0080; 4736.0090; 4736.0120; 4736.0130; 3.61 4763.0100; 4763.0110; 4763.0125; 4763.0135; 4763.0140; 3.62 4763.0150; 4763.0160; 4763.0170; 4763.0180; 4763.0190; 3.63 4763.0205; 4763.0215; 4763.0220; 4763.0230; 4763.0240; 3.64 4763.0250; 4763.0260; 4763.0270; 4763.0285; 4763.0295; 3.65 4763.0300; 9505.0324; 9505.0326; 9505.0327; 9505.3045; 3.66 9505.3050; 9505.3055; 9505.3060; 9505.3068; 9505.3070; 3.67 9505.3075; 9505.3080; 9505.3090; 9505.3095; 9505.3100; 3.68 9505.3105; 9505.3107; 9505.3110; 9505.3115; 9505.3120; 3.69 9505.3125; 9505.3130; 9505.3138; 9505.3139; 9505.3140; 3.70 9505.3680; 9505.3690; 9505.3700; 9545.2000; 9545.2010; 3.71 9545.2020; 9545.2030; 9545.2040; 9550.0010; 9550.0020; 4.1 9550.0030; 9550.0040; 9550.0050; 9550.0060; 9550.0070; 4.2 9550.0080; 9550.0090; 9550.0091; 9550.0092; 9550.0093. 4.3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 4.4 ARTICLE 1 4.5 WELFARE REFORM; PUBLIC ASSISTANCE MODIFICATIONS 4.6 Section 1. Minnesota Statutes 2002, section 256.984, 4.7 subdivision 1, is amended to read: 4.8 Subdivision 1. [DECLARATION.] Every application for public 4.9 assistance under this chapterand/oror chapters 256B, 256D, 4.10256K, MFIP program256J, and food stamps or food support under 4.11 chapter 393 shall be in writing or reduced to writing as 4.12 prescribed by the state agency and shall contain the following 4.13 declaration which shall be signed by the applicant: 4.14 "I declare under the penalties of perjury that this 4.15 application has been examined by me and to the best of my 4.16 knowledge is a true and correct statement of every material 4.17 point. I understand that a person convicted of perjury may 4.18 be sentenced to imprisonment of not more than five years or 4.19 to payment of a fine of not more than $10,000, or both." 4.20 Sec. 2. Minnesota Statutes 2002, section 256D.06, 4.21 subdivision 2, is amended to read: 4.22 Subd. 2. [EMERGENCY NEED.] Notwithstanding the provisions 4.23 of subdivision 1, a grant of emergency general assistance shall, 4.24 to the extent funds are available, be made to an eligible single 4.25 adult, married couple, or family for an emergency need, as 4.26 defined in rules promulgated by the commissioner, where the 4.27 recipient requests temporary assistance not exceeding 30 days if 4.28 an emergency situation appears to exist and(a) until March 31,4.291998, the individual is ineligible for the program of emergency4.30assistance under aid to families with dependent children and is4.31not a recipient of aid to families with dependent children at4.32the time of application; or (b)the individual or family is(i)4.33 ineligible for MFIP or is not a participant of MFIP; and (ii) is4.34ineligible for emergency assistance under section 256J.48. If 4.35 an applicant or recipient relates facts to the county agency 4.36 which may be sufficient to constitute an emergency situation, 5.1 the county agency shall, to the extent funds are available, 5.2 advise the person of the procedure for applying for assistance 5.3 according to this subdivision. An emergency general assistance 5.4 grant is available to a recipient not more than once in any 5.5 12-month period. Funding for an emergency general assistance 5.6 program is limited to the appropriation. Each fiscal year, the 5.7 commissioner shall allocate to counties the money appropriated 5.8 for emergency general assistance grants based on each county 5.9 agency's average share of state's emergency general expenditures 5.10 for the immediate past three fiscal years as determined by the 5.11 commissioner, and may reallocate any unspent amounts to other 5.12 counties. Any emergency general assistance expenditures by a 5.13 county above the amount of the commissioner's allocation to the 5.14 county must be made from county funds. 5.15 Sec. 3. Minnesota Statutes 2002, section 256D.44, 5.16 subdivision 5, is amended to read: 5.17 Subd. 5. [SPECIAL NEEDS.] In addition to the state 5.18 standards of assistance established in subdivisions 1 to 4, 5.19 payments are allowed for the following special needs of 5.20 recipients of Minnesota supplemental aid who are not residents 5.21 of a nursing home, a regional treatment center, or a group 5.22 residential housing facility. 5.23 (a) The county agency shall pay a monthly allowance for 5.24 medically prescribed dietspayable under the Minnesota family5.25investment programif the cost of those additional dietary needs 5.26 cannot be met through some other maintenance benefit. The need 5.27 for special diets or dietary items must be prescribed by a 5.28 licensed physician. Costs for special diets shall be determined 5.29 as percentages of the allotment for a one-person household under 5.30 the thrifty food plan as defined by the United States Department 5.31 of Agriculture. The types of diets and the percentages of the 5.32 thrifty food plan that are covered are as follows: 5.33 (1) high protein diet, at least 80 grams daily, 25 percent 5.34 of thrifty food plan; 5.35 (2) controlled protein diet, 40 to 60 grams and requires 5.36 special products, 100 percent of thrifty food plan; 6.1 (3) controlled protein diet, less than 40 grams and 6.2 requires special products, 125 percent of thrifty food plan; 6.3 (4) low cholesterol diet, 25 percent of thrifty food plan; 6.4 (5) high residue diet, 20 percent of thrifty food plan; 6.5 (6) pregnancy and lactation diet, 35 percent of thrifty 6.6 food plan; 6.7 (7) gluten-free diet, 25 percent of thrifty food plan; 6.8 (8) lactose-free diet, 25 percent of thrifty food plan; 6.9 (9) antidumping diet, 15 percent of thrifty food plan; 6.10 (10) hypoglycemic diet, 15 percent of thrifty food plan; or 6.11 (11) ketogenic diet, 25 percent of thrifty food plan. 6.12 (b) Payment for nonrecurring special needs must be allowed 6.13 for necessary home repairs or necessary repairs or replacement 6.14 of household furniture and appliances using the payment standard 6.15 of the AFDC program in effect on July 16, 1996, for these 6.16 expenses, as long as other funding sources are not available. 6.17 (c) A fee for guardian or conservator service is allowed at 6.18 a reasonable rate negotiated by the county or approved by the 6.19 court. This rate shall not exceed five percent of the 6.20 assistance unit's gross monthly income up to a maximum of $100 6.21 per month. If the guardian or conservator is a member of the 6.22 county agency staff, no fee is allowed. 6.23 (d) The county agency shall continue to pay a monthly 6.24 allowance of $68 for restaurant meals for a person who was 6.25 receiving a restaurant meal allowance on June 1, 1990, and who 6.26 eats two or more meals in a restaurant daily. The allowance 6.27 must continue until the person has not received Minnesota 6.28 supplemental aid for one full calendar month or until the 6.29 person's living arrangement changes and the person no longer 6.30 meets the criteria for the restaurant meal allowance, whichever 6.31 occurs first. 6.32 (e) A fee of ten percent of the recipient's gross income or 6.33 $25, whichever is less, is allowed for representative payee 6.34 services provided by an agency that meets the requirements under 6.35 SSI regulations to charge a fee for representative payee 6.36 services. This special need is available to all recipients of 7.1 Minnesota supplemental aid regardless of their living 7.2 arrangement. 7.3 (f) Notwithstanding the language in this subdivision, an 7.4 amount equal to the maximum allotment authorized by the federal 7.5 Food Stamp Program for a single individual which is in effect on 7.6 the first day of January of the previous year will be added to 7.7 the standards of assistance established in subdivisions 1 to 4 7.8 for individuals under the age of 65 who are relocating from an 7.9 institution and who are shelter needy. An eligible individual 7.10 who receives this benefit prior to age 65 may continue to 7.11 receive the benefit after the age of 65. 7.12 "Shelter needy" means that the assistance unit incurs 7.13 monthly shelter costs that exceed 40 percent of the assistance 7.14 unit's gross income before the application of this special needs 7.15 standard. "Gross income" for the purposes of this section is 7.16 the applicant's or recipient's income as defined in section 7.17 256D.35, subdivision 10, or the standard specified in 7.18 subdivision 3, whichever is greater. A recipient of a federal 7.19 or state housing subsidy, that limits shelter costs to a 7.20 percentage of gross income, shall not be considered shelter 7.21 needy for purposes of this paragraph. 7.22 Sec. 4. Minnesota Statutes 2002, section 256D.46, 7.23 subdivision 1, is amended to read: 7.24 Subdivision 1. [ELIGIBILITY.] A county agency must grant 7.25 emergency Minnesota supplemental aidmust be granted, to the 7.26 extent funds are available, if the recipient is without adequate 7.27 resources to resolve an emergency that, if unresolved, will 7.28 threaten the health or safety of the recipient. For the 7.29 purposes of this section, the term "recipient" includes persons 7.30 for whom a group residential housing benefit is being paid under 7.31 sections 256I.01 to 256I.06. 7.32 Sec. 5. Minnesota Statutes 2002, section 256D.46, 7.33 subdivision 3, is amended to read: 7.34 Subd. 3. [PAYMENT AMOUNT.] The amount of assistance 7.35 granted under emergency Minnesota supplemental aid is limited to 7.36 the amount necessary to resolve the emergency. An emergency 8.1 Minnesota supplemental aid grant is available to a recipient no 8.2 more than once in any 12-month period. Funding for emergency 8.3 Minnesota supplemental aid is limited to the appropriation. 8.4 Each fiscal year, the commissioner shall allocate to counties 8.5 the money appropriated for emergency Minnesota supplemental aid 8.6 grants based on each county agency's average share of state's 8.7 emergency Minnesota supplemental aid expenditures for the 8.8 immediate past three fiscal years as determined by the 8.9 commissioner, and may reallocate any unspent amounts to other 8.10 counties. Any emergency Minnesota supplemental aid expenditures 8.11 by a county above the amount of the commissioner's allocation to 8.12 the county must be made from county funds. 8.13 Sec. 6. Minnesota Statutes 2002, section 256D.48, 8.14 subdivision 1, is amended to read: 8.15 Subdivision 1. [NEED FOR PROTECTIVE PAYEE.] The county 8.16 agency shall determine whether a recipient needs a protective 8.17 payee when a physical or mental condition renders the recipient 8.18 unable to manage funds and when payments to the recipient would 8.19 be contrary to the recipient's welfare. Protective payments 8.20 must be issued when there is evidence of: (1) repeated 8.21 inability to plan the use of income to meet necessary 8.22 expenditures; (2) repeated observation that the recipient is not 8.23 properly fed or clothed; (3) repeated failure to meet 8.24 obligations for rent, utilities, food, and other essentials; (4) 8.25 evictions or a repeated incurrence of debts; or (5) lost or 8.26 stolen checks; or (6) use of emergency Minnesota supplemental8.27aid more than twice in a calendar year. The determination of 8.28 representative payment by the Social Security Administration for 8.29 the recipient is sufficient reason for protective payment of 8.30 Minnesota supplemental aid payments. 8.31 Sec. 7. Minnesota Statutes 2002, section 256J.01, 8.32 subdivision 5, is amended to read: 8.33 Subd. 5. [COMPLIANCE SYSTEM.] The commissioner shall 8.34 administer a compliance system for the state's temporary 8.35 assistance for needy families (TANF) program, the food stamp 8.36 program,emergency assistance,general assistance, medical 9.1 assistance, general assistance medical care, emergency general 9.2 assistance, Minnesota supplemental aid, preadmission screening, 9.3 child support program, and alternative care grants under the 9.4 powers and authorities named in section 256.01, subdivision 2. 9.5 The purpose of the compliance system is to permit the 9.6 commissioner to supervise the administration of public 9.7 assistance programs and to enforce timely and accurate 9.8 distribution of benefits, completeness of service and efficient 9.9 and effective program management and operations, to increase 9.10 uniformity and consistency in the administration and delivery of 9.11 public assistance programs throughout the state, and to reduce 9.12 the possibility of sanction and fiscal disallowances for 9.13 noncompliance with federal regulations and state statutes. 9.14 Sec. 8. Minnesota Statutes 2002, section 256J.02, 9.15 subdivision 2, is amended to read: 9.16 Subd. 2. [USE OF MONEY.] State money appropriated for 9.17 purposes of this section and TANF block grant money must be used 9.18 for: 9.19 (1) financial assistance to or on behalf of any minor child 9.20 who is a resident of this state under section 256J.12; 9.21 (2)employment and training services under this chapter or9.22chapter 256K;9.23(3) emergency financial assistance and services under9.24section 256J.48;9.25(4) diversionary assistance under section 256J.47;9.26(5)the health care and human services training and 9.27 retention program under chapter 116L, for costs associated with 9.28 families with children with incomes below 200 percent of the 9.29 federal poverty guidelines; 9.30(6)(3) the pathways program under section 116L.04, 9.31 subdivision 1a; 9.32(7) welfare-to-work extended employment services for MFIP9.33participants with severe impairment to employment as defined in9.34section 268A.15, subdivision 1a;9.35(8) the family homeless prevention and assistance program9.36under section 462A.204;10.1(9) the rent assistance for family stabilization10.2demonstration project under section 462A.205;10.3(10)(4) welfare to work transportation authorized under 10.4 Public LawNumber105-178; 10.5(11)(5) reimbursements for the federal share of child 10.6 support collections passed through to the custodial parent; 10.7(12)(6) reimbursements for the working family credit under 10.8 section 290.0671; 10.9(13) intensive ESL grants under Laws 2000, chapter 489,10.10article 1;10.11(14) transitional housing programs under section 119A.43;10.12(15) programs and pilot projects under chapter 256K; and10.13(16)(7) program administration under this chapter; 10.14 (8) the diversionary work program under section 256J.95; 10.15 (9) the MFIP consolidated fund under section 256J.626; and 10.16 (10) the Minnesota department of health consolidated fund 10.17 under Laws 2001, First Special Session chapter 9, article 17, 10.18 section 3, subdivision 2. 10.19 Sec. 9. Minnesota Statutes 2002, section 256J.021, is 10.20 amended to read: 10.21 256J.021 [SEPARATE STATE PROGRAM FOR USE OF STATE MONEY.] 10.22 Beginning October 1, 2001, and each year thereafter, the 10.23 commissioner of human services must treatfinancial assistance10.24 MFIP expenditures made to or on behalf of any minor child under 10.25 section 256J.02, subdivision 2, clause (1), who is a resident of 10.26 this state under section 256J.12, and who is part of a 10.27 two-parent eligible household as expenditures under a separately 10.28 funded state program and report those expenditures to the 10.29 federal Department of Health and Human Services as separate 10.30 state program expenditures under Code of Federal Regulations, 10.31 title 45, section 263.5. 10.32 Sec. 10. Minnesota Statutes 2002, section 256J.08, is 10.33 amended by adding a subdivision to read: 10.34 Subd. 11a. [CHILD ONLY CASE.] "Child only case" means a 10.35 case that would be part of the child only TANF program under 10.36 section 256J.88. 11.1 Sec. 11. Minnesota Statutes 2002, section 256J.08, is 11.2 amended by adding a subdivision to read: 11.3 Subd. 24b. [DIVERSIONARY WORK PROGRAM OR DWP.] 11.4 "Diversionary work program" or "DWP" has the meaning given in 11.5 section 256J.95. 11.6 Sec. 12. Minnesota Statutes 2002, section 256J.08, is 11.7 amended by adding a subdivision to read: 11.8 Subd. 28b. [EMPLOYABLE.] "Employable" means a person is 11.9 capable of performing existing positions in the local labor 11.10 market, regardless of the current availability of openings for 11.11 those positions. 11.12 Sec. 13. Minnesota Statutes 2002, section 256J.08, is 11.13 amended by adding a subdivision to read: 11.14 Subd. 34a. [FAMILY VIOLENCE.] (a) "Family violence" means 11.15 the following, if committed against a family or household member 11.16 by a family or household member: 11.17 (1) physical harm, bodily injury, or assault; 11.18 (2) the infliction of fear of imminent physical harm, 11.19 bodily injury, or assault; or 11.20 (3) terroristic threats, within the meaning of section 11.21 609.713, subdivision 1; criminal sexual conduct, within the 11.22 meaning of section 609.342, 609.343, 609.344, 609.345, or 11.23 609.3451; or interference with an emergency call within the 11.24 meaning of section 609.78, subdivision 2. 11.25 (b) For the purposes of family violence, "family or 11.26 household member" means: 11.27 (1) spouses and former spouses; 11.28 (2) parents and children; 11.29 (3) persons related by blood; 11.30 (4) persons who are residing together or who have resided 11.31 together in the past; 11.32 (5) persons who have a child in common regardless of 11.33 whether they have been married or have lived together at any 11.34 time; 11.35 (6) a man and woman if the woman is pregnant and the man is 11.36 alleged to be the father, regardless of whether they have been 12.1 married or have lived together at anytime; and 12.2 (7) persons involved in a current or past significant 12.3 romantic or sexual relationship. 12.4 Sec. 14. Minnesota Statutes, section 256J.08, is amended 12.5 by adding a subdivision to read: 12.6 Subd. 34b. [FAMILY VIOLENCE WAIVER.] "Family violence 12.7 waiver" means a waiver of the 60-month time limit for victims of 12.8 family violence who meet the criteria in section 256J.545 and 12.9 are complying with an employment plan in section 256J.521, 12.10 subdivision 3. 12.11 Sec. 15. Minnesota Statutes 2002, section 256J.08, 12.12 subdivision 35, is amended to read: 12.13 Subd. 35. [FAMILY WAGE LEVEL.] "Family wage level" means 12.14 110 percent of the transitional standard as specified in section 12.15 256J.24, subdivision 7. 12.16 Sec. 16. Minnesota Statutes 2002, section 256J.08, is 12.17 amended by adding a subdivision to read: 12.18 Subd. 51b. [LEARNING DISABLED.] "Learning disabled," for 12.19 purposes of an extension to the 60-month time limit under 12.20 section 256J.425, subdivision 3, clause (3), means the person 12.21 has a disorder in one or more of the psychological processes 12.22 involved in perceiving, understanding, or using concepts through 12.23 verbal language or nonverbal means. Learning disabled does not 12.24 include learning problems that are primarily the result of 12.25 visual, hearing, or motor handicaps, mental retardation, 12.26 emotional disturbance, or due to environmental, cultural, or 12.27 economic disadvantage. 12.28 Sec. 17. Minnesota Statutes 2002, section 256J.08, 12.29 subdivision 65, is amended to read: 12.30 Subd. 65. [PARTICIPANT.] "Participant" means a person who 12.31 is currently receiving cash assistance or the food portion 12.32 available through MFIPas funded by TANF and the food stamp12.33program. A person who fails to withdraw or access 12.34 electronically any portion of the person's cash and food 12.35 assistance payment by the end of the payment month, who makes a 12.36 written request for closure before the first of a payment month 13.1 and repays cash and food assistance electronically issued for 13.2 that payment month within that payment month, or who returns any 13.3 uncashed assistance check and food coupons and withdraws from 13.4 the program is not a participant. A person who withdraws a cash 13.5 or food assistance payment by electronic transfer or receives 13.6 and cashes an MFIP assistance check or food coupons and is 13.7 subsequently determined to be ineligible for assistance for that 13.8 period of time is a participant, regardless whether that 13.9 assistance is repaid. The term "participant" includes the 13.10 caregiver relative and the minor child whose needs are included 13.11 in the assistance payment. A person in an assistance unit who 13.12 does not receive a cash and food assistance payment because the 13.13personcase has been suspended from MFIP is a participant. A 13.14 person who receives cash payments under the diversionary work 13.15 program under section 256J.95 is a participant. 13.16 Sec. 18. Minnesota Statutes 2002, section 256J.08, is 13.17 amended by adding a subdivision to read: 13.18 Subd. 65a. [PARTICIPATION REQUIREMENTS OF 13.19 TANF.] "Participation requirements of TANF" means activities and 13.20 hourly requirements allowed under title IV-A of the federal 13.21 Social Security Act. 13.22 Sec. 19. Minnesota Statutes 2002, section 256J.08, is 13.23 amended by adding a subdivision to read: 13.24 Subd. 73a. [QUALIFIED PROFESSIONAL.] (a) For physical 13.25 illness, injury, or incapacity, a "qualified professional" means 13.26 a licensed physician, a physician's assistant, a nurse 13.27 practitioner, or in the case of spinal subluxation, a licensed 13.28 chiropractor. 13.29 (b) For mental retardation and intelligence testing, a 13.30 "qualified professional" means an individual qualified by 13.31 training and experience to administer the tests necessary to 13.32 make determinations, such as tests of intellectual functioning, 13.33 assessments of adaptive behavior, adaptive skills, and 13.34 developmental functioning. These professionals include licensed 13.35 psychologists, certified school psychologists, or certified 13.36 psychometrists working under the supervision of a licensed 14.1 psychologist. 14.2 (c) For learning disabilities, a "qualified professional" 14.3 means a licensed psychologist or school psychologist with 14.4 experience determining learning disabilities. 14.5 (d) For mental health, a "qualified professional" means a 14.6 licensed physician or a qualified mental health professional. A 14.7 "qualified mental health professional" means: 14.8 (1) for children, in psychiatric nursing, a registered 14.9 nurse who is licensed under sections 148.171 to 148.285, and who 14.10 is certified as a clinical specialist in child and adolescent 14.11 psychiatric or mental health nursing by a national nurse 14.12 certification organization or who has a master's degree in 14.13 nursing or one of the behavioral sciences or related fields from 14.14 an accredited college or university or its equivalent, with at 14.15 least 4,000 hours of post-master's supervised experience in the 14.16 delivery of clinical services in the treatment of mental 14.17 illness; 14.18 (2) for adults, in psychiatric nursing, a registered nurse 14.19 who is licensed under sections 148.171 to 148.285, and who is 14.20 certified as a clinical specialist in adult psychiatric and 14.21 mental health nursing by a national nurse certification 14.22 organization or who has a master's degree in nursing or one of 14.23 the behavioral sciences or related fields from an accredited 14.24 college or university or its equivalent, with at least 4,000 14.25 hours of post-master's supervised experience in the delivery of 14.26 clinical services in the treatment of mental illness; 14.27 (3) in clinical social work, a person licensed as an 14.28 independent clinical social worker under section 148B.21, 14.29 subdivision 6, or a person with a master's degree in social work 14.30 from an accredited college or university, with at least 4,000 14.31 hours of post-master's supervised experience in the delivery of 14.32 clinical services in the treatment of mental illness; 14.33 (4) in psychology, an individual licensed by the board of 14.34 psychology under sections 148.88 to 148.98, who has stated to 14.35 the board of psychology competencies in the diagnosis and 14.36 treatment of mental illness; 15.1 (5) in psychiatry, a physician licensed under chapter 147 15.2 and certified by the American Board of Psychiatry and Neurology 15.3 or eligible for board certification in psychiatry; and 15.4 (6) in marriage and family therapy, the mental health 15.5 professional must be a marriage and family therapist licensed 15.6 under sections 148B.29 to 148B.39, with at least two years of 15.7 post-master's supervised experience in the delivery of clinical 15.8 services in the treatment of mental illness. 15.9 Sec. 20. Minnesota Statutes 2002, section 256J.08, 15.10 subdivision 82, is amended to read: 15.11 Subd. 82. [SANCTION.] "Sanction" means the reduction of a 15.12 family's assistance payment by a specified percentage of the 15.13 MFIP standard of need because: a nonexempt participant fails to 15.14 comply with the requirements of sections256J.52256J.515 to 15.15256J.55256J.57; a parental caregiver fails without good cause 15.16 to cooperate with the child support enforcement requirements; or 15.17 a participant fails to comply withthe insurance, tort15.18liability, orother requirements of this chapter. 15.19 Sec. 21. Minnesota Statutes 2002, section 256J.08, is 15.20 amended by adding a subdivision to read: 15.21 Subd. 84a. [SSI RECIPIENT.] "SSI recipient" means a person 15.22 who receives at least $1 in SSI benefits, or who is not 15.23 receiving an SSI benefit due to recoupment or a one month 15.24 suspension by the Social Security Administration due to excess 15.25 income. 15.26 Sec. 22. Minnesota Statutes 2002, section 256J.08, 15.27 subdivision 85, is amended to read: 15.28 Subd. 85. [TRANSITIONAL STANDARD.] "Transitional standard" 15.29 means the basic standard for a familywith no other income or a15.30nonworking familywithout earned income and is a combination of 15.31 the cashassistance needsportion and foodassistance needs for15.32a family of that sizeportion as specified in section 256J.24, 15.33 subdivision 5. 15.34 Sec. 23. Minnesota Statutes 2002, section 256J.08, is 15.35 amended by adding a subdivision to read: 15.36 Subd. 90. [SEVERE FORMS OF TRAFFICKING IN 16.1 PERSONS.] "Severe forms of trafficking in persons" means: (1) 16.2 sex trafficking in which a commercial sex act is induced by 16.3 force, fraud, or coercion, or in which the person induced to 16.4 perform the act has not attained 18 years of age; or (2) the 16.5 recruitment, harboring, transportation, provision, or obtaining 16.6 of a person for labor or services through the use of force, 16.7 fraud, or coercion for the purposes of subjection to involuntary 16.8 servitude, peonage, debt bondage, or slavery. 16.9 Sec. 24. Minnesota Statutes 2002, section 256J.09, 16.10 subdivision 2, is amended to read: 16.11 Subd. 2. [COUNTY AGENCY RESPONSIBILITY TO PROVIDE 16.12 INFORMATION.] When a person inquires about assistance, a county 16.13 agency must: 16.14 (1) explain the eligibility requirements of, and how to 16.15 apply for, diversionary assistance as provided in section16.16256J.47; emergency assistance as provided in section 256J.48;16.17MFIP as provided in section 256J.10; oranyotherassistance for 16.18 which the person may be eligible; and 16.19 (2) offer the person brochures developed or approved by the 16.20 commissioner that describe how to apply for assistance. 16.21 Sec. 25. Minnesota Statutes 2002, section 256J.09, 16.22 subdivision 3, is amended to read: 16.23 Subd. 3. [SUBMITTING THE APPLICATION FORM.] (a) A county 16.24 agency must offer, in person or by mail, the application forms 16.25 prescribed by the commissioner as soon as a person makes a 16.26 written or oral inquiry. At that time, the county agency must: 16.27 (1) inform the person that assistance begins with the date 16.28 the signed application is received by the county agency or the 16.29 date all eligibility criteria are met, whichever is later; 16.30 (2) inform the person that any delay in submitting the 16.31 application will reduce the amount of assistance paid for the 16.32 month of application; 16.33 (3) inform a person that the person may submit the 16.34 application before an interview; 16.35 (4) explain the information that will be verified during 16.36 the application process by the county agency as provided in 17.1 section 256J.32; 17.2 (5) inform a person about the county agency's average 17.3 application processing time and explain how the application will 17.4 be processed under subdivision 5; 17.5 (6) explain how to contact the county agency if a person's 17.6 application information changes and how to withdraw the 17.7 application; 17.8 (7) inform a person that the next step in the application 17.9 process is an interview and what a person must do if the 17.10 application is approved including, but not limited to, attending 17.11 orientation under section 256J.45 and complying with employment 17.12 and training services requirements in sections256J.52256J.515 17.13 to256J.55256J.57; 17.14 (8) explain the child care and transportation services that 17.15 are available under paragraph (c) to enable caregivers to attend 17.16 the interview, screening, and orientation; and 17.17 (9) identify any language barriers and arrange for 17.18 translation assistance during appointments, including, but not 17.19 limited to, screening under subdivision 3a, orientation under 17.20 section 256J.45, andthe initialassessment under section 17.21256J.52256J.521. 17.22 (b) Upon receipt of a signed application, the county agency 17.23 must stamp the date of receipt on the face of the application. 17.24 The county agency must process the application within the time 17.25 period required under subdivision 5. An applicant may withdraw 17.26 the application at any time by giving written or oral notice to 17.27 the county agency. The county agency must issue a written 17.28 notice confirming the withdrawal. The notice must inform the 17.29 applicant of the county agency's understanding that the 17.30 applicant has withdrawn the application and no longer wants to 17.31 pursue it. When, within ten days of the date of the agency's 17.32 notice, an applicant informs a county agency, in writing, that 17.33 the applicant does not wish to withdraw the application, the 17.34 county agency must reinstate the application and finish 17.35 processing the application. 17.36 (c) Upon a participant's request, the county agency must 18.1 arrange for transportation and child care or reimburse the 18.2 participant for transportation and child care expenses necessary 18.3 to enable participants to attend the screening under subdivision 18.4 3a and orientation under section 256J.45. 18.5 Sec. 26. Minnesota Statutes 2002, section 256J.09, 18.6 subdivision 3a, is amended to read: 18.7 Subd. 3a. [SCREENING.] The county agency, or at county 18.8 option, the county's employment and training service provider as 18.9 defined in section 256J.49, must screen each applicant to 18.10 determine immediate needs and to determine if the applicant may 18.11 be eligible for:18.12(1)another program that is not partially funded through 18.13 the federal temporary assistance to needy families block grant 18.14 under Title I of Public LawNumber104-193, including the 18.15 expedited issuance of food stamps under section 256J.28, 18.16 subdivision 1.If the applicant may be eligible for another18.17program, a county caseworker must provide the appropriate18.18referral to the program;18.19(2) the diversionary assistance program under section18.20256J.47; or18.21(3) the emergency assistance program under section18.22256J.48.If the applicant appears eligible for another program, 18.23 including any program funded by the MFIP consolidated fund, the 18.24 county must make a referral to the appropriate program. 18.25 Sec. 27. Minnesota Statutes 2002, section 256J.09, 18.26 subdivision 3b, is amended to read: 18.27 Subd. 3b. [INTERVIEW TO DETERMINE REFERRALS AND SERVICES.] 18.28 If the applicant is not diverted from applying for MFIP, and if 18.29 the applicant meets the MFIP eligibility requirements, then a 18.30 county agency must: 18.31 (1) identify an applicant who is under the age of 18.32 20 without a high school diploma or its equivalent and explain 18.33 to the applicant the assessment procedures and employment plan 18.34 requirementsfor minor parentsunder section 256J.54; 18.35 (2) explain to the applicant the eligibility criteria in 18.36 section 256J.545 foran exemption underthe family violence 19.1provisions in section 256J.52, subdivision 6waiver, andexplain19.2 what an applicant should do to develop analternativeemployment 19.3 plan; 19.4 (3) determine if an applicant qualifies for an exemption 19.5 under section 256J.56 from employment and training services 19.6 requirements, explain how a person should report to the county 19.7 agency any status changes, and explain that an applicant who is 19.8 exempt may volunteer to participate in employment and training 19.9 services; 19.10 (4) for applicants who are not exempt from the requirement 19.11 to attend orientation, arrange for an orientation under section 19.12 256J.45 and aninitialassessment under section256J.5219.13 256J.521; 19.14 (5) inform an applicant who is not exempt from the 19.15 requirement to attend orientation that failure to attend the 19.16 orientation is considered an occurrence of noncompliance with 19.17 program requirements and will result in an imposition of a 19.18 sanction under section 256J.46; and 19.19 (6) explain how to contact the county agency if an 19.20 applicant has questions about compliance with program 19.21 requirements. 19.22 Sec. 28. Minnesota Statutes 2002, section 256J.09, 19.23 subdivision 8, is amended to read: 19.24 Subd. 8. [ADDITIONAL APPLICATIONS.] Until a county agency 19.25 issues notice of approval or denial, additional applications 19.26 submitted by an applicant are void. However, an application for 19.27 monthly assistance or other benefits funded under section 19.28 256J.626 and an application foremergency assistance or19.29 emergency general assistance may exist concurrently. More than 19.30 one application for monthly assistance, emergency assistance,or 19.31 emergency general assistance may exist concurrently when the 19.32 county agency decisions on one or more earlier applications have 19.33 been appealed to the commissioner, and the applicant asserts 19.34 that a change in circumstances has occurred that would allow 19.35 eligibility. A county agency must require additional 19.36 application forms or supplemental forms as prescribed by the 20.1 commissioner when a payee's name changes, or when a caregiver 20.2 requests the addition of another person to the assistance unit. 20.3 Sec. 29. Minnesota Statutes 2002, section 256J.09, 20.4 subdivision 10, is amended to read: 20.5 Subd. 10. [APPLICANTS WHO DO NOT MEET ELIGIBILITY 20.6 REQUIREMENTS FOR MFIP OR THE DIVERSIONARY WORK PROGRAM.] When an 20.7 applicant is not eligible for MFIP or the diversionary work 20.8 program under section 256J.95 because the applicant does not 20.9 meet eligibility requirements, the county agency must determine 20.10 whether the applicant is eligible for food stamps, medical20.11assistance, diversionary assistance, or has a need for emergency20.12assistance when the applicant meets the eligibility requirements20.13for those programsor health care programs. The county must 20.14 also inform applicants about resources available through the 20.15 county or other agencies to meet short-term emergency needs. 20.16 Sec. 30. Minnesota Statutes 2002, section 256J.14, is 20.17 amended to read: 20.18 256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 20.19 (a) The definitions in this paragraph only apply to this 20.20 subdivision. 20.21 (1) "Household of a parent, legal guardian, or other adult 20.22 relative" means the place of residence of: 20.23 (i) a natural or adoptive parent; 20.24 (ii) a legal guardian according to appointment or 20.25 acceptance under section 260C.325, 525.615, or 525.6165, and 20.26 related laws; 20.27 (iii) a caregiver as defined in section 256J.08, 20.28 subdivision 11; or 20.29 (iv) an appropriate adult relative designated by a county 20.30 agency. 20.31 (2) "Adult-supervised supportive living arrangement" means 20.32 a private family setting which assumes responsibility for the 20.33 care and control of the minor parent and minor child, or other 20.34 living arrangement, not including a public institution, licensed 20.35 by the commissioner of human services which ensures that the 20.36 minor parent receives adult supervision and supportive services, 21.1 such as counseling, guidance, independent living skills 21.2 training, or supervision. 21.3 (b) A minor parent and the minor child who is in the care 21.4 of the minor parent must reside in the household of a parent, 21.5 legal guardian, other adult relative, or in an adult-supervised 21.6 supportive living arrangement in order to receive MFIP unless: 21.7 (1) the minor parent has no living parent, other adult 21.8 relative, or legal guardian whose whereabouts is known; 21.9 (2) no living parent, other adult relative, or legal 21.10 guardian of the minor parent allows the minor parent to live in 21.11 the parent's, other adult relative's, or legal guardian's home; 21.12 (3) the minor parent lived apart from the minor parent's 21.13 own parent or legal guardian for a period of at least one year 21.14 before either the birth of the minor child or the minor parent's 21.15 application for MFIP; 21.16 (4) the physical or emotional health or safety of the minor 21.17 parent or minor child would be jeopardized if the minor parent 21.18 and the minor child resided in the same residence with the minor 21.19 parent's parent, other adult relative, or legal guardian; or 21.20 (5) an adult supervised supportive living arrangement is 21.21 not available for the minor parent and child in the county in 21.22 which the minor parent and child currently reside. If an adult 21.23 supervised supportive living arrangement becomes available 21.24 within the county, the minor parent and child must reside in 21.25 that arrangement. 21.26 (c) The county agency shall inform minor applicants both 21.27 orally and in writing about the eligibility requirements, their 21.28 rights and obligations under the MFIP program, and any other 21.29 applicable orientation information. The county must advise the 21.30 minor of the possible exemptions under section 256J.54, 21.31 subdivision 5, and specifically ask whether one or more of these 21.32 exemptions is applicable. If the minor alleges one or more of 21.33 these exemptions, then the county must assist the minor in 21.34 obtaining the necessary verifications to determine whether or 21.35 not these exemptions apply. 21.36 (d) If the county worker has reason to suspect that the 22.1 physical or emotional health or safety of the minor parent or 22.2 minor child would be jeopardized if they resided with the minor 22.3 parent's parent, other adult relative, or legal guardian, then 22.4 the county worker must make a referral to child protective 22.5 services to determine if paragraph (b), clause (4), applies. A 22.6 new determination by the county worker is not necessary if one 22.7 has been made within the last six months, unless there has been 22.8 a significant change in circumstances which justifies a new 22.9 referral and determination. 22.10 (e) If a minor parent is not living with a parent, legal 22.11 guardian, or other adult relative due to paragraph (b), clause 22.12 (1), (2), or (4), the minor parent must reside, when possible, 22.13 in a living arrangement that meets the standards of paragraph 22.14 (a), clause (2). 22.15 (f) Regardless of living arrangement, MFIP must be paid, 22.16 when possible, in the form of a protective payment on behalf of 22.17 the minor parent and minor child according to section 256J.39, 22.18 subdivisions 2 to 4. 22.19 Sec. 31. Minnesota Statutes 2002, section 256J.20, 22.20 subdivision 3, is amended to read: 22.21 Subd. 3. [OTHER PROPERTY LIMITATIONS.] To be eligible for 22.22 MFIP, the equity value of all nonexcluded real and personal 22.23 property of the assistance unit must not exceed $2,000 for 22.24 applicants and $5,000 for ongoing participants. The value of 22.25 assets in clauses (1) to (19) must be excluded when determining 22.26 the equity value of real and personal property: 22.27 (1) a licensed vehicle up to a loan value of less than or 22.28 equal to $7,500. The county agency shall apply any excess loan 22.29 value as if it were equity value to the asset limit described in 22.30 this section. If the assistance unit owns more than one 22.31 licensed vehicle, the county agency shall determine the vehicle 22.32 with the highest loan value and count only the loan value over 22.33 $7,500, excluding: (i) the value of one vehicle per physically 22.34 disabled person when the vehicle is needed to transport the 22.35 disabled unit member; this exclusion does not apply to mentally 22.36 disabled people; (ii) the value of special equipment for a 23.1 handicapped member of the assistance unit; and (iii) any vehicle 23.2 used for long-distance travel, other than daily commuting, for 23.3 the employment of a unit member. 23.4 The county agency shall count the loan value of all other 23.5 vehicles and apply this amount as if it were equity value to the 23.6 asset limit described in this section. To establish the loan 23.7 value of vehicles, a county agency must use the N.A.D.A. 23.8 Official Used Car Guide, Midwest Edition, for newer model cars. 23.9 When a vehicle is not listed in the guidebook, or when the 23.10 applicant or participant disputes the loan value listed in the 23.11 guidebook as unreasonable given the condition of the particular 23.12 vehicle, the county agency may require the applicant or 23.13 participant document the loan value by securing a written 23.14 statement from a motor vehicle dealer licensed under section 23.15 168.27, stating the amount that the dealer would pay to purchase 23.16 the vehicle. The county agency shall reimburse the applicant or 23.17 participant for the cost of a written statement that documents a 23.18 lower loan value; 23.19 (2) the value of life insurance policies for members of the 23.20 assistance unit; 23.21 (3) one burial plot per member of an assistance unit; 23.22 (4) the value of personal property needed to produce earned 23.23 income, including tools, implements, farm animals, inventory, 23.24 business loans, business checking and savings accounts used at 23.25 least annually and used exclusively for the operation of a 23.26 self-employment business, and any motor vehicles if at least 50 23.27 percent of the vehicle's use is to produce income and if the 23.28 vehicles are essential for the self-employment business; 23.29 (5) the value of personal property not otherwise specified 23.30 which is commonly used by household members in day-to-day living 23.31 such as clothing, necessary household furniture, equipment, and 23.32 other basic maintenance items essential for daily living; 23.33 (6) the value of real and personal property owned by a 23.34 recipient of Supplemental Security Income or Minnesota 23.35 supplemental aid; 23.36 (7) the value of corrective payments, but only for the 24.1 month in which the payment is received and for the following 24.2 month; 24.3 (8) a mobile home or other vehicle used by an applicant or 24.4 participant as the applicant's or participant's home; 24.5 (9) money in a separate escrow account that is needed to 24.6 pay real estate taxes or insurance and that is used for this 24.7 purpose; 24.8 (10) money held in escrow to cover employee FICA, employee 24.9 tax withholding, sales tax withholding, employee worker 24.10 compensation, business insurance, property rental, property 24.11 taxes, and other costs that are paid at least annually, but less 24.12 often than monthly; 24.13 (11) monthly assistance, emergency assistance, and24.14diversionarypayments for the current month'sneedsor 24.15 short-term emergency needs under section 256J.626, subdivision 24.16 2; 24.17 (12) the value of school loans, grants, or scholarships for 24.18 the period they are intended to cover; 24.19 (13) payments listed in section 256J.21, subdivision 2, 24.20 clause (9), which are held in escrow for a period not to exceed 24.21 three months to replace or repair personal or real property; 24.22 (14) income received in a budget month through the end of 24.23 the payment month; 24.24 (15) savings from earned income of a minor child or a minor 24.25 parent that are set aside in a separate account designated 24.26 specifically for future education or employment costs; 24.27 (16) the federal earned income credit, Minnesota working 24.28 family credit, state and federal income tax refunds, state 24.29 homeowners and renters credits under chapter 290A, property tax 24.30 rebates and other federal or state tax rebates in the month 24.31 received and the following month; 24.32 (17) payments excluded under federal law as long as those 24.33 payments are held in a separate account from any nonexcluded 24.34 funds; 24.35 (18) the assets of children ineligible to receive MFIP 24.36 benefits because foster care or adoption assistance payments are 25.1 made on their behalf; and 25.2 (19) the assets of persons whose income is excluded under 25.3 section 256J.21, subdivision 2, clause (43). 25.4 Sec. 32. Minnesota Statutes 2002, section 256J.21, 25.5 subdivision 1, is amended to read: 25.6 Subdivision 1. [INCOME INCLUSIONS.] To determine MFIP 25.7 eligibility, the county agency must evaluate income received by 25.8 members of an assistance unit, or by other persons whose income 25.9 is considered available to the assistance unit, and only count 25.10 income that is available to the member of the assistance unit. 25.11 Income is available if the individual has legal access to the 25.12 income. All payments, unless specifically excluded in 25.13 subdivision 2, must be counted as income. The county agency 25.14 shall verify the income of all MFIP recipients and applicants. 25.15 Sec. 33. Minnesota Statutes 2002, section 256J.21, 25.16 subdivision 2, is amended to read: 25.17 Subd. 2. [INCOME EXCLUSIONS.] The following must be 25.18 excluded in determining a family's available income: 25.19 (1) payments for basic care, difficulty of care, and 25.20 clothing allowances received for providing family foster care to 25.21 children or adults under Minnesota Rules, parts 9545.0010 to 25.22 9545.0260 and 9555.5050 to 9555.6265, and payments received and 25.23 used for care and maintenance of a third-party beneficiary who 25.24 is not a household member; 25.25 (2) reimbursements for employment training received through 25.26 theJob Training PartnershipWorkforce Investment Act 1998, 25.27 United States Code, title2920, chapter1973,sections 150125.28to 1792bsection 9201; 25.29 (3) reimbursement for out-of-pocket expenses incurred while 25.30 performing volunteer services, jury duty, employment, or 25.31 informal carpooling arrangements directly related to employment; 25.32 (4) all educational assistance, except the county agency 25.33 must count graduate student teaching assistantships, 25.34 fellowships, and other similar paid work as earned income and, 25.35 after allowing deductions for any unmet and necessary 25.36 educational expenses, shall count scholarships or grants awarded 26.1 to graduate students that do not require teaching or research as 26.2 unearned income; 26.3 (5) loans, regardless of purpose, from public or private 26.4 lending institutions, governmental lending institutions, or 26.5 governmental agencies; 26.6 (6) loans from private individuals, regardless of purpose, 26.7 provided an applicant or participant documents that the lender 26.8 expects repayment; 26.9 (7)(i) state income tax refunds; and 26.10 (ii) federal income tax refunds; 26.11 (8)(i) federal earned income credits; 26.12 (ii) Minnesota working family credits; 26.13 (iii) state homeowners and renters credits under chapter 26.14 290A; and 26.15 (iv) federal or state tax rebates; 26.16 (9) funds received for reimbursement, replacement, or 26.17 rebate of personal or real property when these payments are made 26.18 by public agencies, awarded by a court, solicited through public 26.19 appeal, or made as a grant by a federal agency, state or local 26.20 government, or disaster assistance organizations, subsequent to 26.21 a presidential declaration of disaster; 26.22 (10) the portion of an insurance settlement that is used to 26.23 pay medical, funeral, and burial expenses, or to repair or 26.24 replace insured property; 26.25 (11) reimbursements for medical expenses that cannot be 26.26 paid by medical assistance; 26.27 (12) payments by a vocational rehabilitation program 26.28 administered by the state under chapter 268A, except those 26.29 payments that are for current living expenses; 26.30 (13) in-kind income, including any payments directly made 26.31 by a third party to a provider of goods and services; 26.32 (14) assistance payments to correct underpayments, but only 26.33 for the month in which the payment is received; 26.34 (15)emergency assistancepayments for short-term emergency 26.35 needs under section 256J.626, subdivision 2; 26.36 (16) funeral and cemetery payments as provided by section 27.1 256.935; 27.2 (17) nonrecurring cash gifts of $30 or less, not exceeding 27.3 $30 per participant in a calendar month; 27.4 (18) any form of energy assistance payment made through 27.5 Public LawNumber97-35, Low-Income Home Energy Assistance Act 27.6 of 1981, payments made directly to energy providers by other 27.7 public and private agencies, and any form of credit or rebate 27.8 payment issued by energy providers; 27.9 (19) Supplemental Security Income (SSI), including 27.10 retroactive SSI payments and other income of an SSI recipient, 27.11 except as described in section 256J.37, subdivision 3b; 27.12 (20) Minnesota supplemental aid, including retroactive 27.13 payments; 27.14 (21) proceeds from the sale of real or personal property; 27.15 (22) adoption assistance payments under section 259.67; 27.16 (23) state-funded family subsidy program payments made 27.17 under section 252.32 to help families care for children with 27.18 mental retardation or related conditions, consumer support grant 27.19 funds under section 256.476, and resources and services for a 27.20 disabled household member under one of the home and 27.21 community-based waiver services programs under chapter 256B; 27.22 (24) interest payments and dividends from property that is 27.23 not excluded from and that does not exceed the asset limit; 27.24 (25) rent rebates; 27.25 (26) income earned by a minor caregiver, minor child 27.26 through age 6, or a minor child who is at least a half-time 27.27 student in an approved elementary or secondary education 27.28 program; 27.29 (27) income earned by a caregiver under age 20 who is at 27.30 least a half-time student in an approved elementary or secondary 27.31 education program; 27.32 (28) MFIP child care payments under section 119B.05; 27.33 (29) all other payments made through MFIP to support a 27.34 caregiver's pursuit of greaterself-supporteconomic stability; 27.35 (30) income a participant receives related to shared living 27.36 expenses; 28.1 (31) reverse mortgages; 28.2 (32) benefits provided by the Child Nutrition Act of 1966, 28.3 United States Code, title 42, chapter 13A, sections 1771 to 28.4 1790; 28.5 (33) benefits provided by the women, infants, and children 28.6 (WIC) nutrition program, United States Code, title 42, chapter 28.7 13A, section 1786; 28.8 (34) benefits from the National School Lunch Act, United 28.9 States Code, title 42, chapter 13, sections 1751 to 1769e; 28.10 (35) relocation assistance for displaced persons under the 28.11 Uniform Relocation Assistance and Real Property Acquisition 28.12 Policies Act of 1970, United States Code, title 42, chapter 61, 28.13 subchapter II, section 4636, or the National Housing Act, United 28.14 States Code, title 12, chapter 13, sections 1701 to 1750jj; 28.15 (36) benefits from the Trade Act of 1974, United States 28.16 Code, title 19, chapter 12, part 2, sections 2271 to 2322; 28.17 (37) war reparations payments to Japanese Americans and 28.18 Aleuts under United States Code, title 50, sections 1989 to 28.19 1989d; 28.20 (38) payments to veterans or their dependents as a result 28.21 of legal settlements regarding Agent Orange or other chemical 28.22 exposure under Public LawNumber101-239, section 10405, 28.23 paragraph (a)(2)(E); 28.24 (39) income that is otherwise specifically excluded from 28.25 MFIP consideration in federal law, state law, or federal 28.26 regulation; 28.27 (40) security and utility deposit refunds; 28.28 (41) American Indian tribal land settlements excluded under 28.29 PublicLaw NumbersLaws 98-123, 98-124, and 99-377 to the 28.30 Mississippi Band Chippewa Indians of White Earth, Leech Lake, 28.31 and Mille Lacs reservations and payments to members of the White 28.32 Earth Band, under United States Code, title 25, chapter 9, 28.33 section 331, and chapter 16, section 1407; 28.34 (42) all income of the minor parent's parents and 28.35 stepparents when determining the grant for the minor parent in 28.36 households that include a minor parent living with parents or 29.1 stepparents on MFIP with other children; 29.2 (43) income of the minor parent's parents and stepparents 29.3 equal to 200 percent of the federal poverty guideline for a 29.4 family size not including the minor parent and the minor 29.5 parent's child in households that include a minor parent living 29.6 with parents or stepparents not on MFIP when determining the 29.7 grant for the minor parent. The remainder of income is deemed 29.8 as specified in section 256J.37, subdivision 1b; 29.9 (44) payments made to children eligible for relative 29.10 custody assistance under section 257.85; 29.11 (45) vendor payments for goods and services made on behalf 29.12 of a client unless the client has the option of receiving the 29.13 payment in cash; and 29.14 (46) the principal portion of a contract for deed payment. 29.15 Sec. 34. Minnesota Statutes 2002, section 256J.24, 29.16 subdivision 3, is amended to read: 29.17 Subd. 3. [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 29.18 ASSISTANCE UNIT.] (a) The following individuals who are part of 29.19 the assistance unit determined under subdivision 2 are 29.20 ineligible to receive MFIP: 29.21 (1) individualsreceivingwho are recipients of 29.22 Supplemental Security Income or Minnesota supplemental aid; 29.23 (2) individuals disqualified from the food stamp program or 29.24 MFIP, until the disqualification ends; 29.25 (3) children on whose behalf federal, state or local foster 29.26 care payments are made, except as provided in sections 256J.13, 29.27 subdivision 2, and 256J.74, subdivision 2; and 29.28 (4) children receiving ongoing monthly adoption assistance 29.29 payments under section 259.67. 29.30 (b) The exclusion of a person under this subdivision does 29.31 not alter the mandatory assistance unit composition. 29.32 Sec. 35. Minnesota Statutes 2002, section 256J.24, 29.33 subdivision 5, is amended to read: 29.34 Subd. 5. [MFIP TRANSITIONAL STANDARD.] Thefollowing table29.35represents theMFIP transitional standardtable when all members29.36ofis based on the number of persons in the assistance unitare30.1 eligible for both food and cash assistance unless the 30.2 restrictions in subdivision 6 on the birth of a child apply. 30.3 The following table represents the transitional standards 30.4 effective October 1, 2002. 30.5 Number of Transitional Cash Food 30.6 Eligible People Standard Portion Portion 30.7 1$351$370: $250 $120 30.8 2$609$658: $437 $221 30.9 3$763$844: $532 $312 30.10 4$903$998: $621 $377 30.11 5$1,025$1,135: $697 $438 30.12 6$1,165$1,296: $773 $523 30.13 7$1,273$1,414: $850 $564 30.14 8$1,403$1,558: $916 $642 30.15 9$1,530$1,700: $980 $720 30.16 10$1,653$1,836: $1,035 $801 30.17 over 10 add$121$136: $53 $83 30.18 per additional member. 30.19 The commissioner shall annually publish in the State 30.20 Register the transitional standard for an assistance unit sizes 30.21 1 to 10 including a breakdown of the cash and food portions. 30.22 Sec. 36. Minnesota Statutes 2002, section 256J.24, 30.23 subdivision 6, is amended to read: 30.24 Subd. 6. [APPLICATION OF ASSISTANCE STANDARDSFAMILY CAP.] 30.25The standards apply to the number of eligible persons in the30.26assistance unit.(a) MFIP assistance units shall not receive an 30.27 increase in the cash portion of the transitional standard as a 30.28 result of the birth of a child, unless one of the conditions 30.29 under paragraph (b) is met. The child shall be considered a 30.30 member of the assistance unit according to subdivisions 1 to 3, 30.31 but shall be excluded in determining family size for purposes of 30.32 determining the amount of the cash portion of the transitional 30.33 standard under subdivision 5. The child shall be included in 30.34 determining family size for purposes of determining the food 30.35 portion of the transitional standard. The transitional standard 30.36 under this subdivision shall be the total of the cash and food 31.1 portions as specified in this paragraph. The family wage level 31.2 under this subdivision shall be based on the family size used to 31.3 determine the food portion of the transitional standard. 31.4 (b) A child shall be included in determining family size 31.5 for purposes of determining the amount of the cash portion of 31.6 the MFIP transitional standard when at least one of the 31.7 following conditions is met: 31.8 (1) for families receiving MFIP assistance on July 1, 2003, 31.9 the child is born to the adult parent before May 1, 2004; 31.10 (2) for families who apply for the diversionary work 31.11 program under section 256J.95 or MFIP assistance on or after 31.12 July 1, 2003, the child is born to the adult parent within ten 31.13 months of the date the family is eligible for assistance; 31.14 (3) the child was conceived as a result of a sexual assault 31.15 or incest, provided that: 31.16 (i) the incident has been reported to a law enforcement 31.17 agency which determines that there is probable cause to believe 31.18 the crime occurred; and 31.19 (ii) a physician verifies that there is reason to believe 31.20 the pregnancy or birth resulted from the reported incident; 31.21 (4) the child's mother is a minor caregiver as defined in 31.22 section 256J.08, subdivision 59, and the child, or multiple 31.23 children, are the mother's first birth; or 31.24 (5) any child previously excluded in determining family 31.25 size under paragraph (a) shall be included if the adult parent 31.26 or parents have not received benefits from the diversionary work 31.27 program under section 256J.95 or MFIP assistance in the previous 31.28 ten months. An adult parent or parents who reapply and have 31.29 received benefits from the diversionary work program or MFIP 31.30 assistance in the past ten months shall be under the ten-month 31.31 grace period of their previous application under clause (2). 31.32 (c) Income and resources of a child excluded under this 31.33 subdivision must be considered using the same policies as for 31.34 other children when determining the grant amount of the 31.35 assistance unit. 31.36 (d) The caregiver must assign support and cooperate with 32.1 the child support enforcement agency to establish paternity and 32.2 collect child support on behalf of the excluded child. Failure 32.3 to cooperate results in the sanction specified in section 32.4 256J.46, subdivisions 2 and 2a. Current support paid on behalf 32.5 of the excluded child shall be distributed according to section 32.6 256.741, subdivision 15, and counted to determine the grant 32.7 amount of the assistance unit. 32.8 (e) County agencies must inform applicants of the 32.9 provisions under this subdivision at the time of each 32.10 application and at recertification. 32.11 (f) Children excluded under this provision shall be deemed 32.12 MFIP recipients for purposes of child care under chapter 119B. 32.13 Sec. 37. Minnesota Statutes 2002, section 256J.24, 32.14 subdivision 7, is amended to read: 32.15 Subd. 7. [FAMILY WAGE LEVELSTANDARD.] The family wage 32.16 levelstandardis 110 percent of the transitional standard under 32.17 subdivision 5 or 6, when applicable, and is the standard used 32.18 when there is earned income in the assistance unit. As 32.19 specified in section 256J.21, earned income is subtracted from 32.20 the family wage level to determine the amount of the assistance 32.21 payment.Not includingThefamily wage level standard,32.22 assistancepaymentspayment may not exceed theMFIP standard of32.23needtransitional standard under subdivision 5 or 6, or the 32.24 shared household standard under subdivision 9, whichever is 32.25 applicable, for the assistance unit. 32.26 Sec. 38. Minnesota Statutes 2002, section 256J.24, 32.27 subdivision 10, is amended to read: 32.28 Subd. 10. [MFIP EXIT LEVEL.] The commissioner shall adjust 32.29 the MFIP earned income disregard to ensure that most 32.30 participants do not lose eligibility for MFIP until their income 32.31 reaches at least120115 percent of the federal poverty 32.32 guidelines in effect in October of each fiscal year. The 32.33 adjustment to the disregard shall be based on a household size 32.34 of three, and the resulting earned income disregard percentage 32.35 must be applied to all household sizes. The adjustment under 32.36 this subdivision must be implemented at the same time as the 33.1 October food stamp cost-of-living adjustment is reflected in the 33.2 food portion of MFIP transitional standard as required under 33.3 subdivision 5a. 33.4 Sec. 39. Minnesota Statutes 2002, section 256J.30, 33.5 subdivision 9, is amended to read: 33.6 Subd. 9. [CHANGES THAT MUST BE REPORTED.] A caregiver must 33.7 report the changes or anticipated changes specified in clauses 33.8 (1) to(17)(16) within ten days of the date they occur, at the 33.9 time of the periodic recertification of eligibility under 33.10 section 256J.32, subdivision 6, or within eight calendar days of 33.11 a reporting period as in subdivision 5 or 6, whichever occurs 33.12 first. A caregiver must report other changes at the time of the 33.13 periodic recertification of eligibility under section 256J.32, 33.14 subdivision 6, or at the end of a reporting period under 33.15 subdivision 5 or 6, as applicable. A caregiver must make these 33.16 reports in writing to the county agency. When a county agency 33.17 could have reduced or terminated assistance for one or more 33.18 payment months if a delay in reporting a change specified under 33.19 clauses (1) to(16)(15) had not occurred, the county agency 33.20 must determine whether a timely notice under section 256J.31, 33.21 subdivision 4, could have been issued on the day that the change 33.22 occurred. When a timely notice could have been issued, each 33.23 month's overpayment subsequent to that notice must be considered 33.24 a client error overpayment under section 256J.38. Calculation 33.25 of overpayments for late reporting under clause(17)(16) is 33.26 specified in section 256J.09, subdivision 9. Changes in 33.27 circumstances which must be reported within ten days must also 33.28 be reported on the MFIP household report form for the reporting 33.29 period in which those changes occurred. Within ten days, a 33.30 caregiver must report: 33.31 (1) a change in initial employment; 33.32 (2) a change in initial receipt of unearned income; 33.33 (3) a recurring change in unearned income; 33.34 (4) a nonrecurring change of unearned income that exceeds 33.35 $30; 33.36 (5) the receipt of a lump sum; 34.1 (6) an increase in assets that may cause the assistance 34.2 unit to exceed asset limits; 34.3 (7) a change in the physical or mental status of an 34.4 incapacitated member of the assistance unit if the physical or 34.5 mental status is the basis of exemption from an MFIP employment 34.6 services program under section 256J.56, or as the basis for 34.7 reducing the hourly participation requirements under section 34.8 256J.55, subdivision 1, or the type of activities included in an 34.9 employment plan under section 256J.521, subdivision 2; 34.10 (8) a change in employment status; 34.11 (9) information affecting an exception under section 34.12 256J.24, subdivision 9; 34.13 (10)a change in health insurance coverage;34.14(11)the marriage or divorce of an assistance unit member; 34.15(12)(11) the death of a parent, minor child, or 34.16 financially responsible person; 34.17(13)(12) a change in address or living quarters of the 34.18 assistance unit; 34.19(14)(13) the sale, purchase, or other transfer of 34.20 property; 34.21(15)(14) a change in school attendance of acustodial34.22parentcaregiver under age 20 or an employed child; 34.23(16)(15) filing a lawsuit, a workers' compensation claim, 34.24 or a monetary claim against a third party; and 34.25(17)(16) a change in household composition, including 34.26 births, returns to and departures from the home of assistance 34.27 unit members and financially responsible persons, or a change in 34.28 the custody of a minor child. 34.29 Sec. 40. Minnesota Statutes 2002, section 256J.32, 34.30 subdivision 2, is amended to read: 34.31 Subd. 2. [DOCUMENTATION.] The applicant or participant 34.32 must document the information required under subdivisions 4 to 6 34.33 or authorize the county agency to verify the information. The 34.34 applicant or participant has the burden of providing documentary 34.35 evidence to verify eligibility. The county agency shall assist 34.36 the applicant or participant in obtaining required documents 35.1 when the applicant or participant is unable to do so.When an35.2applicant or participant and the county agency are unable to35.3obtain documents needed to verify information, the county agency35.4may accept an affidavit from an applicant or participant as35.5sufficient documentation.The county agency may accept an 35.6 affidavit only for factors specified under subdivision 8. 35.7 Sec. 41. Minnesota Statutes 2002, section 256J.32, 35.8 subdivision 4, is amended to read: 35.9 Subd. 4. [FACTORS TO BE VERIFIED.] The county agency shall 35.10 verify the following at application: 35.11 (1) identity of adults; 35.12 (2) presence of the minor child in the home, if 35.13 questionable; 35.14 (3) relationship of a minor child to caregivers in the 35.15 assistance unit; 35.16 (4) age, if necessary to determine MFIP eligibility; 35.17 (5) immigration status; 35.18 (6) social security number according to the requirements of 35.19 section 256J.30, subdivision 12; 35.20 (7) income; 35.21 (8) self-employment expenses used as a deduction; 35.22 (9) source and purpose of deposits and withdrawals from 35.23 business accounts; 35.24 (10) spousal support and child support payments made to 35.25 persons outside the household; 35.26 (11) real property; 35.27 (12) vehicles; 35.28 (13) checking and savings accounts; 35.29 (14) savings certificates, savings bonds, stocks, and 35.30 individual retirement accounts; 35.31 (15) pregnancy, if related to eligibility; 35.32 (16) inconsistent information, if related to eligibility; 35.33 (17)medical insurance;35.34(18)burial accounts; 35.35(19)(18) school attendance, if related to eligibility; 35.36(20)(19) residence; 36.1(21)(20) a claim of family violence if used as a basisfor36.2ato qualify for the family violence waiverfrom the 60-month36.3time limit in section 256J.42 and regular employment and36.4training services requirements in section 256J.56; 36.5(22)(21) disability if used as the basis for an exemption 36.6 from employment and training services requirements under section 36.7 256J.56 or as the basis for reducing the hourly participation 36.8 requirements under section 256J.55, subdivision 1, or the type 36.9 of activity included in an employment plan under section 36.10 256J.521, subdivision 2; and 36.11(23)(22) information needed to establish an exception 36.12 under section 256J.24, subdivision 9. 36.13 Sec. 42. Minnesota Statutes 2002, section 256J.32, 36.14 subdivision 5a, is amended to read: 36.15 Subd. 5a. [INCONSISTENT INFORMATION.] When the county 36.16 agency verifies inconsistent information under subdivision 4, 36.17 clause (16), or 6, clause(4)(5), the reason for verifying the 36.18 information must be documented in the financial case record. 36.19 Sec. 43. Minnesota Statutes 2002, section 256J.32, is 36.20 amended by adding a subdivision to read: 36.21 Subd. 8. [AFFIDAVIT.] The county agency may accept an 36.22 affidavit from the applicant or recipient as sufficient 36.23 documentation at the time of application or recertification only 36.24 for the following factors: 36.25 (1) a claim of family violence if used as a basis to 36.26 qualify for the family violence waiver; 36.27 (2) information needed to establish an exception under 36.28 section 256J.24, subdivision 9; 36.29 (3) relationship of a minor child to caregivers in the 36.30 assistance unit; and 36.31 (4) citizenship status from a noncitizen who reports to be, 36.32 or is identified as, a victim of severe forms of trafficking in 36.33 persons, if the noncitizen reports that the noncitizen's 36.34 immigration documents are being held by an individual or group 36.35 of individuals against the noncitizen's will. The noncitizen 36.36 must follow up with the Office of Refugee Resettlement (ORR) to 37.1 pursue certification. If verification that certification is 37.2 being pursued is not received within 30 days, the MFIP case must 37.3 be closed and the agency shall pursue overpayments. The ORR 37.4 documents certifying the noncitizen's status as a victim of 37.5 severe forms of trafficking in persons, or the reason for the 37.6 delay in processing, must be received within 90 days, or the 37.7 MFIP case must be closed and the agency shall pursue 37.8 overpayments. 37.9 Sec. 44. Minnesota Statutes 2002, section 256J.37, is 37.10 amended by adding a subdivision to read: 37.11 Subd. 3a. [RENTAL SUBSIDIES; UNEARNED INCOME.] (a) 37.12 Effective July 1, 2003, the county agency shall count $100 of 37.13 the value of public and assisted rental subsidies provided 37.14 through the Department of Housing and Urban Development (HUD) as 37.15 unearned income to the cash portion of the MFIP grant. The full 37.16 amount of the subsidy must be counted as unearned income when 37.17 the subsidy is less than $100. For the purposes of initial 37.18 implementation of this subdivision, the county shall budget the 37.19 income from the subsidy prospectively in the months of July and 37.20 August 2003. This shall be done regardless of whether the case 37.21 is in the retrospective or prospective budgeting cycle. 37.22 Thereafter, the income from this subsidy shall be budgeted 37.23 according to section 256J.34. 37.24 (b) The provisions of this subdivision shall not apply to 37.25 an MFIP assistance unit which includes a participant who is: 37.26 (1) age 60 or older; 37.27 (2) a caregiver who is suffering from an illness, injury, 37.28 or incapacity that has been certified by a qualified 37.29 professional when the illness, injury, or incapacity is expected 37.30 to continue for more than 30 days and prevents the person from 37.31 obtaining or retaining employment; or 37.32 (3) a caregiver whose presence in the home is required due 37.33 to the illness or incapacity of another member in the assistance 37.34 unit, a relative in the household, or a foster child in the 37.35 household when the illness or incapacity and the need for the 37.36 participant's presence in the home has been certified by a 38.1 qualified professional and is expected to continue for more than 38.2 30 days. 38.3 (c) The provisions of this subdivision shall not apply to 38.4 an MFIP assistance unit where the parental caregiver is an SSI 38.5 recipient. 38.6 Sec. 45. Minnesota Statutes 2002, section 256J.37, is 38.7 amended by adding a subdivision to read: 38.8 Subd. 3b. [TREATMENT OF SUPPLEMENTAL SECURITY 38.9 INCOME.] Effective July 1, 2003, the county shall reduce the 38.10 cash portion of the MFIP grant by $175 per SSI recipient who 38.11 resides in the household, and who would otherwise be included in 38.12 the MFIP assistance unit under section 256J.24, subdivision 2, 38.13 but is excluded solely due to the SSI recipient status under 38.14 section 256J.24, subdivision 3, paragraph (a), clause (1). If 38.15 the SSI recipient receives less than $175 of SSI, only the 38.16 amount received shall be used in calculating the MFIP cash 38.17 assistance payment. This provision does not apply to relative 38.18 caregivers who could elect to be included in the MFIP assistance 38.19 unit under section 256J.24, subdivision 4, unless the 38.20 caregiver's children or stepchildren are included in the MFIP 38.21 assistance unit. 38.22 Sec. 46. Minnesota Statutes 2002, section 256J.37, 38.23 subdivision 9, is amended to read: 38.24 Subd. 9. [UNEARNED INCOME.](a)The county agency must 38.25 apply unearned income to the MFIP standard of need. When 38.26 determining the amount of unearned income, the county agency 38.27 must deduct the costs necessary to secure payments of unearned 38.28 income. These costs include legal fees, medical fees, and 38.29 mandatory deductions such as federal and state income taxes. 38.30(b) Effective July 1, 2003, the county agency shall count38.31$100 of the value of public and assisted rental subsidies38.32provided through the Department of Housing and Urban Development38.33(HUD) as unearned income. The full amount of the subsidy must38.34be counted as unearned income when the subsidy is less than $100.38.35(c) The provisions of paragraph (b) shall not apply to MFIP38.36participants who are exempt from the employment and training39.1services component because they are:39.2(i) individuals who are age 60 or older;39.3(ii) individuals who are suffering from a professionally39.4certified permanent or temporary illness, injury, or incapacity39.5which is expected to continue for more than 30 days and which39.6prevents the person from obtaining or retaining employment; or39.7(iii) caregivers whose presence in the home is required39.8because of the professionally certified illness or incapacity of39.9another member in the assistance unit, a relative in the39.10household, or a foster child in the household.39.11(d) The provisions of paragraph (b) shall not apply to an39.12MFIP assistance unit where the parental caregiver receives39.13supplemental security income.39.14 Sec. 47. Minnesota Statutes 2002, section 256J.38, 39.15 subdivision 3, is amended to read: 39.16 Subd. 3. [RECOVERING OVERPAYMENTSFROM FORMER39.17PARTICIPANTS.] A county agency must initiate efforts to recover 39.18 overpayments paid to a former participant or caregiver.Adults39.19 Caregivers, both parental and nonparental, and minor caregivers 39.20 of an assistance unit at the time an overpayment occurs, whether 39.21 receiving assistance or not, are jointly and individually liable 39.22 for repayment of the overpayment. The county agency must 39.23 request repayment from the former participants and caregivers. 39.24 When an agreement for repayment is not completed within six 39.25 months of the date of discovery or when there is a default on an 39.26 agreement for repayment after six months, the county agency must 39.27 initiate recovery consistent with chapter 270A, or section 39.28 541.05. When a person has been convicted of fraud under section 39.29 256.98, recovery must be sought regardless of the amount of 39.30 overpayment. When an overpayment is less than $35, and is not 39.31 the result of a fraud conviction under section 256.98, the 39.32 county agency must not seek recovery under this subdivision. 39.33 The county agency must retain information about all overpayments 39.34 regardless of the amount. When an adult, adult caregiver, or 39.35 minor caregiver reapplies for assistance, the overpayment must 39.36 be recouped under subdivision 4. 40.1 Sec. 48. Minnesota Statutes 2002, section 256J.38, 40.2 subdivision 4, is amended to read: 40.3 Subd. 4. [RECOUPING OVERPAYMENTS FROM PARTICIPANTS.] A 40.4 participant may voluntarily repay, in part or in full, an 40.5 overpayment even if assistance is reduced under this 40.6 subdivision, until the total amount of the overpayment is 40.7 repaid. When an overpayment occurs due to fraud, the county 40.8 agency must recover from the overpaid assistance unit, including 40.9 child only cases, ten percent of the applicable standard or the 40.10 amount of the monthly assistance payment, whichever is less. 40.11 When a nonfraud overpayment occurs, the county agency must 40.12 recover from the overpaid assistance unit, including child only 40.13 cases, three percent of the MFIP standard of need or the amount 40.14 of the monthly assistance payment, whichever is less. 40.15 Sec. 49. Minnesota Statutes 2002, section 256J.40, is 40.16 amended to read: 40.17 256J.40 [FAIR HEARINGS.] 40.18 Caregivers receiving a notice of intent to sanction or a 40.19 notice of adverse action that includes a sanction, reduction in 40.20 benefits, suspension of benefits, denial of benefits, or 40.21 termination of benefits may request a fair hearing. A request 40.22 for a fair hearing must be submitted in writing to the county 40.23 agency or to the commissioner and must be mailed within 30 days 40.24 after a participant or former participant receives written 40.25 notice of the agency's action or within 90 days when a 40.26 participant or former participant shows good cause for not 40.27 submitting the request within 30 days. A former participant who 40.28 receives a notice of adverse action due to an overpayment may 40.29 appeal the adverse action according to the requirements in this 40.30 section. Issues that may be appealed are: 40.31 (1) the amount of the assistance payment; 40.32 (2) a suspension, reduction, denial, or termination of 40.33 assistance; 40.34 (3) the basis for an overpayment, the calculated amount of 40.35 an overpayment, and the level of recoupment; 40.36 (4) the eligibility for an assistance payment; and 41.1 (5) the use of protective or vendor payments under section 41.2 256J.39, subdivision 2, clauses (1) to (3). 41.3 Except for benefits issued under section 256J.95, a county 41.4 agency must not reduce, suspend, or terminate payment when an 41.5 aggrieved participant requests a fair hearing prior to the 41.6 effective date of the adverse action or within ten days of the 41.7 mailing of the notice of adverse action, whichever is later, 41.8 unless the participant requests in writing not to receive 41.9 continued assistance pending a hearing decision. An appeal 41.10 request cannot extend benefits for the diversionary work program 41.11 under section 256J.95 beyond the four-month time limit. 41.12 Assistance issued pending a fair hearing is subject to recovery 41.13 under section 256J.38 when as a result of the fair hearing 41.14 decision the participant is determined ineligible for assistance 41.15 or the amount of the assistance received. A county agency may 41.16 increase or reduce an assistance payment while an appeal is 41.17 pending when the circumstances of the participant change and are 41.18 not related to the issue on appeal. The commissioner's order is 41.19 binding on a county agency. No additional notice is required to 41.20 enforce the commissioner's order. 41.21 A county agency shall reimburse appellants for reasonable 41.22 and necessary expenses of attendance at the hearing, such as 41.23 child care and transportation costs and for the transportation 41.24 expenses of the appellant's witnesses and representatives to and 41.25 from the hearing. Reasonable and necessary expenses do not 41.26 include legal fees. Fair hearings must be conducted at a 41.27 reasonable time and date by an impartial referee employed by the 41.28 department. The hearing may be conducted by telephone or at a 41.29 site that is readily accessible to persons with disabilities. 41.30 The appellant may introduce new or additional evidence 41.31 relevant to the issues on appeal. Recommendations of the 41.32 appeals referee and decisions of the commissioner must be based 41.33 on evidence in the hearing record and are not limited to a 41.34 review of the county agency action. 41.35 Sec. 50. Minnesota Statutes 2002, section 256J.42, 41.36 subdivision 4, is amended to read: 42.1 Subd. 4. [VICTIMS OF FAMILY VIOLENCE.] Any cash assistance 42.2 received by an assistance unit in a month when a caregiver 42.3 complied with a safety plan, an alternative employment plan, or 42.4 an employment planor after October 1, 2001, complied or is42.5complying with an alternative employment planunder section 42.6256J.49256J.521, subdivision1a3, does not count toward the 42.7 60-month limitation on assistance. 42.8 Sec. 51. Minnesota Statutes 2002, section 256J.42, 42.9 subdivision 5, is amended to read: 42.10 Subd. 5. [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 42.11 assistance received by an assistance unit does not count toward 42.12 the 60-month limit on assistance during a month in which the 42.13 caregiver isin the category inage 60 or older, including 42.14 months during which the caregiver was exempt under section 42.15 256J.56, paragraph (a), clause (1). 42.16 (b) From July 1, 1997, until the date MFIP is operative in 42.17 the caregiver's county of financial responsibility, any cash 42.18 assistance received by a caregiver who is complying with 42.19 Minnesota Statutes 1996, section 256.73, subdivision 5a, and 42.20 Minnesota Statutes 1998, section 256.736, if applicable, does 42.21 not count toward the 60-month limit on assistance. Thereafter, 42.22 any cash assistance received by a minor caregiver who is 42.23 complying with the requirements of sections 256J.14 and 256J.54, 42.24 if applicable, does not count towards the 60-month limit on 42.25 assistance. 42.26 (c) Any diversionary assistance or emergency assistance 42.27 received prior to July 1, 2003, does not count toward the 42.28 60-month limit. 42.29 (d) Any cash assistance received by an 18- or 19-year-old 42.30 caregiver who is complying withthe requirements ofan 42.31 employment plan that includes an education option under section 42.32 256J.54 does not count toward the 60-month limit. 42.33 (e) Payments provided to meet short-term emergency needs 42.34 under section 256J.626 and diversionary work program benefits 42.35 provided under section 256J.95 do not count toward the 60-month 42.36 time limit. 43.1 Sec. 52. Minnesota Statutes 2002, section 256J.42, 43.2 subdivision 6, is amended to read: 43.3 Subd. 6. [CASE REVIEW.] (a) Within 180 days, but not less 43.4 than 60 days, before the end of the participant's 60th month on 43.5 assistance, the county agency or job counselor must review the 43.6 participant's case to determine if the employment plan is still 43.7 appropriate or if the participant is exempt under section 43.8 256J.56 from the employment and training services component, and 43.9 attempt to meet with the participant face-to-face. 43.10 (b) During the face-to-face meeting, a county agency or the 43.11 job counselor must: 43.12 (1) inform the participant how many months of counted 43.13 assistance the participant has accrued and when the participant 43.14 is expected to reach the 60th month; 43.15 (2) explain the hardship extension criteria under section 43.16 256J.425 and what the participant should do if the participant 43.17 thinks a hardship extension applies; 43.18 (3) identify other resources that may be available to the 43.19 participant to meet the needs of the family; and 43.20 (4) inform the participant of the right to appeal the case 43.21 closure under section 256J.40. 43.22 (c) If a face-to-face meeting is not possible, the county 43.23 agency must send the participant a notice of adverse action as 43.24 provided in section 256J.31, subdivisions 4 and 5. 43.25 (d) Before a participant's case is closed under this 43.26 section, the county must ensure that: 43.27 (1) the case has been reviewed by the job counselor's 43.28 supervisor or the review team designatedinby thecounty's43.29approved local service unit plancounty to determine if the 43.30 criteria for a hardship extension, if requested, were applied 43.31 appropriately; and 43.32 (2) the county agency or the job counselor attempted to 43.33 meet with the participant face-to-face. 43.34 Sec. 53. Minnesota Statutes 2002, section 256J.425, 43.35 subdivision 1, is amended to read: 43.36 Subdivision 1. [ELIGIBILITY.] (a) To be eligible for a 44.1 hardship extension, a participant in an assistance unit subject 44.2 to the time limit under section 256J.42, subdivision 1,in which44.3any participant has received 60 counted months of assistance,44.4 must be in compliance in the participant's 60th counted month 44.5the participant is applying for the extension. For purposes of 44.6 determining eligibility for a hardship extension, a participant 44.7 is in compliance in any month that the participant has not been 44.8 sanctioned. 44.9 (b) If one participant in a two-parent assistance unit is 44.10 determined to be ineligible for a hardship extension, the county 44.11 shall give the assistance unit the option of disqualifying the 44.12 ineligible participant from MFIP. In that case, the assistance 44.13 unit shall be treated as a one-parent assistance unit and the 44.14 assistance unit's MFIP grant shall be calculated using the 44.15 shared household standard under section 256J.08, subdivision 82a. 44.16 Sec. 54. Minnesota Statutes 2002, section 256J.425, 44.17 subdivision 1a, is amended to read: 44.18 Subd. 1a. [REVIEW.] If a county grants a hardship 44.19 extension under this section, a county agency shall review the 44.20 case every six or 12 months, whichever is appropriate based on 44.21 the participant's circumstances and the extension 44.22 category. More frequent reviews shall be required if 44.23 eligibility for an extension is based on a condition that is 44.24 subject to change in less than six months. 44.25 Sec. 55. Minnesota Statutes 2002, section 256J.425, 44.26 subdivision 2, is amended to read: 44.27 Subd. 2. [ILL OR INCAPACITATED.] (a) An assistance unit 44.28 subject to the time limit in section 256J.42, subdivision 1,in44.29which any participant has received 60 counted months of44.30assistance,is eligible to receive months of assistance under a 44.31 hardship extension if the participant who reached the time limit 44.32 belongs to any of the following groups: 44.33 (1) participants who are suffering froma professionally44.34certifiedan illness, injury, or incapacity which has been 44.35 certified by a qualified professional when the illness, injury, 44.36 or incapacity is expected to continue for more than 30 days 45.1 andwhichprevents the person from obtaining or retaining 45.2 employmentand who are following. These participants must 45.3 follow the treatment recommendations of thehealth care provider45.4 qualified professional certifying the illness, injury, or 45.5 incapacity; 45.6 (2) participants whose presence in the home is required as 45.7 a caregiver because ofa professionally certifiedthe illness or 45.8 incapacity of another member in the assistance unit, a relative 45.9 in the household, or a foster child in the householdandwhen 45.10 the illness or incapacity and the need for the participant's 45.11 presence in the home has been certified by a qualified 45.12 professional and is expected to continue for more than 30 days; 45.13 or 45.14 (3) caregivers with a child or an adult in the household 45.15 who meets the disability or medical criteria for home care 45.16 services under section 256B.0627, subdivision 1, paragraph 45.17(c)(f), or a home and community-based waiver services program 45.18 under chapter 256B, or meets the criteria for severe emotional 45.19 disturbance under section 245.4871, subdivision 6, or for 45.20 serious and persistent mental illness under section 245.462, 45.21 subdivision 20, paragraph (c). Caregivers in this category are 45.22 presumed to be prevented from obtaining or retaining employment. 45.23 (b) An assistance unit receiving assistance under a 45.24 hardship extension under this subdivision may continue to 45.25 receive assistance as long as the participant meets the criteria 45.26 in paragraph (a), clause (1), (2), or (3). 45.27 Sec. 56. Minnesota Statutes 2002, section 256J.425, 45.28 subdivision 3, is amended to read: 45.29 Subd. 3. [HARD-TO-EMPLOY PARTICIPANTS.] An assistance unit 45.30 subject to the time limit in section 256J.42, subdivision 1,in45.31which any participant has received 60 counted months of45.32assistance,is eligible to receive months of assistance under a 45.33 hardship extension if the participant who reached the time limit 45.34 belongs to any of the following groups: 45.35 (1) a person who is diagnosed by a licensed physician, 45.36 psychological practitioner, or other qualified professional, as 46.1 mentally retarded or mentally ill, and that condition prevents 46.2 the person from obtaining or retaining unsubsidized employment; 46.3 (2) a person who: 46.4 (i) has been assessed by a vocational specialist or the 46.5 county agency to be unemployable for purposes of this 46.6 subdivision; or 46.7 (ii) has an IQ below 80 who has been assessed by a 46.8 vocational specialist or a county agency to be employable, but 46.9 not at a level that makes the participant eligible for an 46.10 extension under subdivision 4or,. The determination of IQ 46.11 level must be made by a qualified professional. In the case of 46.12 a non-English-speaking personfor whom it is not possible to46.13provide a determination due to language barriers or absence of46.14culturally appropriate assessment tools, is determined by a46.15qualified professional to have an IQ below 80. A person is46.16considered employable if positions of employment in the local46.17labor market exist, regardless of the current availability of46.18openings for those positions, that the person is capable of46.19performing: (A) the determination must be made by a qualified 46.20 professional with experience conducting culturally appropriate 46.21 assessments, whenever possible; (B) the county may accept 46.22 reports that identify an IQ range as opposed to a specific 46.23 score; (C) these reports must include a statement of confidence 46.24 in the results; 46.25 (3) a person who is determined bythe county agencya 46.26 qualified professional to be learning disabledor, and the 46.27 disability severely limits the person's ability to obtain, 46.28 perform, or maintain suitable employment. For purposes of the 46.29 initial approval of a learning disability extension, the 46.30 determination must have been made or confirmed within the 46.31 previous 12 months. In the case of a non-English-speaking 46.32 personfor whom it is not possible to provide a medical46.33diagnosis due to language barriers or absence of culturally46.34appropriate assessment tools, is determined by a qualified46.35professional to have a learning disability. If a rehabilitation46.36plan for the person is developed or approved by the county47.1agency, the plan must be incorporated into the employment plan.47.2However, a rehabilitation plan does not replace the requirement47.3to develop and comply with an employment plan under section47.4256J.52. For purposes of this section, "learning disabled"47.5means the applicant or recipient has a disorder in one or more47.6of the psychological processes involved in perceiving,47.7understanding, or using concepts through verbal language or47.8nonverbal means. The disability must severely limit the47.9applicant or recipient in obtaining, performing, or maintaining47.10suitable employment. Learning disabled does not include47.11learning problems that are primarily the result of visual,47.12hearing, or motor handicaps; mental retardation; emotional47.13disturbance; or due to environmental, cultural, or economic47.14disadvantage: (i) the determination must be made by a qualified 47.15 professional with experience conducting culturally appropriate 47.16 assessments, whenever possible; and (ii) these reports must 47.17 include a statement of confidence in the results. If a 47.18 rehabilitation plan for a participant extended as learning 47.19 disabled is developed or approved by the county agency, the plan 47.20 must be incorporated into the employment plan. However, a 47.21 rehabilitation plan does not replace the requirement to develop 47.22 and comply with an employment plan under section 256J.521; or 47.23 (4) a person whois a victim ofhas been granted a family 47.24 violenceas defined in section 256J.49, subdivision 2waiver, 47.25 and who isparticipating incomplying with analternative47.26 employment plan under section256J.49256J.521, subdivision1a47.27 3. 47.28 Sec. 57. Minnesota Statutes 2002, section 256J.425, 47.29 subdivision 4, is amended to read: 47.30 Subd. 4. [EMPLOYED PARTICIPANTS.] (a) An assistance unit 47.31 subject to the time limit under section 256J.42, subdivision 1, 47.32in which any participant has received 60 months of assistance,47.33 is eligible to receive assistance under a hardship extension if 47.34 the participant who reached the time limit belongs to: 47.35 (1) a one-parent assistance unit in which the participant 47.36 is participating in work activities for at least 30 hours per 48.1 week, of which an average of at least 25 hours per week every 48.2 month are spent participating in employment; 48.3 (2) a two-parent assistance unit in which the participants 48.4 are participating in work activities for at least 55 hours per 48.5 week, of which an average of at least 45 hours per week every 48.6 month are spent participating in employment; or 48.7 (3) an assistance unit in which a participant is 48.8 participating in employment for fewer hours than those specified 48.9 in clause (1), and the participant submits verification from a 48.10health care providerqualified professional, in a form 48.11 acceptable to the commissioner, stating that the number of hours 48.12 the participant may work is limited due to illness or 48.13 disability, as long as the participant is participating in 48.14 employment for at least the number of hours specified by 48.15 thehealth care providerqualified professional. The 48.16 participant must be following the treatment recommendations of 48.17 thehealth care providerqualified professional providing the 48.18 verification. The commissioner shall develop a form to be 48.19 completed and signed by thehealth care providerqualified 48.20 professional, documenting the diagnosis and any additional 48.21 information necessary to document the functional limitations of 48.22 the participant that limit work hours. If the participant is 48.23 part of a two-parent assistance unit, the other parent must be 48.24 treated as a one-parent assistance unit for purposes of meeting 48.25 the work requirements under this subdivision. 48.26 (b) For purposes of this section, employment means: 48.27 (1) unsubsidized employment under section 256J.49, 48.28 subdivision 13, clause (1); 48.29 (2) subsidized employment under section 256J.49, 48.30 subdivision 13, clause (2); 48.31 (3) on-the-job training under section 256J.49, subdivision 48.32 13, clause(4)(2); 48.33 (4) an apprenticeship under section 256J.49, subdivision 48.34 13, clause(19)(1); 48.35 (5) supported work. For purposes of this section,48.36"supported work" means services supporting a participant on the49.1job which include, but are not limited to, supervision, job49.2coaching, and subsidized wagesunder section 256J.49, 49.3 subdivision 13, clause (2); 49.4 (6) a combination of clauses (1) to (5); or 49.5 (7) child care under section 256J.49, subdivision 13, 49.6 clause(25)(7), if it is in combination with paid employment. 49.7 (c) If a participant is complying with a child protection 49.8 plan under chapter 260C, the number of hours required under the 49.9 child protection plan count toward the number of hours required 49.10 under this subdivision. 49.11 (d) The county shall provide the opportunity for subsidized 49.12 employment to participants needing that type of employment 49.13 within available appropriations. 49.14 (e) To be eligible for a hardship extension for employed 49.15 participants under this subdivision, a participantin a49.16one-parent assistance unit or both parents in a two-parent49.17assistance unitmust be in compliance for at least ten out of 49.18 the 12 months immediately preceding the participant's 61st month 49.19 on assistance.If only one parent in a two-parent assistance49.20unit fails to be in compliance ten out of the 12 months49.21immediately preceding the participant's 61st month, the county49.22shall give the assistance unit the option of disqualifying the49.23noncompliant parent. If the noncompliant participant is49.24disqualified, the assistance unit must be treated as a49.25one-parent assistance unit for the purposes of meeting the work49.26requirements under this subdivision and the assistance unit's49.27MFIP grant shall be calculated using the shared household49.28standard under section 256J.08, subdivision 82a.49.29 (f) The employment plan developed under section256J.5249.30 256J.521, subdivision52, for participants under this 49.31 subdivision must contain the number of hours specified in 49.32 paragraph (a) related to employment and work activities. The 49.33 job counselor and the participant must sign the employment plan 49.34 to indicate agreement between the job counselor and the 49.35 participant on the contents of the plan. 49.36 (g) Participants who fail to meet the requirements in 50.1 paragraph (a), without good cause under section 256J.57, shall 50.2 be sanctioned or permanently disqualified under subdivision 6. 50.3 Good cause may only be granted for that portion of the month for 50.4 which the good cause reason applies. Participants must meet all 50.5 remaining requirements in the approved employment plan or be 50.6 subject to sanction or permanent disqualification. 50.7 (h) If the noncompliance with an employment plan is due to 50.8 the involuntary loss of employment, the participant is exempt 50.9 from the hourly employment requirement under this subdivision 50.10 for one month. Participants must meet all remaining 50.11 requirements in the approved employment plan or be subject to 50.12 sanction or permanent disqualification. This exemption is 50.13 available toone-parent assistance unitsa participant two times 50.14 in a 12-month period, and two-parent assistance units, two times50.15per parent in a 12-month period. 50.16(i) This subdivision expires on June 30, 2004.50.17 Sec. 58. Minnesota Statutes 2002, section 256J.425, 50.18 subdivision 6, is amended to read: 50.19 Subd. 6. [SANCTIONS FOR EXTENDED CASES.] (a) If one or 50.20 both participants in an assistance unit receiving assistance 50.21 under subdivision 3 or 4 are not in compliance with the 50.22 employment and training service requirements in sections256J.5250.23 256J.521 to256J.55256J.57, the sanctions under this 50.24 subdivision apply. For a first occurrence of noncompliance, an 50.25 assistance unit must be sanctioned under section 256J.46, 50.26 subdivision 1, paragraph(d)(c), clause (1). For a second or 50.27 third occurrence of noncompliance, the assistance unit must be 50.28 sanctioned under section 256J.46, subdivision 1, 50.29 paragraph(d)(c), clause (2). For a fourth occurrence of 50.30 noncompliance, the assistance unit is disqualified from MFIP. 50.31 If a participant is determined to be out of compliance, the 50.32 participant may claim a good cause exception under section 50.33 256J.57, however, the participant may not claim an exemption 50.34 under section 256J.56. 50.35 (b) If both participants in a two-parent assistance unit 50.36 are out of compliance at the same time, it is considered one 51.1 occurrence of noncompliance. 51.2 Sec. 59. Minnesota Statutes 2002, section 256J.425, 51.3 subdivision 7, is amended to read: 51.4 Subd. 7. [STATUS OF DISQUALIFIED PARTICIPANTS.] (a) An 51.5 assistance unit that is disqualified under subdivision 6, 51.6 paragraph (a), may be approved for MFIP if the participant 51.7 complies with MFIP program requirements and demonstrates 51.8 compliance for up to one month. No assistance shall be paid 51.9 during this period. 51.10 (b) An assistance unit that is disqualified under 51.11 subdivision 6, paragraph (a), and that reapplies under paragraph 51.12 (a) is subject to sanction under section 256J.46, subdivision 1, 51.13 paragraph(d)(c), clause (1), for a first occurrence of 51.14 noncompliance. A subsequent occurrence of noncompliance results 51.15 in a permanent disqualification. 51.16 (c) If one participant in a two-parent assistance unit 51.17 receiving assistance under a hardship extension under 51.18 subdivision 3 or 4 is determined to be out of compliance with 51.19 the employment and training services requirements under sections 51.20256J.52256J.521 to256J.55256J.57, the county shall give the 51.21 assistance unit the option of disqualifying the noncompliant 51.22 participant from MFIP. In that case, the assistance unit shall 51.23 be treated as a one-parent assistance unit for the purposes of 51.24 meeting the work requirements under subdivision 4 and the 51.25 assistance unit's MFIP grant shall be calculated using the 51.26 shared household standard under section 256J.08, subdivision 51.27 82a. An applicant who is disqualified from receiving assistance 51.28 under this paragraph may reapply under paragraph (a). If a 51.29 participant is disqualified from MFIP under this subdivision a 51.30 second time, the participant is permanently disqualified from 51.31 MFIP. 51.32 (d) Prior to a disqualification under this subdivision, a 51.33 county agency must review the participant's case to determine if 51.34 the employment plan is still appropriate and attempt to meet 51.35 with the participant face-to-face. If a face-to-face meeting is 51.36 not conducted, the county agency must send the participant a 52.1 notice of adverse action as provided in section 256J.31. During 52.2 the face-to-face meeting, the county agency must: 52.3 (1) determine whether the continued noncompliance can be 52.4 explained and mitigated by providing a needed preemployment 52.5 activity, as defined in section 256J.49, subdivision 13, clause 52.6(16), or services under a local intervention grant for52.7self-sufficiency under section 256J.625(9); 52.8 (2) determine whether the participant qualifies for a good 52.9 cause exception under section 256J.57; 52.10 (3) inform the participant of the family violence waiver 52.11 criteria and make appropriate referrals if the waiver is 52.12 requested; 52.13 (4) inform the participant of the participant's sanction 52.14 status and explain the consequences of continuing noncompliance; 52.15(4)(5) identify other resources that may be available to 52.16 the participant to meet the needs of the family; and 52.17(5)(6) inform the participant of the right to appeal under 52.18 section 256J.40. 52.19 Sec. 60. Minnesota Statutes 2002, section 256J.45, 52.20 subdivision 2, is amended to read: 52.21 Subd. 2. [GENERAL INFORMATION.] The MFIP orientation must 52.22 consist of a presentation that informs caregivers of: 52.23 (1) the necessity to obtain immediate employment; 52.24 (2) the work incentives under MFIP, including the 52.25 availability of the federal earned income tax credit and the 52.26 Minnesota working family tax credit; 52.27 (3) the requirement to comply with the employment plan and 52.28 other requirements of the employment and training services 52.29 component of MFIP, including a description of the range of work 52.30 and training activities that are allowable under MFIP to meet 52.31 the individual needs of participants; 52.32 (4) the consequences for failing to comply with the 52.33 employment plan and other program requirements, and that the 52.34 county agency may not impose a sanction when failure to comply 52.35 is due to the unavailability of child care or other 52.36 circumstances where the participant has good cause under 53.1 subdivision 3; 53.2 (5) the rights, responsibilities, and obligations of 53.3 participants; 53.4 (6) the types and locations of child care services 53.5 available through the county agency; 53.6 (7) the availability and the benefits of the early 53.7 childhood health and developmental screening under sections 53.8 121A.16 to 121A.19; 123B.02, subdivision 16; and 123B.10; 53.9 (8) the caregiver's eligibility for transition year child 53.10 care assistance under section 119B.05; 53.11 (9)the caregiver's eligibility for extended medical53.12assistance when the caregiver loses eligibility for MFIP due to53.13increased earnings or increased child or spousal supportthe 53.14 availability of all health care programs, including transitional 53.15 medical assistance; 53.16 (10) the caregiver's option to choose an employment and 53.17 training provider and information about each provider, including 53.18 but not limited to, services offered, program components, job 53.19 placement rates, job placement wages, and job retention rates; 53.20 (11) the caregiver's option to request approval of an 53.21 education and training plan according to section256J.5253.22 256J.53; 53.23 (12) the work study programs available under the higher 53.24 education system; and 53.25 (13)effective October 1, 2001,information about the 53.26 60-month time limitexemption and waivers of regular employment53.27and training requirements for family violence victimsexemptions 53.28 under the family violence waiver and referral information about 53.29 shelters and programs for victims of family violence. 53.30 Sec. 61. Minnesota Statutes 2002, section 256J.46, 53.31 subdivision 1, is amended to read: 53.32 Subdivision 1. [PARTICIPANTS NOT COMPLYING WITH PROGRAM 53.33 REQUIREMENTS.] (a) A participant who fails without good 53.34 cause under section 256J.57 to comply with the requirements of 53.35 this chapter, and who is not subject to a sanction under 53.36 subdivision 2, shall be subject to a sanction as provided in 54.1 this subdivision. Prior to the imposition of a sanction, a 54.2 county agency shall provide a notice of intent to sanction under 54.3 section 256J.57, subdivision 2, and, when applicable, a notice 54.4 of adverse action as provided in section 256J.31. 54.5 (b)A participant who fails to comply with an alternative54.6employment plan must have the plan reviewed by a person trained54.7in domestic violence and a job counselor or the county agency to54.8determine if components of the alternative employment plan are54.9still appropriate. If the activities are no longer appropriate,54.10the plan must be revised with a person trained in domestic54.11violence and approved by a job counselor or the county agency.54.12A participant who fails to comply with a plan that is determined54.13not to need revision will lose their exemption and be required54.14to comply with regular employment services activities.54.15(c)A sanction under this subdivision becomes effective the 54.16 month following the month in which a required notice is given. 54.17 A sanction must not be imposed when a participant comes into 54.18 compliance with the requirements for orientation under section 54.19 256J.45or third-party liability for medical services under54.20section 256J.30, subdivision 10,prior to the effective date of 54.21 the sanction. A sanction must not be imposed when a participant 54.22 comes into compliance with the requirements for employment and 54.23 training services under sections256J.49256J.515 to 54.24256J.55256J.57 ten days prior to the effective date of the 54.25 sanction. For purposes of this subdivision, each month that a 54.26 participant fails to comply with a requirement of this chapter 54.27 shall be considered a separate occurrence of noncompliance.A54.28participant who has had one or more sanctions imposed must54.29remain in compliance with the provisions of this chapter for six54.30months in order for a subsequent occurrence of noncompliance to54.31be considered a first occurrence.If both participants in a 54.32 two-parent assistance unit are out of compliance at the same 54.33 time, it is considered one occurrence of noncompliance. 54.34(d)(c) Sanctions for noncompliance shall be imposed as 54.35 follows: 54.36 (1) For the first occurrence of noncompliance by a 55.1 participant in an assistance unit, the assistance unit's grant 55.2 shall be reduced by ten percent of the MFIP standard of need for 55.3 an assistance unit of the same size with the residual grant paid 55.4 to the participant. The reduction in the grant amount must be 55.5 in effect for a minimum of one month and shall be removed in the 55.6 month following the month that the participant returns to 55.7 compliance. 55.8 (2) For a secondor subsequent, third, fourth, fifth, or 55.9 sixth occurrence of noncompliance by a participant in an 55.10 assistance unit,or when each of the participants in a55.11two-parent assistance unit have a first occurrence of55.12noncompliance at the same time,the assistance unit's shelter 55.13 costs shall be vendor paid up to the amount of the cash portion 55.14 of the MFIP grant for which the assistance unit is eligible. At 55.15 county option, the assistance unit's utilities may also be 55.16 vendor paid up to the amount of the cash portion of the MFIP 55.17 grant remaining after vendor payment of the assistance unit's 55.18 shelter costs. The residual amount of the grant after vendor 55.19 payment, if any, must be reduced by an amount equal to 30 55.20 percent of the MFIP standard of need for an assistance unit of 55.21 the same size before the residual grant is paid to the 55.22 assistance unit. The reduction in the grant amount must be in 55.23 effect for a minimum of one month and shall be removed in the 55.24 month following the month that the participant in a one-parent 55.25 assistance unit returns to compliance. In a two-parent 55.26 assistance unit, the grant reduction must be in effect for a 55.27 minimum of one month and shall be removed in the month following 55.28 the month both participants return to compliance. The vendor 55.29 payment of shelter costs and, if applicable, utilities shall be 55.30 removed six months after the month in which the participant or 55.31 participants return to compliance. If an assistance unit is 55.32 sanctioned under this clause, the participant's case file must 55.33 be reviewedas required under paragraph (e)to determine if the 55.34 employment plan is still appropriate. 55.35(e) When a sanction under paragraph (d), clause (2), is in55.36effect(d) For a seventh occurrence of noncompliance by a 56.1 participant in an assistance unit, or when the participants in a 56.2 two-parent assistance unit have a total of seven occurrences of 56.3 noncompliance, the county agency shall close the MFIP assistance 56.4 unit's financial assistance case, both the cash and food 56.5 portions. The case must remain closed for a minimum of one full 56.6 month. Closure under this paragraph does not make a participant 56.7 automatically ineligible for food support, if otherwise eligible. 56.8 Before the case is closed, the county agency must review the 56.9 participant's case to determine if the employment plan is still 56.10 appropriate and attempt to meet with the participant 56.11 face-to-face. The participant may bring an advocate to the 56.12 face-to-face meeting. If a face-to-face meeting is not 56.13 conducted, the county agency must send the participant a written 56.14 notice that includes the information required under clause (1). 56.15 (1) During the face-to-face meeting, the county agency must: 56.16 (i) determine whether the continued noncompliance can be 56.17 explained and mitigated by providing a needed preemployment 56.18 activity, as defined in section 256J.49, subdivision 13, clause 56.19(16), or services under a local intervention grant for56.20self-sufficiency under section 256J.625(9); 56.21 (ii) determine whether the participant qualifies for a good 56.22 cause exception under section 256J.57, or if the sanction is for 56.23 noncooperation with child support requirements, determine if the 56.24 participant qualifies for a good cause exemption under section 56.25 256.741, subdivision 10; 56.26 (iii) determine whether the participant qualifies for an 56.27 exemption under section 256J.56 or the work activities in the 56.28 employment plan are appropriate based on the criteria in section 56.29 256J.521, subdivision 2 or 3; 56.30 (iv)determine whether the participant qualifies for an56.31exemption from regular employment services requirements for56.32victims of family violence under section 256J.52, subdivision56.336determine whether the participant qualifies for the family 56.34 violence waiver; 56.35 (v) inform the participant of the participant's sanction 56.36 status and explain the consequences of continuing noncompliance; 57.1 (vi) identify other resources that may be available to the 57.2 participant to meet the needs of the family; and 57.3 (vii) inform the participant of the right to appeal under 57.4 section 256J.40. 57.5 (2) If the lack of an identified activity or service can 57.6 explain the noncompliance, the county must work with the 57.7 participant to provide the identified activity, and the county57.8must restore the participant's grant amount to the full amount57.9for which the assistance unit is eligible. The grant must be57.10restored retroactively to the first day of the month in which57.11the participant was found to lack preemployment activities or to57.12qualify for an exemption under section 256J.56, a good cause57.13exception under section 256J.57, or an exemption for victims of57.14family violence under section 256J.52, subdivision 6. 57.15 (3)If the participant is found to qualify for a good cause57.16exception or an exemption, the county must restore the57.17participant's grant to the full amount for which the assistance57.18unit is eligible.The grant must be restored to the full amount 57.19 for which the assistance unit is eligible retroactively to the 57.20 first day of the month in which the participant was found to 57.21 lack preemployment activities or to qualify for an exemption 57.22 under section 256J.56, a family violence waiver, or for a good 57.23 cause exemption under section 256.741, subdivision 10, or 57.24 256J.57. 57.25 (e) For the purpose of applying sanctions under this 57.26 section, only occurrences of noncompliance that occur after the 57.27 effective date of this section shall be considered. If the 57.28 participant is in 30 percent sanction in the month this section 57.29 takes effect, that month counts as the first occurrence for 57.30 purposes of applying the sanctions under this section, but the 57.31 sanction shall remain at 30 percent for that month. 57.32 (f) An assistance unit whose case is closed under paragraph 57.33 (d) or (g), or under an approved county option sanction plan 57.34 under section 256J.462 in effect June 30, 2003, or a county 57.35 pilot project under Laws 2000, chapter 488, article 10, section 57.36 29, in effect June 30, 2003, may reapply for MFIP and shall be 58.1 eligible if the participant complies with MFIP program 58.2 requirements and demonstrates compliance for up to one month. 58.3 No assistance shall be paid during this period. 58.4 (g) An assistance unit whose case has been closed for 58.5 noncompliance, that reapplies under paragraph (f) is subject to 58.6 sanction under paragraph (c), clause (2), for a first occurrence 58.7 of noncompliance. Any subsequent occurrence of noncompliance 58.8 shall result in case closure under paragraph (d). 58.9 Sec. 62. Minnesota Statutes 2002, section 256J.46, 58.10 subdivision 2, is amended to read: 58.11 Subd. 2. [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 58.12 REQUIREMENTS.] The grant of an MFIP caregiver who refuses to 58.13 cooperate, as determined by the child support enforcement 58.14 agency, with support requirements under section 256.741, shall 58.15 be subject to sanction as specified in this subdivision and 58.16 subdivision 1. For a first occurrence of noncooperation, the 58.17 assistance unit's grant must be reduced by2530 percent of the 58.18 applicable MFIP standard of need. Subsequent occurrences of 58.19 noncooperation shall be subject to sanction under subdivision 1, 58.20 paragraphs (c), clause (2), and (d). The residual amount of the 58.21 grant, if any, must be paid to the caregiver. A sanction under 58.22 this subdivision becomes effective the first month following the 58.23 month in which a required notice is given. A sanction must not 58.24 be imposed when a caregiver comes into compliance with the 58.25 requirements under section 256.741 prior to the effective date 58.26 of the sanction. The sanction shall be removed in the month 58.27 following the month that the caregiver cooperates with the 58.28 support requirements. Each month that an MFIP caregiver fails 58.29 to comply with the requirements of section 256.741 must be 58.30 considered a separate occurrence of noncompliance for the 58.31 purpose of applying sanctions under subdivision 1, paragraphs 58.32 (c), clause (2), and (d).An MFIP caregiver who has had one or58.33more sanctions imposed must remain in compliance with the58.34requirements of section 256.741 for six months in order for a58.35subsequent sanction to be considered a first occurrence.58.36 Sec. 63. Minnesota Statutes 2002, section 256J.46, 59.1 subdivision 2a, is amended to read: 59.2 Subd. 2a. [DUAL SANCTIONS.] (a) Notwithstanding the 59.3 provisions of subdivisions 1 and 2, for a participant subject to 59.4 a sanction for refusal to comply with child support requirements 59.5 under subdivision 2 and subject to a concurrent sanction for 59.6 refusal to cooperate with other program requirements under 59.7 subdivision 1, sanctions shall be imposed in the manner 59.8 prescribed in this subdivision. 59.9A participant who has had one or more sanctions imposed59.10under this subdivision must remain in compliance with the59.11provisions of this chapter for six months in order for a59.12subsequent occurrence of noncompliance to be considered a first59.13occurrence.Any vendor payment of shelter costs or utilities 59.14 under this subdivision must remain in effect for six months 59.15 after the month in which the participant is no longer subject to 59.16 sanction under subdivision 1. 59.17 (b) If the participant was subject to sanction for: 59.18 (i) noncompliance under subdivision 1 before being subject 59.19 to sanction for noncooperation under subdivision 2; or 59.20 (ii) noncooperation under subdivision 2 before being 59.21 subject to sanction for noncompliance under subdivision 1, the 59.22 participant is considered to have a second occurrence of 59.23 noncompliance and shall be sanctioned as provided in subdivision 59.24 1, paragraph(d)(c), clause (2). Each subsequent occurrence of 59.25 noncompliance shall be considered one additional occurrence and 59.26 shall be subject to the applicable level of sanction under 59.27 subdivision 1, paragraph (d), or section 256J.462. The 59.28 requirement that the county conduct a review as specified in 59.29 subdivision 1, paragraph(e)(d), remains in effect. 59.30 (c) A participant who first becomes subject to sanction 59.31 under both subdivisions 1 and 2 in the same month is subject to 59.32 sanction as follows: 59.33 (i) in the first month of noncompliance and noncooperation, 59.34 the participant's grant must be reduced by2530 percent of the 59.35 applicable MFIP standard of need, with any residual amount paid 59.36 to the participant; 60.1 (ii) in the second and subsequent months of noncompliance 60.2 and noncooperation, the participant shall be subject to the 60.3 applicable level of sanction under subdivision 1, paragraph (d),60.4or section 256J.462. 60.5 The requirement that the county conduct a review as 60.6 specified in subdivision 1, paragraph(e)(d), remains in effect. 60.7 (d) A participant remains subject to sanction under 60.8 subdivision 2 if the participant: 60.9 (i) returns to compliance and is no longer subject to 60.10 sanctionunder subdivision 1 or section 256J.462for 60.11 noncompliance with section 256J.45 or sections 256J.515 to 60.12 256J.57; or 60.13 (ii) has the sanctionunder subdivision 1, paragraph (d),60.14or section 256J.462for noncompliance with section 256J.45 or 60.15 sections 256J.515 to 256J.57 removed upon completion of the 60.16 review under subdivision 1, paragraph (e). 60.17 A participant remains subject to the applicable level of 60.18 sanction under subdivision 1, paragraph (d), or section 256J.46260.19 if the participant cooperates and is no longer subject to 60.20 sanction under subdivision 2. 60.21 Sec. 64. Minnesota Statutes 2002, section 256J.49, 60.22 subdivision 4, is amended to read: 60.23 Subd. 4. [EMPLOYMENT AND TRAINING SERVICE PROVIDER.] 60.24 "Employment and training service provider" means: 60.25 (1) a public, private, or nonprofit employment and training 60.26 agency certified by the commissioner of economic security under 60.27 sections 268.0122, subdivision 3, and 268.871, subdivision 1, or 60.28 is approved under section 256J.51 and is included in the county 60.29planservice agreement submitted under section256J.50256J.626, 60.30 subdivision74; 60.31 (2) a public, private, or nonprofit agency that is not 60.32 certified by the commissioner under clause (1), but with which a 60.33 county has contracted to provide employment and training 60.34 services and which is included in the county'splanservice 60.35 agreement submitted under section256J.50256J.626, 60.36 subdivision74; or 61.1 (3) a county agency, if the county has opted to provide 61.2 employment and training services and the county has indicated 61.3 that fact in theplanservice agreement submitted under section 61.4256J.50256J.626, subdivision74. 61.5 Notwithstanding section 268.871, an employment and training 61.6 services provider meeting this definition may deliver employment 61.7 and training services under this chapter. 61.8 Sec. 65. Minnesota Statutes 2002, section 256J.49, 61.9 subdivision 5, is amended to read: 61.10 Subd. 5. [EMPLOYMENT PLAN.] "Employment plan" means a plan 61.11 developed by the job counselor and the participant which 61.12 identifies the participant's most direct path to unsubsidized 61.13 employment, lists the specific steps that the caregiver will 61.14 take on that path, and includes a timetable for the completion 61.15 of each step. The plan should also identify any subsequent 61.16 steps that support long-term economic stability. For 61.17 participants who request and qualify for a family violence 61.18 waiver, an employment plan must be developed by the job 61.19 counselor, the participant, and a person trained in domestic 61.20 violence and follow the employment plan provisions in section 61.21 256J.521, subdivision 3. 61.22 Sec. 66. Minnesota Statutes 2002, section 256J.49, is 61.23 amended by adding a subdivision to read: 61.24 Subd. 6a. [FUNCTIONAL WORK LITERACY.] "Functional work 61.25 literacy" means an intensive English as a second language 61.26 program that is work focused and offers at least 20 hours of 61.27 class time per week. 61.28 Sec. 67. Minnesota Statutes 2002, section 256J.49, 61.29 subdivision 9, is amended to read: 61.30 Subd. 9. [PARTICIPANT.] "Participant" means a recipient of 61.31 MFIP assistance who participates or is required to participate 61.32 in employment and training services under sections 256J.515 to 61.33 256J.57 and 256J.95. 61.34 Sec. 68. Minnesota Statutes 2002, section 256J.49, is 61.35 amended by adding a subdivision to read: 61.36 Subd. 12a. [SUPPORTED WORK.] "Supported work" means a 62.1 subsidized or unsubsidized work experience placement with a 62.2 public or private sector employer, which may include services 62.3 such as individualized supervision and job coaching to support 62.4 the participant on the job. 62.5 Sec. 69. Minnesota Statutes 2002, section 256J.49, 62.6 subdivision 13, is amended to read: 62.7 Subd. 13. [WORK ACTIVITY.] "Work activity" means any 62.8 activity in a participant's approved employment plan thatis62.9tied to the participant'sleads to employmentgoal. For 62.10 purposes of the MFIP program,any activity that is included in a62.11participant's approved employment plan meetsthis includes 62.12 activities that meet the definition of work activityas counted62.13 under thefederalparticipationstandardsrequirements of TANF. 62.14 Work activity includes, but is not limited to: 62.15 (1) unsubsidized employment, including work study and paid 62.16 apprenticeships or internships; 62.17 (2) subsidized private sector or public sector employment, 62.18 including grant diversion as specified in section 256J.69, 62.19 on-the-job training as specified in section 256J.66, the 62.20 self-employment investment demonstration program (SEID) as 62.21 specified in section 256J.65, paid work experience, and 62.22 supported work when a wage subsidy is provided; 62.23 (3) unpaid work experience, includingCWEPcommunity 62.24 service, volunteer work, the community work experience program 62.25 as specified in section 256J.67, unpaid apprenticeships or 62.26 internships, andincluding work associated with the refurbishing62.27of publicly assisted housing if sufficient private sector62.28employment is not availablesupported work when a wage subsidy 62.29 is not provided; 62.30 (4)on-the-job training as specified in section 256J.66job 62.31 search including job readiness assistance, job clubs, job 62.32 placement, job-related counseling, and job retention services; 62.33(5) job search, either supervised or unsupervised;62.34(6) job readiness assistance;62.35(7) job clubs, including job search workshops;62.36(8) job placement;63.1(9) job development;63.2(10) job-related counseling;63.3(11) job coaching;63.4(12) job retention services;63.5(13) job-specific training or education;63.6(14) job skills training directly related to employment;63.7(15) the self-employment investment demonstration (SEID),63.8as specified in section 256J.65;63.9(16) preemployment activities, based on availability and63.10resources, such as volunteer work, literacy programs and related63.11activities, citizenship classes, English as a second language63.12(ESL) classes as limited by the provisions of section 256J.52,63.13subdivisions 3, paragraph (d), and 5, paragraph (c), or63.14participation in dislocated worker services, chemical dependency63.15treatment, mental health services, peer group networks,63.16displaced homemaker programs, strength-based resiliency63.17training, parenting education, or other programs designed to63.18help families reach their employment goals and enhance their63.19ability to care for their children;63.20(17) community service programs;63.21(18) vocational educational training or educational63.22programs that can reasonably be expected to lead to employment,63.23as limited by the provisions of section 256J.53;63.24(19) apprenticeships;63.25(20) satisfactory attendance in general educational63.26development diploma classes or an adult diploma program;63.27(21) satisfactory attendance at secondary school, if the63.28participant has not received a high school diploma;63.29(22) adult basic education classes;63.30(23) internships;63.31(24) bilingual employment and training services;63.32(25) providing child care services to a participant who is63.33working in a community service program; and63.34(26) activities included in an alternative employment plan63.35that is developed under section 256J.52, subdivision 6.63.36 (5) job readiness education, including English as a second 64.1 language (ESL) or functional work literacy classes as limited by 64.2 the provisions of section 256J.531, subdivision 2, general 64.3 educational development (GED) course work, high school 64.4 completion, and adult basic education as limited by the 64.5 provisions of section 256J.531, subdivision 1; 64.6 (6) job skills training directly related to employment, 64.7 including education and training that can reasonably be expected 64.8 to lead to employment, as limited by the provisions of section 64.9 256J.53; 64.10 (7) providing child care services to a participant who is 64.11 working in a community service program; 64.12 (8) activities included in the employment plan that is 64.13 developed under section 256J.521, subdivision 3; and 64.14 (9) preemployment activities including chemical and mental 64.15 health assessments, treatment, and services; learning 64.16 disabilities services; child protective services; family 64.17 stabilization services; or other programs designed to enhance 64.18 employability. 64.19 Sec. 70. Minnesota Statutes 2002, section 256J.50, 64.20 subdivision 1, is amended to read: 64.21 Subdivision 1. [EMPLOYMENT AND TRAINING SERVICES COMPONENT 64.22 OF MFIP.] (a)By January 1, 1998,Each county must develop and 64.23implementprovide an employment and training services component 64.24of MFIPwhich is designed to put participants on the most direct 64.25 path to unsubsidized employment. Participation in these 64.26 services is mandatory for all MFIP caregivers, unless the 64.27 caregiver is exempt under section 256J.56. 64.28 (b) A county must provide employment and training services 64.29 under sections 256J.515 to 256J.74 within 30 days after 64.30 thecaregiver's participation becomes mandatory under64.31subdivision 5 or within 30 days of receipt of a request for64.32services from a caregiver who under section 256J.42 is no longer64.33eligible to receive MFIP but whose income is below 120 percent64.34of the federal poverty guidelines for a family of the same64.35size. The request must be made within 12 months of the date the64.36caregivers' MFIP case was closedcaregiver is determined 65.1 eligible for MFIP, or within five days when the caregiver 65.2 participated in the diversionary work program under section 65.3 256J.95 within the past 12 months. 65.4 Sec. 71. Minnesota Statutes 2002, section 256J.50, 65.5 subdivision 8, is amended to read: 65.6 Subd. 8. [COUNTY DUTY TO ENSURE EMPLOYMENT AND TRAINING 65.7 CHOICES FOR PARTICIPANTS.] Each county, or group of counties 65.8 working cooperatively, shall make available to participants the 65.9 choice of at least two employment and training service providers 65.10 as defined under section 256J.49, subdivision 4, except in 65.11 counties utilizing workforce centers that use multiple 65.12 employment and training services, offer multiple services 65.13 options under a collaborative effort and can document that 65.14 participants have choice among employment and training services 65.15 designed to meet specialized needs. The requirements of this 65.16 subdivision do not apply to the diversionary work program under 65.17 section 256J.95. 65.18 Sec. 72. Minnesota Statutes 2002, section 256J.50, 65.19 subdivision 9, is amended to read: 65.20 Subd. 9. [EXCEPTION; FINANCIAL HARDSHIP.] Notwithstanding 65.21 subdivision 8, a county that explains in theplanservice 65.22 agreement required under section 256J.626, subdivision74, that 65.23 the provision of alternative employment and training service 65.24 providers would result in financial hardship for the county is 65.25 not required to make available more than one employment and 65.26 training provider. 65.27 Sec. 73. Minnesota Statutes 2002, section 256J.50, 65.28 subdivision 10, is amended to read: 65.29 Subd. 10. [REQUIRED NOTIFICATION TO VICTIMS OF FAMILY 65.30 VIOLENCE.] (a) County agencies and their contractors must 65.31 provide universal notification to all applicants and recipients 65.32 of MFIP that: 65.33 (1) referrals to counseling and supportive services are 65.34 available for victims of family violence; 65.35 (2) nonpermanent resident battered individuals married to 65.36 United States citizens or permanent residents may be eligible to 66.1 petition for permanent residency under the federal Violence 66.2 Against Women Act, and that referrals to appropriate legal 66.3 services are available; 66.4 (3) victims of family violence are exempt from the 60-month 66.5 limit on assistancewhile the individual isif they are 66.6 complying with anapproved safety plan or, after October 1,66.72001, an alternativeemployment plan, as defined inunder 66.8 section256J.49256J.521, subdivision1a3; and 66.9 (4) victims of family violence may choose to have regular 66.10 work requirements waived while the individual is complying with 66.11 analternativeemployment planas defined inunder section 66.12256J.49256J.521, subdivision1a3. 66.13 (b) If analternativeemployment plan under section 66.14 256J.521, subdivision 3, is denied, the county or a job 66.15 counselor must provide reasons why the plan is not approved and 66.16 document how the denial of the plan does not interfere with the 66.17 safety of the participant or children. 66.18 Notification must be in writing and orally at the time of 66.19 application and recertification, when the individual is referred 66.20 to the title IV-D child support agency, and at the beginning of 66.21 any job training or work placement assistance program. 66.22 Sec. 74. Minnesota Statutes 2002, section 256J.51, 66.23 subdivision 1, is amended to read: 66.24 Subdivision 1. [PROVIDER APPLICATION.] An employment and 66.25 training service provider that is not included in a county's 66.26planservice agreement under section256J.50256J.626, 66.27 subdivision74, because the county has demonstrated financial 66.28 hardship under section 256J.50, subdivision 9of that section, 66.29 may appeal its exclusion to the commissioner of economic 66.30 security under this section. 66.31 Sec. 75. Minnesota Statutes 2002, section 256J.51, 66.32 subdivision 2, is amended to read: 66.33 Subd. 2. [APPEAL; ALTERNATE APPROVAL.] (a) An employment 66.34 and training service provider that is not included by a county 66.35 agency in theplanservice agreement under section 66.36256J.50256J.626, subdivision74, and that meets the criteria 67.1 in paragraph (b), may appeal its exclusion to the commissioner 67.2 of economic security, and may request alternative approval by 67.3 the commissioner of economic security to provide services in the 67.4 county. 67.5 (b) An employment and training services provider that is 67.6 requesting alternative approval must demonstrate to the 67.7 commissioner that the provider meets the standards specified in 67.8 section 268.871, subdivision 1, paragraph (b), except that the 67.9 provider's past experience may be in services and programs 67.10 similar to those specified in section 268.871, subdivision 1, 67.11 paragraph (b). 67.12 Sec. 76. Minnesota Statutes 2002, section 256J.51, 67.13 subdivision 3, is amended to read: 67.14 Subd. 3. [COMMISSIONER'S REVIEW.] (a) The commissioner 67.15 must act on a request for alternative approval under this 67.16 section within 30 days of the receipt of the request. If after 67.17 reviewing the provider's request, and the county'splanservice 67.18 agreement submitted under section256J.50256J.626, 67.19 subdivision74, the commissioner determines that the provider 67.20 meets the criteria under subdivision 2, paragraph (b), and that 67.21 approval of the provider would not cause financial hardship to 67.22 the county, the county must submit a revisedplanservice 67.23 agreement under subdivision 4 that includes the approved 67.24 provider. 67.25 (b) If the commissioner determines that the approval of the 67.26 provider would cause financial hardship to the county, the 67.27 commissioner must notify the provider and the county of this 67.28 determination. The alternate approval process under this 67.29 section shall be closed to other requests for alternate approval 67.30 to provide employment and training services in the county for up 67.31 to 12 months from the date that the commissioner makes a 67.32 determination under this paragraph. 67.33 Sec. 77. Minnesota Statutes 2002, section 256J.51, 67.34 subdivision 4, is amended to read: 67.35 Subd. 4. [REVISEDPLANSERVICE AGREEMENT REQUIRED.] The 67.36 commissioner of economic security must notify the county agency 68.1 when the commissioner grants an alternative approval to an 68.2 employment and training service provider under subdivision 2. 68.3 Upon receipt of the notice, the county agency must submit a 68.4 revisedplanservice agreement under section256J.50256J.626, 68.5 subdivision74, that includes the approved provider. The 68.6 county has 90 days from the receipt of the commissioner's notice 68.7 to submit the revisedplanservice agreement. 68.8 Sec. 78. [256J.521] [ASSESSMENT; EMPLOYMENT PLANS.] 68.9 Subdivision 1. [ASSESSMENTS.] (a) For purposes of MFIP 68.10 employment services, assessment is a continuing process of 68.11 gathering information related to employability for the purpose 68.12 of identifying both participant's strengths and strategies for 68.13 coping with issues that interfere with employment. The job 68.14 counselor must use information from the assessment process to 68.15 develop and update the employment plan under subdivision 2. 68.16 (b) The scope of assessment must cover at least the 68.17 following areas: 68.18 (1) basic information about the participant's ability to 68.19 obtain and retain employment, including: a review of the 68.20 participant's education level; interests, skills, and abilities; 68.21 prior employment or work experience; transferable work skills; 68.22 child care and transportation needs; 68.23 (2) identification of personal and family circumstances 68.24 that impact the participant's ability to obtain and retain 68.25 employment, including: any special needs of the children, the 68.26 level of English proficiency, family violence issues, and any 68.27 involvement with social services or the legal system; 68.28 (3) the results of a mental and chemical health screening 68.29 tool designed by the commissioner and results of the brief 68.30 screening tool for special learning needs. Screening for mental 68.31 and chemical health and special learning needs must be completed 68.32 by participants who are unable to find suitable employment after 68.33 six weeks of job search under subdivision 2, paragraph (b), and 68.34 participants who are determined to have barriers to employment 68.35 under subdivision 2, paragraph (d). Failure to complete the 68.36 screens will result in sanction under section 256J.46; and 69.1 (4) a comprehensive review of participation and progress 69.2 for participants who have received MFIP assistance and have not 69.3 worked in unsubsidized employment during the past 12 months. 69.4 The purpose of the review is to determine the need for 69.5 additional services and supports, including placement in 69.6 subsidized employment or unpaid work experience under section 69.7 256J.49, subdivision 13. 69.8 (c) Information gathered during a caregiver's participation 69.9 in the diversionary work program under section 256J.95 must be 69.10 incorporated into the assessment process. 69.11 (d) The job counselor may require the participant to 69.12 complete a professional chemical use assessment to be performed 69.13 according to the rules adopted under section 254A.03, 69.14 subdivision 3, including provisions in the administrative rules 69.15 which recognize the cultural background of the participant, or a 69.16 professional psychological assessment as a component of the 69.17 assessment process, when the job counselor has a reasonable 69.18 belief, based on objective evidence, that a participant's 69.19 ability to obtain and retain suitable employment is impaired by 69.20 a medical condition. The job counselor may assist the 69.21 participant with arranging services, including child care 69.22 assistance and transportation, necessary to meet needs 69.23 identified by the assessment. Data gathered as part of a 69.24 professional assessment must be classified and disclosed 69.25 according to the provisions in section 13.46. 69.26 Subd. 2. [EMPLOYMENT PLAN; CONTENTS.] (a) Based on the 69.27 assessment under subdivision 1, the job counselor and the 69.28 participant must develop an employment plan that includes 69.29 participation in activities and hours that meet the requirements 69.30 of section 256J.55, subdivision 1. The purpose of the 69.31 employment plan is to identify for each participant the most 69.32 direct path to unsubsidized employment and any subsequent steps 69.33 that support long-term economic stability. The employment plan 69.34 should be developed using the highest level of activity 69.35 appropriate for the participant. Activities must be chosen from 69.36 clauses (1) to (6), which are listed in order of preference. 70.1 The employment plan must also list the specific steps the 70.2 participant will take to obtain employment, including steps 70.3 necessary for the participant to progress from one level of 70.4 activity to another, and a timetable for completion of each 70.5 step. Levels of activity include: 70.6 (1) unsubsidized employment; 70.7 (2) job search; 70.8 (3) subsidized employment or unpaid work experience; 70.9 (4) unsubsidized employment and job readiness education or 70.10 job skills training; 70.11 (5) unsubsidized employment or unpaid work experience, and 70.12 activities related to a family violence waiver or preemployment 70.13 needs; and 70.14 (6) activities related to a family violence waiver or 70.15 preemployment needs. 70.16 (b) Participants who are determined able to work in 70.17 unsubsidized employment must job search at least 30 hours per 70.18 week for up to six weeks, and accept any offer of suitable 70.19 employment. The remaining hours necessary to meet the 70.20 requirements of section 256J.55, subdivision 1, may be met 70.21 through participation in other work activities under section 70.22 256J.49, subdivision 13. The participant's employment plan must 70.23 specify, at a minimum: (1) whether the job search is supervised 70.24 or unsupervised; (2) support services that will be provided; and 70.25 (3) how frequently the participant must report to the job 70.26 counselor. Participants who are unable to find suitable 70.27 employment after six weeks must meet with the job counselor to 70.28 determine whether other activities in paragraph (a) should be 70.29 incorporated into the employment plan. Job search activities 70.30 which are continued after six weeks must be structured and 70.31 supervised. 70.32 (c) Beginning July 1, 2004, activities and hourly 70.33 requirements in the employment plan may be adjusted as necessary 70.34 to accommodate the personal and family circumstances of 70.35 participants identified under section 256J.561, subdivision 2, 70.36 paragraph (d). Participants who no longer meet the provisions 71.1 of section 256J.561, subdivision 2, paragraph (d), must meet 71.2 with the job counselor within ten days of the determination to 71.3 revise the employment plan. 71.4 (d) Participants who are determined to have barriers to 71.5 obtaining or retaining employment that will not be overcome 71.6 during six weeks of job search under paragraph (b) must work 71.7 with the job counselor to develop an employment plan that 71.8 addresses those barriers by incorporating appropriate activities 71.9 from paragraph (a), clauses (1) to (6). The employment plan 71.10 must include enough hours to meet the participation requirements 71.11 in section 256J.55, subdivision 1, unless a compelling reason to 71.12 require fewer hours is noted in the participant's file. 71.13 (e) The job counselor and the participant must sign the 71.14 employment plan to indicate agreement on the contents. Failure 71.15 to develop or comply with activities in the plan, or voluntarily 71.16 quitting suitable employment without good cause, will result in 71.17 the imposition of a sanction under section 256J.46. 71.18 (f) Employment plans must be reviewed at least every three 71.19 months to determine whether activities and hourly requirements 71.20 should be revised. 71.21 Subd. 3. [EMPLOYMENT PLAN; FAMILY VIOLENCE WAIVER.] (a) A 71.22 participant who requests and qualifies for a family violence 71.23 waiver shall develop or revise the employment plan as specified 71.24 in this subdivision with a job counselor or county, and a person 71.25 trained in domestic violence. The revised or new employment 71.26 plan must be approved by the county or the job counselor. The 71.27 plan may address safety, legal, or emotional issues, and other 71.28 demands on the family as a result of the family violence. 71.29 Information in section 256J.515, clauses (1) to (8), must be 71.30 included as part of the development of the plan. 71.31 (b) The primary goal of an employment plan developed under 71.32 this subdivision is to ensure the safety of the caregiver and 71.33 children. To the extent it is consistent with ensuring safety, 71.34 the plan shall also include activities that are designed to lead 71.35 to economic stability. An activity is inconsistent with 71.36 ensuring safety if, in the opinion of a person trained in 72.1 domestic violence, the activity would endanger the safety of the 72.2 participant or children. A plan under this subdivision may not 72.3 automatically include a provision that requires a participant to 72.4 obtain an order for protection or to attend counseling. 72.5 (c) If at any time there is a disagreement over whether the 72.6 activities in the plan are appropriate or the participant is not 72.7 complying with activities in the plan under this subdivision, 72.8 the participant must receive the assistance of a person trained 72.9 in domestic violence to help resolve the disagreement or 72.10 noncompliance with the county or job counselor. If the person 72.11 trained in domestic violence recommends that the activities are 72.12 still appropriate, the county or a job counselor must approve 72.13 the activities in the plan or provide written reasons why 72.14 activities in the plan are not approved and document how denial 72.15 of the activities do not endanger the safety of the participant 72.16 or children. 72.17 Subd. 4. [SELF-EMPLOYMENT.] (a) Self-employment activities 72.18 may be included in an employment plan contingent on the 72.19 development of a business plan which establishes a timetable and 72.20 earning goals that will result in the participant exiting MFIP 72.21 assistance. Business plans must be developed with assistance 72.22 from an individual or organization with expertise in small 72.23 business as approved by the job counselor. 72.24 (b) Participants with an approved plan that includes 72.25 self-employment must meet the participation requirements in 72.26 section 256J.55, subdivision 1. Only hours where the 72.27 participant earns at least minimum wage shall be counted toward 72.28 the requirement. Additional activities and hours necessary to 72.29 meet the participation requirements in section 256J.55, 72.30 subdivision 1, must be included in the employment plan. 72.31 (c) Employment plans which include self-employment 72.32 activities must be reviewed every three months. Participants 72.33 who fail, without good cause, to make satisfactory progress as 72.34 established in the business plan must revise the employment plan 72.35 to replace the self-employment with other approved work 72.36 activities. 73.1 (d) The requirements of this subdivision may be waived for 73.2 participants who are enrolled in the self-employment investment 73.3 demonstration program (SEID) under section 256J.65, and who make 73.4 satisfactory progress as determined by the job counselor and the 73.5 SEID provider. 73.6 Subd. 5. [TRANSITION FROM THE DIVERSIONARY WORK 73.7 PROGRAM.] Participants who become eligible for MFIP assistance 73.8 after completing the diversionary work program under section 73.9 256J.95 must comply with all requirements of subdivisions 1 and 73.10 2. Participants who become eligible for MFIP assistance after 73.11 being determined unable to benefit from the diversionary work 73.12 program must comply with the requirements of subdivisions 1 and 73.13 2, with the exception of subdivision 2, paragraph (b). 73.14 Subd. 6. [LOSS OF EMPLOYMENT.] Participants who are laid 73.15 off, quit with good cause, or are terminated from employment 73.16 through no fault of their own must meet with the job counselor 73.17 within ten working days to ascertain the reason for the job loss 73.18 and to revise the employment plan as necessary to address the 73.19 problem. 73.20 Sec. 79. Minnesota Statutes 2002, section 256J.53, 73.21 subdivision 1, is amended to read: 73.22 Subdivision 1. [LENGTH OF PROGRAM.] (a) In order for a 73.23 post-secondary education or training program to be an approved 73.24 work activity as defined in section 256J.49, subdivision 13, 73.25 clause(18)(6), it must be a program lasting2412 months or 73.26 less, and the participant must meet the requirements of 73.27 subdivisions 2and, 3, and 5. 73.28 (b) The 12 months of allowable postsecondary education or 73.29 training may be used to complete the final 12 months of a longer 73.30 program, provided the program does not exceed the undergraduate 73.31 level. 73.32 (c) All course work must be completed within 18 months of 73.33 enrollment in the program. 73.34 Sec. 80. Minnesota Statutes 2002, section 256J.53, 73.35 subdivision 2, is amended to read: 73.36 Subd. 2. [DOCUMENTATION SUPPORTING PROGRAMAPPROVAL OF 74.1 POSTSECONDARY EDUCATION OR TRAINING.] (a) In order for a 74.2 post-secondary education or training program to be an approved 74.3 activity ina participant'san employment plan, the participant 74.4or the employment and training service providermustprovide74.5documentation that:be working in unsubsidized employment at 74.6 least 25 hours per week. 74.7 (b) Participants seeking approval of a postsecondary 74.8 education or training plan must provide documentation that: 74.9 (1) theparticipant'semploymentplan identifies specific74.10goals thatgoal can only be met with the additional education or 74.11 training; 74.12 (2) there are suitable employment opportunities that 74.13 require the specific education or training in the area in which 74.14 the participant resides or is willing to reside; 74.15 (3) the education or training will result in significantly 74.16 higher wages for the participant than the participant could earn 74.17 without the education or training; 74.18 (4) the participant can meet the requirements for admission 74.19 into the program; and 74.20 (5) there is a reasonable expectation that the participant 74.21 will complete the training program based on such factors as the 74.22 participant's MFIP assessment, previous education, training, and 74.23 work history; current motivation; and changes in previous 74.24 circumstances. 74.25 (c) The hourly unsubsidized employment requirement may be 74.26 reduced for intensive education or training programs lasting 12 74.27 weeks or less when full-time attendance is required. 74.28 (d) Participants with an approved employment plan in place 74.29 on July 1, 2003, which includes more than 12 months of 74.30 postsecondary education or training shall be allowed to complete 74.31 that plan provided that hourly requirements in section 256J.55, 74.32 subdivision 1, and conditions specified in paragraph (b), and 74.33 subdivisions 3 and 5 are met. 74.34 Sec. 81. Minnesota Statutes 2002, section 256J.53, 74.35 subdivision 5, is amended to read: 74.36 Subd. 5. [JOB SEARCH AFTER COMPLETION OF WORK ACTIVITY75.1 REQUIREMENTS AFTER POSTSECONDARY EDUCATION OR TRAINING.]If a75.2participant's employment plan includes a post-secondary75.3educational or training program, the plan must include an75.4anticipated completion date for those activities. At the time75.5the education or training is completed, the participant must75.6participate in job search. If, after three months of job75.7search, the participant does not find a job that is consistent75.8with the participant's employment goal, the participant must75.9accept any offer of suitable employment.Upon completion of an 75.10 approved education or training program, a participant who does 75.11 not meet the participation requirements in section 256J.55, 75.12 subdivision 1, through unsubsidized employment must participate 75.13 in job search. If, after six weeks of job search, the 75.14 participant does not find a full-time job consistent with the 75.15 employment goal, the participant must accept any offer of 75.16 full-time suitable employment, or meet with the job counselor to 75.17 revise the employment plan to include additional work activities 75.18 necessary to meet hourly requirements. 75.19 Sec. 82. [256J.531] [BASIC EDUCATION; ENGLISH AS A SECOND 75.20 LANGUAGE.] 75.21 Subdivision 1. [APPROVAL OF ADULT BASIC EDUCATION.] With 75.22 the exception of classes related to obtaining a general 75.23 educational development credential (GED), a participant must 75.24 have reading or mathematics proficiency below a ninth grade 75.25 level in order for adult basic education classes to be an 75.26 approved work activity. The employment plan must also specify 75.27 that the participant fulfill no more than one-half of the 75.28 participation requirements in section 256J.55, subdivision 1, 75.29 through attending adult basic educational or general educational 75.30 development classes. 75.31 Subd. 2. [APPROVAL OF ENGLISH AS A SECOND LANGUAGE.] In 75.32 order for English as a second language (ESL) classes to be an 75.33 approved work activity in an employment plan, a participant must 75.34 be below a spoken language proficiency level of SPL6 or its 75.35 equivalent, as measured by a nationally recognized test. In 75.36 approving ESL as a work activity, the job counselor must give 76.1 preference to enrollment in a functional work literacy program, 76.2 if one is available, over a regular ESL program. A participant 76.3 may not be approved for more than a combined total of 24 months 76.4 of ESL classes while participating in the diversionary work 76.5 program and the employment and training services component of 76.6 MFIP. The employment plan must also specify that the 76.7 participant fulfill no more than one-half of the participation 76.8 requirements in section 256J.55, subdivision 1, through 76.9 attending ESL classes. 76.10 Sec. 83. Minnesota Statutes 2002, section 256J.54, 76.11 subdivision 1, is amended to read: 76.12 Subdivision 1. [ASSESSMENT OF EDUCATIONAL PROGRESS AND 76.13 NEEDS.] (a) The county agency must document the educational 76.14 level of each MFIP caregiver who is under the age of 20 and 76.15 determine if the caregiver has obtained a high school diploma or 76.16 its equivalent. If the caregiver has not obtained a high school 76.17 diploma or its equivalent,and is not exempt from the76.18requirement to attend school under subdivision 5,the county 76.19 agency must complete an individual assessment for the 76.20 caregiver unless the caregiver is exempt from the requirement to 76.21 attend school under subdivision 5 or has chosen to have an 76.22 employment plan under section 256J.521, subdivision 2, as 76.23 allowed in paragraph (b). The assessment must be performed as 76.24 soon as possible but within 30 days of determining MFIP 76.25 eligibility for the caregiver. The assessment must provide an 76.26 initial examination of the caregiver's educational progress and 76.27 needs, literacy level, child care and supportive service needs, 76.28 family circumstances, skills, and work experience. In the case 76.29 of a caregiver under the age of 18, the assessment must also 76.30 consider the results of either the caregiver's or the 76.31 caregiver's minor child's child and teen checkup under Minnesota 76.32 Rules, parts 9505.0275 and 9505.1693 to 9505.1748, if available, 76.33 and the effect of a child's development and educational needs on 76.34 the caregiver's ability to participate in the program. The 76.35 county agency must advise the caregiver that the caregiver's 76.36 first goal must be to complete an appropriateeducational77.1 education option if one is identified for the caregiver through 77.2 the assessment and, in consultation with educational agencies, 77.3 must review the various school completion options with the 77.4 caregiver and assist in selecting the most appropriate option. 77.5 (b) The county agency must give a caregiver, who is age 18 77.6 or 19 and has not obtained a high school diploma or its 77.7 equivalent, the option to choose an employment plan with an 77.8 education option under subdivision 3 or an employment plan under 77.9 section 256J.521, subdivision 2. 77.10 Sec. 84. Minnesota Statutes 2002, section 256J.54, 77.11 subdivision 2, is amended to read: 77.12 Subd. 2. [RESPONSIBILITY FOR ASSESSMENT AND EMPLOYMENT 77.13 PLAN.] For caregivers who are under age 18 without a high school 77.14 diploma or its equivalent, the assessment under subdivision 1 77.15 and the employment plan under subdivision 3 must be completed by 77.16 the social services agency under section 257.33. For caregivers 77.17 who are age 18 or 19 without a high school diploma or its 77.18 equivalent who choose to have an employment plan with an 77.19 education option under subdivision 3, the assessment under 77.20 subdivision 1 and the employment plan under subdivision 3 must 77.21 be completed by the job counselor or, at county option, by the 77.22 social services agency under section 257.33. Upon reaching age 77.23 18 or 19 a caregiver who received social services under section 77.24 257.33 and is without a high school diploma or its equivalent 77.25 has the option to choose whether to continue receiving services 77.26 under the caregiver's plan from the social services agency or to 77.27 utilize an MFIP employment and training service provider. The 77.28 social services agency or the job counselor shall consult with 77.29 representatives of educational agencies that are required to 77.30 assist in developing educational plans under section 124D.331. 77.31 Sec. 85. Minnesota Statutes 2002, section 256J.54, 77.32 subdivision 3, is amended to read: 77.33 Subd. 3. [EDUCATIONALEDUCATION OPTION DEVELOPED.] If the 77.34 job counselor or county social services agency identifies an 77.35 appropriateeducationaleducation option for a minor caregiver 77.36under the age of 20without a high school diploma or its 78.1 equivalent, or a caregiver age 18 or 19 without a high school 78.2 diploma or its equivalent who chooses an employment plan with an 78.3 education option, the job counselor or agency must develop an 78.4 employment plan which reflects the identified option. The plan 78.5 must specify that participation in an educational activity is 78.6 required, what school or educational program is most 78.7 appropriate, the services that will be provided, the activities 78.8 the caregiver will take part in, including child care and 78.9 supportive services, the consequences to the caregiver for 78.10 failing to participate or comply with the specified 78.11 requirements, and the right to appeal any adverse action. The 78.12 employment plan must, to the extent possible, reflect the 78.13 preferences of the caregiver. 78.14 Sec. 86. Minnesota Statutes 2002, section 256J.54, 78.15 subdivision 5, is amended to read: 78.16 Subd. 5. [SCHOOL ATTENDANCE REQUIRED.] (a) Notwithstanding 78.17 the provisions of section 256J.56, minor parents, or 18- or 78.18 19-year-old parents without a high school diploma or its 78.19 equivalent who chooses an employment plan with an education 78.20 option must attend school unless: 78.21 (1) transportation services needed to enable the caregiver 78.22 to attend school are not available; 78.23 (2) appropriate child care services needed to enable the 78.24 caregiver to attend school are not available; 78.25 (3) the caregiver is ill or incapacitated seriously enough 78.26 to prevent attendance at school; or 78.27 (4) the caregiver is needed in the home because of the 78.28 illness or incapacity of another member of the household. This 78.29 includes a caregiver of a child who is younger than six weeks of 78.30 age. 78.31 (b) The caregiver must be enrolled in a secondary school 78.32 and meeting the school's attendance requirements. The county, 78.33 social service agency, or job counselor must verify at least 78.34 once per quarter that the caregiver is meeting the school's 78.35 attendance requirements. An enrolled caregiver is considered to 78.36 be meeting the attendance requirements when the school is not in 79.1 regular session, including during holiday and summer breaks. 79.2 Sec. 87. [256J.545] [FAMILY VIOLENCE WAIVER CRITERIA.] 79.3 (a) In order to qualify for a family violence waiver, an 79.4 individual must provide documentation of past or current family 79.5 violence which may prevent the individual from participating in 79.6 certain employment activities. A claim of family violence must 79.7 be documented by the applicant or participant providing a sworn 79.8 statement which is supported by collateral documentation. 79.9 (b) Collateral documentation may consist of: 79.10 (1) police, government agency, or court records; 79.11 (2) a statement from a battered women's shelter staff with 79.12 knowledge of the circumstances or credible evidence that 79.13 supports the sworn statement; 79.14 (3) a statement from a sexual assault or domestic violence 79.15 advocate with knowledge of the circumstances or credible 79.16 evidence that supports the sworn statement; 79.17 (4) a statement from professionals from whom the applicant 79.18 or recipient has sought assistance for the abuse; or 79.19 (5) a sworn statement from any other individual with 79.20 knowledge of circumstances or credible evidence that supports 79.21 the sworn statement. 79.22 Sec. 88. Minnesota Statutes 2002, section 256J.55, 79.23 subdivision 1, is amended to read: 79.24 Subdivision 1. [COMPLIANCE WITH JOB SEARCH OR EMPLOYMENT79.25PLAN; SUITABLE EMPLOYMENTPARTICIPATION REQUIREMENTS.](a) Each79.26MFIP participant must comply with the terms of the participant's79.27job search support plan or employment plan. When the79.28participant has completed the steps listed in the employment79.29plan, the participant must comply with section 256J.53,79.30subdivision 5, if applicable, and then the participant must not79.31refuse any offer of suitable employment. The participant may79.32choose to accept an offer of suitable employment before the79.33participant has completed the steps of the employment plan.79.34(b) For a participant under the age of 20 who is without a79.35high school diploma or general educational development diploma,79.36the requirement to comply with the terms of the employment plan80.1means the participant must meet the requirements of section80.2256J.54.80.3(c) Failure to develop or comply with a job search support80.4plan or an employment plan, or quitting suitable employment80.5without good cause, shall result in the imposition of a sanction80.6as specified in sections 256J.46 and 256J.57.80.7 (a) All caregivers must participate in employment services 80.8 under sections 256J.515 to 256J.57 concurrent with receipt of 80.9 MFIP assistance. 80.10 (b) Until July 1, 2004, participants who meet the 80.11 requirements of section 256J.56 are exempt from participation 80.12 requirements. 80.13 (c) Participants under paragraph (a) must develop and 80.14 comply with an employment plan under section 256J.521, or 80.15 section 256J.54 in the case of a participant under the age of 20 80.16 who has not obtained a high school diploma or its equivalent. 80.17 (d) With the exception of participants under the age of 20 80.18 who must meet the education requirements of section 256J.54, all 80.19 participants must meet the hourly participation requirements of 80.20 TANF or the hourly requirements listed in clauses (1) to (3), 80.21 whichever is higher. 80.22 (1) In single-parent families with no children under six 80.23 years of age, the job counselor and the caregiver must develop 80.24 an employment plan that includes 30 to 35 hours per week of work 80.25 activities. 80.26 (2) In single-parent families with a child under six years 80.27 of age, the job counselor and the caregiver must develop an 80.28 employment plan that includes 20 to 35 hours per week of work 80.29 activities. 80.30 (3) In two-parent families, the job counselor and the 80.31 caregivers must develop employment plans which result in a 80.32 combined total of at least 55 hours per week of work activities. 80.33 (e) Failure to participate in employment services, 80.34 including the requirement to develop and comply with an 80.35 employment plan, including hourly requirements, without good 80.36 cause under section 256J.57, shall result in the imposition of a 81.1 sanction under section 256J.46. 81.2 Sec. 89. Minnesota Statutes 2002, section 256J.55, 81.3 subdivision 2, is amended to read: 81.4 Subd. 2. [DUTY TO REPORT.] The participant must inform the 81.5 job counselor withinthreeten working days regarding any 81.6 changes related to the participant's employment status. 81.7 Sec. 90. Minnesota Statutes 2002, section 256J.56, is 81.8 amended to read: 81.9 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 81.10 EXEMPTIONS.] 81.11 (a) An MFIP participant is exempt from the requirements of 81.12 sections256J.52256J.515 to256J.55256J.57 if the participant 81.13 belongs to any of the following groups: 81.14 (1) participants who are age 60 or older; 81.15 (2) participants who are suffering from aprofessionally81.16certifiedpermanent or temporary illness, injury, or incapacity 81.17 which has been certified by a qualified professional when the 81.18 illness, injury, or incapacity is expected to continue for more 81.19 than 30 days andwhichprevents the person from obtaining or 81.20 retaining employment. Persons in this category with a temporary 81.21 illness, injury, or incapacity must be reevaluated at least 81.22 quarterly; 81.23 (3) participants whose presence in the home is required as 81.24 a caregiver because ofa professionally certifiedthe illness or 81.25 incapacity of another member in the assistance unit, a relative 81.26 in the household, or a foster child in the householdandwhen 81.27 the illness or incapacity and the need for the participant's 81.28 presence in the home has been certified by a qualified 81.29 professional and is expected to continue for more than 30 days; 81.30 (4) women who are pregnant, if the pregnancy has resulted 81.31 ina professionally certifiedan incapacity that prevents the 81.32 woman from obtaining or retaining employment, and the incapacity 81.33 has been certified by a qualified professional; 81.34 (5) caregivers of a child under the age of one year who 81.35 personally provide full-time care for the child. This exemption 81.36 may be used for only 12 months in a lifetime. In two-parent 82.1 households, only one parent or other relative may qualify for 82.2 this exemption; 82.3 (6) participants experiencing a personal or family crisis 82.4 that makes them incapable of participating in the program, as 82.5 determined by the county agency. If the participant does not 82.6 agree with the county agency's determination, the participant 82.7 may seekprofessionalcertification from a qualified 82.8 professional, as defined in section 256J.08, that the 82.9 participant is incapable of participating in the program. 82.10 Persons in this exemption category must be reevaluated 82.11 every 60 days. A personal or family crisis related to family 82.12 violence, as determined by the county or a job counselor with 82.13 the assistance of a person trained in domestic violence, should 82.14 not result in an exemption, but should be addressed through the 82.15 development or revision of analternativeemployment plan under 82.16 section256J.52256J.521, subdivision63; or 82.17 (7) caregivers with a child or an adult in the household 82.18 who meets the disability or medical criteria for home care 82.19 services under section 256B.0627, subdivision 1, 82.20 paragraph(c)(f), or a home and community-based waiver services 82.21 program under chapter 256B, or meets the criteria for severe 82.22 emotional disturbance under section 245.4871, subdivision 6, or 82.23 for serious and persistent mental illness under section 245.462, 82.24 subdivision 20, paragraph (c). Caregivers in this exemption 82.25 category are presumed to be prevented from obtaining or 82.26 retaining employment. 82.27 A caregiver who is exempt under clause (5) must enroll in 82.28 and attend an early childhood and family education class, a 82.29 parenting class, or some similar activity, if available, during 82.30 the period of time the caregiver is exempt under this section. 82.31 Notwithstanding section 256J.46, failure to attend the required 82.32 activity shall not result in the imposition of a sanction. 82.33 (b) The county agency must provide employment and training 82.34 services to MFIP participants who are exempt under this section, 82.35 but who volunteer to participate. Exempt volunteers may request 82.36 approval for any work activity under section 256J.49, 83.1 subdivision 13. The hourly participation requirements for 83.2 nonexempt participants under section256J.50256J.55, 83.3 subdivision51, do not apply to exempt participants who 83.4 volunteer to participate. 83.5 (c) This section expires on June 30, 2004. 83.6 Sec. 91. [256J.561] [UNIVERSAL PARTICIPATION REQUIRED.] 83.7 Subdivision 1. [IMPLEMENTATION OF UNIVERSAL PARTICIPATION 83.8 REQUIREMENTS.] (a) All caregivers whose applications were 83.9 received July 1, 2004, or after, are immediately subject to the 83.10 requirements in subdivision 2. 83.11 (b) For all MFIP participants who were exempt from 83.12 participating in employment services under section 256J.56 as of 83.13 June 30, 2004, between July 1, 2004, and June 30, 2005, the 83.14 county, as part of the participant's recertification under 83.15 section 256J.32, subdivision 6, shall determine whether a new 83.16 employment plan is required to meet the requirements in 83.17 subdivision 2. Counties shall notify each participant who is in 83.18 need of an employment plan that the participant must meet with a 83.19 job counselor within ten days to develop an employment plan. 83.20 Until a participant's employment plan is developed, the 83.21 participant shall be considered in compliance with the 83.22 participation requirements in this section if the participant 83.23 continues to meet the criteria for an exemption under section 83.24 256J.56 as in effect on June 30, 2004, and is cooperating in the 83.25 development of the new plan. 83.26 Subd. 2. [PARTICIPATION REQUIREMENTS.] (a) All MFIP 83.27 caregivers, except caregivers who meet the criteria in 83.28 subdivision 3, must participate in employment services. Except 83.29 as specified in paragraphs (b) to (d), the employment plan must 83.30 meet the requirements of section 256J.521, subdivision 2, 83.31 contain allowable work activities, as defined in section 83.32 256J.49, subdivision 13, and, include at a minimum, the number 83.33 of participation hours required under section 256J.55, 83.34 subdivision 1. 83.35 (b) Minor caregivers and caregivers who are less than age 83.36 20 who have not completed high school or obtained a GED are 84.1 required to comply with section 256J.54. 84.2 (c) A participant who has a family violence waiver shall 84.3 develop and comply with an employment plan under section 84.4 256J.521, subdivision 3. 84.5 (d) As specified in section 256J.521, subdivision 2, 84.6 paragraph (c), a participant who meets any one of the following 84.7 criteria may work with the job counselor to develop an 84.8 employment plan that contains less than the number of 84.9 participation hours under section 256J.55, subdivision 1. 84.10 Employment plans for participants covered under this paragraph 84.11 must be tailored to recognize the special circumstances of 84.12 caregivers and families including limitations due to illness or 84.13 disability and caregiving needs: 84.14 (1) a participant who is age 60 or older; 84.15 (2) a participant who has been diagnosed by a qualified 84.16 professional as suffering from an illness or incapacity that is 84.17 expected to last for 30 days or more, including a pregnant 84.18 participant who is determined to be unable to obtain or retain 84.19 employment due to the pregnancy; or 84.20 (3) a participant who is determined by a qualified 84.21 professional as being needed in the home to care for an ill or 84.22 incapacitated family member, including caregivers with a child 84.23 or an adult in the household who meets the disability or medical 84.24 criteria for home care services under section 256B.0627, 84.25 subdivision 1, paragraph (f), or a home and community-based 84.26 waiver services program under chapter 256B, or meets the 84.27 criteria for severe emotional disturbance under section 84.28 245.4871, subdivision 6, or for serious and persistent mental 84.29 illness under section 245.462, subdivision 20, paragraph (c). 84.30 (e) For participants covered under paragraphs (c) and (d), 84.31 the county shall review the participant's employment services 84.32 status every three months to determine whether conditions have 84.33 changed. When it is determined that the participant's status is 84.34 no longer covered under paragraph (c) or (d), the county shall 84.35 notify the participant that a new or revised employment plan is 84.36 needed. The participant and job counselor shall meet within ten 85.1 days of the determination to revise the employment plan. 85.2 Subd. 3. [CHILD UNDER 12 WEEKS OF AGE.] (a) A participant 85.3 who has a natural born child who is less than 12 weeks of age 85.4 who meets the criteria in clauses (1) and (2) is not required to 85.5 participate in employment services until the child reaches 12 85.6 weeks of age. To be eligible for this provision, the following 85.7 conditions must be met: 85.8 (1) the child must have been born within ten months of the 85.9 caregiver's application for the diversionary work program or 85.10 MFIP; and 85.11 (2) the assistance unit must not have already used this 85.12 provision or the previously allowed child under age one 85.13 exemption. However, an assistance unit that has an approved 85.14 child under age one exemption at the time this provision becomes 85.15 effective may continue to use that exemption until the child 85.16 reaches one year of age. 85.17 (b) The provision in paragraph (a) ends the first full 85.18 month after the child reaches 12 weeks of age. This provision 85.19 is available only once in a caregiver's lifetime. In a 85.20 two-parent household, only one parent shall be allowed to use 85.21 this provision. The participant and job counselor must meet 85.22 within ten days after the child reaches 12 weeks of age to 85.23 revise the participant's employment plan. 85.24 [EFFECTIVE DATE.] This section is effective July 1, 2004. 85.25 Sec. 92. Minnesota Statutes 2002, section 256J.57, is 85.26 amended to read: 85.27 256J.57 [GOOD CAUSE; FAILURE TO COMPLY; NOTICE; 85.28 CONCILIATION CONFERENCE.] 85.29 Subdivision 1. [GOOD CAUSE FOR FAILURE TO COMPLY.] The 85.30 county agency shall not impose the sanction under section 85.31 256J.46 if it determines that the participant has good cause for 85.32 failing to comply with the requirements of sections256J.5285.33 256J.515 to256J.55256J.57. Good cause exists when: 85.34 (1) appropriate child care is not available; 85.35 (2) the job does not meet the definition of suitable 85.36 employment; 86.1 (3) the participant is ill or injured; 86.2 (4) a member of the assistance unit, a relative in the 86.3 household, or a foster child in the household is ill and needs 86.4 care by the participant that prevents the participant from 86.5 complying with thejob search support plan oremployment plan; 86.6 (5) the parental caregiver is unable to secure necessary 86.7 transportation; 86.8 (6) the parental caregiver is in an emergency situation 86.9 that prevents compliance with thejob search support plan or86.10 employment plan; 86.11 (7) the schedule of compliance with thejob search support86.12plan oremployment plan conflicts with judicial proceedings; 86.13 (8) a mandatory MFIP meeting is scheduled during a time 86.14 that conflicts with a judicial proceeding or a meeting related 86.15 to a juvenile court matter, or a participant's work schedule; 86.16 (9) the parental caregiver is already participating in 86.17 acceptable work activities; 86.18 (10) the employment plan requires an educational program 86.19 for a caregiver under age 20, but the educational program is not 86.20 available; 86.21 (11) activities identified in thejob search support plan86.22oremployment plan are not available; 86.23 (12) the parental caregiver is willing to accept suitable 86.24 employment, but suitable employment is not available; or 86.25 (13) the parental caregiver documents other verifiable 86.26 impediments to compliance with thejob search support plan or86.27 employment plan beyond the parental caregiver's control. 86.28 The job counselor shall work with the participant to 86.29 reschedule mandatory meetings for individuals who fall under 86.30 clauses (1), (3), (4), (5), (6), (7), and (8). 86.31 Subd. 2. [NOTICE OF INTENT TO SANCTION.] (a) When a 86.32 participant fails without good cause to comply with the 86.33 requirements of sections256J.52256J.515 to256J.55256J.57, 86.34 the job counselor or the county agency must provide a notice of 86.35 intent to sanction to the participant specifying the program 86.36 requirements that were not complied with, informing the 87.1 participant that the county agency will impose the sanctions 87.2 specified in section 256J.46, and informing the participant of 87.3 the opportunity to request a conciliation conference as 87.4 specified in paragraph (b). The notice must also state that the 87.5 participant's continuing noncompliance with the specified 87.6 requirements will result in additional sanctions under section 87.7 256J.46, without the need for additional notices or conciliation 87.8 conferences under this subdivision. The notice, written in 87.9 English, must include the department of human services language 87.10 block, and must be sent to every applicable participant. If the 87.11 participant does not request a conciliation conference within 87.12 ten calendar days of the mailing of the notice of intent to 87.13 sanction, the job counselor must notify the county agency that 87.14 the assistance payment should be reduced. The county must then 87.15 send a notice of adverse action to the participant informing the 87.16 participant of the sanction that will be imposed, the reasons 87.17 for the sanction, the effective date of the sanction, and the 87.18 participant's right to have a fair hearing under section 256J.40. 87.19 (b) The participant may request a conciliation conference 87.20 by sending a written request, by making a telephone request, or 87.21 by making an in-person request. The request must be received 87.22 within ten calendar days of the date the county agency mailed 87.23 the ten-day notice of intent to sanction. If a timely request 87.24 for a conciliation is received, the county agency's service 87.25 provider must conduct the conference within five days of the 87.26 request. The job counselor's supervisor, or a designee of the 87.27 supervisor, must review the outcome of the conciliation 87.28 conference. If the conciliation conference resolves the 87.29 noncompliance, the job counselor must promptly inform the county 87.30 agency and request withdrawal of the sanction notice. 87.31 (c) Upon receiving a sanction notice, the participant may 87.32 request a fair hearing under section 256J.40, without exercising 87.33 the option of a conciliation conference. In such cases, the 87.34 county agency shall not require the participant to engage in a 87.35 conciliation conference prior to the fair hearing. 87.36 (d) If the participant requests a fair hearing or a 88.1 conciliation conference, sanctions will not be imposed until 88.2 there is a determination of noncompliance. Sanctions must be 88.3 imposed as provided in section 256J.46. 88.4 Sec. 93. Minnesota Statutes 2002, section 256J.62, 88.5 subdivision 9, is amended to read: 88.6 Subd. 9. [CONTINUATION OF CERTAIN SERVICES.] Only if 88.7 services were approved as part of an employment plan prior to 88.8 June 30, 2003, at the request of the participant, the county may 88.9 continue to provide case management, counseling, or other 88.10 support services to a participant: 88.11(a)(1) who has achieved the employment goal; or 88.12(b)(2) who under section 256J.42 is no longer eligible to 88.13 receive MFIP but whose income is below 115 percent of the 88.14 federal poverty guidelines for a family of the same size. 88.15 These services may be provided for up to 12 months 88.16 following termination of the participant's eligibility for MFIP. 88.17 Sec. 94. [256J.626] [MFIP CONSOLIDATED FUND.] 88.18 Subdivision 1. [CONSOLIDATED FUND.] The consolidated fund 88.19 is established to support counties and tribes in meeting their 88.20 duties under this chapter. Counties and tribes must use funds 88.21 from the consolidated fund to develop programs and services that 88.22 are designed to improve participant outcomes as measured in 88.23 section 256J.751, subdivision 2. Counties may use the funds for 88.24 any allowable expenditures under subdivision 2. Tribes may use 88.25 the funds for any allowable expenditures under subdivision 2, 88.26 except those in clauses (1) and (6). 88.27 Subd. 2. [ALLOWABLE EXPENDITURES.] (a) The commissioner 88.28 must restrict expenditures under the consolidated fund to 88.29 benefits and services allowed under title IV-A of the federal 88.30 Social Security Act. Allowable expenditures under the 88.31 consolidated fund may include, but are not limited to: 88.32 (1) short-term, nonrecurring shelter and utility needs that 88.33 are excluded from the definition of assistance under Code of 88.34 Federal Regulations, title 45, section 260.31, for families who 88.35 meet the residency requirement in section 256J.12, subdivisions 88.36 1 and 1a. Payments under this subdivision are not considered 89.1 TANF cash assistance and are not counted towards the 60-month 89.2 time limit; 89.3 (2) transportation needed to obtain or retain employment or 89.4 to participate in other approved work activities; 89.5 (3) direct and administrative costs of staff to deliver 89.6 employment services for MFIP or the diversionary work program, 89.7 to administer financial assistance, and to provide specialized 89.8 services intended to assist hard-to-employ participants to 89.9 transition to work; 89.10 (4) costs of education and training including functional 89.11 work literacy and English as a second language; 89.12 (5) cost of work supports including tools, clothing, boots, 89.13 and other work-related expenses; 89.14 (6) county administrative expenses as defined in Code of 89.15 Federal Regulations, title 45, section 260(b); 89.16 (7) services to parenting and pregnant teens; 89.17 (8) supported work; 89.18 (9) wage subsidies; 89.19 (10) child care needed for MFIP or diversionary work 89.20 program participants to participate in social services; 89.21 (11) child care to ensure that families leaving MFIP or 89.22 diversionary work program will continue to receive child care 89.23 assistance from the time the family no longer qualifies for 89.24 transition year child care until an opening occurs under the 89.25 basic sliding fee child care program; and 89.26 (12) services to help noncustodial parents who live in 89.27 Minnesota and have minor children receiving MFIP or DWP 89.28 assistance, but do not live in the same household as the child, 89.29 obtain or retain employment. 89.30 (b) Administrative costs that are not matched with county 89.31 funds as provided in subdivision 8 may not exceed 7.5 percent of 89.32 a county's or 15 percent of a tribe's reimbursement under this 89.33 section. The commissioner shall define administrative costs for 89.34 purposes of this subdivision. 89.35 Subd. 3. [ELIGIBILITY FOR SERVICES.] Families with a minor 89.36 child, a pregnant woman, or a noncustodial parent of a minor 90.1 child receiving assistance, with incomes below 200 percent of 90.2 the federal poverty guideline for a family of the applicable 90.3 size, are eligible for services funded under the consolidated 90.4 fund. Counties and tribes must give priority to families 90.5 currently receiving MFIP or diversionary work program, and 90.6 families at risk of receiving MFIP or diversionary work program. 90.7 Subd. 4. [COUNTY AND TRIBAL BIENNIAL SERVICE 90.8 AGREEMENTS.] (a) Effective January 1, 2004, and each two-year 90.9 period thereafter, each county and tribe must have in place an 90.10 approved biennial service agreement related to the services and 90.11 programs in this chapter. Counties may collaborate to develop 90.12 multicounty, multitribal, or regional service agreements. 90.13 (b) The service agreements will be completed in a form 90.14 prescribed by the commissioner. The agreement must include: 90.15 (1) a statement of the needs of the service population and 90.16 strengths and resources in the community; 90.17 (2) numerical goals for participant outcomes measures to be 90.18 accomplished during the biennial period. The commissioner may 90.19 identify outcomes from section 256J.751, subdivision 2, as core 90.20 outcomes for all counties and tribes; 90.21 (3) strategies the county or tribe will pursue to achieve 90.22 the outcome targets. Strategies must include specification of 90.23 how funds under this section will be used and may include 90.24 community partnerships that will be established or strengthened; 90.25 and 90.26 (4) other items prescribed by the commissioner in 90.27 consultation with counties and tribes. 90.28 (c) The commissioner shall provide each county and tribe 90.29 with information needed to complete an agreement, including: 90.30 (1) information on MFIP cases in the county or tribe; (2) 90.31 comparisons with the rest of the state; (3) baseline performance 90.32 on outcome measures; and (4) promising program practices. 90.33 (d) The service agreement must be submitted to the 90.34 commissioner by October 15, 2003, and October 15 of each second 90.35 year thereafter. The county or tribe must allow a period of not 90.36 less than 30 days prior to the submission of the agreement to 91.1 solicit comments from the public on the contents of the 91.2 agreement. 91.3 (e) The commissioner must, within 60 days of receiving each 91.4 county or tribal service agreement, inform the county or tribe 91.5 if the service agreement is approved. If the service agreement 91.6 is not approved, the commissioner must inform the county or 91.7 tribe of any revisions needed prior to approval. 91.8 (f) The service agreement in this subdivision supersedes 91.9 the plan requirements of section 268.88. 91.10 Subd. 5. [INNOVATION PROJECTS.] Beginning January 1, 2005, 91.11 no more than $3,000,000 of the funds annually appropriated to 91.12 the commissioner for use in the consolidated fund shall be 91.13 available to the commissioner for projects testing innovative 91.14 approaches to improving outcomes for MFIP participants, and 91.15 persons at risk of receiving MFIP as detailed in subdivision 3. 91.16 Projects shall be targeted to geographic areas with poor 91.17 outcomes as specified in section 256J.751, subdivision 5, or to 91.18 subgroups within the MFIP case load who are experiencing poor 91.19 outcomes. 91.20 Subd. 6. [BASE ALLOCATION TO COUNTIES AND TRIBES.] (a) For 91.21 purposes of this section, the following terms have the meanings 91.22 given them: 91.23 (1) "2002 historic spending base" means the commissioner's 91.24 determination of the sum of the reimbursement related to fiscal 91.25 year 2002 of county or tribal agency expenditures for the base 91.26 programs listed in clause (4), items (i) to (iv), and earnings 91.27 related to calendar year 2002 in the base program listed in 91.28 clause (4), item (v), and the amount of spending in fiscal year 91.29 2002 in the base program listed in clause (4), item (vi), issued 91.30 to or on behalf of persons residing in the county or tribal 91.31 service delivery area. 91.32 (2) "Initial allocation" means the amount potentially 91.33 available to each county or tribe based on the formula in 91.34 paragraphs (b) to (d). 91.35 (3) "Final allocation" means the amount available to each 91.36 county or tribe based on the formula in paragraphs (b) to (d), 92.1 after adjustment by subdivision 7. 92.2 (4) "Base programs" means the: 92.3 (i) MFIP employment and training services under section 92.4 256J.62, subdivision 1, in effect June 30, 2002; 92.5 (ii) bilingual employment and training services to refugees 92.6 under section 256J.62, subdivision 6, in effect June 30, 2002; 92.7 (iii) work literacy language programs under section 92.8 256J.62, subdivision 7, in effect June 30, 2002; 92.9 (iv) supported work program authorized in Laws 2001, First 92.10 Special Session chapter 9, article 17, section 2, in effect June 92.11 30, 2002; 92.12 (v) administrative aid program under section 256J.76 in 92.13 effect December 31, 2002; and 92.14 (vi) emergency assistance program under section 256J.48 in 92.15 effect June 30, 2002. 92.16 (b)(1) Beginning July 1, 2003, the commissioner shall 92.17 determine the initial allocation of funds available under this 92.18 section according to clause (2). 92.19 (2)(i) Ninety percent of the funds available for the period 92.20 beginning July 1, 2003, and ending December 31, 2004, shall be 92.21 allocated to each county or tribe in proportion to the county's 92.22 or tribe's share of the statewide 2002 historic spending base; 92.23 (ii) the remaining funds for the period beginning July 1, 92.24 2003, and ending December 31, 2004, shall be allocated to each 92.25 county or tribe in proportion to the average number of MFIP 92.26 cases: 92.27 (A) the average number of cases must be based upon counts 92.28 of MFIP or tribal TANF cases as of March 31, June 30, September 92.29 30, and December 31 using the most recent available data, less 92.30 the number of child only cases. Two-parent cases, with the 92.31 exception of those with a caregiver age 60 or over, will be 92.32 multiplied by a factor of two; 92.33 (B) the MFIP or tribal TANF case count for each eligible 92.34 tribal provider shall be based upon the number of MFIP or tribal 92.35 TANF cases with participating adults who are enrolled in, or are 92.36 eligible for enrollment in, the tribe; and to be counted, the 93.1 case must be an active MFIP case, and the case members must 93.2 reside within the tribal program's service delivery area; 93.3 (C) the MFIP or tribal TANF case count for each eligible 93.4 tribal provider shall be further adjusted by multiplying the 93.5 count by the proportion of base program spending in paragraph 93.6 (a), clause (4), item (i), compared to paragraph (a), clause 93.7 (4), items (i) to (vi); and 93.8 (D) to prevent duplicate counts, MFIP or tribal TANF cases 93.9 counted for determining allocations to tribal providers in 93.10 clause (C) shall be removed from the case counts of the 93.11 respective counties where they reside. 93.12 (c)(1) Beginning January 1, 2005, the commissioner shall 93.13 determine the initial allocation of funds to be made available 93.14 under this section according to clause (2). 93.15 (2)(i) Seventy percent of the funds available for the 93.16 calendar year shall be allocated to each county or tribe in 93.17 proportion to the county's or tribe's share of the statewide 93.18 2002 historic spending base; 93.19 (ii) the remaining funds shall be allocated to each county 93.20 or tribe in proportion to the sum of the average number of MFIP 93.21 cases and the average monthly count of diversionary work program 93.22 cases. The commissioner shall determine the count of MFIP and 93.23 diversionary work program cases according to subitems (A) to (C): 93.24 (A) the average number of cases must be based upon counts 93.25 of MFIP, tribal TANF, or diversionary work program cases as of 93.26 March 31, June 30, September 30, and December 31 using the most 93.27 recent available data, less the number of child only cases. 93.28 Two-parent cases, with the exception of those with a caregiver 93.29 age 60 or over, will be multiplied by a factor of two; 93.30 (B) the case count for each eligible tribal provider shall 93.31 be based upon the number of MFIP, tribal TANF, or diversionary 93.32 work program cases with participating adults who are enrolled 93.33 in, or are eligible for enrollment in, the tribe; and to be 93.34 counted, the case must be an active MFIP or diversionary work 93.35 program case, and the case members must reside within the tribal 93.36 program's service delivery area; 94.1 (C) the MFIP or tribal TANF case count, including 94.2 diversionary work program cases, for each eligible tribal 94.3 provider shall be further adjusted by multiplying the count by 94.4 the proportion of base program spending in paragraph (a), clause 94.5 (4), item (i), compared to paragraph (a), clause (4), items (i) 94.6 to (vi); and 94.7 (D) to prevent duplicate counts, MFIP, tribal TANF, or 94.8 diversionary work program cases counted for determining 94.9 allocations to tribal providers under clause (C) shall be 94.10 removed from the case counts of the respective counties where 94.11 they reside. 94.12 (d)(1) Beginning January 1, 2006, and effective January 1 94.13 of each subsequent year, the commissioner shall determine the 94.14 initial allocation of funds available under this section 94.15 according to clause (2). 94.16 (2)(i) Fifty percent of the funds available for the 94.17 calendar year shall be allocated to each county or tribe in 94.18 proportion to the county's or tribe's share of the statewide 94.19 2002 historic spending base; 94.20 (ii) the remaining funds shall be allocated to each county 94.21 or tribe in proportion to the sum of the average number of MFIP 94.22 cases and the average monthly count of diversionary work program 94.23 cases. The commissioner shall determine the count of MFIP and 94.24 diversionary work program cases according to subitems (A) to (C): 94.25 (A) the average number of cases must be based upon counts 94.26 of MFIP, tribal TANF, or diversionary work program cases as of 94.27 March 31, June 30, September 30, and December 31 using the most 94.28 recent available data, less the number of child only cases. 94.29 Two-parent cases, with the exception of those with a caregiver 94.30 age 60 or over, will be multiplied by a factor of two; 94.31 (B) the case count for each eligible tribal provider shall 94.32 be based upon the number of MFIP, tribal TANF, or diversionary 94.33 work program cases with participating adults who are enrolled 94.34 in, or are eligible for, enrollment in the tribe; and to be 94.35 counted, the case must be an active MFIP or diversionary work 94.36 program case, and the case members must reside within the tribal 95.1 program's service delivery area; 95.2 (C) the MFIP or tribal TANF case count, including 95.3 diversionary work program cases, for each eligible tribal 95.4 provider shall be further adjusted by multiplying the count by 95.5 the proportion of base program spending in paragraph (a), clause 95.6 (4), item (i), compared to paragraph (a), clause (4), items (i) 95.7 to (vi); and 95.8 (D) to prevent duplicate counts, MFIP, tribal TANF, or 95.9 diversionary work program cases counted for determining 95.10 allocations to tribal providers in clause (C) shall be removed 95.11 from the case counts of the respective counties where they 95.12 reside. 95.13 (e) Before November 30, 2003, a county or tribe may ask for 95.14 a review of the commissioner's determination of the historic 95.15 base spending when the county or tribe believes the 2002 95.16 information was inaccurate or incomplete. By January 1, 2004, 95.17 the commissioner must adjust that county's or tribe's base when 95.18 the commissioner has determined that inaccurate or incomplete 95.19 information was used to develop that base. The commissioner 95.20 shall adjust each county's or tribe's initial allocation under 95.21 paragraph (c) and final allocation under subdivision 7 to 95.22 reflect the base change. 95.23 (f) Effective January 1, 2005, and effective January 1 of 95.24 each succeeding year, counties and tribes will have their final 95.25 allocations adjusted based on the performance provisions of 95.26 subdivision 7. 95.27 Subd. 7. [PERFORMANCE BASE FUNDS.] (a) Beginning with 95.28 allocations for calendar year 2005, each county and tribe will 95.29 be allocated 95 percent of their initial allocation. Counties 95.30 and tribes will be allocated additional funds based on 95.31 performance as follows: 95.32 (1) a county or tribe that achieves a 50 percent rate or 95.33 higher on the MFIP participation rate under section 256J.751, 95.34 subdivision 2, clause (8), as averaged across the four quarterly 95.35 measurements for the most recent year for which the measurements 95.36 are available, will receive an additional allocation equal to 96.1 2.5 percent of its initial allocation; and 96.2 (2) a county or tribe that performs above the top of its 96.3 range of expected performance on the three-year self-support 96.4 index under section 256J.751, subdivision 2, clause (7), in both 96.5 measurements in the preceding year will receive an additional 96.6 allocation equal to five percent of its initial allocation; or 96.7 (3) a county or tribe that performs within its range of 96.8 expected performance on the three-year self-support index under 96.9 section 256J.751, subdivision 2, clause (7), in both 96.10 measurements in the preceding year, or above the top of its 96.11 range of expected performance in one measurement and within its 96.12 expected range of performance in the other measurement, will 96.13 receive an additional allocation equal to 2.5 percent of its 96.14 initial allocation. 96.15 (b) Funds remaining unallocated after the performance-based 96.16 allocations in paragraph (a) are available to the commissioner 96.17 for innovation projects under subdivision 5. 96.18 (c)(1) If available funds are insufficient to meet county 96.19 and tribal allocations under paragraph (a), the commissioner may 96.20 make available for allocation funds that are unobligated and 96.21 available from the innovation projects through the end of the 96.22 current biennium. 96.23 (2) If after the application of clause (1) funds remain 96.24 insufficient to meet county and tribal allocations under 96.25 paragraph (a), the commissioner must proportionally reduce the 96.26 allocation of each county and tribe with respect to their 96.27 maximum allocation available under paragraph (a). 96.28 Subd. 8. [REPORTING REQUIREMENT AND REIMBURSEMENT.] (a) 96.29 The commissioner shall specify requirements for reporting 96.30 according to section 256.01, subdivision 2, clause (17). Each 96.31 county or tribe shall be reimbursed for eligible expenditures up 96.32 to the limit of its allocation and subject to availability of 96.33 funds. 96.34 (b) Reimbursements for county administrative-related 96.35 expenditures determined through the income maintenance random 96.36 moment time study shall be reimbursed at a rate of 50 percent of 97.1 eligible expenditures. 97.2 (c) The commissioner of human services shall review county 97.3 and tribal agency expenditures of the MFIP consolidated fund as 97.4 appropriate and may reallocate unencumbered or unexpended money 97.5 appropriated under this section to those county and tribal 97.6 agencies that can demonstrate a need for additional money. 97.7 Subd. 9. [REPORT.] The commissioner shall, in consultation 97.8 with counties and tribes: 97.9 (1) determine how performance-based allocations under 97.10 subdivision 7, paragraph (a), clauses (2) and (3), will be 97.11 allocated to groupings of counties and tribes when groupings are 97.12 used to measure expected performance ranges for the self-support 97.13 index under section 256J.751, subdivision 2, clause (7); and 97.14 (2) determine how performance-based allocations under 97.15 subdivision 7, paragraph (a), clauses (2) and (3), will be 97.16 allocated to tribes. 97.17 The commissioner shall report to the legislature on the formulas 97.18 developed in clauses (1) and (2) by January 1, 2004. 97.19 Sec. 95. Minnesota Statutes 2002, section 256J.645, 97.20 subdivision 3, is amended to read: 97.21 Subd. 3. [FUNDING.] If the commissioner and an Indian 97.22 tribe are parties to an agreement under this subdivision, the 97.23 agreement shall annually provide to the Indian tribe the funding 97.24 allocated in section256J.62, subdivisions 1 and 2a256J.626. 97.25 Sec. 96. Minnesota Statutes 2002, section 256J.66, 97.26 subdivision 2, is amended to read: 97.27 Subd. 2. [TRAINING AND PLACEMENT.] (a) County agencies 97.28 shall limit the length of training based on the complexity of 97.29 the job and the caregiver's previous experience and training. 97.30 Placement in an on-the-job training position with an employer is 97.31 for the purpose of training and employment with the same 97.32 employer who has agreed to retain the person upon satisfactory 97.33 completion of training. 97.34 (b) Placement of any participant in an on-the-job training 97.35 position must be compatible with the participant's assessment 97.36 and employment plan under section256J.52256J.521. 98.1 Sec. 97. Minnesota Statutes 2002, section 256J.67, 98.2 subdivision 1, is amended to read: 98.3 Subdivision 1. [ESTABLISHING THE COMMUNITY WORK EXPERIENCE 98.4 PROGRAM.] To the extent of available resources, each county 98.5 agency may establish and operate a work experience component for 98.6 MFIP caregivers who are participating in employment and training 98.7 services. This option for county agencies supersedes the 98.8 requirement in section 402(a)(1)(B)(iv) of the Social Security 98.9 Act that caregivers who have received assistance for two months 98.10 and who are not exempt from work requirements must participate 98.11 in a work experience program. The purpose of the work 98.12 experience component is to enhance the caregiver's employability 98.13 and self-sufficiency and to provide meaningful, productive work 98.14 activities. The county shall use this program for an individual 98.15 after exhausting all other unsubsidized employment 98.16 opportunities.The county agency shall not require a caregiver98.17to participate in the community work experience program unless98.18the caregiver has been given an opportunity to participate in98.19other work activities.98.20 Sec. 98. Minnesota Statutes 2002, section 256J.67, 98.21 subdivision 3, is amended to read: 98.22 Subd. 3. [EMPLOYMENT OPTIONS.] (a) Work sites developed 98.23 under this section are limited to projects that serve a useful 98.24 public service such as: health, social service, environmental 98.25 protection, education, urban and rural development and 98.26 redevelopment, welfare, recreation, public facilities, public 98.27 safety, community service, services to aged or disabled 98.28 citizens, and child care. To the extent possible, the prior 98.29 training, skills, and experience of a caregiver must be 98.30 considered in making appropriate work experience assignments. 98.31 (b) Structured, supervised volunteer work with an agency or 98.32 organization, which is monitored by the county service provider, 98.33 may, with the approval of the county agency, be used as a work 98.34 experience placement. 98.35 (c) As a condition of placing a caregiver in a program 98.36 under this section, the county agency shall first provide the 99.1 caregiver the opportunity:99.2(1)for placement in suitablesubsidized orunsubsidized 99.3 employment through participation in a job search; or99.4(2) for placement in suitable employment through99.5participation in on-the-job training, if such employment is99.6available. 99.7 Sec. 99. Minnesota Statutes 2002, section 256J.69, 99.8 subdivision 2, is amended to read: 99.9 Subd. 2. [TRAINING AND PLACEMENT.] (a) County agencies 99.10 shall limit the length of training to nine months. Placement in 99.11 a grant diversion training position with an employer is for the 99.12 purpose of training and employment with the same employer who 99.13 has agreed to retain the person upon satisfactory completion of 99.14 training. 99.15 (b) Placement of any participant in a grant diversion 99.16 subsidized training position must be compatible with the 99.17 assessment and employment plan or employability development plan 99.18 established for the recipient under section256J.52 or 256K.03,99.19subdivision 8256J.521. 99.20 Sec. 100. Minnesota Statutes 2002, section 256J.75, 99.21 subdivision 3, is amended to read: 99.22 Subd. 3. [RESPONSIBILITY FOR INCORRECT ASSISTANCE 99.23 PAYMENTS.] A county of residence, when different from the county 99.24 of financial responsibility, will be charged by the commissioner 99.25 for the value of incorrect assistance paymentsand medical99.26assistancepaid to or on behalf of a person who was not eligible 99.27 to receive that amount. Incorrect payments include payments to 99.28 an ineligible person or family resulting from decisions, 99.29 failures to act, miscalculations, or overdue recertification. 99.30 However, financial responsibility does not accrue for a county 99.31 when the recertification is overdue at the time the referral is 99.32 received by the county of residence or when the county of 99.33 financial responsibility does not act on the recommendation of 99.34 the county of residence.When federal or state law requires99.35that medical assistance continue after assistance ends, this99.36subdivision also governs financial responsibility for the100.1extended medical assistance.100.2 Sec. 101. Minnesota Statutes 2002, section 256J.751, 100.3 subdivision 1, is amended to read: 100.4 Subdivision 1. [QUARTERLYMONTHLY COUNTY CASELOAD REPORT.] 100.5 The commissioner shall reportquarterlymonthly to each county 100.6onthecounty's performance on the following measuresfollowing 100.7 caseload information: 100.8(1) number of cases receiving only the food portion of100.9assistance;100.10(2) number of child-only cases;100.11(3) number of minor caregivers;100.12(4) number of cases that are exempt from the 60-month time100.13limit by the exemption category under section 256J.42;100.14(5) number of participants who are exempt from employment100.15and training services requirements by the exemption category100.16under section 256J.56;100.17(6) number of assistance units receiving assistance under a100.18hardship extension under section 256J.425;100.19(7) number of participants and number of months spent in100.20each level of sanction under section 256J.46, subdivision 1;100.21(8) number of MFIP cases that have left assistance;100.22(9) federal participation requirements as specified in100.23title 1 of Public Law Number 104-193;100.24(10) median placement wage rate; and100.25(11) of each county's total MFIP caseload less the number100.26of cases in clauses (1) to (6):100.27(i) number of one-parent cases;100.28(ii) number of two-parent cases;100.29(iii) percent of one-parent cases that are working more100.30than 20 hours per week;100.31(iv) percent of two-parent cases that are working more than100.3220 hours per week; and100.33(v) percent of cases that have received more than 36 months100.34of assistance.100.35 (1) total number of cases receiving MFIP, and subtotals of 100.36 cases with one eligible parent, two eligible parents, and an 101.1 eligible caregiver who is not a parent; 101.2 (2) total number of child only assistance cases; 101.3 (3) total number of eligible adults and children receiving 101.4 an MFIP grant, and subtotals for cases with one eligible parent, 101.5 two eligible parents, an eligible caregiver who is not a parent, 101.6 and child only cases; 101.7 (4) number of cases with an exemption from the 60-month 101.8 time limit based on a family violence waiver; 101.9 (5) number of MFIP cases with work hours, and subtotals for 101.10 cases with one eligible parent, two eligible parents, and an 101.11 eligible caregiver who is not a parent; 101.12 (6) number of employed MFIP cases, and subtotals for cases 101.13 with one eligible parent, two eligible parents, and an eligible 101.14 caregiver who is not a parent; 101.15 (7) average monthly gross earnings, and averages for 101.16 subgroups of cases with one eligible parent, two eligible 101.17 parents, and an eligible caregiver who is not a parent; 101.18 (8) number of employed cases receiving only the food 101.19 portion of assistance; 101.20 (9) number of parents or caregivers exempt from work 101.21 activity requirements, with subtotals for each exemption type; 101.22 and 101.23 (10) number of cases with a sanction, with subtotals by 101.24 level of sanction for cases with one eligible parent, two 101.25 eligible parents, and an eligible caregiver who is not a parent. 101.26 Sec. 102. Minnesota Statutes 2002, section 256J.751, 101.27 subdivision 2, is amended to read: 101.28 Subd. 2. [QUARTERLY COMPARISON REPORT.] The commissioner 101.29 shall report quarterly to all counties on each county's 101.30 performance on the following measures: 101.31 (1) percent of MFIP caseload working in paid employment; 101.32 (2) percent of MFIP caseload receiving only the food 101.33 portion of assistance; 101.34 (3) number of MFIP cases that have left assistance; 101.35 (4) federal participation requirements as specified in 101.36 Title 1 of Public LawNumber104-193; 102.1 (5) median placement wage rate;and102.2 (6) caseload by months of TANF assistance; 102.3 (7) percent of MFIP cases off cash assistance or working 30 102.4 or more hours per week at one-year, two-year, and three-year 102.5 follow-up points from a base line quarter. This measure is 102.6 called the self-support index. Twice annually, the commissioner 102.7 shall report an expected range of performance for each county, 102.8 county grouping, and tribe on the self-support index. The 102.9 expected range shall be derived by a statistical methodology 102.10 developed by the commissioner in consultation with the counties 102.11 and tribes. The statistical methodology shall control 102.12 differences across counties in economic conditions and 102.13 demographics of the MFIP case load; and 102.14 (8) the MFIP work participation rate, defined as the 102.15 participation requirements specified in title 1 of Public Law 102.16 104-193 applied to all MFIP cases except child only cases and 102.17 cases exempt under section 256J.56. 102.18 Sec. 103. Minnesota Statutes 2002, section 256J.751, 102.19 subdivision 5, is amended to read: 102.20 Subd. 5. [FAILURE TO MEET FEDERAL PERFORMANCE STANDARDS.] 102.21 (a) If sanctions occur for failure to meet the performance 102.22 standards specified in title 1 of Public LawNumber104-193 of 102.23 the Personal Responsibility and Work Opportunity Act of 1996, 102.24 the state shall pay 88 percent of the sanction. The remaining 102.25 12 percent of the sanction will be paid by the counties. The 102.26 county portion of the sanction will be distributed across all 102.27 counties in proportion to each county's percentage of the MFIP 102.28 average monthly caseload during the period for which the 102.29 sanction was applied. 102.30 (b) If a county fails to meet the performance standards 102.31 specified in title 1 of Public LawNumber104-193 of the 102.32 Personal Responsibility and Work Opportunity Act of 1996 for any 102.33 year, the commissioner shall work with counties to organize a 102.34 joint state-county technical assistance team to work with the 102.35 county. The commissioner shall coordinate any technical 102.36 assistance with other departments and agencies including the 103.1 departments of economic security and children, families, and 103.2 learning as necessary to achieve the purpose of this paragraph. 103.3 (c) For state performance measures, a low-performing county 103.4 is one that: 103.5 (1) performs below the bottom of their expected range for 103.6 the measure in subdivision 2, clause (7), in both measurements 103.7 during the year; or 103.8 (2) performs below 40 percent for the measure in 103.9 subdivision 2, clause (8), as averaged across the four quarterly 103.10 measurements for the year, or the ten counties with the lowest 103.11 rates if more than ten are below 40 percent. 103.12 (d) Low-performing counties under paragraph (c) must engage 103.13 in corrective action planning as defined by the commissioner. 103.14 The commissioner may coordinate technical assistance as 103.15 specified in paragraph (b) for low-performing counties under 103.16 paragraph (c). 103.17 Sec. 104. [256J.95] [DIVERSIONARY WORK PROGRAM.] 103.18 Subdivision 1. [ESTABLISHING A DIVERSIONARY WORK PROGRAM 103.19 (DWP).] (a) The Personal Responsibility and Work Opportunity 103.20 Reconciliation Act of 1996, Public Law 104-193, establishes 103.21 block grants to states for temporary assistance for needy 103.22 families (TANF). TANF provisions allow states to use TANF 103.23 dollars for nonrecurrent, short-term diversionary benefits. The 103.24 diversionary work program established on July 1, 2003, is 103.25 Minnesota's TANF program to provide short-term diversionary 103.26 benefits to eligible recipients of the diversionary work program. 103.27 (b) The goal of the diversionary work program is to provide 103.28 short-term, necessary services and supports to families which 103.29 will lead to unsubsidized employment, increase economic 103.30 stability, and reduce the risk of those families needing longer 103.31 term assistance, under the Minnesota family investment program 103.32 (MFIP). 103.33 (c) When a family unit meets the eligibility criteria in 103.34 this section, the family must receive a diversionary work 103.35 program grant and is not eligible for MFIP. 103.36 (d) A family unit is eligible for the diversionary work 104.1 program for a maximum of four months only once in a 12-month 104.2 period. The 12-month period begins at the date of application 104.3 or the date eligibility is met, whichever is later. During the 104.4 four-month period, family maintenance needs as defined in 104.5 subdivision 2, shall be vendor paid, up to the cash portion of 104.6 the MFIP standard of need for the same size household. To the 104.7 extent there is a balance available between the amount paid for 104.8 family maintenance needs and the cash portion of the 104.9 transitional standard, a personal needs allowance of up to $70 104.10 per DWP recipient in the family unit shall be issued. The 104.11 personal needs allowance payment plus the family maintenance 104.12 needs shall not exceed the cash portion of the MFIP standard of 104.13 need. Counties may provide supportive and other allowable 104.14 services funded by the MFIP consolidated fund under section 104.15 256J.626 to eligible participants during the four-month 104.16 diversionary period. 104.17 Subd. 2. [DEFINITIONS.] The terms used in this section 104.18 have the following meanings. 104.19 (a) "Diversionary Work Program (DWP)" means the program 104.20 established under this section. 104.21 (b) "Employment plan" means a plan developed by the job 104.22 counselor and the participant which identifies the participant's 104.23 most direct path to unsubsidized employment, lists the specific 104.24 steps that the caregiver will take on that path, and includes a 104.25 timetable for the completion of each step. For participants who 104.26 request and qualify for a family violence waiver in section 104.27 256J.521, subdivision 3, an employment plan must be developed by 104.28 the job counselor, the participant and a person trained in 104.29 domestic violence and follow the employment plan provisions in 104.30 section 256J.521, subdivision 3. Employment plans under this 104.31 section shall be written for a period of time not to exceed four 104.32 months. 104.33 (c) "Employment services" means programs, activities, and 104.34 services in this section that are designed to assist 104.35 participants in obtaining and retaining employment. 104.36 (d) "Family maintenance needs" means current housing costs 105.1 including rent, manufactured home lot rental costs, or monthly 105.2 principal, interest, insurance premiums, and property taxes due 105.3 for mortgages or contracts for deed, association fees required 105.4 for homeownership, utility costs for current month expenses of 105.5 gas and electric, garbage, water and sewer, and a flat rate of 105.6 $35 for telephone services. 105.7 (e) "Family unit" means a group of people applying for or 105.8 receiving DWP benefits together. For the purposes of 105.9 determining eligibility for this program, the unit includes the 105.10 relationships in section 256J.24, subdivisions 2 and 4. 105.11 (f) "Minnesota family investment program (MFIP)" means the 105.12 assistance program as defined in section 256J.08, subdivision 57. 105.13 (g) "Personal needs allowance" means an allowance of up to 105.14 $70 per month per DWP unit member to pay for expenses such as 105.15 household products and personal products. 105.16 (h) "Work activities" means allowable work activities as 105.17 defined in section 256J.49, subdivision 13. 105.18 Subd. 3. [ELIGIBILITY FOR DIVERSIONARY WORK PROGRAM.] (a) 105.19 Except for the categories of family units listed below, all 105.20 family units who apply for cash benefits and who meet MFIP 105.21 eligibility as required in sections 256J.11 to 256J.15 are 105.22 eligible and must participate in the diversionary work program. 105.23 Family units that are not eligible for the diversionary work 105.24 program include: 105.25 (1) child only cases; 105.26 (2) a single-parent family unit that includes a child under 105.27 12 weeks of age. A parent is eligible for this exception once 105.28 in a parent's lifetime and is not eligible if the parent has 105.29 already used the previously allowed child under age one 105.30 exemption from MFIP employment services; 105.31 (3) a minor parent without a high school diploma or its 105.32 equivalent; 105.33 (4) a caregiver 18 or 19 years of age without a high school 105.34 diploma or its equivalent who chooses to have an employment plan 105.35 with an education option; 105.36 (5) a caregiver age 60 or over; 106.1 (6) family units with a parent who received DWP benefits 106.2 within a 12-month period as defined in subdivision 1, paragraph 106.3 (d); and 106.4 (7) family units with a parent who received MFIP within the 106.5 past 12 months. 106.6 (b) A two-parent family must participate in DWP unless both 106.7 parents meet the criteria for an exception under paragraph (a), 106.8 clauses (1) through (5), or the family unit includes a parent 106.9 who meets the criteria in paragraph (a), clause (6) or (7). 106.10 Subd. 4. [COOPERATION WITH PROGRAM REQUIREMENTS.] (a) To 106.11 be eligible for DWP, an applicant must comply with the 106.12 requirements of paragraphs (b) to (d). 106.13 (b) Applicants and participants must cooperate with the 106.14 requirements of the child support enforcement program, but will 106.15 not be charged a fee under section 518.551, subdivision 7. 106.16 (c) The applicant must provide each member of the family 106.17 unit's social security number to the county agency. This 106.18 requirement is satisfied when each member of the family unit 106.19 cooperates with the procedures for verification of numbers, 106.20 issuance of duplicate cards, and issuance of new numbers which 106.21 have been established jointly between the Social Security 106.22 Administration and the commissioner. 106.23 (d) Before DWP benefits can be issued to a family unit, the 106.24 caregiver must, in conjunction with a job counselor, develop and 106.25 sign an employment plan. In two-parent family units, both 106.26 parents must develop and sign employment plans before benefits 106.27 can be issued. Food support and health care benefits are not 106.28 contingent on the requirement for a signed employment plan. 106.29 Subd. 5. [SUBMITTING APPLICATION FORM.] The eligibility 106.30 date for the diversionary work program begins with the date the 106.31 signed combined application form (CAF) is received by the county 106.32 agency or the date diversionary work program eligibility 106.33 criteria are met, whichever is later. The county agency must 106.34 inform the applicant that any delay in submitting the 106.35 application will reduce the benefits paid for the month of 106.36 application. The county agency must inform a person that an 107.1 application may be submitted before the person has an interview 107.2 appointment. Upon receipt of a signed application, the county 107.3 agency must stamp the date of receipt on the face of the 107.4 application. The applicant may withdraw the application at any 107.5 time prior to approval by giving written or oral notice to the 107.6 county agency. The county agency must follow the notice 107.7 requirements in section 256J.09, subdivision 3, when issuing a 107.8 notice confirming the withdrawal. 107.9 Subd. 6. [INITIAL SCREENING OF APPLICATIONS.] Upon receipt 107.10 of the application, the county agency must determine if the 107.11 applicant may be eligible for other benefits as required in 107.12 sections 256J.09, subdivision 3a, and 256J.28, subdivisions 1 107.13 and 5. The county must also follow the provisions in section 107.14 256J.09, subdivision 3b, clause (2). 107.15 Subd. 7. [PROGRAM AND PROCESSING STANDARDS.] (a) The 107.16 interview to determine financial eligibility for the 107.17 diversionary work program must be conducted within five working 107.18 days of the receipt of the cash application form. During the 107.19 intake interview the financial worker must discuss: 107.20 (1) the goals, requirements, and services of the 107.21 diversionary work program; 107.22 (2) the availability of child care assistance. If child 107.23 care is needed, the worker must obtain a completed application 107.24 for child care from the applicant before the interview is 107.25 terminated. The same day the application for child care is 107.26 received, the application must be forwarded to the appropriate 107.27 child care worker. For purposes of eligibility for child care 107.28 assistance under chapter 119B, DWP participants shall be 107.29 eligible for the same benefits as MFIP recipients; and 107.30 (3) if the applicant has not requested food support and 107.31 health care assistance on the application, the county agency 107.32 shall, during the interview process, talk with the applicant 107.33 about the availability of these benefits. 107.34 (b) The county shall follow section 256J.74, subdivision 2, 107.35 paragraph (b), clauses (1) and (2), when an applicant or a 107.36 recipient of DWP has a person who is a member of more than one 108.1 assistance unit in a given payment month. 108.2 (c) If within 30 days the county agency cannot determine 108.3 eligibility for the diversionary work program, the county must 108.4 deny the application and inform the applicant of the decision 108.5 according to the notice provisions in section 256J.31. A family 108.6 unit is eligible for a fair hearing under section 256J.40. 108.7 Subd. 8. [VERIFICATION REQUIREMENTS.] (a) A county agency 108.8 must only require verification of information necessary to 108.9 determine DWP eligibility and the amount of the payment. The 108.10 applicant or participant must document the information required 108.11 or authorize the county agency to verify the information. The 108.12 applicant or participant has the burden of providing documentary 108.13 evidence to verify eligibility. The county agency shall assist 108.14 the applicant or participant in obtaining required documents 108.15 when the applicant or participant is unable to do so. 108.16 (b) A county agency must not request information about an 108.17 applicant or participant that is not a matter of public record 108.18 from a source other than county agencies, the department of 108.19 human services, or the United States Department of Health and 108.20 Human Services without the person's prior written consent. An 108.21 applicant's signature on an application form constitutes consent 108.22 for contact with the sources specified on the application. A 108.23 county agency may use a single consent form to contact a group 108.24 of similar sources, but the sources to be contacted must be 108.25 identified by the county agency prior to requesting an 108.26 applicant's consent. 108.27 (c) Factors to be verified shall follow section 256J.32, 108.28 subdivision 4. Except for personal needs, family maintenance 108.29 needs must be verified before the expense can be allowed in the 108.30 calculation of the DWP grant. 108.31 Subd. 9. [PROPERTY AND INCOME LIMITATIONS.] The asset 108.32 limits and exclusions in section 256J.20, apply to applicants 108.33 and recipients of DWP. All payments, unless excluded in section 108.34 256J.21, must be counted as income to determine eligibility for 108.35 the diversionary work program. The county shall treat income as 108.36 outlined in section 256J.37, except for subdivision 3a. The 109.1 initial income test and the disregards in section 256J.21, 109.2 subdivision 3, shall be followed for determining eligibility for 109.3 the diversionary work program. 109.4 Subd. 10. [DIVERSIONARY WORK PROGRAM GRANT.] (a) The 109.5 amount of cash benefits that a family unit is eligible for under 109.6 the diversionary work program is based on the number of persons 109.7 in the family unit, the family maintenance needs, personal needs 109.8 allowance, and countable income. The county agency shall 109.9 evaluate the income of the family unit that is requesting 109.10 payments under the diversionary work program. Countable income 109.11 means gross earned and unearned income not excluded or 109.12 disregarded under MFIP. The same disregards for earned income 109.13 that are allowed under MFIP are allowed for the diversionary 109.14 work program. 109.15 (b) The DWP grant is based on the family maintenance needs 109.16 for which the DWP family unit is responsible plus a personal 109.17 needs allowance. Housing and utilities, except for telephone 109.18 service, shall be vendor paid. Unless otherwise stated in this 109.19 section, actual housing and utility expenses shall be used when 109.20 determining the amount of the DWP grant. 109.21 (c) The maximum monthly benefit amount available under the 109.22 diversionary work program is the difference between the family 109.23 unit's family maintenance needs under paragraph (b) and the 109.24 family unit's countable income not to exceed the cash portion of 109.25 the MFIP standard of need as defined in section 256J.08, 109.26 subdivision 55a, for the family unit's size. The family wage 109.27 level as defined in section 256J.08, subdivision 35, shall be 109.28 used when determining the amount of countable income for working 109.29 members. 109.30 (d) Once the county has determined a grant amount, the DWP 109.31 grant amount will not be decreased if the determination is based 109.32 on the best information available at the time of approval and 109.33 shall not be decreased because of any additional income to the 109.34 family unit. The grant can be increased if a participant later 109.35 verifies an increase in family maintenance needs or family unit 109.36 size. The minimum cash benefit amount, if income and asset 110.1 tests are met, is $10. Benefits of $10 shall not be vendor paid. 110.2 (e) When all criteria are met, including the development of 110.3 an employment plan as described in subdivision 14 and 110.4 eligibility exists for the month of application, the amount of 110.5 benefits for the diversionary work program retroactive to the 110.6 date of application is as specified in section 256J.35, 110.7 paragraph (a). 110.8 (f) Any month during the four-month DWP period that a 110.9 person receives a DWP benefit directly or through a vendor 110.10 payment made on the person's behalf, that person is ineligible 110.11 for MFIP or any other TANF cash assistance program except for 110.12 benefits defined in section 256J.626, subdivision 2, clause (1). 110.13 If during the four-month period a family unit that receives 110.14 DWP benefits moves to a county that has not established a 110.15 diversionary work program, the family unit may be eligible for 110.16 MFIP the month following the last month of the issuance of the 110.17 DWP benefit. 110.18 Subd. 11. [UNIVERSAL PARTICIPATION REQUIRED.] (a) All DWP 110.19 caregivers, except caregivers who meet the criteria in paragraph 110.20 (d), are required to participate in DWP employment services. 110.21 Except as specified in paragraphs (b) and (c), employment plans 110.22 under DWP must, at a minimum, meet the requirements in section 110.23 256J.55, subdivision 1. 110.24 (b) A caregiver who is a member of a two-parent family that 110.25 is required to participate in DWP who would otherwise be 110.26 ineligible for DWP under subdivision 3 may be allowed to develop 110.27 an employment plan under section 256J.521, subdivision 2, 110.28 paragraph (c), that may contain alternate activities and reduced 110.29 hours. 110.30 (c) A participant who has a family violence waiver shall be 110.31 allowed to develop an employment plan under section 256J.521, 110.32 subdivision 3. 110.33 (d) One parent in a two-parent family unit that has a 110.34 natural born child under 12 weeks of age is not required to have 110.35 an employment plan until the child reaches 12 weeks of age 110.36 unless the family unit has already used the exclusion under 111.1 section 256J.561, subdivision 2, or the previously allowed child 111.2 under age one exemption under section 256J.56, paragraph (a), 111.3 clause (5). 111.4 (e) The provision in paragraph (d) ends the first full 111.5 month after the child reaches 12 weeks of age. This provision 111.6 is allowable only once in a caregiver's lifetime. In a 111.7 two-parent household, only one parent shall be allowed to use 111.8 this category. 111.9 (f) The participant and job counselor must meet within ten 111.10 working days after the child reaches 12 weeks of age to revise 111.11 the participant's employment plan. The employment plan for a 111.12 family unit that has a child under 12 weeks of age that has 111.13 already used the exclusion in section 256J.561 or the previously 111.14 allowed child under age one exemption under section 256J.56, 111.15 paragraph (a), clause (5), must be tailored to recognize the 111.16 caregiving needs of the parent. 111.17 Subd. 12. [CONVERSION OR REFERRAL TO MFIP.] (a) If at any 111.18 time during the DWP application process or during the four-month 111.19 DWP eligibility period, it is determined that a participant is 111.20 unlikely to benefit from the diversionary work program, the 111.21 county shall convert or refer the participant to MFIP as 111.22 specified in paragraph (d). Participants who are determined to 111.23 be unlikely to benefit from the diversionary work program must 111.24 develop and sign an employment plan. Participants who meet the 111.25 criteria in paragraph (b) shall be considered to be unlikely to 111.26 benefit from DWP, provided the necessary documentation is 111.27 available to support the determination. 111.28 (b) A participant who: 111.29 (1) has been determined by a qualified professional as 111.30 being unable to obtain or retain employment due to an illness, 111.31 injury, or incapacity that is expected to last at least 60 days; 111.32 (2) is determined by a qualified professional as being 111.33 needed in the home to care for a family member, or a relative in 111.34 the household, or a foster child, due to an illness, injury, or 111.35 incapacity that is expected to last at least 60 days; 111.36 (3) is determined by a qualified professional as being 112.1 needed in the home to care for a child meeting the special 112.2 medical criteria in section 256J.425, subdivision 2, clause (3); 112.3 (4) is pregnant and is determined by a qualified 112.4 professional as being unable to obtain or retain employment due 112.5 to the pregnancy; and 112.6 (5) has applied for SSI or RSDI. 112.7 (c) In a two-parent family unit, both parents must be 112.8 determined to be unlikely to benefit from the diversionary work 112.9 program before the family unit can be converted or referred to 112.10 MFIP. 112.11 (d) A participant who is determined to be unlikely to 112.12 benefit from the diversionary work program shall be converted to 112.13 MFIP and, if the determination was made within 30 days of the 112.14 initial application for benefits, a new combined application 112.15 form will not be required. A participant who is determined to 112.16 be unlikely to benefit from the diversionary work program shall 112.17 be referred to MFIP and, if the determination is made more than 112.18 30 days after the initial application, the participant must 112.19 submit a new combined application form. The county agency shall 112.20 process the combined application form by the first of the 112.21 following month to ensure that no gap in benefits is due to 112.22 delayed action by the county agency. 112.23 Subd. 13. [IMMEDIATE REFERRAL TO EMPLOYMENT SERVICES.] 112.24 Within one working day of determination that the applicant is 112.25 eligible for the diversionary work program, but before benefits 112.26 are issued to or on behalf of the family unit, the county shall 112.27 refer all caregivers to employment services. The referral to 112.28 the DWP employment services must be in writing and must contain 112.29 the following information: 112.30 (1) notification that, as part of the application process, 112.31 applicants are required to develop an employment plan or the DWP 112.32 application will be denied; 112.33 (2) the employment services provider name and phone number; 112.34 (3) the date, time, and location of the scheduled 112.35 employment services interview; 112.36 (4) the immediate availability of supportive services, 113.1 including, but not limited to, child care, transportation, and 113.2 other work-related aid; and 113.3 (5) the rights, responsibilities, and obligations of 113.4 participants in the program, including, but not limited to, the 113.5 grounds for good cause, the consequences of refusing or failing 113.6 to participate fully with program requirements, and the appeal 113.7 process. 113.8 Subd. 14. [EMPLOYMENT PLAN; DWP BENEFITS.] Within five 113.9 working days of being notified that a participant is financially 113.10 eligible for the diversionary work program, the employment 113.11 services provider and participant shall meet to develop an 113.12 employment plan. Once the employment plan has been developed 113.13 and signed by the participant and the job counselor, the 113.14 employment services provider shall notify the county within one 113.15 working day that the employment plan has been signed. The 113.16 county shall issue DWP benefits within one working day after 113.17 receiving notice that the employment plan has been signed. 113.18 Subd. 15. [LIMITATIONS ON CERTAIN WORK ACTIVITIES.] (a) 113.19 Except as specified in paragraphs (b) to (d), employment 113.20 activities listed in section 256J.49, subdivision 13, are 113.21 allowable under the diversionary work program. 113.22 (b) Work activities under section 256J.49, subdivision 13, 113.23 clause (5), shall be allowable only when in combination with 113.24 approved work activities under section 256J.49, subdivision 13, 113.25 clauses (1) to (4), and shall be limited to no more than 113.26 one-half of the hours required in the employment plan. 113.27 (c) In order for an English as a second language (ESL) 113.28 class to be an approved work activity, a participant must: 113.29 (1) be below a spoken language proficiency level of SPL6 or 113.30 its equivalent, as measured by a nationally recognized test; and 113.31 (2) not have been enrolled in ESL for more than 24 months 113.32 while previously participating in MFIP or DWP. A participant 113.33 who has been enrolled in ESL for 20 or more months may be 113.34 approved for ESL until the participant has received 24 total 113.35 months. 113.36 (d) Work activities under section 256J.49, subdivision 13, 114.1 clause (6), shall be allowable only when the training or 114.2 education program will be completed within the four-month DWP 114.3 period. Training or education programs that will not be 114.4 completed within the four-month DWP period shall not be approved. 114.5 Subd. 16. [FAILURE TO COMPLY WITH REQUIREMENTS.] A family 114.6 unit that includes a participant who fails to comply with DWP 114.7 employment service or child support enforcement requirements, 114.8 without good cause as defined in sections 256.741 and 256J.57, 114.9 shall be disqualified from the diversionary work program. The 114.10 county shall provide written notice as specified in section 114.11 256J.31 to the participant prior to disqualifying the family 114.12 unit due to noncompliance with employment service or child 114.13 support. The disqualification does not apply to food support or 114.14 health care benefits. 114.15 Subd. 17. [GOOD CAUSE FOR NOT COMPLYING WITH 114.16 REQUIREMENTS.] A participant who fails to comply with the 114.17 requirements of the diversionary work program may claim good 114.18 cause for reasons listed in sections 256.741 and 256J.57, 114.19 subdivision 1, clauses (1) to (13). The county shall not impose 114.20 a disqualification if good cause exists. 114.21 Subd. 18. [REINSTATEMENT FOLLOWING DISQUALIFICATION.] A 114.22 participant who has been disqualified from the diversionary work 114.23 program due to noncompliance with employment services may regain 114.24 eligibility for the diversionary work program by complying with 114.25 program requirements. A participant who has been disqualified 114.26 from the diversionary work program due to noncooperation with 114.27 child support enforcement requirements may regain eligibility by 114.28 complying with child support requirements under section 114.29 256J.741. Once a participant has been reinstated, the county 114.30 shall issue prorated benefits for the remaining portion of the 114.31 month. A family unit that has been disqualified from the 114.32 diversionary work program due to noncompliance shall not be 114.33 eligible for MFIP or any other TANF cash program during the 114.34 period of time the participant remains noncompliant. In a 114.35 two-parent family, both parents must be in compliance before the 114.36 family unit can regain eligibility for benefits. 115.1 Subd. 19. [RECOVERY OF OVERPAYMENTS.] When an overpayment 115.2 or an ATM error is determined, the overpayment shall be recouped 115.3 or recovered as specified in section 256J.38. 115.4 Subd. 20. [IMPLEMENTATION OF DWP.] Counties may establish 115.5 a diversionary work program according to this section any time 115.6 on or after July 1, 2003. Prior to establishing a diversionary 115.7 work program, the county must notify the commissioner. All 115.8 counties must implement the provisions of this section no later 115.9 than July 1, 2004. 115.10 Sec. 105. Minnesota Statutes 2002, section 261.063, is 115.11 amended to read: 115.12 261.063 [TAX LEVY FOR SOCIAL SERVICES; BOARD DUTY; 115.13 PENALTY.] 115.14 (a) The board of county commissioners of each county shall 115.15 annually levy taxes and fix a rate sufficient to produce the 115.16 full amount required for poor relief, general assistance, 115.17 Minnesota family investment program, diversionary work program, 115.18 county share of county and state supplemental aid to 115.19 supplemental security income applicants or recipients, and any 115.20 other social security measures wherein there is now or may 115.21 hereafter be county participation, sufficient to produce the 115.22 full amount necessary for each such item, including 115.23 administrative expenses, for the ensuing year, within the time 115.24 fixed by law in addition to all other tax levies and tax rates, 115.25 however fixed or determined, and any commissioner who shall fail 115.26 to comply herewith shall be guilty of a gross misdemeanor and 115.27 shall be immediately removed from office by the governor. For 115.28 the purposes of this paragraph, "poor relief" means county 115.29 services provided under sections 261.035, 261.04,and 261.21 to 115.30 261.231. 115.31 (b) Nothing within the provisions of this section shall be 115.32 construed as requiring a county agency to provide income support 115.33 or cash assistance to needy persons when they are no longer 115.34 eligible for assistance under general assistance,the Minnesota115.35family investment programchapter 256J, or Minnesota 115.36 supplemental aid. 116.1 Sec. 106. Minnesota Statutes 2002, section 393.07, 116.2 subdivision 10, is amended to read: 116.3 Subd. 10. [FEDERAL FOOD STAMP PROGRAM AND THE MATERNAL AND 116.4 CHILD NUTRITION ACT.] (a) The local social services agency shall 116.5 establish and administer the food stamp or support program 116.6 according to rules of the commissioner of human services, the 116.7 supervision of the commissioner as specified in section 256.01, 116.8 and all federal laws and regulations. The commissioner of human 116.9 services shall monitor food stamp or support program delivery on 116.10 an ongoing basis to ensure that each county complies with 116.11 federal laws and regulations. Program requirements to be 116.12 monitored include, but are not limited to, number of 116.13 applications, number of approvals, number of cases pending, 116.14 length of time required to process each application and deliver 116.15 benefits, number of applicants eligible for expedited issuance, 116.16 length of time required to process and deliver expedited 116.17 issuance, number of terminations and reasons for terminations, 116.18 client profiles by age, household composition and income level 116.19 and sources, and the use of phone certification and home 116.20 visits. The commissioner shall determine the county-by-county 116.21 and statewide participation rate. 116.22 (b) On July 1 of each year, the commissioner of human 116.23 services shall determine a statewide and county-by-county food 116.24 stamp program participation rate. The commissioner may 116.25 designate a different agency to administer the food stamp 116.26 program in a county if the agency administering the program 116.27 fails to increase the food stamp program participation rate 116.28 among families or eligible individuals, or comply with all 116.29 federal laws and regulations governing the food stamp program. 116.30 The commissioner shall review agency performance annually to 116.31 determine compliance with this paragraph. 116.32 (c) A person who commits any of the following acts has 116.33 violated section 256.98 or 609.821, or both, and is subject to 116.34 both the criminal and civil penalties provided under those 116.35 sections: 116.36 (1) obtains or attempts to obtain, or aids or abets any 117.1 person to obtain by means of a willful statement or 117.2 misrepresentation, or intentional concealment of a material 117.3 fact, food stamps or vouchers issued according to sections 117.4 145.891 to 145.897 to which the person is not entitled or in an 117.5 amount greater than that to which that person is entitled or 117.6 which specify nutritional supplements to which that person is 117.7 not entitled; or 117.8 (2) presents or causes to be presented, coupons or vouchers 117.9 issued according to sections 145.891 to 145.897 for payment or 117.10 redemption knowing them to have been received, transferred or 117.11 used in a manner contrary to existing state or federal law; or 117.12 (3) willfully uses, possesses, or transfers food stamp 117.13 coupons, authorization to purchase cards or vouchers issued 117.14 according to sections 145.891 to 145.897 in any manner contrary 117.15 to existing state or federal law, rules, or regulations; or 117.16 (4) buys or sells food stamp coupons, authorization to 117.17 purchase cards, other assistance transaction devices, vouchers 117.18 issued according to sections 145.891 to 145.897, or any food 117.19 obtained through the redemption of vouchers issued according to 117.20 sections 145.891 to 145.897 for cash or consideration other than 117.21 eligible food. 117.22 (d) A peace officer or welfare fraud investigator may 117.23 confiscate food stamps, authorization to purchase cards, or 117.24 other assistance transaction devices found in the possession of 117.25 any person who is neither a recipient of the food stamp program 117.26 nor otherwise authorized to possess and use such materials. 117.27 Confiscated property shall be disposed of as the commissioner 117.28 may direct and consistent with state and federal food stamp 117.29 law. The confiscated property must be retained for a period of 117.30 not less than 30 days to allow any affected person to appeal the 117.31 confiscation under section 256.045. 117.32 (e) Food stamp overpayment claims which are due in whole or 117.33 in part to client error shall be established by the county 117.34 agency for a period of six years from the date of any resultant 117.35 overpayment. 117.36 (f) With regard to the federal tax revenue offset program 118.1 only, recovery incentives authorized by the federal food and 118.2 consumer service shall be retained at the rate of 50 percent by 118.3 the state agency and 50 percent by the certifying county agency. 118.4 (g) A peace officer, welfare fraud investigator, federal 118.5 law enforcement official, or the commissioner of health may 118.6 confiscate vouchers found in the possession of any person who is 118.7 neither issued vouchers under sections 145.891 to 145.897, nor 118.8 otherwise authorized to possess and use such vouchers. 118.9 Confiscated property shall be disposed of as the commissioner of 118.10 health may direct and consistent with state and federal law. 118.11 The confiscated property must be retained for a period of not 118.12 less than 30 days. 118.13 (h) The commissioner of human services shall seek a waiver 118.14 from the United States Department of Agriculture to allow the 118.15 state to specify foods that may and may not be purchased in 118.16 Minnesota with benefits funded by the federal Food Stamp Program. 118.17 Sec. 107. Laws 1997, chapter 203, article 9, section 21, 118.18 as amended by Laws 1998, chapter 407, article 6, section 111, 118.19 Laws 2000, chapter 488, article 10, section 28, and Laws 2001, 118.20 First Special Session chapter 9, article 10, section 62, is 118.21 amended to read: 118.22 Sec. 21. [INELIGIBILITY FOR STATE FUNDED PROGRAMS.] 118.23 (a) Effective on the date specified, the following persons 118.24 will be ineligible for general assistance and general assistance 118.25 medical care under Minnesota Statutes, chapter 256D, group 118.26 residential housing under Minnesota Statutes, chapter 256I, and 118.27 MFIP assistance under Minnesota Statutes, chapter 256J, funded 118.28 with state money: 118.29 (1) Beginning July 1, 2002, persons who are terminated from 118.30 or denied Supplemental Security Income due to the 1996 changes 118.31 in the federal law making persons whose alcohol or drug 118.32 addiction is a material factor contributing to the person's 118.33 disability ineligible for Supplemental Security Income, and are 118.34 eligible for general assistance under Minnesota Statutes, 118.35 section 256D.05, subdivision 1, paragraph (a), clause (15), 118.36 general assistance medical care under Minnesota Statutes, 119.1 chapter 256D, or group residential housing under Minnesota 119.2 Statutes, chapter 256I; and 119.3 (2) Beginning July 1, 2002, legal noncitizens who are 119.4 ineligible for Supplemental Security Income due to the 1996 119.5 changes in federal law making certain noncitizens ineligible for 119.6 these programs due to their noncitizen status; and. 119.7(3) Beginning July 1, 2003, legal noncitizens who are119.8eligible for MFIP assistance, either the cash assistance portion119.9or the food assistance portion, funded entirely with state money.119.10 (b) State money that remains unspent due to changes in 119.11 federal law enacted after May 12, 1997, that reduce state 119.12 spending for legal noncitizens or for persons whose alcohol or 119.13 drug addiction is a material factor contributing to the person's 119.14 disability, or enacted after February 1, 1998, that reduce state 119.15 spending for food benefits for legal noncitizens shall not 119.16 cancel and shall be deposited in the TANF reserve account. 119.17 Sec. 108. [REVISOR'S INSTRUCTION.] 119.18 (a) In the next publication of Minnesota Statutes, the 119.19 revisor of statutes shall codify section 107 of this act. 119.20 (b) Wherever "food stamp" or "food stamps" appears in 119.21 Minnesota Statutes and Rules, the revisor of statutes shall 119.22 insert "food support" or "or food support" except for instances 119.23 where federal code or federal law is referenced. 119.24 (c) For sections in Minnesota Statutes and Minnesota Rules 119.25 affected by the repealed sections in this article, the revisor 119.26 shall delete internal cross-references where appropriate and 119.27 make changes necessary to correct the punctuation, grammar, or 119.28 structure of the remaining text and preserve its meaning. 119.29 Sec. 109. [REPEALER.] 119.30 (a) Minnesota Statutes 2002, sections 256J.02, subdivision 119.31 3; 256J.08, subdivisions 28 and 70; 256J.24, subdivision 8; 119.32 256J.30, subdivision 10; 256J.462; 256J.47; 256J.48; 256J.49, 119.33 subdivisions 1a, 2, 6, and 7; 256J.50, subdivisions 2, 3, 3a, 5, 119.34 and 7; 256J.52; 256J.62, subdivisions 1, 2a, 4, 6, 7, and 8; 119.35 256J.625; 256J.655; 256J.74, subdivision 3; 256J.751, 119.36 subdivisions 3 and 4; 256J.76; and 256K.30, are repealed. 120.1 (b) Laws 2000, chapter 488, article 10, section 29, is 120.2 repealed. 120.3 ARTICLE 2 120.4 HEALTH CARE 120.5 Section 1. Minnesota Statutes 2002, section 16A.724, is 120.6 amended to read: 120.7 16A.724 [HEALTH CARE ACCESS FUND.] 120.8 A health care access fund is created in the state 120.9 treasury. The fund is a direct appropriated special revenue 120.10 fund. The commissioner shall deposit to the credit of the fund 120.11 money made available to the fund. Notwithstanding section 120.12 11A.20, after June 30, 1997, all investment income and all 120.13 investment losses attributable to the investment of the health 120.14 care access fund not currently needed shall be credited to the 120.15 health care access fund. The health care access fund shall 120.16 sunset on June 30, 2005, and all remaining funds shall be 120.17 deposited in the general fund. Beginning July 1, 2005, all 120.18 activities which would otherwise receive funding from the health 120.19 care access fund shall be funded out of the general fund. 120.20 Sec. 2. [151.4611] [PURCHASE OF PRESCRIBER PRACTICE DATA 120.21 PROHIBITED.] 120.22 A manufacturer or wholesale drug distributor shall not 120.23 purchase or otherwise obtain data relating to practitioners 120.24 prescribing or dispensing practices or patterns. 120.25 [EFFECTIVE DATE.] This section is effective July 1, 2003. 120.26 Sec. 3. Minnesota Statutes 2002, section 256.01, 120.27 subdivision 2, is amended to read: 120.28 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 120.29 section 241.021, subdivision 2, the commissioner of human 120.30 services shall: 120.31 (1) Administer and supervise all forms of public assistance 120.32 provided for by state law and other welfare activities or 120.33 services as are vested in the commissioner. Administration and 120.34 supervision of human services activities or services includes, 120.35 but is not limited to, assuring timely and accurate distribution 120.36 of benefits, completeness of service, and quality program 121.1 management. In addition to administering and supervising human 121.2 services activities vested by law in the department, the 121.3 commissioner shall have the authority to: 121.4 (a) require county agency participation in training and 121.5 technical assistance programs to promote compliance with 121.6 statutes, rules, federal laws, regulations, and policies 121.7 governing human services; 121.8 (b) monitor, on an ongoing basis, the performance of county 121.9 agencies in the operation and administration of human services, 121.10 enforce compliance with statutes, rules, federal laws, 121.11 regulations, and policies governing welfare services and promote 121.12 excellence of administration and program operation; 121.13 (c) develop a quality control program or other monitoring 121.14 program to review county performance and accuracy of benefit 121.15 determinations; 121.16 (d) require county agencies to make an adjustment to the 121.17 public assistance benefits issued to any individual consistent 121.18 with federal law and regulation and state law and rule and to 121.19 issue or recover benefits as appropriate; 121.20 (e) delay or deny payment of all or part of the state and 121.21 federal share of benefits and administrative reimbursement 121.22 according to the procedures set forth in section 256.017; 121.23 (f) make contracts with and grants to public and private 121.24 agencies and organizations, both profit and nonprofit, and 121.25 individuals, using appropriated funds; and 121.26 (g) enter into contractual agreements with federally 121.27 recognized Indian tribes with a reservation in Minnesota to the 121.28 extent necessary for the tribe to operate a federally approved 121.29 family assistance program or any other program under the 121.30 supervision of the commissioner. The commissioner shall consult 121.31 with the affected county or counties in the contractual 121.32 agreement negotiations, if the county or counties wish to be 121.33 included, in order to avoid the duplication of county and tribal 121.34 assistance program services. The commissioner may establish 121.35 necessary accounts for the purposes of receiving and disbursing 121.36 funds as necessary for the operation of the programs. 122.1 (2) Inform county agencies, on a timely basis, of changes 122.2 in statute, rule, federal law, regulation, and policy necessary 122.3 to county agency administration of the programs. 122.4 (3) Administer and supervise all child welfare activities; 122.5 promote the enforcement of laws protecting handicapped, 122.6 dependent, neglected and delinquent children, and children born 122.7 to mothers who were not married to the children's fathers at the 122.8 times of the conception nor at the births of the children; 122.9 license and supervise child-caring and child-placing agencies 122.10 and institutions; supervise the care of children in boarding and 122.11 foster homes or in private institutions; and generally perform 122.12 all functions relating to the field of child welfare now vested 122.13 in the state board of control. 122.14 (4) Administer and supervise all noninstitutional service 122.15 to handicapped persons, including those who are visually 122.16 impaired, hearing impaired, or physically impaired or otherwise 122.17 handicapped. The commissioner may provide and contract for the 122.18 care and treatment of qualified indigent children in facilities 122.19 other than those located and available at state hospitals when 122.20 it is not feasible to provide the service in state hospitals. 122.21 (5) Assist and actively cooperate with other departments, 122.22 agencies and institutions, local, state, and federal, by 122.23 performing services in conformity with the purposes of Laws 122.24 1939, chapter 431. 122.25 (6) Act as the agent of and cooperate with the federal 122.26 government in matters of mutual concern relative to and in 122.27 conformity with the provisions of Laws 1939, chapter 431, 122.28 including the administration of any federal funds granted to the 122.29 state to aid in the performance of any functions of the 122.30 commissioner as specified in Laws 1939, chapter 431, and 122.31 including the promulgation of rules making uniformly available 122.32 medical care benefits to all recipients of public assistance, at 122.33 such times as the federal government increases its participation 122.34 in assistance expenditures for medical care to recipients of 122.35 public assistance, the cost thereof to be borne in the same 122.36 proportion as are grants of aid to said recipients. 123.1 (7) Establish and maintain any administrative units 123.2 reasonably necessary for the performance of administrative 123.3 functions common to all divisions of the department. 123.4 (8) Act as designated guardian of both the estate and the 123.5 person of all the wards of the state of Minnesota, whether by 123.6 operation of law or by an order of court, without any further 123.7 act or proceeding whatever, except as to persons committed as 123.8 mentally retarded. For children under the guardianship of the 123.9 commissioner whose interests would be best served by adoptive 123.10 placement, the commissioner may contract with a licensed 123.11 child-placing agency or a Minnesota tribal social services 123.12 agency to provide adoption services. A contract with a licensed 123.13 child-placing agency must be designed to supplement existing 123.14 county efforts and may not replace existing county programs, 123.15 unless the replacement is agreed to by the county board and the 123.16 appropriate exclusive bargaining representative or the 123.17 commissioner has evidence that child placements of the county 123.18 continue to be substantially below that of other counties. 123.19 Funds encumbered and obligated under an agreement for a specific 123.20 child shall remain available until the terms of the agreement 123.21 are fulfilled or the agreement is terminated. 123.22 (9) Act as coordinating referral and informational center 123.23 on requests for service for newly arrived immigrants coming to 123.24 Minnesota. 123.25 (10) The specific enumeration of powers and duties as 123.26 hereinabove set forth shall in no way be construed to be a 123.27 limitation upon the general transfer of powers herein contained. 123.28 (11) Establish county, regional, or statewide schedules of 123.29 maximum fees and charges which may be paid by county agencies 123.30 for medical, dental, surgical, hospital, nursing and nursing 123.31 home care and medicine and medical supplies under all programs 123.32 of medical care provided by the state and for congregate living 123.33 care under the income maintenance programs. 123.34 (12) Have the authority to conduct and administer 123.35 experimental projects to test methods and procedures of 123.36 administering assistance and services to recipients or potential 124.1 recipients of public welfare. To carry out such experimental 124.2 projects, it is further provided that the commissioner of human 124.3 services is authorized to waive the enforcement of existing 124.4 specific statutory program requirements, rules, and standards in 124.5 one or more counties. The order establishing the waiver shall 124.6 provide alternative methods and procedures of administration, 124.7 shall not be in conflict with the basic purposes, coverage, or 124.8 benefits provided by law, and in no event shall the duration of 124.9 a project exceed four years. It is further provided that no 124.10 order establishing an experimental project as authorized by the 124.11 provisions of this section shall become effective until the 124.12 following conditions have been met: 124.13 (a) The secretary of health and human services of the 124.14 United States has agreed, for the same project, to waive state 124.15 plan requirements relative to statewide uniformity. 124.16 (b) A comprehensive plan, including estimated project 124.17 costs, shall be approved by the legislative advisory commission 124.18 and filed with the commissioner of administration. 124.19 (13) According to federal requirements, establish 124.20 procedures to be followed by local welfare boards in creating 124.21 citizen advisory committees, including procedures for selection 124.22 of committee members. 124.23 (14) Allocate federal fiscal disallowances or sanctions 124.24 which are based on quality control error rates for the aid to 124.25 families with dependent children program formerly codified in 124.26 sections 256.72 to 256.87, medical assistance, or food stamp 124.27 program in the following manner: 124.28 (a) One-half of the total amount of the disallowance shall 124.29 be borne by the county boards responsible for administering the 124.30 programs. For the medical assistance and the AFDC program 124.31 formerly codified in sections 256.72 to 256.87, disallowances 124.32 shall be shared by each county board in the same proportion as 124.33 that county's expenditures for the sanctioned program are to the 124.34 total of all counties' expenditures for the AFDC program 124.35 formerly codified in sections 256.72 to 256.87, and medical 124.36 assistance programs. For the food stamp program, sanctions 125.1 shall be shared by each county board, with 50 percent of the 125.2 sanction being distributed to each county in the same proportion 125.3 as that county's administrative costs for food stamps are to the 125.4 total of all food stamp administrative costs for all counties, 125.5 and 50 percent of the sanctions being distributed to each county 125.6 in the same proportion as that county's value of food stamp 125.7 benefits issued are to the total of all benefits issued for all 125.8 counties. Each county shall pay its share of the disallowance 125.9 to the state of Minnesota. When a county fails to pay the 125.10 amount due hereunder, the commissioner may deduct the amount 125.11 from reimbursement otherwise due the county, or the attorney 125.12 general, upon the request of the commissioner, may institute 125.13 civil action to recover the amount due. 125.14 (b) Notwithstanding the provisions of paragraph (a), if the 125.15 disallowance results from knowing noncompliance by one or more 125.16 counties with a specific program instruction, and that knowing 125.17 noncompliance is a matter of official county board record, the 125.18 commissioner may require payment or recover from the county or 125.19 counties, in the manner prescribed in paragraph (a), an amount 125.20 equal to the portion of the total disallowance which resulted 125.21 from the noncompliance, and may distribute the balance of the 125.22 disallowance according to paragraph (a). 125.23 (15) Develop and implement special projects that maximize 125.24 reimbursements and result in the recovery of money to the 125.25 state. For the purpose of recovering state money, the 125.26 commissioner may enter into contracts with third parties. Any 125.27 recoveries that result from projects or contracts entered into 125.28 under this paragraph shall be deposited in the state treasury 125.29 and credited to a special account until the balance in the 125.30 account reaches $1,000,000. When the balance in the account 125.31 exceeds $1,000,000, the excess shall be transferred and credited 125.32 to the general fund. All money in the account is appropriated 125.33 to the commissioner for the purposes of this paragraph. 125.34 (16) Have the authority to make direct payments to 125.35 facilities providing shelter to women and their children 125.36 according to section 256D.05, subdivision 3. Upon the written 126.1 request of a shelter facility that has been denied payments 126.2 under section 256D.05, subdivision 3, the commissioner shall 126.3 review all relevant evidence and make a determination within 30 126.4 days of the request for review regarding issuance of direct 126.5 payments to the shelter facility. Failure to act within 30 days 126.6 shall be considered a determination not to issue direct payments. 126.7 (17) Have the authority to establish and enforce the 126.8 following county reporting requirements: 126.9 (a) The commissioner shall establish fiscal and statistical 126.10 reporting requirements necessary to account for the expenditure 126.11 of funds allocated to counties for human services programs. 126.12 When establishing financial and statistical reporting 126.13 requirements, the commissioner shall evaluate all reports, in 126.14 consultation with the counties, to determine if the reports can 126.15 be simplified or the number of reports can be reduced. 126.16 (b) The county board shall submit monthly or quarterly 126.17 reports to the department as required by the commissioner. 126.18 Monthly reports are due no later than 15 working days after the 126.19 end of the month. Quarterly reports are due no later than 30 126.20 calendar days after the end of the quarter, unless the 126.21 commissioner determines that the deadline must be shortened to 126.22 20 calendar days to avoid jeopardizing compliance with federal 126.23 deadlines or risking a loss of federal funding. Only reports 126.24 that are complete, legible, and in the required format shall be 126.25 accepted by the commissioner. 126.26 (c) If the required reports are not received by the 126.27 deadlines established in clause (b), the commissioner may delay 126.28 payments and withhold funds from the county board until the next 126.29 reporting period. When the report is needed to account for the 126.30 use of federal funds and the late report results in a reduction 126.31 in federal funding, the commissioner shall withhold from the 126.32 county boards with late reports an amount equal to the reduction 126.33 in federal funding until full federal funding is received. 126.34 (d) A county board that submits reports that are late, 126.35 illegible, incomplete, or not in the required format for two out 126.36 of three consecutive reporting periods is considered 127.1 noncompliant. When a county board is found to be noncompliant, 127.2 the commissioner shall notify the county board of the reason the 127.3 county board is considered noncompliant and request that the 127.4 county board develop a corrective action plan stating how the 127.5 county board plans to correct the problem. The corrective 127.6 action plan must be submitted to the commissioner within 45 days 127.7 after the date the county board received notice of noncompliance. 127.8 (e) The final deadline for fiscal reports or amendments to 127.9 fiscal reports is one year after the date the report was 127.10 originally due. If the commissioner does not receive a report 127.11 by the final deadline, the county board forfeits the funding 127.12 associated with the report for that reporting period and the 127.13 county board must repay any funds associated with the report 127.14 received for that reporting period. 127.15 (f) The commissioner may not delay payments, withhold 127.16 funds, or require repayment under paragraph (c) or (e) if the 127.17 county demonstrates that the commissioner failed to provide 127.18 appropriate forms, guidelines, and technical assistance to 127.19 enable the county to comply with the requirements. If the 127.20 county board disagrees with an action taken by the commissioner 127.21 under paragraph (c) or (e), the county board may appeal the 127.22 action according to sections 14.57 to 14.69. 127.23 (g) Counties subject to withholding of funds under 127.24 paragraph (c) or forfeiture or repayment of funds under 127.25 paragraph (e) shall not reduce or withhold benefits or services 127.26 to clients to cover costs incurred due to actions taken by the 127.27 commissioner under paragraph (c) or (e). 127.28 (18) Allocate federal fiscal disallowances or sanctions for 127.29 audit exceptions when federal fiscal disallowances or sanctions 127.30 are based on a statewide random sample for the foster care 127.31 program under title IV-E of the Social Security Act, United 127.32 States Code, title 42, in direct proportion to each county's 127.33 title IV-E foster care maintenance claim for that period. 127.34 (19) Be responsible for ensuring the detection, prevention, 127.35 investigation, and resolution of fraudulent activities or 127.36 behavior by applicants, recipients, and other participants in 128.1 the human services programs administered by the department. 128.2 (20) Require county agencies to identify overpayments, 128.3 establish claims, and utilize all available and cost-beneficial 128.4 methodologies to collect and recover these overpayments in the 128.5 human services programs administered by the department. 128.6 (21) Have the authority to administer a drug rebate program 128.7 for drugs purchased pursuant to the prescription drug program 128.8 established under section 256.955 after the beneficiary's 128.9 satisfaction of any deductible established in the program. The 128.10 commissioner shall require a rebate agreement from all 128.11 manufacturers of covered drugs as defined in section 256B.0625, 128.12 subdivision 13. Rebate agreements for prescription drugs 128.13 delivered on or after July 1, 2002, must include rebates for 128.14 individuals covered under the prescription drug program who are 128.15 under 65 years of age. For each drug, the amount of the rebate 128.16 shall be equal to thebasicrebate as defined for purposes of 128.17 the federal rebate program in United States Code, title 42, 128.18 section 1396r-8(c)(1).This basic rebate shall be applied to128.19single-source and multiple-source drugs.The manufacturers must 128.20 provide full payment within 30 days of receipt of the state 128.21 invoice for the rebate within the terms and conditions used for 128.22 the federal rebate program established pursuant to section 1927 128.23 of title XIX of the Social Security Act. The manufacturers must 128.24 provide the commissioner with any information necessary to 128.25 verify the rebate determined per drug. The rebate program shall 128.26 utilize the terms and conditions used for the federal rebate 128.27 program established pursuant to section 1927 of title XIX of the 128.28 Social Security Act. 128.29 (22) Have the authority to administer the federal drug 128.30 rebate program for drugs purchased under the medical assistance 128.31 program as allowed by section 1927 of title XIX of the Social 128.32 Security Act and according to the terms and conditions of 128.33 section 1927. Rebates shall be collected for all drugs that 128.34 have been dispensed or administered in an outpatient setting and 128.35 that are from manufacturers who have signed a rebate agreement 128.36 with the United States Department of Health and Human Services. 129.1 (23) Have the authority to administer a supplemental drug 129.2 rebate program for drugs purchased under the medical assistance 129.3 program. The commissioner may enter into supplemental rebate 129.4 contracts with pharmaceutical manufacturers and may require 129.5 prior authorization for drugs that are from manufacturers that 129.6 have not signed a supplemental rebate contract. Prior 129.7 authorization of drugs shall be subject to the provisions of 129.8 section 256B.0625, subdivision 13. 129.9 (24) Operate the department's communication systems account 129.10 established in Laws 1993, First Special Session chapter 1, 129.11 article 1, section 2, subdivision 2, to manage shared 129.12 communication costs necessary for the operation of the programs 129.13 the commissioner supervises. A communications account may also 129.14 be established for each regional treatment center which operates 129.15 communications systems. Each account must be used to manage 129.16 shared communication costs necessary for the operations of the 129.17 programs the commissioner supervises. The commissioner may 129.18 distribute the costs of operating and maintaining communication 129.19 systems to participants in a manner that reflects actual usage. 129.20 Costs may include acquisition, licensing, insurance, 129.21 maintenance, repair, staff time and other costs as determined by 129.22 the commissioner. Nonprofit organizations and state, county, 129.23 and local government agencies involved in the operation of 129.24 programs the commissioner supervises may participate in the use 129.25 of the department's communications technology and share in the 129.26 cost of operation. The commissioner may accept on behalf of the 129.27 state any gift, bequest, devise or personal property of any 129.28 kind, or money tendered to the state for any lawful purpose 129.29 pertaining to the communication activities of the department. 129.30 Any money received for this purpose must be deposited in the 129.31 department's communication systems accounts. Money collected by 129.32 the commissioner for the use of communication systems must be 129.33 deposited in the state communication systems account and is 129.34 appropriated to the commissioner for purposes of this section. 129.35 (25) Receive any federal matching money that is made 129.36 available through the medical assistance program for the 130.1 consumer satisfaction survey. Any federal money received for 130.2 the survey is appropriated to the commissioner for this 130.3 purpose. The commissioner may expend the federal money received 130.4 for the consumer satisfaction survey in either year of the 130.5 biennium. 130.6 (26) Incorporate cost reimbursement claims from First Call 130.7 Minnesota and Greater Twin Cities United Way into the federal 130.8 cost reimbursement claiming processes of the department 130.9 according to federal law, rule, and regulations. Any 130.10 reimbursement received is appropriated to the commissioner and 130.11 shall be disbursed to First Call Minnesota and Greater Twin 130.12 Cities United Way according to normal department payment 130.13 schedules. 130.14 (27) Develop recommended standards for foster care homes 130.15 that address the components of specialized therapeutic services 130.16 to be provided by foster care homes with those services. 130.17 Sec. 4. Minnesota Statutes 2002, section 256.046, 130.18 subdivision 1, is amended to read: 130.19 Subdivision 1. [HEARING AUTHORITY.] A local agency must 130.20 initiate an administrative fraud disqualification hearing for 130.21 individuals accused of wrongfully obtaining assistance or 130.22 intentional program violations, in lieu of a criminal action 130.23 when it has not been pursued, in the aid to families with 130.24 dependent children program formerly codified in sections 256.72 130.25 to 256.87, MFIP, child care assistance programs, general 130.26 assistance, family general assistance program formerly codified 130.27 in section 256D.05, subdivision 1, clause (15), Minnesota 130.28 supplemental aid,medical care, orfood stamp programs, general 130.29 assistance medical care, MinnesotaCare for adults without 130.30 children, and upon federal approval, all categories of medical 130.31 assistance and remaining categories of MinnesotaCare except for 130.32 children ages up to 18. The hearing is subject to the 130.33 requirements of section 256.045 and the requirements in Code of 130.34 Federal Regulations, title 7, section 273.16, for the food stamp 130.35 program and title 45, section 235.112, as of September 30, 1995, 130.36 for the cash grant and medical care programs. 131.1 Sec. 5. [256.954] [PRESCRIPTION DRUG DISCOUNT PROGRAM.] 131.2 Subdivision 1. [ESTABLISHMENT; ADMINISTRATION.] The 131.3 commissioner of human services shall establish and administer 131.4 the prescription drug discount program, effective January 1, 131.5 2004. 131.6 Subd. 2. [COMMISSIONER'S AUTHORITY.] The commissioner 131.7 shall administer a drug rebate program for drugs purchased 131.8 according to the prescription drug discount program. The 131.9 commissioner shall require a rebate agreement from all 131.10 manufacturers of covered drugs as defined in section 256B.0625, 131.11 subdivision 13. For each drug, the amount of the rebate shall 131.12 be equal to the rebate as defined for purposes of the federal 131.13 rebate program in United States Code, title 42, section 131.14 1396r-8. The rebate program shall utilize the terms and 131.15 conditions used for the federal rebate program established 131.16 according to section 1927 of title XIX of the federal Social 131.17 Security Act. 131.18 Subd. 3. [DEFINITIONS.] For the purpose of this section, 131.19 the following terms have the meanings given them: 131.20 (a) "Commissioner" means the commissioner of human services. 131.21 (b) "Manufacturer" means a manufacturer as defined in 131.22 section 151.44, paragraph (c). 131.23 (c) "Covered prescription drug" means a prescription drug 131.24 as defined in section 151.44, paragraph (d), that is covered 131.25 under medical assistance as described in section 256B.0625, 131.26 subdivision 13, and that is provided by a manufacturer that has 131.27 a fully executed rebate agreement with the commissioner under 131.28 this section and complies with that agreement. Multisource 131.29 drugs for which there are three or more drug products are not 131.30 subject to the requirements of this section. This exemption 131.31 does not apply to innovator multisource drugs. 131.32 (d) "Health carrier" means an insurance company licensed 131.33 under chapter 60A to offer, sell, or issue an individual or 131.34 group policy of accident and sickness insurance as defined in 131.35 section 62A.01; a nonprofit health service plan corporation 131.36 operating under chapter 62C; a health maintenance organization 132.1 operating under chapter 62D; a joint self-insurance employee 132.2 health plan operating under chapter 62H; a community integrated 132.3 systems network licensed under chapter 62N; a fraternal benefit 132.4 society operating under chapter 64B; a city, county, school 132.5 district, or other political subdivision providing self-insured 132.6 health coverage under section 461.617 or sections 471.98 to 132.7 471.982; and a self-funded health plan under the Employee 132.8 Retirement Income Security Act of 1974, as amended. 132.9 (e) "Participating pharmacy" means a pharmacy as defined in 132.10 section 151.01, subdivision 2, that agrees to participate in the 132.11 prescription drug discount program. 132.12 (f) "Enrolled individual" means a person who is eligible 132.13 for the program under subdivision 4 and has enrolled in the 132.14 program according to subdivision 5. 132.15 Subd. 4. [ELIGIBLE PERSONS.] To be eligible for the 132.16 program, an applicant must: 132.17 (1) be a permanent resident of Minnesota as defined in 132.18 section 256L.09, subdivision 4; 132.19 (2) not be enrolled in medical assistance, general 132.20 assistance medical care, MinnesotaCare, or the prescription drug 132.21 program under section 256.955; 132.22 (3) not be enrolled in and have currently available 132.23 prescription drug coverage under a health plan offered by a 132.24 health carrier; 132.25 (4) not be enrolled in and have currently available 132.26 prescription drug coverage under a Medicare supplement plan, as 132.27 defined in sections 62A.31 to 62A.44, or policies, contracts, or 132.28 certificates that supplement Medicare issued by health 132.29 maintenance organizations or those policies, contracts, or 132.30 certificates governed by section 1833 or 1876 of the federal 132.31 Social Security Act, United States Code, title 42, section 1395, 132.32 et. seq., as amended; and 132.33 (5) have a gross household income that does not exceed 250 132.34 percent of the federal poverty guidelines. 132.35 Subd. 5. [APPLICATION PROCEDURE.] (a) Applications and 132.36 information on the program must be made available at county 133.1 social services agencies, health care provider offices, and 133.2 agencies and organizations serving senior citizens. Individuals 133.3 shall submit applications and any information specified by the 133.4 commissioner as being necessary to verify eligibility directly 133.5 to the commissioner. The commissioner shall determine an 133.6 applicant's eligibility for the program within 30 days from the 133.7 date the application is received. Eligibility begins the month 133.8 after approval. 133.9 (b) The commissioner shall develop an application form that 133.10 does not exceed one page in length and requires information 133.11 necessary to determine eligibility for the program. 133.12 Subd. 6. [PARTICIPATING PHARMACY.] According to a valid 133.13 prescription, a participating pharmacy must sell a covered 133.14 prescription drug to an enrolled individual at the pharmacy's 133.15 usual and customary retail price, minus an amount that is equal 133.16 to the rebate amount described in subdivision 8, plus the amount 133.17 of any administrative fee and switch fee established by the 133.18 commissioner under subdivision 10. Each participating pharmacy 133.19 shall provide the commissioner with all information necessary to 133.20 administer the program, including, but not limited to, 133.21 information on prescription drug sales to enrolled individuals 133.22 and usual and customary retail prices. 133.23 Subd. 7. [NOTIFICATION OF REBATE AMOUNT.] The commissioner 133.24 shall notify each drug manufacturer, each calendar quarter or 133.25 according to a schedule to be established by the commissioner, 133.26 of the amount of the rebate owed on the prescription drugs sold 133.27 by participating pharmacies to enrolled individuals. 133.28 Subd. 8. [PROVISION OF REBATE.] To the extent that a 133.29 manufacturer's prescription drugs are prescribed to a citizen of 133.30 this state, the manufacturer must provide a rebate equal to the 133.31 rebate provided under the medical assistance program for any 133.32 prescription drug distributed by the manufacturer that is 133.33 purchased by an enrolled individual at a participating 133.34 pharmacy. The manufacturer must provide full payment within 30 133.35 days of receipt of the state invoice for the rebate, or 133.36 according to a schedule to be established by the commissioner. 134.1 The commissioner shall deposit all rebates received into the 134.2 Minnesota prescription drug dedicated fund established under 134.3 this section. The manufacturer must provide the commissioner 134.4 with any information necessary to verify the rebate determined 134.5 per drug. 134.6 Subd. 9. [PAYMENT TO PHARMACIES.] The commissioner shall 134.7 distribute on a biweekly basis an amount that is equal to an 134.8 estimate of the rebate amount described in subdivision 8 to each 134.9 participating pharmacy based on the prescription drugs sold by 134.10 that pharmacy to enrolled individuals, minus the amount of the 134.11 administrative fee established by the commissioner under 134.12 subdivision 10. 134.13 Subd. 10. [ADMINISTRATIVE FEE; SWITCH FEE.] The 134.14 commissioner shall establish a reasonable administrative fee 134.15 that covers the commissioner's expenses for enrollment, 134.16 processing claims, repaying the appropriation from the health 134.17 care access fund over a seven-year period, and distributing 134.18 rebates under this program. The commissioner shall establish a 134.19 reasonable switch fee that covers expenses incurred by 134.20 pharmacies in formatting for electronic submission claims for 134.21 prescription drugs sold to enrolled individuals. 134.22 Subd. 11. [DEDICATED FUND; CREATION; USE OF FUND.] (a) The 134.23 Minnesota prescription drug dedicated fund is established as an 134.24 account in the state treasury. The commissioner of finance 134.25 shall credit to the dedicated fund all rebates paid under 134.26 subdivision 8, any federal funds received for the program, and 134.27 any appropriations or allocations designated for the fund. The 134.28 commissioner of finance shall ensure that fund money is invested 134.29 under section 11A.25. All money earned by the fund must be 134.30 credited to the fund. The fund shall earn a proportionate share 134.31 of the total state annual investment income. 134.32 (b) Money in the fund is appropriated to the commissioner 134.33 of human services to reimburse participating pharmacies for 134.34 prescription drug discounts provided to enrolled individuals 134.35 under this section, to reimburse the commissioner of human 134.36 services for costs related to enrollment, processing claims, 135.1 distributing rebates, and for other reasonable administrative 135.2 costs related to administration of the prescription drug 135.3 discount program, and to repay the appropriation provided for 135.4 this section. The commissioner must administer the program so 135.5 that the costs total no more than funds appropriated plus the 135.6 drug rebate proceeds. 135.7 Sec. 6. Minnesota Statutes 2002, section 256.955, 135.8 subdivision 2a, is amended to read: 135.9 Subd. 2a. [ELIGIBILITY.] An individual satisfying the 135.10 following requirements and the requirements described in 135.11 subdivision 2, paragraph (d), is eligible for the prescription 135.12 drug program: 135.13 (1) is at least 65 years of age or older; and 135.14 (2) is eligible as a qualified Medicare beneficiary 135.15 according to section 256B.057, subdivision 3,or 3a,or 3b,135.16clause (1),or is eligible under section 256B.057, subdivision 135.17 3,or 3a,or 3b, clause (1),and is also eligible for medical 135.18 assistance or general assistance medical care with a spenddown 135.19 as defined in section 256B.056, subdivision 5. 135.20 Sec. 7. Minnesota Statutes 2002, section 256.955, 135.21 subdivision 3, is amended to read: 135.22 Subd. 3. [PRESCRIPTION DRUG COVERAGE.] Coverage under the 135.23 program shall be limited to those prescription drugs that: 135.24 (1) are covered under the medical assistance program as 135.25 described in section 256B.0625, subdivision 13;and135.26 (2) are provided by manufacturers that have fully executed 135.27 senior drug rebate agreements with the commissioner and comply 135.28 with such agreements; and 135.29 (3) for a specific enrollee, are not covered under an 135.30 assistance program offered by a pharmaceutical manufacturer, as 135.31 determined by the board on aging under section 256.975, 135.32 subdivision 9, except that this shall not apply to qualified 135.33 individuals under this section who are also eligible for medical 135.34 assistance with a spenddown as described in subdivision 2a, 135.35 clause (2), and subdivision 2b, clause (2). 135.36 [EFFECTIVE DATE.] This section is effective 90 days after 136.1 implementation by the board of aging of the prescription drug 136.2 assistance program under section 256.975, subdivision 9. 136.3 Sec. 8. Minnesota Statutes 2002, section 256.955, is 136.4 amended by adding a subdivision to read: 136.5 Subd. 4a. [REFERRALS TO PRESCRIPTION DRUG ASSISTANCE 136.6 PROGRAM.] County social service agencies, in coordination with 136.7 the commissioner and the Minnesota board on aging, shall refer 136.8 individuals applying to the prescription drug program, or 136.9 enrolled in the prescription drug program, to the prescription 136.10 drug assistance program for all required prescription drugs that 136.11 the board on aging determines, under section 256.975, 136.12 subdivision 9, are covered under an assistance program offered 136.13 by a pharmaceutical manufacturer. Applicants and enrollees 136.14 referred to the prescription drug assistance program remain 136.15 eligible for coverage under the prescription drug program of all 136.16 prescription drugs covered under subdivision 3. The board on 136.17 aging shall phase-in participation of enrollees, over a period 136.18 of 90 days, after implementation of the program under section 136.19 256.975, subdivision 9. This subdivision does not apply to 136.20 individuals who are also eligible for medical assistance with a 136.21 spenddown as defined in section 256B.056, subdivision 5. 136.22 [EFFECTIVE DATE.] This section is effective 90 days after 136.23 implementation by the board of aging of the prescription drug 136.24 assistance program under section 256.975, subdivision 9. 136.25 Sec. 9. Minnesota Statutes 2002, section 256.969, 136.26 subdivision 2b, is amended to read: 136.27 Subd. 2b. [OPERATING PAYMENT RATES.] In determining 136.28 operating payment rates for admissions occurring on or after the 136.29 rate year beginning January 1, 1991, and every two years after, 136.30 or more frequently as determined by the commissioner, the 136.31 commissioner shall obtain operating data from an updated base 136.32 year and establish operating payment rates per admission for 136.33 each hospital based on the cost-finding methods and allowable 136.34 costs of the Medicare program in effect during the base year. 136.35 Rates under the general assistance medical care, medical 136.36 assistance, and MinnesotaCare programs shall not be rebased to 137.1 more current data on January 1, 1997, and January 1, 2005. The 137.2 base year operating payment rate per admission is standardized 137.3 by the case mix index and adjusted by the hospital cost index, 137.4 relative values, and disproportionate population adjustment. 137.5 The cost and charge data used to establish operating rates shall 137.6 only reflect inpatient services covered by medical assistance 137.7 and shall not include property cost information and costs 137.8 recognized in outlier payments. 137.9 Sec. 10. Minnesota Statutes 2002, section 256.969, 137.10 subdivision 3a, is amended to read: 137.11 Subd. 3a. [PAYMENTS.] (a) Acute care hospital billings 137.12 under the medical assistance program must not be submitted until 137.13 the recipient is discharged. However, the commissioner shall 137.14 establish monthly interim payments for inpatient hospitals that 137.15 have individual patient lengths of stay over 30 days regardless 137.16 of diagnostic category. Except as provided in section 256.9693, 137.17 medical assistance reimbursement for treatment of mental illness 137.18 shall be reimbursed based on diagnostic classifications. 137.19 Individual hospital payments established under this section and 137.20 sections 256.9685, 256.9686, and 256.9695, in addition to third 137.21 party and recipient liability, for discharges occurring during 137.22 the rate year shall not exceed, in aggregate, the charges for 137.23 the medical assistance covered inpatient services paid for the 137.24 same period of time to the hospital. This payment limitation 137.25 shall be calculated separately for medical assistance and 137.26 general assistance medical care services. The limitation on 137.27 general assistance medical care shall be effective for 137.28 admissions occurring on or after July 1, 1991. Services that 137.29 have rates established under subdivision 11 or 12, must be 137.30 limited separately from other services. After consulting with 137.31 the affected hospitals, the commissioner may consider related 137.32 hospitals one entity and may merge the payment rates while 137.33 maintaining separate provider numbers. The operating and 137.34 property base rates per admission or per day shall be derived 137.35 from the best Medicare and claims data available when rates are 137.36 established. The commissioner shall determine the best Medicare 138.1 and claims data, taking into consideration variables of recency 138.2 of the data, audit disposition, settlement status, and the 138.3 ability to set rates in a timely manner. The commissioner shall 138.4 notify hospitals of payment rates by December 1 of the year 138.5 preceding the rate year. The rate setting data must reflect the 138.6 admissions data used to establish relative values. Base year 138.7 changes from 1981 to the base year established for the rate year 138.8 beginning January 1, 1991, and for subsequent rate years, shall 138.9 not be limited to the limits ending June 30, 1987, on the 138.10 maximum rate of increase under subdivision 1. The commissioner 138.11 may adjust base year cost, relative value, and case mix index 138.12 data to exclude the costs of services that have been 138.13 discontinued by the October 1 of the year preceding the rate 138.14 year or that are paid separately from inpatient services. 138.15 Inpatient stays that encompass portions of two or more rate 138.16 years shall have payments established based on payment rates in 138.17 effect at the time of admission unless the date of admission 138.18 preceded the rate year in effect by six months or more. In this 138.19 case, operating payment rates for services rendered during the 138.20 rate year in effect and established based on the date of 138.21 admission shall be adjusted to the rate year in effect by the 138.22 hospital cost index. 138.23 (b) For fee-for-service admissions occurring on or after 138.24 July 1, 2002, the total payment, before third-party liability 138.25 and spenddown, made to hospitals for inpatient services is 138.26 reduced by .5 percent from the current statutory rates. 138.27 (c) In addition to the reduction in paragraph (b), the 138.28 total payment for fee-for-service admissions occurring on or 138.29 after July 1, 2003, made to hospitals for inpatient services 138.30 before third-party liability and spenddown, is reduced 2.5 138.31 percent from the current statutory rates. Mental health 138.32 services within diagnosis related groups 424 to 432, and 138.33 facilities defined under subdivision 16 are excluded from this 138.34 paragraph. 138.35 Sec. 11. Minnesota Statutes 2002, section 256.975, is 138.36 amended by adding a subdivision to read: 139.1 Subd. 9. [PRESCRIPTION DRUG ASSISTANCE.] (a) The Minnesota 139.2 board on aging shall establish and administer a prescription 139.3 drug assistance program to assist individuals in accessing 139.4 programs offered by pharmaceutical manufacturers that provide 139.5 free or discounted prescription drugs or provide coverage for 139.6 prescription drugs. The board shall use computer software 139.7 programs to link individuals with the pharmaceutical assistance 139.8 programs most appropriate for the individual. The board shall 139.9 make information on the prescription drug assistance program 139.10 available to interested individuals and health care providers 139.11 and shall coordinate the program with the statewide information 139.12 and assistance services provided through the Senior LinkAge Line 139.13 under subdivision 7. 139.14 (b) The board shall work with the commissioner and county 139.15 social service agencies to coordinate the enrollment of 139.16 individuals who are referred to the prescription drug assistance 139.17 program from the prescription drug program, as required under 139.18 section 256.955, subdivision 4a. 139.19 Sec. 12. Minnesota Statutes 2002, section 256.98, 139.20 subdivision 3, is amended to read: 139.21 Subd. 3. [AMOUNT OF ASSISTANCE INCORRECTLY PAID.] The 139.22 amount of the assistance incorrectly paid under this section is: 139.23 (a) the difference between the amount of assistance 139.24 actually received on the basis of misrepresented or concealed 139.25 facts and the amount to which the recipient would have been 139.26 entitled had the specific concealment or misrepresentation not 139.27 occurred. Unless required by law, rule, or regulation, earned 139.28 income disregards shall not be applied to earnings not reported 139.29 by the recipient; or 139.30 (b) equal to all payments for health care services, 139.31 including capitation payments made to a health plan, made on 139.32 behalf of a person enrolled in MinnesotaCare, medical 139.33 assistance, or general assistance medical care, for which the 139.34 person was not entitled due to the concealment or 139.35 misrepresentation of facts. 139.36 Sec. 13. Minnesota Statutes 2002, section 256.98, 140.1 subdivision 4, is amended to read: 140.2 Subd. 4. [RECOVERY OF ASSISTANCE.] The amount of 140.3 assistance determined to have been incorrectly paid is 140.4 recoverable from: 140.5 (1) the recipient or the recipient's estate by the county 140.6 or the state as a debt due the county or the state or both; and 140.7 (2) any person found to have taken independent action to 140.8 establish eligibility for, conspired with, or aided and abetted, 140.9 any recipient of public assistance found to have been 140.10 incorrectly paid. 140.11 The obligations established under this subdivision shall be 140.12 joint and several and shall extend to all cases involving client 140.13 error as well as cases involving wrongfully obtained assistance. 140.14 MinnesotaCare participants who have been found to have 140.15 wrongfully obtained assistance as described in subdivision 1, 140.16 but who otherwise remain eligible for the program, may agree to 140.17 have their MinnesotaCare premiums increased by an amount equal 140.18 to ten percent of their premiums or $10 per month, whichever is 140.19 greater, until the debt is satisfied. 140.20 Sec. 14. Minnesota Statutes 2002, section 256.98, 140.21 subdivision 8, is amended to read: 140.22 Subd. 8. [DISQUALIFICATION FROM PROGRAM.] (a) Any person 140.23 found to be guilty of wrongfully obtaining assistance by a 140.24 federal or state court or by an administrative hearing 140.25 determination, or waiver thereof, through a disqualification 140.26 consent agreement, or as part of any approved diversion plan 140.27 under section 401.065, or any court-ordered stay which carries 140.28 with it any probationary or other conditions, in the Minnesota 140.29 family investment program, the food stamp program, the general 140.30 assistance program, the group residential housing program, or 140.31 the Minnesota supplemental aid program shall be disqualified 140.32 from that program. In addition, any person disqualified from 140.33 the Minnesota family investment program shall also be 140.34 disqualified from the food stamp program. The needs of that 140.35 individual shall not be taken into consideration in determining 140.36 the grant level for that assistance unit: 141.1 (1) for one year after the first offense; 141.2 (2) for two years after the second offense; and 141.3 (3) permanently after the third or subsequent offense. 141.4 The period of program disqualification shall begin on the 141.5 date stipulated on the advance notice of disqualification 141.6 without possibility of postponement for administrative stay or 141.7 administrative hearing and shall continue through completion 141.8 unless and until the findings upon which the sanctions were 141.9 imposed are reversed by a court of competent jurisdiction. The 141.10 period for which sanctions are imposed is not subject to 141.11 review. The sanctions provided under this subdivision are in 141.12 addition to, and not in substitution for, any other sanctions 141.13 that may be provided for by law for the offense involved. A 141.14 disqualification established through hearing or waiver shall 141.15 result in the disqualification period beginning immediately 141.16 unless the person has become otherwise ineligible for 141.17 assistance. If the person is ineligible for assistance, the 141.18 disqualification period begins when the person again meets the 141.19 eligibility criteria of the program from which they were 141.20 disqualified and makes application for that program. 141.21 (b) A family receiving assistance through child care 141.22 assistance programs under chapter 119B with a family member who 141.23 is found to be guilty of wrongfully obtaining child care 141.24 assistance by a federal court, state court, or an administrative 141.25 hearing determination or waiver, through a disqualification 141.26 consent agreement, as part of an approved diversion plan under 141.27 section 401.065, or a court-ordered stay with probationary or 141.28 other conditions, is disqualified from child care assistance 141.29 programs. The disqualifications must be for periods of three 141.30 months, six months, and two years for the first, second, and 141.31 third offenses respectively. Subsequent violations must result 141.32 in permanent disqualification. During the disqualification 141.33 period, disqualification from any child care program must extend 141.34 to all child care programs and must be immediately applied. 141.35 (c) Any person found to be guilty of wrongfully obtaining 141.36 general assistance medical care, MinnesotaCare for adults 142.1 without children, and upon federal approval, all categories of 142.2 medical assistance and remaining categories of MinnesotaCare, 142.3 except for children up to age 18, by a federal or state court or 142.4 by an administrative hearing determination, or waiver thereof, 142.5 through a disqualification consent agreement, or as part of any 142.6 approved diversion plan under section 401.065, or any 142.7 court-ordered stay which carries with it any probationary or 142.8 other conditions, is disqualified from that program. The period 142.9 of disqualification is one year after the first offense, two 142.10 years after the second offense, and permanently after the third 142.11 or subsequent offense. The period of program disqualification 142.12 shall begin on the date stipulated on the advance notice of 142.13 disqualification without possibility of postponement for 142.14 administrative stay or administrative hearing and shall continue 142.15 through completion unless and until the findings upon which the 142.16 sanctions were imposed are reversed by a court of competent 142.17 jurisdiction. The period for which sanctions are imposed is not 142.18 subject to review. The sanctions provided under this 142.19 subdivision are in addition to, and not in substitution for, any 142.20 other sanctions that may be provided for by law for the offense 142.21 involved. 142.22 Sec. 15. Minnesota Statutes 2002, section 256B.055, is 142.23 amended by adding a subdivision to read: 142.24 Subd. 13. [RESIDENTS OF INSTITUTIONS FOR MENTAL DISEASES.] 142.25 Beginning October 1, 2003, persons who would be eligible for 142.26 medical assistance under this chapter but for residing in a 142.27 facility that is determined by the commissioner or the federal 142.28 Centers for Medicare and Medicaid Services to be an institution 142.29 for mental diseases are eligible for medical assistance without 142.30 federal financial participation. 142.31 Sec. 16. Minnesota Statutes 2002, section 256B.056, 142.32 subdivision 1a, is amended to read: 142.33 Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless 142.34 specifically required by state law or rule or federal law or 142.35 regulation, the methodologies used in counting income and assets 142.36 to determine eligibility for medical assistance for persons 143.1 whose eligibility category is based on blindness, disability, or 143.2 age of 65 or more years, the methodologies for the supplemental 143.3 security income program shall be used. Increases in benefits 143.4 under title II of the Social Security Act shall not be counted 143.5 as income for purposes of this subdivision until July 1 of each 143.6 year. Effective upon federal approval, for children eligible 143.7 under section 256B.055, subdivision 12, or for home and 143.8 community-based waiver services whose eligibility for medical 143.9 assistance is determined without regard to parental income, 143.10 child support payments, including any payments made by an 143.11 obligor in satisfaction of or in addition to a temporary or 143.12 permanent order for child support, and social security payments 143.13 are not counted as income. For families and children, which 143.14 includes all other eligibility categories, the methodologies 143.15 under the state's AFDC plan in effect as of July 16, 1996, as 143.16 required by the Personal Responsibility and Work Opportunity 143.17 Reconciliation Act of 1996 (PRWORA), Public LawNumber104-193, 143.18 shall be used, except that effectiveJuly 1, 2002, the $90 and143.19$30 and one-third earned income disregards shall not apply and143.20the disregard specified in subdivision 1c shall applyOctober 1, 143.21 2003, the earned income disregards and deductions are limited to 143.22 those in subdivision 1c. For these purposes, a "methodology" 143.23 does not include an asset or income standard, or accounting 143.24 method, or method of determining effective dates. 143.25 Sec. 17. Minnesota Statutes 2002, section 256B.056, 143.26 subdivision 1c, is amended to read: 143.27 Subd. 1c. [FAMILIES WITH CHILDREN INCOME METHODOLOGY.] 143.28 (a)(1) For children ages one to five whose eligibility is 143.29 determined under section 256B.057, subdivision 2, 21 percent of 143.30 countable earned income shall be disregarded for up to four 143.31 months. This clause expires July 1, 2003. 143.32 (2) For children ages one through 18 whose eligibility is 143.33 determined under section 256B.057, subdivision 2, the following 143.34 deductions shall be applied to income counted toward the child's 143.35 eligibility as allowed under the state's AFDC plan in effect as 143.36 of July 16, 1996: $90 work expense, dependent care, and child 144.1 support paid under court order. This clause is effective 144.2 October 1, 2003. 144.3 (b) For families with children whose eligibility is 144.4 determined using the standard specified in section 256B.056, 144.5 subdivision 4, paragraph (c), 17 percent of countable earned 144.6 income shall be disregarded for up to four months and the 144.7 following deductions shall be applied to each individual's 144.8 income counted toward eligibility as allowed under the state's 144.9 AFDC plan in effect as of July 16, 1996: dependent care and 144.10 child support paid under court order. 144.11 (c) If the four month disregard in paragraph (b) has been 144.12 applied to the wage earner's income for four months, the 144.13 disregard shall not be applied again until the wage earner's 144.14 income has not been considered in determining medical assistance 144.15 eligibility for 12 consecutive months. 144.16 [EFFECTIVE DATE.] The amendments to paragraphs (b) and (c) 144.17 are effective July 1, 2003. 144.18 Sec. 18. Minnesota Statutes 2002, section 256B.057, 144.19 subdivision 1, is amended to read: 144.20 Subdivision 1. [PREGNANT WOMEN AND INFANTS.] (a) An infant 144.21 less than one year of ageor a pregnant woman who has written144.22verification of a positive pregnancy test from a physician or144.23licensed registered nurse,is eligible for medical assistance if 144.24 countable family income is equal to or less than 275 percent of 144.25 the federal poverty guideline for the same family size. A 144.26 pregnant woman who has written verification of a positive 144.27 pregnancy test from a physician or licensed registered nurse is 144.28 eligible for medical assistance if countable family income is 144.29 equal to or less than 200 percent of the federal poverty 144.30 guideline for the same family size. For purposes of this 144.31 subdivision, "countable family income" means the amount of 144.32 income considered available using the methodology of the AFDC 144.33 program under the state's AFDC plan as of July 16, 1996, as 144.34 required by the Personal Responsibility and Work Opportunity 144.35 Reconciliation Act of 1996 (PRWORA), Public LawNumber104-193, 144.36 except for the earned income disregard and employment deductions. 145.1 (b) An amount equal to the amount of earned income 145.2 exceeding 275 percent of the federal poverty guideline, up to a 145.3 maximum of the amount by which the combined total of 185 percent 145.4 of the federal poverty guideline plus the earned income 145.5 disregards and deductions of the AFDC program under the state's 145.6 AFDC plan as of July 16, 1996, as required by the Personal 145.7 Responsibility and Work Opportunity Reconciliation Act of 1996 145.8 (PRWORA), Public LawNumber104-193, exceeds 275 percent of the 145.9 federal poverty guideline will be deducted for pregnant women 145.10 and infants less than one year of age. This paragraph expires 145.11 July 1, 2003. 145.12 (c) Effective July 1, 2003, dependent care and child 145.13 support paid under court order shall be deducted from the 145.14 countable income of pregnant women. 145.15(b)(d) An infant born on or after January 1, 1991, to a 145.16 woman who was eligible for and receiving medical assistance on 145.17 the date of the child's birth shall continue to be eligible for 145.18 medical assistance without redetermination until the child's 145.19 first birthday, as long as the child remains in the woman's 145.20 household. 145.21 [EFFECTIVE DATE.] This section is effective February 1, 145.22 2004, or upon federal approval, whichever is later, except where 145.23 a different date is specified in the text. 145.24 Sec. 19. Minnesota Statutes 2002, section 256B.057, 145.25 subdivision 2, is amended to read: 145.26 Subd. 2. [CHILDREN.] Except as specified in subdivision 145.27 1b, effectiveJuly 1, 2002October 1, 2003, a child one through 145.28 18 years of age in a family whose countable income is no greater 145.29 than170150 percent of the federal poverty guidelines for the 145.30 same family size, is eligible for medical assistance. 145.31 Sec. 20. Minnesota Statutes 2002, section 256B.057, 145.32 subdivision 3b, is amended to read: 145.33 Subd. 3b. [QUALIFYING INDIVIDUALS.] Beginning July 1, 145.34 1998,to the extent of the federal allocation to Minnesota145.35 contingent upon federal funding, a person who would otherwise be 145.36 eligible as a qualified Medicare beneficiary under subdivision 146.1 3, except that the person's income is in excess of the limit, is 146.2 eligible as a qualifying individual according to the following 146.3 criteria: 146.4 (1) if the person's income is greater than 120 percent, but 146.5 less than 135 percent of the official federal poverty guidelines 146.6 for the applicable family size, the person is eligible for 146.7 medical assistance reimbursement of Medicare Part B premiums; or 146.8 (2) if the person's income is equal to or greater than 135 146.9 percent but less than 175 percent of the official federal 146.10 poverty guidelines for the applicable family size, the person is 146.11 eligible for medical assistance reimbursement of that portion of 146.12 the Medicare Part B premium attributable to an increase in Part 146.13 B expenditures which resulted from the shift of home care 146.14 services from Medicare Part A to Medicare Part B under Public 146.15 LawNumber105-33, section 4732, the Balanced Budget Act of 1997. 146.16 The commissioner shall limit enrollment of qualifying 146.17 individuals under this subdivision according to the requirements 146.18 of Public LawNumber105-33, section 4732. 146.19 [EFFECTIVE DATE.] This section is effective July 1, 2003. 146.20 Sec. 21. Minnesota Statutes 2002, section 256B.057, 146.21 subdivision 9, is amended to read: 146.22 Subd. 9. [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 146.23 assistance may be paid for a person who is employed and who: 146.24 (1) meets the definition of disabled under the supplemental 146.25 security income program; 146.26 (2) is at least 16 but less than 65 years of age; 146.27 (3) meets the asset limits in paragraph (b); and 146.28 (4) effective November 1, 2003, pays a premium, if146.29required,and other obligations under paragraph(c)(d). 146.30 Any spousal income or assets shall be disregarded for purposes 146.31 of eligibility and premium determinations. 146.32 After the month of enrollment, a person enrolled in medical 146.33 assistance under this subdivision who: 146.34 (1) is temporarily unable to work and without receipt of 146.35 earned income due to a medical condition, as verified by a 146.36 physician, may retain eligibility for up to four calendar 147.1 months; or 147.2 (2) effective January 1, 2004, loses employment for reasons 147.3 not attributable to the enrollee, may retain eligibility for up 147.4 to four consecutive months after the month of job loss. To 147.5 receive a four-month extension, enrollees must verify the 147.6 medical condition or provide notification of job loss. All 147.7 other eligibility requirements must be met and the enrollee must 147.8 pay all calculated premium costs for continued eligibility. 147.9 (b) For purposes of determining eligibility under this 147.10 subdivision, a person's assets must not exceed $20,000, 147.11 excluding: 147.12 (1) all assets excluded under section 256B.056; 147.13 (2) retirement accounts, including individual accounts, 147.14 401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 147.15 (3) medical expense accounts set up through the person's 147.16 employer. 147.17 (c)(1) Effective January 1, 2004, for purposes of 147.18 eligibility, there will be a $65 earned income disregard. To be 147.19 eligible, a person applying for medical assistance under this 147.20 subdivision must have earned income above the disregard level. 147.21 (2) Effective January 1, 2004, to be considered earned 147.22 income, Medicare, social security, and applicable state and 147.23 federal income taxes must be withheld. To be eligible, a person 147.24 must document earned income tax withholding. 147.25 (d)(1) A person whose earned and unearned income is equal 147.26 to or greater than 100 percent of federal poverty guidelines for 147.27 the applicable family size must pay a premium to be eligible for 147.28 medical assistance under this subdivision. The premium shall be 147.29 based on the person's gross earned and unearned income and the 147.30 applicable family size using a sliding fee scale established by 147.31 the commissioner, which begins at one percent of income at 100 147.32 percent of the federal poverty guidelines and increases to 7.5 147.33 percent of income for those with incomes at or above 300 percent 147.34 of the federal poverty guidelines. Annual adjustments in the 147.35 premium schedule based upon changes in the federal poverty 147.36 guidelines shall be effective for premiums due in July of each 148.1 year. 148.2 (2) Effective January 1, 2004, all enrollees must pay a 148.3 premium to be eligible for medical assistance under this 148.4 subdivision. An enrollee shall pay the greater of a $35 premium 148.5 or the premium calculated in clause (1). 148.6 (3) Effective November 1, 2003, all enrollees who receive 148.7 unearned income must pay one-half of one percent of unearned 148.8 income in addition to the premium amount. 148.9 (4) Effective November 1, 2003, for enrollees whose income 148.10 does not exceed 150 percent of the federal poverty guidelines 148.11 and who are also enrolled in Medicare, the commissioner must 148.12 reimburse the enrollee for Medicare Part B premiums under 148.13 section 256B.0625, subdivision 15, paragraph (a). 148.14(d)(e) A person's eligibility and premium shall be 148.15 determined by the local county agency. Premiums must be paid to 148.16 the commissioner. All premiums are dedicated to the 148.17 commissioner. 148.18(e)(f) Any required premium shall be determined at 148.19 application and redeterminedannually at recertificationat the 148.20 enrollee's six-month income review or when a change in income or 148.21familyhousehold sizeoccursis reported. Enrollees must report 148.22 any change in income or household size within ten days of when 148.23 the change occurs. A decreased premium resulting from a 148.24 reported change in income or household size shall be effective 148.25 the first day of the next available billing month after the 148.26 change is reported. Except for changes occurring from annual 148.27 cost-of-living increases or verification of income under section 148.28 256B.061, paragraph (b), a change resulting in an increased 148.29 premium shall not affect the premium amount until the next 148.30 six-month review. 148.31(f)(g) Premium payment is due upon notification from the 148.32 commissioner of the premium amount required. Premiums may be 148.33 paid in installments at the discretion of the commissioner. 148.34(g)(h) Nonpayment of the premium shall result in denial or 148.35 termination of medical assistance unless the person demonstrates 148.36 good cause for nonpayment. Good cause exists if the 149.1 requirements specified in Minnesota Rules, part 9506.0040, 149.2 subpart 7, items B to D, are met. Except when an installment 149.3 agreement is accepted by the commissioner, all persons 149.4 disenrolled for nonpayment of a premium must pay any past due 149.5 premiums as well as current premiums due prior to being 149.6 reenrolled. Nonpayment shall include payment with a returned, 149.7 refused, or dishonored instrument. The commissioner may require 149.8 a guaranteed form of payment as the only means to replace a 149.9 returned, refused, or dishonored instrument. 149.10 [EFFECTIVE DATE.] This section is effective November 1, 149.11 2003, except the amendments to Minnesota Statutes 2002, section 149.12 256B.057, subdivision 9, paragraphs (e) and (g), are effective 149.13 July 1, 2003. 149.14 Sec. 22. Minnesota Statutes 2002, section 256B.057, 149.15 subdivision 10, is amended to read: 149.16 Subd. 10. [CERTAIN PERSONS NEEDING TREATMENT FOR BREAST OR 149.17 CERVICAL CANCER.] (a) Medical assistance may be paid for a 149.18 person who: 149.19 (1) has been screened for breast or cervical cancer by the 149.20 Minnesota breast and cervical cancer control program, and 149.21 program funds have been used to pay for the person's screening; 149.22 (2) according to the person's treating health professional, 149.23 needs treatment, including diagnostic services necessary to 149.24 determine the extent and proper course of treatment, for breast 149.25 or cervical cancer, including precancerous conditions and early 149.26 stage cancer; 149.27 (3) meets the income eligibility guidelines for the 149.28 Minnesota breast and cervical cancer control program; 149.29 (4) is under age 65; 149.30 (5) is not otherwise eligible for medical assistance under 149.31 United States Code, title 42, section 1396(a)(10)(A)(i); and 149.32 (6) is not otherwise covered under creditable coverage, as 149.33 defined under United States Code, title 42, section 149.34300gg(c)1396a(aa). 149.35 (b) Medical assistance provided for an eligible person 149.36 under this subdivision shall be limited to services provided 150.1 during the period that the person receives treatment for breast 150.2 or cervical cancer. 150.3 (c) A person meeting the criteria in paragraph (a) is 150.4 eligible for medical assistance without meeting the eligibility 150.5 criteria relating to income and assets in section 256B.056, 150.6 subdivisions 1a to 5b. 150.7 Sec. 23. Minnesota Statutes 2002, section 256B.0595, 150.8 subdivision 1, is amended to read: 150.9 Subdivision 1. [PROHIBITED TRANSFERS.] (a) For transfers 150.10 of assets made on or before August 10, 1993, if a person or the 150.11 person's spouse has given away, sold, or disposed of, for less 150.12 than fair market value, any asset or interest therein, except 150.13 assets other than the homestead that are excluded under the 150.14 supplemental security program, within 30 months before or any 150.15 time after the date of institutionalization if the person has 150.16 been determined eligible for medical assistance, or within 30 150.17 months before or any time after the date of the first approved 150.18 application for medical assistance if the person has not yet 150.19 been determined eligible for medical assistance, the person is 150.20 ineligible for long-term care services for the period of time 150.21 determined under subdivision 2. 150.22 (b) Effective for transfers made after August 10, 1993, a 150.23 person, a person's spouse, or any person, court, or 150.24 administrative body with legal authority to act in place of, on 150.25 behalf of, at the direction of, or upon the request of the 150.26 person or person's spouse, may not give away, sell, or dispose 150.27 of, for less than fair market value, any asset or interest 150.28 therein, except assets other than the homestead that are 150.29 excluded under the supplemental security income program, for the 150.30 purpose of establishing or maintaining medical assistance 150.31 eligibility. This applies to all transfers, including those 150.32 made by a community spouse after the month in which the 150.33 institutionalized spouse is determined eligible for medical 150.34 assistance. For purposes of determining eligibility for 150.35 long-term care services, any transfer of such assets within 36 150.36 months before or any time after an institutionalized person 151.1 applies for medical assistance, or 36 months before or any time 151.2 after a medical assistance recipient becomes institutionalized, 151.3 for less than fair market value may be considered. Any such 151.4 transfer is presumed to have been made for the purpose of 151.5 establishing or maintaining medical assistance eligibility and 151.6 the person is ineligible for long-term care services for the 151.7 period of time determined under subdivision 2, unless the person 151.8 furnishes convincing evidence to establish that the transaction 151.9 was exclusively for another purpose, or unless the transfer is 151.10 permitted under subdivision 3 or 4. Notwithstanding the 151.11 provisions of this paragraph, in the case of payments from a 151.12 trust or portions of a trust that are considered transfers of 151.13 assets under federal law, any transfers made within 60 months 151.14 before or any time after an institutionalized person applies for 151.15 medical assistance and within 60 months before or any time after 151.16 a medical assistance recipient becomes institutionalized, may be 151.17 considered. 151.18 (c) This section applies to transfers, for less than fair 151.19 market value, of income or assets, including assets that are 151.20 considered income in the month received, such as inheritances, 151.21 court settlements, and retroactive benefit payments or income to 151.22 which the person or the person's spouse is entitled but does not 151.23 receive due to action by the person, the person's spouse, or any 151.24 person, court, or administrative body with legal authority to 151.25 act in place of, on behalf of, at the direction of, or upon the 151.26 request of the person or the person's spouse. 151.27 (d) This section applies to payments for care or personal 151.28 services provided by a relative, unless the compensation was 151.29 stipulated in a notarized, written agreement which was in 151.30 existence when the service was performed, the care or services 151.31 directly benefited the person, and the payments made represented 151.32 reasonable compensation for the care or services provided. A 151.33 notarized written agreement is not required if payment for the 151.34 services was made within 60 days after the service was provided. 151.35 (e) This section applies to the portion of any asset or 151.36 interest that a person, a person's spouse, or any person, court, 152.1 or administrative body with legal authority to act in place of, 152.2 on behalf of, at the direction of, or upon the request of the 152.3 person or the person's spouse, transfers to any annuity that 152.4 exceeds the value of the benefit likely to be returned to the 152.5 person or spouse while alive, based on estimated life expectancy 152.6 using the life expectancy tables employed by the supplemental 152.7 security income program to determine the value of an agreement 152.8 for services for life. The commissioner may adopt rules 152.9 reducing life expectancies based on the need for long-term 152.10 care. This section applies to an annuity described in this 152.11 paragraph purchased on or after March 1, 2002, that: 152.12 (1) is not purchased from an insurance company or financial 152.13 institution that is subject to licensing or regulation by the 152.14 Minnesota department of commerce or a similar regulatory agency 152.15 of another state; 152.16 (2) does not pay out principal and interest in equal 152.17 monthly installments; or 152.18 (3) does not begin payment at the earliest possible date 152.19 after annuitization. 152.20 (f) For purposes of this section, long-term care services 152.21 include services in a nursing facility, services that are 152.22 eligible for payment according to section 256B.0625, subdivision 152.23 2, because they are provided in a swing bed, intermediate care 152.24 facility for persons with mental retardation, and home and 152.25 community-based services provided pursuant to sections 152.26 256B.0915, 256B.092, and 256B.49. For purposes of this 152.27 subdivision and subdivisions 2, 3, and 4, "institutionalized 152.28 person" includes a person who is an inpatient in a nursing 152.29 facility or in a swing bed, or intermediate care facility for 152.30 persons with mental retardation or who is receiving home and 152.31 community-based services under sections 256B.0915, 256B.092, and 152.32 256B.49. 152.33 [EFFECTIVE DATE.] This section is effective July 1, 2003. 152.34 Sec. 24. Minnesota Statutes 2002, section 256B.0595, is 152.35 amended by adding a subdivision to read: 152.36 Subd. 1b. [PROHIBITED TRANSFERS.] (a) Notwithstanding any 153.1 contrary provisions of this section, this subdivision applies to 153.2 transfers involving recipients of medical assistance that are 153.3 made on or after its effective date and to all transfers 153.4 involving persons who apply for medical assistance on or after 153.5 its effective date if the transfer occurred within 72 months 153.6 before the person applies for medical assistance, except that 153.7 this subdivision does not apply to transfers made prior to July 153.8 1, 2003. A person, a person's spouse, or any person, court, or 153.9 administrative body with legal authority to act in place of, on 153.10 behalf of, at the direction of, or upon the request of the 153.11 person or the person's spouse, may not give away, sell, dispose 153.12 of, or reduce ownership or control of any income, asset, or 153.13 interest therein for less than fair market value for the purpose 153.14 of establishing or maintaining medical assistance eligibility. 153.15 This applies to all transfers, including those made by a 153.16 community spouse after the month in which the institutionalized 153.17 spouse is determined eligible for medical assistance. For 153.18 purposes of determining eligibility for medical assistance 153.19 services, any transfer of such income or assets for less than 153.20 fair market value within 72 months before or any time after a 153.21 person applies for medical assistance may be considered. Any 153.22 such transfer is presumed to have been made for the purpose of 153.23 establishing or maintaining medical assistance eligibility, and 153.24 the person is ineligible for medical assistance services for the 153.25 period of time determined under subdivision 2b, unless the 153.26 person furnishes convincing evidence to establish that the 153.27 transaction was exclusively for another purpose or unless the 153.28 transfer is permitted under subdivision 3b or 4b. 153.29 (b) This section applies to transfers to trusts. The 153.30 commissioner shall determine valid trust purposes under this 153.31 section. Assets placed into a trust that is not for a valid 153.32 purpose shall always be considered available for the purposes of 153.33 medical assistance eligibility, regardless of when the trust is 153.34 established. 153.35 (c) This section applies to transfers of income or assets 153.36 for less than fair market value, including assets that are 154.1 considered income in the month received, such as inheritances, 154.2 court settlements, and retroactive benefit payments or income to 154.3 which the person or the person's spouse is entitled but does not 154.4 receive due to action by the person, the person's spouse, or any 154.5 person, court, or administrative body with legal authority to 154.6 act in place of, on behalf of, at the direction of, or upon the 154.7 request of the person or the person's spouse. 154.8 (d) This section applies to payments for care or personal 154.9 services provided by a relative, unless the compensation was 154.10 stipulated in a notarized written agreement that was in 154.11 existence when the service was performed, the care or services 154.12 directly benefited the person, and the payments made represented 154.13 reasonable compensation for the care or services provided. A 154.14 notarized written agreement is not required if payment for the 154.15 services was made within 60 days after the service was provided. 154.16 (e) This section applies to the portion of any income, 154.17 asset, or interest therein that a person, a person's spouse, or 154.18 any person, court, or administrative body with legal authority 154.19 to act in place of, on behalf of, at the direction of, or upon 154.20 the request of the person or the person's spouse, transfers to 154.21 any annuity that exceeds the value of the benefit likely to be 154.22 returned to the person or the person's spouse while alive, based 154.23 on estimated life expectancy, using the life expectancy tables 154.24 employed by the supplemental security income program, or based 154.25 on a shorter life expectancy if the annuitant had a medical 154.26 condition that would shorten the annuitant's life expectancy and 154.27 that was diagnosed before funds were placed into the annuity. 154.28 The agency may request and receive a physician's statement to 154.29 determine if the annuitant had a diagnosed medical condition 154.30 that would shorten the annuitant's life expectancy. If so, the 154.31 agency shall determine the expected value of the benefits based 154.32 upon the physician's statement instead of using a life 154.33 expectancy table. This section applies to an annuity described 154.34 in this paragraph purchased on or after March 1, 2002, that: 154.35 (1) is not purchased from an insurance company or financial 154.36 institution that is subject to licensing or regulation by the 155.1 Minnesota department of commerce or a similar regulatory agency 155.2 of another state; 155.3 (2) does not pay out principal and interest in equal 155.4 monthly installments; or 155.5 (3) does not begin payment at the earliest possible date 155.6 after annuitization. 155.7 (f) Transfers under this section shall affect 155.8 determinations of eligibility for all medical assistance 155.9 services or long-term care services, whichever receives federal 155.10 approval. 155.11 [EFFECTIVE DATE.] (a) This section is effective July 1, 155.12 2003, to the extent permitted by federal law. If any provision 155.13 of this section is prohibited by federal law, the provision 155.14 shall become effective when federal law is changed to permit its 155.15 application or a waiver is received. The commissioner of human 155.16 services shall notify the revisor of statutes when federal law 155.17 is enacted or a waiver or other federal approval is received and 155.18 publish a notice in the State Register. The commissioner must 155.19 include the notice in the first State Register published after 155.20 the effective date of the federal changes. 155.21 (b) If, by July 1, 2003, any provision of this section is 155.22 not effective because of prohibitions in federal law, the 155.23 commissioner of human services shall apply to the federal 155.24 government by August 1, 2003, for a waiver of those prohibitions 155.25 or other federal authority, and that provision shall become 155.26 effective upon receipt of a federal waiver or other federal 155.27 approval, notification to the revisor of statutes, and 155.28 publication of a notice in the State Register to that effect. 155.29 In applying for federal approval to extend the lookback period, 155.30 the commissioner shall seek the longest lookback period the 155.31 federal government will approve, not to exceed 72 months. 155.32 Sec. 25. Minnesota Statutes 2002, section 256B.0595, 155.33 subdivision 2, is amended to read: 155.34 Subd. 2. [PERIOD OF INELIGIBILITY.] (a) For any 155.35 uncompensated transfer occurring on or before August 10, 1993, 155.36 the number of months of ineligibility for long-term care 156.1 services shall be the lesser of 30 months, or the uncompensated 156.2 transfer amount divided by the average medical assistance rate 156.3 for nursing facility services in the state in effect on the date 156.4 of application. The amount used to calculate the average 156.5 medical assistance payment rate shall be adjusted each July 1 to 156.6 reflect payment rates for the previous calendar year. The 156.7 period of ineligibility begins with the month in which the 156.8 assets were transferred. If the transfer was not reported to 156.9 the local agency at the time of application, and the applicant 156.10 received long-term care services during what would have been the 156.11 period of ineligibility if the transfer had been reported, a 156.12 cause of action exists against the transferee for the cost of 156.13 long-term care services provided during the period of 156.14 ineligibility, or for the uncompensated amount of the transfer, 156.15 whichever is less. The action may be brought by the state or 156.16 the local agency responsible for providing medical assistance 156.17 under chapter 256G. The uncompensated transfer amount is the 156.18 fair market value of the asset at the time it was given away, 156.19 sold, or disposed of, less the amount of compensation received. 156.20 (b) For uncompensated transfers made after August 10, 1993, 156.21 the number of months of ineligibility for long-term care 156.22 services shall be the total uncompensated value of the resources 156.23 transferred divided by the average medical assistance rate for 156.24 nursing facility services in the state in effect on the date of 156.25 application. The amount used to calculate the average medical 156.26 assistance payment rate shall be adjusted each July 1 to reflect 156.27 payment rates for the previous calendar year. The period of 156.28 ineligibility begins with the first day of the month after the 156.29 month in which the assets were transferred except that if one or 156.30 more uncompensated transfers are made during a period of 156.31 ineligibility, the total assets transferred during the 156.32 ineligibility period shall be combined and a penalty period 156.33 calculated to begininon the first day of the month after the 156.34 month in which the first uncompensated transfer was made. If 156.35 the transfer was not reported to the local agencyat the time of156.36application, and the applicant received medical assistance 157.1 services during what would have been the period of ineligibility 157.2 if the transfer had been reported, a cause of action exists 157.3 against the transferee for the cost of medical assistance 157.4 services provided during the period of ineligibility, or for the 157.5 uncompensated amount of the transfer, whichever is less. The 157.6 action may be brought by the state or the local agency 157.7 responsible for providing medical assistance under chapter 157.8 256G. The uncompensated transfer amount is the fair market 157.9 value of the asset at the time it was given away, sold, or 157.10 disposed of, less the amount of compensation received. 157.11 Effective for transfers made on or after March 1, 1996, 157.12 involving persons who apply for medical assistance on or after 157.13 April 13, 1996, no cause of action exists for a transfer unless: 157.14 (1) the transferee knew or should have known that the 157.15 transfer was being made by a person who was a resident of a 157.16 long-term care facility or was receiving that level of care in 157.17 the community at the time of the transfer; 157.18 (2) the transferee knew or should have known that the 157.19 transfer was being made to assist the person to qualify for or 157.20 retain medical assistance eligibility; or 157.21 (3) the transferee actively solicited the transfer with 157.22 intent to assist the person to qualify for or retain eligibility 157.23 for medical assistance. 157.24 (c) If a calculation of a penalty period results in a 157.25 partial month, payments for long-term care services shall be 157.26 reduced in an amount equal to the fraction, except that in 157.27 calculating the value of uncompensated transfers, if the total 157.28 value of all uncompensated transfers made in a month not 157.29 included in an existing penalty period does not exceed $200, 157.30 then such transfers shall be disregarded for each month prior to 157.31 the month of application for or during receipt of medical 157.32 assistance. 157.33 [EFFECTIVE DATE.] Paragraph (b) of this section is 157.34 effective July 1, 2003. 157.35 Sec. 26. Minnesota Statutes 2002, section 256B.0595, is 157.36 amended by adding a subdivision to read: 158.1 Subd. 2b. [PERIOD OF INELIGIBILITY.] (a) Notwithstanding 158.2 any contrary provisions of this section, this subdivision 158.3 applies to transfers, including transfers to trusts, involving 158.4 recipients of medical assistance that are made on or after its 158.5 effective date and to all transfers involving persons who apply 158.6 for medical assistance on or after its effective date, 158.7 regardless of when the transfer occurred, except that this 158.8 subdivision does not apply to transfers made prior to July 1, 158.9 2003. For any uncompensated transfer occurring within 72 months 158.10 prior to the date of application, at any time after application, 158.11 or while eligible, the number of months of cumulative 158.12 ineligibility for medical assistance services shall be the total 158.13 uncompensated value of the assets and income transferred divided 158.14 by the statewide average per-person nursing facility payment 158.15 made by the state in effect at the time a penalty for a transfer 158.16 is determined. The amount used to calculate the average 158.17 per-person nursing facility payment shall be adjusted each July 158.18 1 to reflect average payments for the previous calendar year. 158.19 For applicants, the period of ineligibility begins with the 158.20 month in which the person applied for medical assistance and 158.21 satisfied all other requirements for eligibility, or the first 158.22 month the local agency becomes aware of the transfer and can 158.23 give proper notice, if later. For recipients, the period of 158.24 ineligibility begins in the first month after the month the 158.25 agency becomes aware of the transfer and can give proper notice, 158.26 except that penalty periods for transfers made during a period 158.27 of ineligibility as determined under this section shall begin in 158.28 the month following the existing period of ineligibility. If 158.29 the transfer was not reported to the local agency, and the 158.30 applicant received medical assistance services during what would 158.31 have been the period of ineligibility if the transfer had been 158.32 reported, a cause of action exists against the transferee for 158.33 the cost of medical assistance services provided during the 158.34 period of ineligibility or for the uncompensated amount of the 158.35 transfer that was not recovered from the transferor through the 158.36 implementation of a penalty period under this subdivision, 159.1 whichever is less. Recovery shall include the costs incurred 159.2 due to the action. The action may be brought by the state or 159.3 the local agency responsible for providing medical assistance 159.4 under chapter 256B. The uncompensated transfer amount is the 159.5 fair market value of the asset at the time it was given away, 159.6 sold, or disposed of, less the amount of compensation received. 159.7 No cause of action exists for a transfer unless: 159.8 (1) the transferee knew or should have known that the 159.9 transfer was being made by a person who was a resident of a 159.10 long-term care facility or was receiving that level of care in 159.11 the community at the time of the transfer; 159.12 (2) the transferee knew or should have known that the 159.13 transfer was being made to assist the person to qualify for or 159.14 retain medical assistance eligibility; or 159.15 (3) the transferee actively solicited the transfer with 159.16 intent to assist the person to qualify for or retain eligibility 159.17 for medical assistance. 159.18 (b) If a calculation of a penalty period results in a 159.19 partial month, payments for medical assistance services shall be 159.20 reduced in an amount equal to the fraction, except that in 159.21 calculating the value of uncompensated transfers, if the total 159.22 value of all uncompensated transfers made in a month not 159.23 included in an existing penalty period does not exceed $200, 159.24 then such transfers shall be disregarded for each month prior to 159.25 the month of application for or during receipt of medical 159.26 assistance. 159.27 (c) Ineligibility under this section shall apply to medical 159.28 assistance services or long-term care services, whichever 159.29 receives federal approval. 159.30 [EFFECTIVE DATE.] (a) This section is effective July 1, 159.31 2003, to the extent permitted by federal law. If any provision 159.32 of this section is prohibited by federal law, the provision 159.33 shall become effective when federal law is changed to permit its 159.34 application or a waiver is received. The commissioner of human 159.35 services shall notify the revisor of statutes when federal law 159.36 is enacted or a waiver or other federal approval is received and 160.1 publish a notice in the State Register. The commissioner must 160.2 include the notice in the first State Register published after 160.3 the effective date of the federal changes. 160.4 (b) If, by July 1, 2003, any provision of this section is 160.5 not effective because of prohibitions in federal law, the 160.6 commissioner of human services shall apply to the federal 160.7 government by August 1, 2003, for a waiver of those prohibitions 160.8 or other federal authority, and that provision shall become 160.9 effective upon receipt of a federal waiver or other federal 160.10 approval, notification to the revisor of statutes, and 160.11 publication of a notice in the State Register to that effect. 160.12 In applying for federal approval to extend the lookback period, 160.13 the commissioner shall seek the longest lookback period the 160.14 federal government will approve, not to exceed 72 months. 160.15 Sec. 27. Minnesota Statutes 2002, section 256B.0595, is 160.16 amended by adding a subdivision to read: 160.17 Subd. 3b. [HOMESTEAD EXCEPTION TO TRANSFER 160.18 PROHIBITION.] (a) This subdivision applies to transfers 160.19 involving recipients of medical assistance that are made on or 160.20 after its effective date and to all transfers involving persons 160.21 who apply for medical assistance on or after its effective date, 160.22 regardless of when the transfer occurred, except that this 160.23 subdivision does not apply to transfers made prior to July 1, 160.24 2003. A person is not ineligible for medical assistance 160.25 services due to a transfer of assets for less than fair market 160.26 value as described in subdivision 1b, if the asset transferred 160.27 was a homestead, and: 160.28 (1) a satisfactory showing is made that the individual 160.29 intended to dispose of the homestead at fair market value or for 160.30 other valuable consideration; or 160.31 (2) the local agency grants a waiver of a penalty resulting 160.32 from a transfer for less than fair market value because denial 160.33 of eligibility would cause undue hardship for the individual and 160.34 there exists an imminent threat to the individual's health and 160.35 well-being. Whenever an applicant or recipient is denied 160.36 eligibility because of a transfer for less than fair market 161.1 value, the local agency shall notify the applicant or recipient 161.2 that the applicant or recipient may request a waiver of the 161.3 penalty if the denial of eligibility will cause undue hardship. 161.4 In evaluating a waiver, the local agency shall take into account 161.5 whether the individual was the victim of financial exploitation, 161.6 whether the individual has made reasonable efforts to recover 161.7 the transferred property or resource, and other factors relevant 161.8 to a determination of hardship. If the local agency does not 161.9 approve a hardship waiver, the local agency shall issue a 161.10 written notice to the individual stating the reasons for the 161.11 denial and the process for appealing the local agency's decision. 161.12 (b) When a waiver is granted under paragraph (a), clause 161.13 (2), a cause of action exists against the person to whom the 161.14 homestead was transferred for that portion of medical assistance 161.15 services granted within 72 months of the date the transferor 161.16 applied for medical assistance and satisfied all other 161.17 requirements for eligibility or the amount of the uncompensated 161.18 transfer, whichever is less, together with the costs incurred 161.19 due to the action. The action shall be brought by the state 161.20 unless the state delegates this responsibility to the local 161.21 agency responsible for providing medical assistance under 161.22 chapter 256B. 161.23 [EFFECTIVE DATE.] (a) This section is effective July 1, 161.24 2003, to the extent permitted by federal law. If any provision 161.25 of this section is prohibited by federal law, the provision 161.26 shall become effective when federal law is changed to permit its 161.27 application or a waiver is received. The commissioner of human 161.28 services shall notify the revisor of statutes when federal law 161.29 is enacted or a waiver or other federal approval is received and 161.30 publish a notice in the State Register. The commissioner must 161.31 include the notice in the first State Register published after 161.32 the effective date of the federal changes. 161.33 (b) If, by July 1, 2003, any provision of this section is 161.34 not effective because of prohibitions in federal law, the 161.35 commissioner of human services shall apply to the federal 161.36 government by August 1, 2003, for a waiver of those prohibitions 162.1 or other federal authority, and that provision shall become 162.2 effective upon receipt of a federal waiver or other federal 162.3 approval, notification to the revisor of statutes, and 162.4 publication of a notice in the State Register to that effect. 162.5 In applying for federal approval to extend the lookback period, 162.6 the commissioner shall seek the longest lookback period the 162.7 federal government will approve, not to exceed 72 months. 162.8 Sec. 28. Minnesota Statutes 2002, section 256B.0595, is 162.9 amended by adding a subdivision to read: 162.10 Subd. 4b. [OTHER EXCEPTIONS TO TRANSFER PROHIBITION.] (a) 162.11 This subdivision applies to transfers involving recipients of 162.12 medical assistance that are made on or after its effective date 162.13 and to all transfers involving persons who apply for medical 162.14 assistance on or after its effective date regardless of when the 162.15 transfer occurred, except that this subdivision does not apply 162.16 to transfers made prior to July 1, 2003. A person or a person's 162.17 spouse who made a transfer prohibited by subdivision 1b is not 162.18 ineligible for medical assistance services if one of the 162.19 following conditions applies: 162.20 (1) the assets or income were transferred to the 162.21 individual's spouse or to another for the sole benefit of the 162.22 spouse, except that after eligibility is established and the 162.23 assets have been divided between the spouses as part of the 162.24 asset allowance under section 256B.059, no further transfers 162.25 between spouses may be made; 162.26 (2) the institutionalized spouse, prior to being 162.27 institutionalized, transferred assets or income to a spouse, 162.28 provided that the spouse to whom the assets or income were 162.29 transferred does not then transfer those assets or income to 162.30 another person for less than fair market value. At the time 162.31 when one spouse is institutionalized, assets must be allocated 162.32 between the spouses as provided under section 256B.059; 162.33 (3) the assets or income were transferred to a trust for 162.34 the sole benefit of the individual's child who is blind or 162.35 permanently and totally disabled as determined in the 162.36 supplemental security income program and the trust reverts to 163.1 the state upon the disabled child's death to the extent the 163.2 medical assistance has paid for services for the grantor or 163.3 beneficiary of the trust. This clause applies to a trust 163.4 established after the commissioner publishes a notice in the 163.5 State Register that the commissioner has been authorized to 163.6 implement this clause due to a change in federal law or the 163.7 approval of a federal waiver; 163.8 (4) a satisfactory showing is made that the individual 163.9 intended to dispose of the assets or income either at fair 163.10 market value or for other valuable consideration; or 163.11 (5) the local agency determines that denial of eligibility 163.12 for medical assistance services would cause undue hardship and 163.13 grants a waiver of a penalty resulting from a transfer for less 163.14 than fair market value because there exists an imminent threat 163.15 to the individual's health and well-being. Whenever an 163.16 applicant or recipient is denied eligibility because of a 163.17 transfer for less than fair market value, the local agency shall 163.18 notify the applicant or recipient that the applicant or 163.19 recipient may request a waiver of the penalty if the denial of 163.20 eligibility will cause undue hardship. In evaluating a waiver, 163.21 the local agency shall take into account whether the individual 163.22 was the victim of financial exploitation, whether the individual 163.23 has made reasonable efforts to recover the transferred property 163.24 or resource, and other factors relevant to a determination of 163.25 hardship. If the local agency does not approve a hardship 163.26 waiver, the local agency shall issue a written notice to the 163.27 individual stating the reasons for the denial and the process 163.28 for appealing the local agency's decision. When a waiver is 163.29 granted, a cause of action exists against the person to whom the 163.30 assets were transferred for that portion of medical assistance 163.31 services granted within 72 months of the date the transferor 163.32 applied for medical assistance and satisfied all other 163.33 requirements for eligibility, or the amount of the uncompensated 163.34 transfer, whichever is less, together with the costs incurred 163.35 due to the action. The action shall be brought by the state 163.36 unless the state delegates this responsibility to the local 164.1 agency responsible for providing medical assistance under this 164.2 chapter. 164.3 [EFFECTIVE DATE.] (a) This section is effective July 1, 164.4 2003, to the extent permitted by federal law. If any provision 164.5 of this section is prohibited by federal law, the provision 164.6 shall become effective when federal law is changed to permit its 164.7 application or a waiver is received. The commissioner of human 164.8 services shall notify the revisor of statutes when federal law 164.9 is enacted or a waiver or other federal approval is received and 164.10 publish a notice in the State Register. The commissioner must 164.11 include the notice in the first State Register published after 164.12 the effective date of the federal changes. 164.13 (b) If, by July 1, 2003, any provision of this section is 164.14 not effective because of prohibitions in federal law, the 164.15 commissioner of human services shall apply to the federal 164.16 government by August 1, 2003, for a waiver of those prohibitions 164.17 or other federal authority, and that provision shall become 164.18 effective upon receipt of a federal waiver or other federal 164.19 approval, notification to the revisor of statutes, and 164.20 publication of a notice in the State Register to that effect. 164.21 In applying for federal approval to extend the lookback period, 164.22 the commissioner shall seek the longest lookback period the 164.23 federal government will approve, not to exceed 72 months. 164.24 Sec. 29. Minnesota Statutes 2002, section 256B.06, 164.25 subdivision 4, is amended to read: 164.26 Subd. 4. [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for 164.27 medical assistance is limited to citizens of the United States, 164.28 qualified noncitizens as defined in this subdivision, and other 164.29 persons residing lawfully in the United States. 164.30 (b) "Qualified noncitizen" means a person who meets one of 164.31 the following immigration criteria: 164.32 (1) admitted for lawful permanent residence according to 164.33 United States Code, title 8; 164.34 (2) admitted to the United States as a refugee according to 164.35 United States Code, title 8, section 1157; 164.36 (3) granted asylum according to United States Code, title 165.1 8, section 1158; 165.2 (4) granted withholding of deportation according to United 165.3 States Code, title 8, section 1253(h); 165.4 (5) paroled for a period of at least one year according to 165.5 United States Code, title 8, section 1182(d)(5); 165.6 (6) granted conditional entrant status according to United 165.7 States Code, title 8, section 1153(a)(7); 165.8 (7) determined to be a battered noncitizen by the United 165.9 States Attorney General according to the Illegal Immigration 165.10 Reform and Immigrant Responsibility Act of 1996, title V of the 165.11 Omnibus Consolidated Appropriations Bill, Public Law Number 165.12 104-200; 165.13 (8) is a child of a noncitizen determined to be a battered 165.14 noncitizen by the United States Attorney General according to 165.15 the Illegal Immigration Reform and Immigrant Responsibility Act 165.16 of 1996, title V, of the Omnibus Consolidated Appropriations 165.17 Bill, Public Law Number 104-200; or 165.18 (9) determined to be a Cuban or Haitian entrant as defined 165.19 in section 501(e) of Public Law Number 96-422, the Refugee 165.20 Education Assistance Act of 1980. 165.21 (c) All qualified noncitizens who were residing in the 165.22 United States before August 22, 1996, who otherwise meet the 165.23 eligibility requirements of chapter 256B, are eligible for 165.24 medical assistance with federal financial participation. 165.25 (d) All qualified noncitizens who entered the United States 165.26 on or after August 22, 1996, and who otherwise meet the 165.27 eligibility requirements of chapter 256B, are eligible for 165.28 medical assistance with federal financial participation through 165.29 November 30, 1996. 165.30 Beginning December 1, 1996, qualified noncitizens who 165.31 entered the United States on or after August 22, 1996, and who 165.32 otherwise meet the eligibility requirements of chapter 256B are 165.33 eligible for medical assistance with federal participation for 165.34 five years if they meet one of the following criteria: 165.35 (i) refugees admitted to the United States according to 165.36 United States Code, title 8, section 1157; 166.1 (ii) persons granted asylum according to United States 166.2 Code, title 8, section 1158; 166.3 (iii) persons granted withholding of deportation according 166.4 to United States Code, title 8, section 1253(h); 166.5 (iv) veterans of the United States Armed Forces with an 166.6 honorable discharge for a reason other than noncitizen status, 166.7 their spouses and unmarried minor dependent children; or 166.8 (v) persons on active duty in the United States Armed 166.9 Forces, other than for training, their spouses and unmarried 166.10 minor dependent children. 166.11 Beginning December 1, 1996, qualified noncitizens who do 166.12 not meet one of the criteria in items (i) to (v) are eligible 166.13 for medical assistance without federal financial participation 166.14 as described in paragraph(j)(i). 166.15 (e) Noncitizens who are not qualified noncitizens as 166.16 defined in paragraph (b), who are lawfully residing in the 166.17 United States and who otherwise meet the eligibility 166.18 requirements of chapter 256B, are eligible for medical 166.19 assistance under clauses (1) to (3). These individuals must 166.20 cooperate with the Immigration and Naturalization Service to 166.21 pursue any applicable immigration status, including citizenship, 166.22 that would qualify them for medical assistance with federal 166.23 financial participation. 166.24 (1) Persons who were medical assistance recipients on 166.25 August 22, 1996, are eligible for medical assistance with 166.26 federal financial participation through December 31, 1996. 166.27 (2) Beginning January 1, 1997, persons described in clause 166.28 (1) are eligible for medical assistance without federal 166.29 financial participation as described in paragraph(j)(i). 166.30 (3) Beginning December 1, 1996, persons residing in the 166.31 United States prior to August 22, 1996, who were not receiving 166.32 medical assistance and persons who arrived on or after August 166.33 22, 1996, are eligible for medical assistance without federal 166.34 financial participation as described in paragraph(j)(i). 166.35 (f) Nonimmigrants who otherwise meet the eligibility 166.36 requirements of chapter 256B are eligible for the benefits as 167.1 provided in paragraphs (g)to (i)and (h). For purposes of this 167.2 subdivision, a "nonimmigrant" is a person in one of the classes 167.3 listed in United States Code, title 8, section 1101(a)(15). 167.4 (g) Payment shall also be made for care and services that 167.5 are furnished to noncitizens, regardless of immigration status, 167.6 who otherwise meet the eligibility requirements of chapter 256B, 167.7 if such care and services are necessary for the treatment of an 167.8 emergency medical condition, except for organ transplants and 167.9 related care and services and routine prenatal care. 167.10 (h) For purposes of this subdivision, the term "emergency 167.11 medical condition" means a medical condition that meets the 167.12 requirements of United States Code, title 42, section 1396b(v). 167.13 (i)Pregnant noncitizens who are undocumented or167.14nonimmigrants, who otherwise meet the eligibility requirements167.15of chapter 256B, are eligible for medical assistance payment167.16without federal financial participation for care and services167.17through the period of pregnancy, and 60 days postpartum, except167.18for labor and delivery.167.19(j)Qualified noncitizens as described in paragraph (d), 167.20 and all other noncitizens lawfully residing in the United States 167.21 as described in paragraph (e), who are ineligible for medical 167.22 assistance with federal financial participation and who 167.23 otherwise meet the eligibility requirements of chapter 256B and 167.24 of this paragraph, are eligible for medical assistance without 167.25 federal financial participation. Qualified noncitizens as 167.26 described in paragraph (d) are only eligible for medical 167.27 assistance without federal financial participation for five 167.28 years from their date of entry into the United States. 167.29(k) The commissioner shall submit to the legislature by167.30December 31, 1998, a report on the number of recipients and cost167.31of coverage of care and services made according to paragraphs167.32(i) and (j).167.33 (j) Beginning October 1, 2003, persons who are receiving 167.34 care and rehabilitation services from a nonprofit center 167.35 established to serve victims of torture and are otherwise 167.36 ineligible for medical assistance under chapter 256B or general 168.1 assistance medical care under section 256D.03 are eligible for 168.2 medical assistance without federal financial participation. 168.3 These individuals are eligible only for the period during which 168.4 they are receiving services from the center. Individuals 168.5 eligible under this clause shall not be required to participate 168.6 in prepaid medical assistance. 168.7 [EFFECTIVE DATE.] This section is effective July 1, 2003, 168.8 except where a different date is specified in the text. 168.9 Sec. 30. Minnesota Statutes 2002, section 256B.061, is 168.10 amended to read: 168.11 256B.061 [ELIGIBILITY; RETROACTIVE EFFECT; RESTRICTIONS.] 168.12(a)If any individual has been determined to be eligible 168.13 for medical assistance, it will be made available for care and 168.14 services included under the plan and furnished in or after the 168.15 third month before the month in which the individual made 168.16 application for such assistance, if such individual was, or upon 168.17 application would have been, eligible for medical assistance at 168.18 the time the care and services were furnished. The commissioner 168.19 may limit, restrict, or suspend the eligibility of an individual 168.20 for up to one year upon that individual's conviction of a 168.21 criminal offense related to application for or receipt of 168.22 medical assistance benefits. 168.23(b) On the basis of information provided on the completed168.24application, an applicant who meets the following criteria shall168.25be determined eligible beginning in the month of application:168.26(1) whose gross income is less than 90 percent of the168.27applicable income standard;168.28(2) whose total liquid assets are less than 90 percent of168.29the asset limit;168.30(3) does not reside in a long-term care facility; and168.31(4) meets all other eligibility requirements.168.32The applicant must provide all required verifications within 30168.33days' notice of the eligibility determination or eligibility168.34shall be terminated.168.35 [EFFECTIVE DATE.] This section is effective July 1, 2003. 168.36 Sec. 31. Minnesota Statutes 2002, section 256B.0625, 169.1 subdivision 5a, is amended to read: 169.2 Subd. 5a. [INTENSIVE EARLY INTERVENTION BEHAVIOR THERAPY 169.3 SERVICES FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS.](a)169.4 [COVERAGE.] Medical assistance covers home-based intensive early 169.5 intervention behavior therapy for children with autism spectrum 169.6 disorders, effective July 1, 2007. Children with autism 169.7 spectrum disorder, and their custodial parents or foster 169.8 parents, may access other covered services to treat autism 169.9 spectrum disorder, and are not required to receive intensive 169.10 early intervention behavior therapy services under this 169.11 subdivision. Intensive early intervention behavior therapy does 169.12 not include coverage for services to treat developmental 169.13 disorders of language, early onset psychosis, Rett's disorder, 169.14 selective mutism, social anxiety disorder, stereotypic movement 169.15 disorder, dementia, obsessive compulsive disorder, schizoid 169.16 personality disorder, avoidant personality disorder, or reactive 169.17 attachment disorder. If a child with autism spectrum disorder 169.18 is diagnosed to have one or more of these conditions, intensive 169.19 early intervention behavior therapy includes coverage only for 169.20 services necessary to treat the autism spectrum disorder. 169.21(b)Subd. 5b. [PURPOSE OF INTENSIVE EARLY INTERVENTION 169.22 BEHAVIOR THERAPY SERVICES (IEIBTS).] The purpose of IEIBTS is to 169.23 improve the child's behavioral functioning, to prevent 169.24 development of challenging behaviors, to eliminate autistic 169.25 behaviors, to reduce the risk of out-of-home placement, and to 169.26 establish independent typical functioning in language and social 169.27 behavior. The procedures used to accomplish these goals are 169.28 based upon research in applied behavior analysis. 169.29(c)Subd. 5c. [ELIGIBLE CHILDREN.] A child is eligible to 169.30 initiate IEIBTS if, the child meets the additional eligibility 169.31 criteria in paragraph (d) and in a diagnostic assessment by a 169.32 mental health professional who is not under the employ of the 169.33 service provider, the child: 169.34 (1) is found to have an autism spectrum disorder; 169.35 (2) has a current IQ of either untestable, or at least 30; 169.36 (3) if nonverbal, initiated behavior therapy by 42 months 170.1 of age; 170.2 (4) if verbal, initiated behavior therapy by 48 months of 170.3 age; or 170.4 (5) if having an IQ of at least 50, initiated behavior 170.5 therapy by 84 months of age. 170.6 To continue after six-month individualized treatment plan (ITP) 170.7 reviews, at least one of the child's custodial parents or foster 170.8 parents must participate in an average of at least five hours of 170.9 documented behavior therapy per week for six months, and 170.10 consistently implement behavior therapy recommendations 24 hours 170.11 a day. To continue after six-month individualized treatment 170.12 plan (ITP) reviews, the child must show documented progress 170.13 toward mastery of six-month benchmark behavior objectives. The 170.14 maximum number of months during which services may be billed is 170.15 54, or up to the month of August in the first year in which the 170.16 child completes first grade, whichever comes last. If 170.17 significant progress towards treatment goals has not been 170.18 achieved after 24 months of treatment, treatment must be 170.19 discontinued. 170.20(d)Subd. 5d. [ADDITIONAL ELIGIBILITY CRITERIA.] A child 170.21 is eligible to initiate IEIBTS if: 170.22 (1) in medical and diagnostic assessments by medical and 170.23 mental health professionals, it is determined that the child 170.24 does not have severe or profound mental retardation; 170.25 (2) an accurate assessment of the child's hearing has been 170.26 performed, including audiometry if the brain stem auditory 170.27 evokes response; 170.28 (3) a blood lead test has been performed prior to 170.29 initiation of treatment; and 170.30 (4) an EEG or neurologic evaluation is done, prior to 170.31 initiation of treatment, if the child has a history of staring 170.32 spells or developmental regression. 170.33(e)Subd. 5e. [COVERED SERVICES.] The focus of IEIBTS must 170.34 be to treat the principal diagnostic features of the autism 170.35 spectrum disorder. All IEIBTS must be delivered by a team of 170.36 practitioners under the consistent supervision of a single 171.1 clinical supervisor. A mental health professional must develop 171.2 the ITP for IEIBTS. The ITP must include six-month benchmark 171.3 behavior objectives. All behavior therapy must be based upon 171.4 research in applied behavior analysis, with an emphasis upon 171.5 positive reinforcement of carefully task-analyzed skills for 171.6 optimum rates of progress. All behavior therapy must be 171.7 consistently applied and generalized throughout the 24-hour day 171.8 and seven-day week by all of the child's regular care 171.9 providers. When placing the child in school activities, a 171.10 majority of the peers must have no mental health diagnosis, and 171.11 the child must have sufficient social skills to succeed with 80 171.12 percent of the school activities. Reactive consequences, such 171.13 as redirection, correction, positive practice, or time-out, must 171.14 be used only when necessary to improve the child's success when 171.15 proactive procedures alone have not been effective. IEIBTS must 171.16 be delivered by a team of behavior therapy practitioners who are 171.17 employed under the direction of the same agency. The team may 171.18 deliver up to 200 billable hours per year of direct clinical 171.19 supervisor services, up to 700 billable hours per year of senior 171.20 behavior therapist services, and up to 1,800 billable hours per 171.21 year of direct behavior therapist services. A one-hour clinical 171.22 review meeting for the child, parents, and staff must be 171.23 scheduled 50 weeks a year, at which behavior therapy is reviewed 171.24 and planned. At least one-quarter of the annual clinical 171.25 supervisor billable hours shall consist of on-site clinical 171.26 meeting time. At least one-half of the annual senior behavior 171.27 therapist billable hours shall consist of direct services to the 171.28 child or parents. All of the behavioral therapist billable 171.29 hours shall consist of direct on-site services to the child or 171.30 parents. None of the senior behavior therapist billable hours 171.31 or behavior therapist billable hours shall consist of clinical 171.32 meeting time. If there is any regression of the autistic 171.33 spectrum disorder after 12 months of therapy, a neurologic 171.34 consultation must be performed. 171.35(f)Subd. 5f. [PROVIDER QUALIFICATIONS.] The provider 171.36 agency must be capable of delivering consistent applied behavior 172.1 analysis (ABA) based behavior therapy in the home. The site 172.2 director of the agency must be a mental health professional and 172.3 a board certified behavior analyst certified by the behavior 172.4 analyst certification board. Each clinical supervisor must be a 172.5 certified associate behavior analyst certified by the behavior 172.6 analyst certification board or have equivalent experience in 172.7 applied behavior analysis. 172.8(g)Subd. 5g. [SUPERVISION REQUIREMENTS.] (1) Each 172.9 behavior therapist practitioner must be continuously supervised 172.10 while in the home until the practitioner has mastered 172.11 competencies for independent practice. Each behavior therapist 172.12 must have mastered three credits of academic content and 172.13 practice in an applied behavior analysis sequence at an 172.14 accredited university before providing more than 12 months of 172.15 therapy. A college degree or minimum hours of experience are 172.16 not required. Each behavior therapist must continue training 172.17 through weekly direct observation by the senior behavior 172.18 therapist, through demonstrated performance in clinical meetings 172.19 with the clinical supervisor, and annual training in applied 172.20 behavior analysis. 172.21 (2) Each senior behavior therapist practitioner must have 172.22 mastered the senior behavior therapy competencies, completed one 172.23 year of practice as a behavior therapist, and six months of 172.24 co-therapy training with another senior behavior therapist or 172.25 have an equivalent amount of experience in applied behavior 172.26 analysis. Each senior behavior therapist must have mastered 12 172.27 credits of academic content and practice in an applied behavior 172.28 analysis sequence at an accredited university before providing 172.29 more than 12 months of senior behavior therapy. Each senior 172.30 behavior therapist must continue training through demonstrated 172.31 performance in clinical meetings with the clinical supervisor, 172.32 and annual training in applied behavior analysis. 172.33 (3) Each clinical supervisor practitioner must have 172.34 mastered the clinical supervisor and family consultation 172.35 competencies, completed two years of practice as a senior 172.36 behavior therapist and one year of co-therapy training with 173.1 another clinical supervisor, or equivalent experience in applied 173.2 behavior analysis. Each clinical supervisor must continue 173.3 training through annual training in applied behavior analysis. 173.4(h)Subd. 5h. [PLACE OF SERVICE.] IEIBTS are provided 173.5 primarily in the child's home and community. Services may be 173.6 provided in the child's natural school or preschool classroom, 173.7 home of a relative, natural recreational setting, or day care. 173.8(i)Subd. 5i. [PRIOR AUTHORIZATION REQUIREMENTS.] Prior 173.9 authorization shall be required for services provided after 200 173.10 hours of clinical supervisor, 700 hours of senior behavior 173.11 therapist, or 1,800 hours of behavior therapist services per 173.12 year. 173.13(j)Subd. 5j. [PAYMENT RATES.] The following payment rates 173.14 apply: 173.15 (1) for an IEIBTS clinical supervisor practitioner under 173.16 supervision of a mental health professional, the lower of the 173.17 submitted charge or $67 per hour unit; 173.18 (2) for an IEIBTS senior behavior therapist practitioner 173.19 under supervision of a mental health professional, the lower of 173.20 the submitted charge or $37 per hour unit; or 173.21 (3) for an IEIBTS behavior therapist practitioner under 173.22 supervision of a mental health professional, the lower of the 173.23 submitted charge or $27 per hour unit. 173.24 An IEIBTS practitioner may receive payment for travel time which 173.25 exceeds 50 minutes one-way. The maximum payment allowed will be 173.26 $0.51 per minute for up to a maximum of 300 hours per year. 173.27 For any week during which the above charges are made to 173.28 medical assistance, payments for the following services are 173.29 excluded: supervising mental health professional hours and 173.30 personal care attendant, home-based mental health, 173.31 family-community support, or mental health behavioral aide hours. 173.32(k)Subd. 5k. [REPORT.] The commissioner shall collect 173.33 evidence of the effectiveness of intensive early intervention 173.34 behavior therapy services and present a report to the 173.35 legislature by July 1,20062010. 173.36 Sec. 32. Minnesota Statutes 2002, section 256B.0625, 174.1 subdivision 9, is amended to read: 174.2 Subd. 9. [DENTAL SERVICES.] (a) Medical assistance covers 174.3 dental services. Dental services include, with prior 174.4 authorization, fixed bridges that are cost-effective for persons 174.5 who cannot use removable dentures because of their medical 174.6 condition. 174.7 (b) Coverage of dental services for adults age 21 and over 174.8 who are not pregnant is subject to a $500 annual benefit limit 174.9 and covered services are limited to: 174.10 (1) diagnostic and preventative services; 174.11 (2) basic restorative services; and 174.12 (3) emergency services. 174.13 Sec. 33. Minnesota Statutes 2002, section 256B.0625, 174.14 subdivision 13, is amended to read: 174.15 Subd. 13. [DRUGS.] (a) Medical assistance covers drugs, 174.16 except for fertility drugs when specifically used to enhance 174.17 fertility, if prescribed by a licensed practitioner and 174.18 dispensed by a licensed pharmacist, by a physician enrolled in 174.19 the medical assistance program as a dispensing physician, or by 174.20 a physician or a nurse practitioner employed by or under 174.21 contract with a community health board as defined in section 174.22 145A.02, subdivision 5, for the purposes of communicable disease 174.23 control. 174.24 (b) The dispensed quantity of a prescription drug must not 174.25 exceed a 34-day supply, unless prior authorization is obtained. 174.26 (c) Medical assistance covers the following 174.27 over-the-counter drugs when prescribed by a licensed 174.28 practitioner or by a licensed pharmacist who meets standards 174.29 established by the commissioner, in consultation with the board 174.30 of pharmacy: antacids, acetaminophen, family planning products, 174.31 aspirin, insulin, products for the treatment of lice, vitamins 174.32 for adults with documented vitamin deficiencies, vitamins for 174.33 children under the age of seven and pregnant or nursing women, 174.34 and any other over-the-counter drug identified by the 174.35 commissioner, in consultation with the pharmaceutical and 174.36 therapeutics committee, as necessary, appropriate, and 175.1 cost-effective for the treatment of certain specified chronic 175.2 diseases, conditions, or disorders, and this determination shall 175.3 not be subject to the requirements of chapter 14. A pharmacist 175.4 may prescribe over-the-counter medications as provided under 175.5 this paragraph for purposes of receiving reimbursement under 175.6 Medicaid. When prescribing over-the-counter drugs under this 175.7 paragraph, licensed pharmacists must consult with the recipient 175.8 to determine necessity, provide drug counseling, review drug 175.9 therapy for potential adverse interactions, and make referrals 175.10 as needed to other health care professionals. 175.11 (d) The commissioner may contract with a pharmacy benefit 175.12 administrator or pharmacy benefit manager to administer the 175.13 medical assistance prescription drug benefit in compliance with 175.14 subdivisions 13 to 13i. Any contract must require that the 175.15 entity under contract make transparent and transfer to the state 175.16 all direct and indirect payments received from pharmaceutical 175.17 manufacturers. For purposes of this paragraph, a "pharmacy 175.18 benefit administrator or pharmacy benefit manager" means an 175.19 entity under contract to process and adjudicate claims, disburse 175.20 payments to pharmacy providers, channel communication of 175.21 eligibility and coverage information to beneficiaries and 175.22 pharmacy providers, provide information and computer support to 175.23 enable pharmacy providers to conduct drug utilization review, 175.24 conduct activities to control fraud, abuse, and waste, and 175.25 negotiate and collect payments from participating pharmaceutical 175.26 manufacturers. 175.27 Subd. 13c. [LIMITS ON NUMBER OF BRAND NAME 175.28 PRESCRIPTIONS.] (a) Medical assistance outpatient prescription 175.29 drug coverage for brand name drugs is limited to the dispensing 175.30 of four brand name drug products per recipient per month. 175.31 Antiretroviral agents and brand name drugs dispensed to 175.32 recipients under 18 years of age are exempt from this 175.33 restriction. For purposes of this subdivision, "brand name 175.34 drugs" means single source and innovator multiple source drugs. 175.35 The commissioner may, through prior authorization, allow 175.36 exceptions to the limitation on the dispensing of brand name 176.1 drugs, based on the treatment needs of a recipient. 176.2 Subd. 13d. [PHARMACEUTICAL AND THERAPEUTICS COMMITTEE.] (a) 176.3 The commissioner, after receiving recommendations from 176.4 professional medical associations and professional pharmacist 176.5 associations, shall designate aformulary committee to advise176.6the commissioner on the names of drugs for which payment is176.7made, recommend a system for reimbursing providers on a set fee176.8or charge basis rather than the present system, and develop176.9methods encouraging use of generic drugs when they are less176.10expensive and equally effective as trademark176.11drugspharmaceutical and therapeutics committee to develop and 176.12 assist the commissioner in implementing a medical assistance 176.13 preferred drug list and to review and recommend to the 176.14 commissioner drugs which require prior authorization. The 176.15 committee shall meet at least quarterly. The commissioner may 176.16 designate the Medicaid drug utilization review board as the 176.17 committee established under this subdivision. 176.18 (b) Theformularypharmaceutical and therapeutics committee 176.19 shall consist ofnine members, four of whom shall be physicians176.20who are not employed by the department of human services, and a176.21majority of whose practice is for persons paying privately or176.22through health insurance, three of whom shall be pharmacists who176.23are not employed by the department of human services, and a176.24majority of whose practice is for persons paying privately or176.25through health insurance, a consumer representative, and a176.26nursing home representative. Committee members shall serve176.27three-year terms and shall serve without compensation. Members176.28may be reappointed oncethe following nine members: at least 176.29 three but no more than four licensed physicians actively engaged 176.30 in the practice of medicine in Minnesota; at least three 176.31 licensed pharmacists actively engaged in the practice of 176.32 pharmacy in Minnesota; and one consumer representative; the 176.33 remainder to be made up of health care professionals who are 176.34 licensed in their field and have recognized knowledge in the 176.35 clinically appropriate prescribing, dispensing, and monitoring 176.36 of covered outpatient drugs. An honorarium of $100 per meeting 177.1 and reimbursement for mileage shall be paid to each committee 177.2 member in attendance. 177.3 Subd. 13e. [DRUG FORMULARY.](b)The commissioner shall 177.4 establish a drug formulary. Its establishment and publication 177.5 shall not be subject to the requirements of the Administrative 177.6 Procedure Act, but theformularypharmaceutical and therapeutics 177.7 committee shall review and comment on the formulary contents. 177.8 The formulary shall not include: 177.9(i)(1) drugs or products for which there is no federal 177.10 funding; 177.11(ii)(2) over-the-counter drugs, exceptfor antacids,177.12acetaminophen, family planning products, aspirin, insulin,177.13products for the treatment of lice, vitamins for adults with177.14documented vitamin deficiencies, vitamins for children under the177.15age of seven and pregnant or nursing women, and any other177.16over-the-counter drug identified by the commissioner, in177.17consultation with the drug formulary committee, as necessary,177.18appropriate, and cost-effective for the treatment of certain177.19specified chronic diseases, conditions or disorders, and this177.20determination shall not be subject to the requirements of177.21chapter 14as provided in subdivision 13; 177.22(iii) anorectics, except that medically necessary177.23anorectics shall be covered for a recipient previously diagnosed177.24as having pickwickian syndrome and currently diagnosed as having177.25diabetes and being morbidly obese(3) drugs used for weight 177.26 loss; 177.27(iv)(4) drugs for which medical value has not been 177.28 established; and 177.29(v)(5) drugs from manufacturers who have not signed a 177.30 rebate agreement with the Department of Health and Human 177.31 Services pursuant to section 1927 of title XIX of the Social 177.32 Security Act. 177.33The commissioner shall publish conditions for prohibiting177.34payment for specific drugs after considering the formulary177.35committee's recommendations. An honorarium of $100 per meeting177.36and reimbursement for mileage shall be paid to each committee178.1member in attendance.178.2 Subd. 13f. [PAYMENT RATES.](c)(a) The basis for 178.3 determining the amount of payment shall be the lower of the 178.4 actual acquisition costs of the drugs plus a fixed dispensing 178.5 fee; the maximum allowable cost set by the federal government or 178.6 by the commissioner plus the fixed dispensing fee; or the usual 178.7 and customary price charged to the public. The amount of 178.8 payment basis must be reduced to reflect all discount amounts 178.9 applied to the charge by any provider/insurer agreement or 178.10 contract for submitted charges to medical assistance programs. 178.11 The net submitted charge may not be greater than the patient 178.12 liability for the service. The pharmacy dispensing fee shall be 178.13 $3.65, except that the dispensing fee for intravenous solutions 178.14 which must be compounded by the pharmacist shall be $8 per bag, 178.15 $14 per bag for cancer chemotherapy products, and $30 per bag 178.16 for total parenteral nutritional products dispensed in one liter 178.17 quantities, or $44 per bag for total parenteral nutritional 178.18 products dispensed in quantities greater than one liter. Actual 178.19 acquisition cost includes quantity and other special discounts 178.20 except time and cash discounts. The actual acquisition cost of 178.21 a drug shall be estimated by the commissioner, at average 178.22 wholesale price minusnine11.5 percent, except that where a 178.23 drug has had its wholesale price reduced as a result of the 178.24 actions of the National Association of Medicaid Fraud Control 178.25 Units, the estimated actual acquisition cost shall be the 178.26 reduced average wholesale price, without thenine11.5 percent 178.27 deduction. The maximum allowable cost of a multisource drug may 178.28 be set by the commissioner and it shall be comparable to, but no 178.29 higher than, the maximum amount paid by other third-party payors 178.30 in this state who have maximum allowable cost programs.The178.31commissioner shall set maximum allowable costs for multisource178.32drugs that are not on the federal upper limit list as described178.33in United States Code, title 42, chapter 7, section 1396r-8(e),178.34the Social Security Act, and Code of Federal Regulations, title178.3542, part 447, section 447.332.Establishment of the amount of 178.36 payment for drugs shall not be subject to the requirements of 179.1 the Administrative Procedure Act. 179.2 (b) An additional dispensing fee of $.30 may be added to 179.3 the dispensing fee paid to pharmacists for legend drug 179.4 prescriptions dispensed to residents of long-term care 179.5 facilities when a unit dose blister card system, approved by the 179.6 department, is used. Under this type of dispensing system, the 179.7 pharmacist must dispense a 30-day supply of drug. The National 179.8 Drug Code (NDC) from the drug container used to fill the blister 179.9 card must be identified on the claim to the department. The 179.10 unit dose blister card containing the drug must meet the 179.11 packaging standards set forth in Minnesota Rules, part 179.12 6800.2700, that govern the return of unused drugs to the 179.13 pharmacy for reuse. The pharmacy provider will be required to 179.14 credit the department for the actual acquisition cost of all 179.15 unused drugs that are eligible for reuse. Over-the-counter 179.16 medications must be dispensed in the manufacturer's unopened 179.17 package. The commissioner may permit the drug clozapine to be 179.18 dispensed in a quantity that is less than a 30-day supply. 179.19 (c) Whenever a generically equivalent product is available, 179.20 payment shall be on the basis of the actual acquisition cost of 179.21 the generic drug, unless the prescriber specifically indicates 179.22 "dispense as written - brand necessary" on the prescription as 179.23 required by section 151.21, subdivision 2. 179.24 (d)For purposes of this subdivision, "multisource drugs"179.25means covered outpatient drugs, excluding innovator multisource179.26drugs for which there are two or more drug products, which:179.27(1) are related as therapeutically equivalent under the179.28Food and Drug Administration's most recent publication of179.29"Approved Drug Products with Therapeutic Equivalence179.30Evaluations";179.31(2) are pharmaceutically equivalent and bioequivalent as179.32determined by the Food and Drug Administration; and179.33(3) are sold or marketed in Minnesota.179.34"Innovator multisource drug" means a multisource drug that was179.35originally marketed under an original new drug application179.36approved by the Food and Drug Administration.180.1 (e) The basis for determining the amount of payment for 180.2 drugs administered in an outpatient setting shall be the lower 180.3 of the usual and customary cost submitted by the provider, the 180.4 average wholesale price minus five percent, or the maximum 180.5 allowable cost set by the federal government under United States 180.6 Code, title 42, chapter 7, section 1396r-8(e), and Code of 180.7 Federal Regulations, title 42, section 447.332, or by the 180.8 commissioner under paragraphs (a) to (c). 180.9 Subd. 13g. [PRIOR AUTHORIZATION.] (a) Theformulary180.10 pharmaceutical and therapeutics committee shall review and 180.11 recommend drugs which require prior authorization. The 180.12 pharmaceutical and therapeutics committee shall establish 180.13 general criteria to be used for the prior authorization of 180.14 brand-name drugs for which generically equivalent drugs are 180.15 available, but the committee is not required to review each 180.16 brand-name drug for which a generically equivalent drug is 180.17 available. Theformularycommittee may recommend drugs for 180.18 prior authorization directly to the commissioner, as long as 180.19 opportunity for public input is provided.Prior authorization180.20may be requested by the commissioner based on medical and180.21clinical criteria and on cost before certain drugs are eligible180.22for payment. Before a drug may be considered for prior180.23authorization at the request of the commissioner:180.24(1) the drug formulary committee must develop criteria to180.25be used for identifying drugs; the development of these criteria180.26is not subject to the requirements of chapter 14, but the180.27formulary committee shall provide opportunity for public input180.28in developing criteria;180.29(2) the drug formulary committee must hold a public forum180.30and receive public comment for an additional 15 days;180.31(3) the drug formulary committee must consider data from180.32the state Medicaid program if such data is available; and180.33(4) the commissioner must provide information to the180.34formulary committee on the impact that placing the drug on prior180.35authorization will have on the quality of patient care and on180.36program costs, and information regarding whether the drug is181.1subject to clinical abuse or misuse.181.2 Prior authorization may be required by the commissioner 181.3 before certain formulary drugs are eligible for payment. If 181.4 prior authorization of a drug is required by the commissioner, 181.5 the commissioner must provide a 30-day notice period before 181.6 implementing the prior authorization. If a prior authorization 181.7 request is denied by the department, the recipient may appeal 181.8 the denial in accordance with section 256.045. If an appeal is 181.9 filed, the drug must be provided without prior authorization 181.10 until a decision is made on the appeal. 181.11(f) The basis for determining the amount of payment for181.12drugs administered in an outpatient setting shall be the lower181.13of the usual and customary cost submitted by the provider; the181.14average wholesale price minus five percent; or the maximum181.15allowable cost set by the federal government under United States181.16Code, title 42, chapter 7, section 1396r-8(e), and Code of181.17Federal Regulations, title 42, section 447.332, or by the181.18commissioner under paragraph (c).181.19(g)Prior authorization shall not be required or utilized 181.20 for any antipsychotic drug prescribed to an individual before 181.21 July 1, 2003, for the treatment of mental illness where there is 181.22 no generically equivalent drug available unless the commissioner 181.23 determines that prior authorization is necessary for patient 181.24 safety. This paragraph applies to any supplemental drug rebate 181.25 program established or administered by the commissioner. 181.26 (b) The prior authorization procedure must: 181.27 (1) respond to requests, by telephone or other 181.28 telecommunications devices, within 24 hours; 181.29 (2) provide a 72-hour supply of a prescription drug in an 181.30 emergency, when the commissioner does not respond within 24 181.31 hours as required under clause (1), or when the recipient or 181.32 provider appeals a denial; and 181.33 (3) provide an appeals process under which a recipient or 181.34 provider may appeal a denial of a request and receive a response 181.35 within 24 hours. 181.36 (c) Prior authorization shall not be required for 182.1 nonpreferred antipsychotic drugs for the treatment of mental 182.2 illness, where there is no generically equivalent drug 182.3 available, and on which patients have been stabilized prior to 182.4 the implementation of the preferred drug list and supplemental 182.5 rebate program. All prescriptions for antipsychotic drugs 182.6 issued after June 30, 2003, must be accompanied by an ICD-9 code 182.7 and are subject to the preferred drug list and any step therapy 182.8 guidelines established by the commissioner. 182.9(h)(d) Prior authorization shall not be required or 182.10 utilized for any antihemophilic factor drug prescribed for the 182.11 treatment of hemophilia and blood disorders where there is no 182.12 generically equivalent drug available unless the commissioner 182.13 determines that prior authorization is necessary for patient 182.14 safety. This paragraph applies to any supplemental drug rebate 182.15 program established or administered by the commissioner. This 182.16 paragraph expires July 1,20032005. 182.17 (e) The commissioner shall require prior authorization of 182.18 all brand name prescriptions for which the prescription 182.19 indicates "dispense as written - brand medically necessary" when 182.20 a generically equivalent product is available. 182.21 Subd. 13h. [STEP THERAPY.] The commissioner, in 182.22 consultation with the pharmaceutical and therapeutics committee, 182.23 may develop and implement a step therapy program. For purposes 182.24 of this subdivision, "step therapy" means a prior authorization 182.25 or prior utilization review procedure that: 182.26 (1) requires a prescribing health care provider to 182.27 prescribe the least costly pharmacological or nonpharmacological 182.28 therapy which can be used to safely and effectively treat the 182.29 symptoms of, or effect a cure for, the medical condition for 182.30 which the therapy is prescribed; and 182.31 (2) allows the prescribing health care provider to 182.32 sequentially prescribe increasingly more costly therapies after 182.33 providing clinical substantiation that therapies previously 182.34 prescribed were unsafe or ineffective in treating the medical 182.35 condition or illness. 182.36 Subd. 13i. [PREFERRED DRUG LIST.] (a) The commissioner 183.1 shall adopt and implement a preferred drug list by January 1, 183.2 2004. The commissioner may enter into a contract with a vendor 183.3 or one or more states for the purpose of participating in a 183.4 multistate preferred drug list and supplemental rebate program. 183.5 The commissioner shall ensure that any contract meets all 183.6 federal requirements and maximizes federal financial 183.7 participation. The commissioner shall publish the preferred 183.8 drug list annually in the State Register and shall maintain an 183.9 accurate and up-to-date list on the agency Web site. 183.10 (b) The commissioner may add to, delete from, and otherwise 183.11 modify the preferred drug list, after consulting with the 183.12 pharmaceutical and therapeutics committee and appropriate 183.13 medical specialists and providing public notice and the 183.14 opportunity for public comment. 183.15 (c) The commissioner shall establish procedures for the 183.16 timely review of prescription drugs recently approved by the 183.17 federal Food and Drug Administration, including procedures for 183.18 the review of newly approved prescription drugs in emergency 183.19 circumstances. 183.20 (d) The commissioner shall adopt and administer the 183.21 preferred drug list as part of the administration of the 183.22 supplemental drug rebate program. Reimbursement for 183.23 prescription drugs not on the preferred drug list may be subject 183.24 to prior authorization, unless the drug manufacturer signs a 183.25 supplemental rebate contract. 183.26 (e) For purposes of this subdivision, "preferred drug list" 183.27 means a list of prescription drugs within designated therapeutic 183.28 classes selected by the commissioner, for which prior 183.29 authorization based on the identity of the drug or class is not 183.30 required. 183.31 (f) The commissioner shall seek any federal waivers or 183.32 approvals necessary to implement this subdivision. 183.33 [EFFECTIVE DATE.] This section is effective July 1, 2003. 183.34 Sec. 34. Minnesota Statutes 2002, section 256B.0625, 183.35 subdivision 17, is amended to read: 183.36 Subd. 17. [TRANSPORTATION COSTS.] (a) Medical assistance 184.1 covers transportation costs incurred solely for obtaining 184.2 emergency medical care or transportation costs incurred by 184.3 nonambulatory persons in obtaining emergency or nonemergency 184.4 medical care when paid directly to an ambulance company, common 184.5 carrier, or other recognized providers of transportation 184.6 services. For the purpose of this subdivision, a person who is 184.7 incapable of transport by taxicab or bus shall be considered to 184.8 be nonambulatory. 184.9 (b) Medical assistance covers special transportation, as 184.10 defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 184.11 if the provider receives and maintains a current physician's 184.12 order by the recipient's attending physician certifying that the 184.13 recipient has a physical or mental impairment that would 184.14 prohibit the recipient from safely accessing and using a bus, 184.15 taxi, other commercial transportation, or private automobile. 184.16 Special transportation includes driver-assisted service to 184.17 eligible individuals. Driver-assisted service includes 184.18 passenger pickup at and return to the individual's residence or 184.19 place of business, assistance with admittance of the individual 184.20 to the medical facility, and assistance in passenger securement 184.21 or in securing of wheelchairs or stretchers in the vehicle.The184.22commissioner shall establish maximum medical assistance184.23reimbursement rates for special transportation services for184.24persons who need a wheelchair-accessible van or184.25stretcher-accessible vehicle and for those who do not need a184.26wheelchair-accessible van or stretcher-accessible vehicle. The184.27average of these two rates per trip must not exceed $15 for the184.28base rate and $1.40 per mile. Special transportation provided184.29to nonambulatory persons who do not need a wheelchair-accessible184.30van or stretcher-accessible vehicle, may be reimbursed at a184.31lower rate than special transportation provided to persons who184.32need a wheelchair-accessible van or stretcher-accessible184.33vehicle.The maximum medical assistance reimbursement rates for 184.34 special transportation services are: 184.35 (1) for trips originating within a major metropolitan area, 184.36 a flat rate of $28.50 per trip for nonambulatory persons who 185.1 need a wheelchair-accessible van and a flat rate of $21 per trip 185.2 for nonambulatory persons who do not need a 185.3 wheelchair-accessible van or a stretcher-accessible vehicle; 185.4 (2) for trips originating outside of a major metropolitan 185.5 area, a base rate of $18 per trip and $1.20 per mile for 185.6 nonambulatory persons who need a wheelchair-accessible van and a 185.7 base rate of $12 per trip and $1.40 per mile for nonambulatory 185.8 persons who do not need a wheelchair-accessible van or a 185.9 stretcher-accessible vehicle; and 185.10 (3) for all trips, a base rate of $36 and $1.40 per mile, 185.11 and an attendant rate of $9 per trip, for nonambulatory persons 185.12 who need a stretcher-accessible vehicle. 185.13 For purposes of the determining rates under clauses (1) and 185.14 (2), major metropolitan area means a standard metropolitan 185.15 statistical area with a population of more than 2,000,0000 185.16 people. 185.17 Sec. 35. Minnesota Statutes 2002, section 256B.0625, 185.18 subdivision 18a, is amended to read: 185.19 Subd. 18a. [ACCESS TO MEDICAL SERVICES.] (a) Medical 185.20 assistance reimbursement for meals for persons traveling to 185.21 receive medical care shall be provided only for travel involving 185.22 lodging, and may not exceed $5.50 for breakfast, $6.50 for 185.23 lunch, or $8 for dinner. 185.24 (b) Medical assistance reimbursement for lodging for 185.25 persons traveling to receive medical care shall be provided only 185.26 if the local agency determines that the medical care service is 185.27 not available at a location that does not require lodging, and 185.28 may not exceed $50 per day unless prior authorized by the local 185.29 agency. 185.30 (c) Medical assistance direct mileage reimbursement to the 185.31 eligible person or the eligible person's driver may not exceed 185.32 20 cents per mile. 185.33 (d) Medical assistance covers oral language interpreter 185.34 services when provided by an enrolled health care provider 185.35 during the course of providing a direct, person-to-person 185.36 covered health care service to an enrolled recipient with 186.1 limited English proficiency. 186.2 Sec. 36. [256B.0631] [MEDICAL ASSISTANCE CO-PAYMENTS.] 186.3 Subdivision 1. [CO-PAYMENTS.] (a) Except as provided in 186.4 subdivision 2, the medical assistance benefit plan shall include 186.5 the following co-payments for all recipients, effective for 186.6 services provided on or after October 1, 2003: 186.7 (1) $3 per nonpreventive visit. For purposes of this 186.8 subdivision, a visit means an episode of service which is 186.9 required because of a recipient's symptoms, diagnosis, or 186.10 established illness, and which is delivered in an ambulatory 186.11 setting by a physician or physician ancillary, chiropractor, 186.12 podiatrist, nurse midwife, mental health professional, advanced 186.13 practice nurse, physical therapist, occupational therapist, 186.14 speech therapist, audiologist, optician, or optometrist; 186.15 (2) $3 for eyeglasses; 186.16 (3) $6 for nonemergency visits to a hospital-based 186.17 emergency room; and 186.18 (4) $3 per brand-name drug prescription and $1 per generic 186.19 drug prescription, subject to a $20 per month maximum for 186.20 prescription drug co-payments. 186.21 (b) Recipients of medical assistance are responsible for 186.22 all co-payments in this subdivision. 186.23 Subd. 2. [EXCEPTIONS.] Co-payments shall be subject to the 186.24 following exceptions: 186.25 (1) children under the age of 21; 186.26 (2) pregnant women for services that relate to the 186.27 pregnancy or any other medical condition that may complicate the 186.28 pregnancy; 186.29 (3) recipients expected to reside for at least 30 days in a 186.30 hospital, nursing home, or intermediate care facility for the 186.31 mentally retarded; 186.32 (4) recipients receiving hospice care; 186.33 (5) 100 percent federally funded services provided by an 186.34 Indian health service; 186.35 (6) emergency services; 186.36 (7) family planning services; 187.1 (8) services that are paid by Medicare, resulting in the 187.2 medical assistance program paying for the coinsurance and 187.3 deductible; and 187.4 (9) co-payments that exceed one per day per provider for 187.5 nonpreventive visits, eyeglasses, and nonemergency visits to a 187.6 hospital-based emergency room. 187.7 Subd. 3. [COLLECTION.] The medical assistance 187.8 reimbursement to the provider shall be reduced by the amount of 187.9 the co-payment, except that reimbursement for prescription drugs 187.10 shall not be reduced once a recipient has reached the $20 per 187.11 month maximum for prescription drug co-payments. The provider 187.12 collects the co-payment from the recipient. Providers may not 187.13 deny services to recipients who are unable to pay the 187.14 co-payment, except as provided in subdivision 4. 187.15 Subd. 4. [UNCOLLECTED DEBT.] If it is the routine business 187.16 practice of a provider to refuse service to an individual with 187.17 uncollected debt, the provider may include uncollected 187.18 co-payments under this section. A provider must give advance 187.19 notice to a recipient with uncollected debt before services can 187.20 be denied. 187.21 Sec. 37. Minnesota Statutes 2002, section 256B.0635, 187.22 subdivision 1, is amended to read: 187.23 Subdivision 1. [INCREASED EMPLOYMENT.] (a) Until June 30, 187.24 2002, medical assistance may be paid for persons who received 187.25 MFIP or medical assistance for families and children in at least 187.26 three of six months preceding the month in which the person 187.27 became ineligible for MFIP or medical assistance, if the 187.28 ineligibility was due to an increase in hours of employment or 187.29 employment income or due to the loss of an earned income 187.30 disregard. In addition, to receive continued assistance under 187.31 this section, persons who received medical assistance for 187.32 families and children but did not receive MFIP must have had 187.33 income less than or equal to the assistance standard for their 187.34 family size under the state's AFDC plan in effect as of July 16, 187.35 1996, increased by three percent effective July 1, 2000, at the 187.36 time medical assistance eligibility began. A person who is 188.1 eligible for extended medical assistance is entitled to six 188.2 months of assistance without reapplication, unless the 188.3 assistance unit ceases to include a dependent child. For a 188.4 person under 21 years of age, medical assistance may not be 188.5 discontinued within the six-month period of extended eligibility 188.6 until it has been determined that the person is not otherwise 188.7 eligible for medical assistance. Medical assistance may be 188.8 continued for an additional six months if the person meets all 188.9 requirements for the additional six months, according to title 188.10 XIX of the Social Security Act, as amended by section 303 of the 188.11 Family Support Act of 1988, Public LawNumber100-485. 188.12 (b) Beginning July 1, 2002, contingent upon federal 188.13 funding, medical assistance for families and children may be 188.14 paid for persons who were eligible under section 256B.055, 188.15 subdivision 3a, in at least three of six months preceding the 188.16 month in which the person became ineligible under that section 188.17 if the ineligibility was due to an increase in hours of 188.18 employment or employment income or due to the loss of an earned 188.19 income disregard. A person who is eligible for extended medical 188.20 assistance is entitled to six months of assistance without 188.21 reapplication, unless the assistance unit ceases to include a 188.22 dependent child, except medical assistance may not be 188.23 discontinued for that dependent child under 21 years of age 188.24 within the six-month period of extended eligibility until it has 188.25 been determined that the person is not otherwise eligible for 188.26 medical assistance. Medical assistance may be continued for an 188.27 additional six months if the person meets all requirements for 188.28 the additional six months, according to title XIX of the Social 188.29 Security Act, as amended by section 303 of the Family Support 188.30 Act of 1988, Public LawNumber100-485. 188.31 [EFFECTIVE DATE.] This section is effective July 1, 2003. 188.32 Sec. 38. Minnesota Statutes 2002, section 256B.0635, 188.33 subdivision 2, is amended to read: 188.34 Subd. 2. [INCREASED CHILD OR SPOUSAL SUPPORT.] (a) Until 188.35 June 30, 2002, medical assistance may be paid for persons who 188.36 received MFIP or medical assistance for families and children in 189.1 at least three of the six months preceding the month in which 189.2 the person became ineligible for MFIP or medical assistance, if 189.3 the ineligibility was the result of the collection of child or 189.4 spousal support under part D of title IV of the Social Security 189.5 Act. In addition, to receive continued assistance under this 189.6 section, persons who received medical assistance for families 189.7 and children but did not receive MFIP must have had income less 189.8 than or equal to the assistance standard for their family size 189.9 under the state's AFDC plan in effect as of July 16, 1996, 189.10 increased by three percent effective July 1, 2000, at the time 189.11 medical assistance eligibility began. A person who is eligible 189.12 for extended medical assistance under this subdivision is 189.13 entitled to four months of assistance without reapplication, 189.14 unless the assistance unit ceases to include a dependent child, 189.15 except medical assistance may not be discontinued for that 189.16 dependent child under 21 years of age within the four-month 189.17 period of extended eligibility until it has been determined that 189.18 the person is not otherwise eligible for medical assistance. 189.19 (b) Beginning July 1, 2002, contingent upon federal 189.20 funding, medical assistance for families and children may be 189.21 paid for persons who were eligible under section 256B.055, 189.22 subdivision 3a, in at least three of the six months preceding 189.23 the month in which the person became ineligible under that 189.24 section if the ineligibility was the result of the collection of 189.25 child or spousal support under part D of title IV of the Social 189.26 Security Act. A person who is eligible for extended medical 189.27 assistance under this subdivision is entitled to four months of 189.28 assistance without reapplication, unless the assistance unit 189.29 ceases to include a dependent child, except medical assistance 189.30 may not be discontinued for that dependent child under 21 years 189.31 of age within the four-month period of extended eligibility 189.32 until it has been determined that the person is not otherwise 189.33 eligible for medical assistance. 189.34 [EFFECTIVE DATE.] This section is effective July 1, 2003. 189.35 Sec. 39. Minnesota Statutes 2002, section 256B.15, 189.36 subdivision 1, is amended to read: 190.1 Subdivision 1. [POLICY, APPLICABILITY, PURPOSE, AND 190.2 CONSTRUCTION; DEFINITION.] (a) It is the policy of this state 190.3 that individuals or couples, either or both of whom participate 190.4 in the medical assistance program, use their own assets to pay 190.5 their share of the total cost of their care during or after 190.6 their enrollment in the program according to applicable federal 190.7 law and the laws of this state. The following provisions apply: 190.8 (1) subdivisions 1c to 1k shall not apply to claims arising 190.9 under this section which are presented under section 525.313; 190.10 (2) the provisions of subdivisions 1c to 1k expanding the 190.11 interests included in an estate for purposes of recovery under 190.12 this section give effect to the provisions of United States 190.13 Code, title 42, section 1396p, governing recoveries, but do not 190.14 give rise to any express or implied liens in favor of any other 190.15 parties not named in these provisions; 190.16 (3) the continuation of a recipient's life estate or joint 190.17 tenancy interest in real property after the recipient's death 190.18 for the purpose of recovering medical assistance under this 190.19 section modifies common law principles holding that these 190.20 interests terminate on the death of the holder; 190.21 (4) all laws, rules, and regulations governing or involved 190.22 with a recovery of medical assistance shall be liberally 190.23 construed to accomplish their intended purposes; 190.24 (5) a deceased recipient's life estate and joint tenancy 190.25 interests continued under this section shall be owned by the 190.26 remaindermen or surviving joint tenants as their interests may 190.27 appear on the date of the recipient's death. They shall not be 190.28 merged into the remainder interest or the interests of the 190.29 surviving joint tenants by reason of ownership. They shall be 190.30 subject to the provisions of this section. Any conveyance, 190.31 transfer, sale, assignment, or encumbrance by a remainderman, a 190.32 surviving joint tenant, or their heirs, successors, and assigns 190.33 shall be deemed to include all of their interest in the deceased 190.34 recipient's life estate or joint tenancy interest continued 190.35 under this section; and 190.36 (6) the provisions of subdivisions 1c to 1k continuing a 191.1 recipient's joint tenancy interests in real property after the 191.2 recipient's death do not apply to a homestead owned of record, 191.3 on the date the recipient dies, by the recipient and the 191.4 recipient's spouse as joint tenants with a right of survivorship. 191.5 (b) For purposes of this section, "medical assistance" 191.6 includes the medical assistance program under this chapter and 191.7 the general assistance medical care program under chapter 256D, 191.8 but does not include the alternative care program for nonmedical 191.9 assistance recipients under section 256B.0913, subdivision 4. 191.10 [EFFECTIVE DATE.] This section is effective August 1, 2003, 191.11 and applies to estates of decedents who die on or after that 191.12 date. 191.13 Sec. 40. Minnesota Statutes 2002, section 256B.15, 191.14 subdivision 1a, is amended to read: 191.15 Subd. 1a. [ESTATES SUBJECT TO CLAIMS.] If a person 191.16 receives any medical assistance hereunder, on the person's 191.17 death, if single, or on the death of the survivor of a married 191.18 couple, either or both of whom received medical assistance, or 191.19 as otherwise provided for in this section, the total amount paid 191.20 for medical assistance rendered for the person and spouse shall 191.21 be filed as a claim against the estate of the person or the 191.22 estate of the surviving spouse in the court having jurisdiction 191.23 to probate the estate or to issue a decree of descent according 191.24 to sections 525.31 to 525.313. 191.25 A claim shall be filed if medical assistance was rendered 191.26 for either or both persons under one of the following 191.27 circumstances: 191.28 (a) the person was over 55 years of age, and received 191.29 services under this chapter, excluding alternative care; 191.30 (b) the person resided in a medical institution for six 191.31 months or longer, received services under this chapter excluding 191.32 alternative care, and, at the time of institutionalization or 191.33 application for medical assistance, whichever is later, the 191.34 person could not have reasonably been expected to be discharged 191.35 and returned home, as certified in writing by the person's 191.36 treating physician. For purposes of this section only, a 192.1 "medical institution" means a skilled nursing facility, 192.2 intermediate care facility, intermediate care facility for 192.3 persons with mental retardation, nursing facility, or inpatient 192.4 hospital; or 192.5 (c) the person received general assistance medical care 192.6 services under chapter 256D. 192.7 The claim shall be considered an expense of the last 192.8 illness of the decedent for the purpose of section 524.3-805. 192.9 Any statute of limitations that purports to limit any county 192.10 agency or the state agency, or both, to recover for medical 192.11 assistance granted hereunder shall not apply to any claim made 192.12 hereunder for reimbursement for any medical assistance granted 192.13 hereunder. Notice of the claim shall be given to all heirs and 192.14 devisees of the decedent whose identity can be ascertained with 192.15 reasonable diligence. The notice must include procedures and 192.16 instructions for making an application for a hardship waiver 192.17 under subdivision 5; time frames for submitting an application 192.18 and determination; and information regarding appeal rights and 192.19 procedures. Counties are entitled to one-half of the nonfederal 192.20 share of medical assistance collections from estates that are 192.21 directly attributable to county effort. 192.22 [EFFECTIVE DATE.] This section is effective August 1, 2003, 192.23 and applies to the estates of decedents who die on and after 192.24 that date. 192.25 Sec. 41. Minnesota Statutes 2002, section 256B.15, is 192.26 amended by adding a subdivision to read: 192.27 Subd. 1c. [NOTICE OF POTENTIAL CLAIM.] (a) A state agency 192.28 with a claim or potential claim under this section may file a 192.29 notice of potential claim under this subdivision anytime before 192.30 or within one year after a medical assistance recipient dies. 192.31 The claimant shall be the state agency. A notice filed prior to 192.32 the recipient's death shall not take effect and shall not be 192.33 effective as notice until the recipient dies. A notice filed 192.34 after a recipient dies shall be effective from the time of 192.35 filing. 192.36 (b) The notice of claim shall be filed or recorded in the 193.1 real estate records in the office of the county recorder or 193.2 registrar of titles for each county in which any part of the 193.3 property is located. The recorder shall accept the notice for 193.4 recording or filing. The registrar of titles shall accept the 193.5 notice for filing if the recipient has a recorded interest in 193.6 the property. The registrar of titles shall not carry forward 193.7 to a new certificate of title any notice filed more than one 193.8 year from the date of the recipient's death. 193.9 (c) The notice must be dated, state the name of the 193.10 claimant, the medical assistance recipient's name and social 193.11 security number if filed before their death and their date of 193.12 death if filed after they die, the name and date of death of any 193.13 predeceased spouse of the medical assistance recipient for whom 193.14 a claim may exist, a statement that the claimant may have a 193.15 claim arising under this section, generally identify the 193.16 recipient's interest in the property, contain a legal 193.17 description for the property and whether it is abstract or 193.18 registered property, a statement of when the notice becomes 193.19 effective and the effect of the notice, be signed by an 193.20 authorized representative of the state agency, and may include 193.21 such other contents as the state agency may deem appropriate. 193.22 [EFFECTIVE DATE.] This section is effective August 1, 2003, 193.23 and applies to the estates of decedents who die on or after that 193.24 date. 193.25 Sec. 42. Minnesota Statutes 2002, section 256B.15, is 193.26 amended by adding a subdivision to read: 193.27 Subd. 1d. [EFFECT OF NOTICE.] From the time it takes 193.28 effect, the notice shall be notice to remaindermen, joint 193.29 tenants, or to anyone else owning or acquiring an interest in or 193.30 encumbrance against the property described in the notice that 193.31 the medical assistance recipient's life estate, joint tenancy, 193.32 or other interests in the real estate described in the notice: 193.33 (1) shall, in the case of life estate and joint tenancy 193.34 interests, continue to exist for purposes of this section, and 193.35 be subject to liens and claims as provided in this section; 193.36 (2) shall be subject to a lien in favor of the claimant 194.1 effective upon the death of the recipient and dealt with as 194.2 provided in this section; 194.3 (3) may be included in the recipient's estate, as defined 194.4 in this section; and 194.5 (4) may be subject to administration and all other 194.6 provisions of chapter 524 and may be sold, assigned, 194.7 transferred, or encumbered free and clear of their interest or 194.8 encumbrance to satisfy claims under this section. 194.9 [EFFECTIVE DATE.] This section is effective August 1, 2003, 194.10 and applies to the estates of decedents who die on or after that 194.11 date. 194.12 Sec. 43. Minnesota Statutes 2002, section 256B.15, is 194.13 amended by adding a subdivision to read: 194.14 Subd. 1e. [FULL OR PARTIAL RELEASE OF NOTICE.] (a) The 194.15 claimant may fully or partially release the notice and the lien 194.16 arising out of the notice of record in the real estate records 194.17 where the notice is filed or recorded at any time. The claimant 194.18 may give a full or partial release to extinguish any life 194.19 estates or joint tenancy interests which are or may be continued 194.20 under this section or whose existence or nonexistence may create 194.21 a cloud on the title to real property at any time whether or not 194.22 a notice has been filed. The recorder or registrar of titles 194.23 shall accept the release for recording or filing. If the 194.24 release is a partial release, it must include a legal 194.25 description of the property being released. 194.26 (b) At any time, the claimant may, at the claimant's 194.27 discretion, wholly or partially release, subordinate, modify, or 194.28 amend the recorded notice and the lien arising out of the notice. 194.29 [EFFECTIVE DATE.] This section is effective August 1, 2003, 194.30 and applies to the estates of decedents who die on or after that 194.31 date. 194.32 Sec. 44. Minnesota Statutes 2002, section 256B.15, is 194.33 amended by adding a subdivision to read: 194.34 Subd. 1f. [AGENCY LIEN.] (a) The notice shall constitute a 194.35 lien in favor of the department of human services against the 194.36 recipient's interests in the real estate it describes for a 195.1 period of 20 years from the date of filing or the date of the 195.2 recipient's death, whichever is later. Notwithstanding any law 195.3 or rule to the contrary, a recipient's life estate and joint 195.4 tenancy interests shall not end upon the recipient's death but 195.5 shall continue according to subdivisions 1h, 1i, and 1j. The 195.6 amount of the lien shall be equal to the total amount of the 195.7 claims that could be presented in the recipient's estate under 195.8 this section. 195.9 (b) If no estate has been opened for the deceased 195.10 recipient, any holder of an interest in the property may apply 195.11 to the lien holder for a statement of the amount of the lien or 195.12 for a full or partial release of the lien. The application 195.13 shall include the applicant's name, current mailing address, 195.14 current home and work telephone numbers, and a description of 195.15 their interest in the property, a legal description of the 195.16 recipient's interest in the property, and the deceased 195.17 recipient's name, date of birth, and social security number. 195.18 The lien holder shall send the applicant by certified mail, 195.19 return receipt requested, a written statement showing the amount 195.20 of the lien, whether the lien holder is willing to release the 195.21 lien and under what conditions, and inform them of the right to 195.22 a hearing under section 256.045. The lien holder shall have the 195.23 discretion to compromise and settle the lien upon any terms and 195.24 conditions the lien holder deems appropriate. 195.25 (c) Any holder of an interest in property subject to the 195.26 lien has a right to request a hearing under section 256.045 to 195.27 determine the validity, extent, or amount of the lien. The 195.28 request must be in writing, and must include the names, current 195.29 addresses, and home and business telephone numbers for all other 195.30 parties holding an interest in the property. A request for a 195.31 hearing by any holder of an interest in the property shall be 195.32 deemed to be a request for a hearing by all parties owning 195.33 interests in the property. Notice of the hearing shall be given 195.34 to the lien holder, the party filing the appeal, and all of the 195.35 other holders of interests in the property at the addresses 195.36 listed in the appeal by certified mail, return receipt 196.1 requested, or by ordinary mail. Any owner of an interest in the 196.2 property to whom notice of the hearing is mailed shall be deemed 196.3 to have waived any and all claims or defenses in respect to the 196.4 lien unless they appear and assert any claims or defenses at the 196.5 hearing. 196.6 (d) If the claim the lien secures could be filed under 196.7 subdivision 1h, the lien holder may collect, compromise, settle, 196.8 or release the lien upon any terms and conditions it deems 196.9 appropriate. If the claim the lien secures could be filed under 196.10 subdivision 1i or 1j, the lien may be adjusted or enforced to 196.11 the same extent had it been filed under subdivisions 1i and 1j, 196.12 and the provisions of subdivisions 1i, clause (f), and lj, 196.13 clause (d), shall apply to voluntary payment, settlement, or 196.14 satisfaction of the lien. 196.15 (e) If no probate proceedings have been commenced for the 196.16 recipient as of the date the lien holder executes a release of 196.17 the lien on a recipient's life estate or joint tenancy interest, 196.18 created for purposes of this section, the release shall 196.19 terminate the life estate or joint tenancy interest created 196.20 under this section as of the date it is recorded or filed to the 196.21 extent of the release. If the claimant executes a release for 196.22 purposes of extinguishing a life estate or a joint tenancy 196.23 interest created under this section to remove a cloud on title 196.24 to real property, the release shall have the effect of 196.25 extinguishing any life estate or joint tenancy interests in the 196.26 property it describes which may have been continued by reason of 196.27 this section retroactive to the date of death of the deceased 196.28 life tenant or joint tenant except as provided for in section 196.29 514.981, subdivision 6. 196.30 (f) If the deceased recipient's estate is probated, a claim 196.31 shall be filed under this section. The amount of the lien shall 196.32 be limited to the amount of the claim as finally allowed. If 196.33 the claim the lien secures is filed under subdivision 1h, the 196.34 lien may be released in full after any allowance of the claim 196.35 becomes final or according to any agreement to settle and 196.36 satisfy the claim. The release shall release the lien but shall 197.1 not extinguish or terminate the interest being released. If the 197.2 claim the lien secures is filed under subdivision 1i or 1j, the 197.3 lien shall be released after the lien under subdivision 1i or 1j 197.4 is filed or recorded, or settled according to any agreement to 197.5 settle and satisfy the claim. The release shall not extinguish 197.6 or terminate the interest being released. If the claim is 197.7 finally disallowed in full, the claimant shall release the 197.8 claimant's lien at the claimant's expense. 197.9 [EFFECTIVE DATE.] This section takes effect on August 1, 197.10 2003, and applies to the estates of decedents who die on or 197.11 after that date. 197.12 Sec. 45. Minnesota Statutes 2002, section 256B.15, is 197.13 amended by adding a subdivision to read: 197.14 Subd. 1g. [ESTATE PROPERTY.] Notwithstanding any law or 197.15 rule to the contrary, if a claim is presented under this 197.16 section, interests or the proceeds of interests in real property 197.17 a decedent owned as a life tenant or a joint tenant with a right 197.18 of survivorship shall be part of the decedent's estate, subject 197.19 to administration, and shall be dealt with as provided in this 197.20 section. 197.21 [EFFECTIVE DATE.] This section takes effect on August 1, 197.22 2003, and applies to the estates of decedents who die on or 197.23 after that date. 197.24 Sec. 46. Minnesota Statutes 2002, section 256B.15, is 197.25 amended by adding a subdivision to read: 197.26 Subd. 1h. [ESTATES OF SPECIFIC PERSONS RECEIVING MEDICAL 197.27 ASSISTANCE.] (a) For purposes of this section, paragraphs (b) to 197.28 (k) apply if a person received medical assistance for which a 197.29 claim may be filed under this section and died single, or the 197.30 surviving spouse of the couple and was not survived by any of 197.31 the persons described in subdivisions 3 and 4. 197.32 (b) For purposes of this section, the person's estate 197.33 consists of: (1) their probate estate; (2) all of the person's 197.34 interests or proceeds of those interests in real property the 197.35 person owned as a life tenant or as a joint tenant with a right 197.36 of survivorship at the time of the person's death; (3) all of 198.1 the person's interests or proceeds of those interests in 198.2 securities the person owned in beneficiary form as provided 198.3 under sections 524.6-301 to 524.6-311 at the time of the 198.4 person's death, to the extent they become part of the probate 198.5 estate under section 524.6-307; and (4) all of the person's 198.6 interests in joint accounts, multiple party accounts, and pay on 198.7 death accounts, or the proceeds of those accounts, as provided 198.8 under sections 524.6-201 to 524.6-214 at the time of the 198.9 person's death to the extent they become part of the probate 198.10 estate under section 524.6-207. Notwithstanding any law or rule 198.11 to the contrary, a state or county agency with a claim under 198.12 this section shall be a creditor under section 524.6-307. 198.13 (c) Notwithstanding any law or rule to the contrary, the 198.14 person's life estate or joint tenancy interest in real property 198.15 not subject to a medical assistance lien under sections 514.980 198.16 to 514.985 on the date of the person's death shall not end upon 198.17 the person's death and shall continue as provided in this 198.18 subdivision. The life estate in the person's estate shall be 198.19 that portion of the interest in the real property subject to the 198.20 life estate that is equal to the life estate percentage factor 198.21 for the life estate as listed in the Life Estate Mortality Table 198.22 of the health care program's manual for a person who was the age 198.23 of the medical assistance recipient on the date of the person's 198.24 death. The joint tenancy interest in real property in the 198.25 estate shall be equal to the fractional interest the person 198.26 would have owned in the jointly held interest in the property 198.27 had they and the other owners held title to the property as 198.28 tenants in common on the date the person died. 198.29 (d) The court upon its own motion, or upon motion by the 198.30 personal representative or any interested party, may enter an 198.31 order directing the remaindermen or surviving joint tenants and 198.32 their spouses, if any, to sign all documents, take all actions, 198.33 and otherwise fully cooperate with the personal representative 198.34 and the court to liquidate the decedent's life estate or joint 198.35 tenancy interests in the estate and deliver the cash or the 198.36 proceeds of those interests to the personal representative and 199.1 provide for any legal and equitable sanctions as the court deems 199.2 appropriate to enforce and carry out the order, including an 199.3 award of reasonable attorney fees. 199.4 (e) The personal representative may make, execute, and 199.5 deliver any conveyances or other documents necessary to convey 199.6 the decedent's life estate or joint tenancy interest in the 199.7 estate that are necessary to liquidate and reduce to cash the 199.8 decedent's interest or for any other purposes. 199.9 (f) Subject to administration, all costs, including 199.10 reasonable attorney fees, directly and immediately related to 199.11 liquidating the decedent's life estate or joint tenancy interest 199.12 in the decedent's estate, shall be paid from the gross proceeds 199.13 of the liquidation allocable to the decedent's interest and the 199.14 net proceeds shall be turned over to the personal representative 199.15 and applied to payment of the claim presented under this section. 199.16 (g) The personal representative shall bring a motion in the 199.17 district court in which the estate is being probated to compel 199.18 the remaindermen or surviving joint tenants to account for and 199.19 deliver to the personal representative all or any part of the 199.20 proceeds of any sale, mortgage, transfer, conveyance, or any 199.21 disposition of real property allocable to the decedent's life 199.22 estate or joint tenancy interest in the decedent's estate, and 199.23 do everything necessary to liquidate and reduce to cash the 199.24 decedent's interest and turn the proceeds of the sale or other 199.25 disposition over to the personal representative. The court may 199.26 grant any legal or equitable relief including, but not limited 199.27 to, ordering a partition of real estate under chapter 558 199.28 necessary to make the value of the decedent's life estate or 199.29 joint tenancy interest available to the estate for payment of a 199.30 claim under this section. 199.31 (h) Subject to administration, the personal representative 199.32 shall use all of the cash or proceeds of interests to pay an 199.33 allowable claim under this section. The remaindermen or 199.34 surviving joint tenants and their spouses, if any, may enter 199.35 into a written agreement with the personal representative or the 199.36 claimant to settle and satisfy obligations imposed at any time 200.1 before or after a claim is filed. 200.2 (i) The personal representative may provide any or all of 200.3 the other owners, remaindermen, or surviving joint tenants with 200.4 an affidavit terminating the decedent's estate's interest in 200.5 real property the decedent owned as a life tenant or as a joint 200.6 tenant with others, if the personal representative determines 200.7 that neither the decedent nor any of the decedent's predeceased 200.8 spouses received any medical assistance for which a claim could 200.9 be filed under this section, or if the personal representative 200.10 has filed an affidavit with the court that the estate has other 200.11 assets sufficient to pay a claim, as presented, or if there is a 200.12 written agreement under paragraph (h), or if the claim, as 200.13 allowed, has been paid in full or to the full extent of the 200.14 assets the estate has available to pay it. The affidavit may be 200.15 recorded in the office of the county recorder or filed in the 200.16 office of the registrar of titles for the county in which the 200.17 real property is located. Except as provided in section 200.18 514.981, subdivision 6, when recorded or filed, the affidavit 200.19 shall terminate the decedent's interest in real estate the 200.20 decedent owned as a life tenant or a joint tenant with others. 200.21 The affidavit shall: (1) be signed by the personal 200.22 representative; (2) identify the decedent and the interest being 200.23 terminated; (3) give recording information sufficient to 200.24 identify the instrument that created the interest in real 200.25 property being terminated; (4) legally describe the affected 200.26 real property; (5) state that the personal representative has 200.27 determined that neither the decedent nor any of the decedent's 200.28 predeceased spouses received any medical assistance for which a 200.29 claim could be filed under this section; (6) state that the 200.30 decedent's estate has other assets sufficient to pay the claim, 200.31 as presented, or that there is a written agreement between the 200.32 personal representative and the claimant and the other owners or 200.33 remaindermen or other joint tenants to satisfy the obligations 200.34 imposed under this subdivision; and (7) state that the affidavit 200.35 is being given to terminate the estate's interest under this 200.36 subdivision, and any other contents as may be appropriate. 201.1 The recorder or registrar of titles shall accept the affidavit 201.2 for recording or filing. The affidavit shall be effective as 201.3 provided in this section and shall constitute notice even if it 201.4 does not include recording information sufficient to identify 201.5 the instrument creating the interest it terminates. The 201.6 affidavit shall be conclusive evidence of the stated facts. 201.7 (j) The holder of a lien arising under subdivision 1c shall 201.8 release the lien at the holder's expense against an interest 201.9 terminated under paragraph (h) to the extent of the termination. 201.10 (k) If a lien arising under subdivision 1c is not released 201.11 under paragraph (j), prior to closing the estate, the personal 201.12 representative shall deed the interest subject to the lien to 201.13 the remaindermen or surviving joint tenants as their interests 201.14 may appear. Upon recording or filing, the deed shall work a 201.15 merger of the recipient's life estate or joint tenancy interest, 201.16 subject to the lien, into the remainder interest or interest the 201.17 decedent and others owned jointly. The lien shall attach to and 201.18 run with the property to the extent of the decedent's interest 201.19 at the time of the decedent's death. 201.20 [EFFECTIVE DATE.] This section takes effect on August 1, 201.21 2003, and applies to the estates of decedents who die on or 201.22 after that date. 201.23 Sec. 47. Minnesota Statutes 2002, section 256B.15, is 201.24 amended by adding a subdivision to read: 201.25 Subd. 1i. [ESTATES OF PERSONS RECEIVING MEDICAL ASSISTANCE 201.26 AND SURVIVED BY OTHERS.] (a) For purposes of this subdivision, 201.27 the person's estate consists of the person's probate estate and 201.28 all of the person's interests in real property the person owned 201.29 as a life tenant or a joint tenant at the time of the person's 201.30 death. 201.31 (b) Notwithstanding any law or rule to the contrary, this 201.32 subdivision applies if a person received medical assistance for 201.33 which a claim could be filed under this section but for the fact 201.34 the person was survived by a spouse or by a person listed in 201.35 subdivision 3, or if subdivision 4 applies to a claim arising 201.36 under this section. 202.1 (c) The person's life estate or joint tenancy interests in 202.2 real property not subject to a medical assistance lien under 202.3 sections 514.980 to 514.985 on the date of the person's death 202.4 shall not end upon death and shall continue as provided in this 202.5 subdivision. The life estate in the estate shall be the portion 202.6 of the interest in the property subject to the life estate that 202.7 is equal to the life estate percentage factor for the life 202.8 estate as listed in the Life Estate Mortality Table of the 202.9 health care program's manual for a person who was the age of the 202.10 medical assistance recipient on the date of the person's death. 202.11 The joint tenancy interest in the estate shall be equal to the 202.12 fractional interest the medical assistance recipient would have 202.13 owned in the jointly held interest in the property had they and 202.14 the other owners held title to the property as tenants in common 202.15 on the date the medical assistance recipient died. 202.16 (d) The county agency shall file a claim in the estate 202.17 under this section on behalf of the claimant who shall be the 202.18 commissioner of human services, notwithstanding that the 202.19 decedent is survived by a spouse or a person listed in 202.20 subdivision 3. The claim, as allowed, shall not be paid by the 202.21 estate and shall be disposed of as provided in this paragraph. 202.22 The personal representative or the court shall make, execute, 202.23 and deliver a lien in favor of the claimant on the decedent's 202.24 interest in real property in the estate in the amount of the 202.25 allowed claim on forms provided by the commissioner to the 202.26 county agency filing the lien. The lien shall bear interest as 202.27 provided under section 524.3-806, shall attach to the property 202.28 it describes upon filing or recording, and shall remain a lien 202.29 on the real property it describes for a period of 20 years from 202.30 the date it is filed or recorded. The lien shall be a 202.31 disposition of the claim sufficient to permit the estate to 202.32 close. 202.33 (e) The state or county agency shall file or record the 202.34 lien in the office of the county recorder or registrar of titles 202.35 for each county in which any of the real property is located. 202.36 The recorder or registrar of titles shall accept the lien for 203.1 filing or recording. All recording or filing fees shall be paid 203.2 by the department of human services. The recorder or registrar 203.3 of titles shall mail the recorded lien to the department of 203.4 human services. The lien need not be attested, certified, or 203.5 acknowledged as a condition of recording or filing. Upon 203.6 recording or filing of a lien against a life estate or a joint 203.7 tenancy interest, the interest subject to the lien shall merge 203.8 into the remainder interest or the interest the recipient and 203.9 others owned jointly. The lien shall attach to and run with the 203.10 property to the extent of the decedent's interest in the 203.11 property at the time of the decedent's death as determined under 203.12 this section. 203.13 (f) The department shall make no adjustment or recovery 203.14 under the lien until after the decedent's spouse, if any, has 203.15 died, and only at a time when the decedent has no surviving 203.16 child described in subdivision 3. The estate, any owner of an 203.17 interest in the property which is or may be subject to the lien, 203.18 or any other interested party, may voluntarily pay off, settle, 203.19 or otherwise satisfy the claim secured or to be secured by the 203.20 lien at any time before or after the lien is filed or recorded. 203.21 Such payoffs, settlements, and satisfactions shall be deemed to 203.22 be voluntary repayments of past medical assistance payments for 203.23 the benefit of the deceased recipient, and neither the process 203.24 of settling the claim, the payment of the claim, or the 203.25 acceptance of a payment shall constitute an adjustment or 203.26 recovery that is prohibited under this subdivision. 203.27 (g) The lien under this subdivision may be enforced or 203.28 foreclosed in the manner provided by law for the enforcement of 203.29 judgment liens against real estate or by a foreclosure by action 203.30 under chapter 581. When the lien is paid, satisfied, or 203.31 otherwise discharged, the state or county agency shall prepare 203.32 and file a release of lien at its own expense. No action to 203.33 foreclose the lien shall be commenced unless the lien holder has 203.34 first given 30 days' prior written notice to pay the lien to the 203.35 owners and parties in possession of the property subject to the 203.36 lien. The notice shall: (1) include the name, address, and 204.1 telephone number of the lien holder; (2) describe the lien; (3) 204.2 give the amount of the lien; (4) inform the owner or party in 204.3 possession that payment of the lien in full must be made to the 204.4 lien holder within 30 days after service of the notice or the 204.5 lien holder may begin proceedings to foreclose the lien; and (5) 204.6 be served by personal service, certified mail, return receipt 204.7 requested, ordinary first class mail, or by publishing it once 204.8 in a newspaper of general circulation in the county in which any 204.9 part of the property is located. Service of the notice shall be 204.10 complete upon mailing or publication. 204.11 [EFFECTIVE DATE.] This section takes effect August 1, 2003, 204.12 and applies to estates of decedents who die on or after that 204.13 date. 204.14 Sec. 48. Minnesota Statutes 2002, section 256B.15, is 204.15 amended by adding a subdivision to read: 204.16 Subd. 1j. [CLAIMS IN ESTATES OF DECEDENTS SURVIVED BY 204.17 OTHER SURVIVORS.] For purposes of this subdivision, the 204.18 provisions in subdivision 1i, paragraphs (a) to (c) apply. 204.19 (a) If payment of a claim filed under this section is 204.20 limited as provided in subdivision 4, and if the estate does not 204.21 have other assets sufficient to pay the claim in full, as 204.22 allowed, the personal representative or the court shall make, 204.23 execute, and deliver a lien on the property in the estate that 204.24 is exempt from the claim under subdivision 4 in favor of the 204.25 commissioner of human services on forms provided by the 204.26 commissioner to the county agency filing the claim. If the 204.27 estate pays a claim filed under this section in full from other 204.28 assets of the estate, no lien shall be filed against the 204.29 property described in subdivision 4. 204.30 (b) The lien shall be in an amount equal to the unpaid 204.31 balance of the allowed claim under this section remaining after 204.32 the estate has applied all other available assets of the estate 204.33 to pay the claim. The property exempt under subdivision 4 shall 204.34 not be sold, assigned, transferred, conveyed, encumbered, or 204.35 distributed until after the personal representative has 204.36 determined the estate has other assets sufficient to pay the 205.1 allowed claim in full, or until after the lien has been filed or 205.2 recorded. The lien shall bear interest as provided under 205.3 section 524.3-806, shall attach to the property it describes 205.4 upon filing or recording, and shall remain a lien on the real 205.5 property it describes for a period of 20 years from the date it 205.6 is filed or recorded. The lien shall be a disposition of the 205.7 claim sufficient to permit the estate to close. 205.8 (c) The state or county agency shall file or record the 205.9 lien in the office of the county recorder or registrar of titles 205.10 in each county in which any of the real property is located. 205.11 The department shall pay the filing fees. The lien need not be 205.12 attested, certified, or acknowledged as a condition of recording 205.13 or filing. The recorder or registrar of titles shall accept the 205.14 lien for filing or recording. 205.15 (d) The commissioner shall make no adjustment or recovery 205.16 under the lien until none of the persons listed in subdivision 4 205.17 are residing on the property or until the property is sold or 205.18 transferred. The estate or any owner of an interest in the 205.19 property that is or may be subject to the lien, or any other 205.20 interested party, may voluntarily pay off, settle, or otherwise 205.21 satisfy the claim secured or to be secured by the lien at any 205.22 time before or after the lien is filed or recorded. The 205.23 payoffs, settlements, and satisfactions shall be deemed to be 205.24 voluntary repayments of past medical assistance payments for the 205.25 benefit of the deceased recipient and neither the process of 205.26 settling the claim, the payment of the claim, or acceptance of a 205.27 payment shall constitute an adjustment or recovery that is 205.28 prohibited under this subdivision. 205.29 (e) A lien under this subdivision may be enforced or 205.30 foreclosed in the manner provided for by law for the enforcement 205.31 of judgment liens against real estate or by a foreclosure by 205.32 action under chapter 581. When the lien has been paid, 205.33 satisfied, or otherwise discharged, the claimant shall prepare 205.34 and file a release of lien at the claimant's expense. No action 205.35 to foreclose the lien shall be commenced unless the lien holder 205.36 has first given 30 days prior written notice to pay the lien to 206.1 the record owners of the property and the parties in possession 206.2 of the property subject to the lien. The notice shall: (1) 206.3 include the name, address, and telephone number of the lien 206.4 holder; (2) describe the lien; (3) give the amount of the lien; 206.5 (4) inform the owner or party in possession that payment of the 206.6 lien in full must be made to the lien holder within 30 days 206.7 after service of the notice or the lien holder may begin 206.8 proceedings to foreclose the lien; and (5) be served by personal 206.9 service, certified mail, return receipt requested, ordinary 206.10 first class mail, or by publishing it once in a newspaper of 206.11 general circulation in the county in which any part of the 206.12 property is located. Service shall be complete upon mailing or 206.13 publication. 206.14 (f) Upon filing or recording of a lien against a life 206.15 estate or joint tenancy interest under this subdivision, the 206.16 interest subject to the lien shall merge into the remainder 206.17 interest or the interest the decedent and others owned jointly, 206.18 effective on the date of recording and filing. The lien shall 206.19 attach to and run with the property to the extent of the 206.20 decedent's interest in the property at the time of the 206.21 decedent's death as determined under this section. 206.22 (g)(1) An affidavit may be provided by a personal 206.23 representative stating the personal representative has 206.24 determined in good faith that a decedent survived by a spouse or 206.25 a person listed in subdivision 3, or by a person listed in 206.26 subdivision 4, or the decedent's predeceased spouse did not 206.27 receive any medical assistance giving rise to a claim under this 206.28 section, or that the real property described in subdivision 4 is 206.29 not needed to pay in full a claim arising under this section. 206.30 (2) The affidavit shall: (i) describe the property and the 206.31 interest being extinguished; (ii) name the decedent and give the 206.32 date of death; (iii) state the facts listed in clause (1); (iv) 206.33 state that the affidavit is being filed to terminate the life 206.34 estate or joint tenancy interest created under this subdivision; 206.35 (v) be signed by the personal representative; and (vi) contain 206.36 any other information that the affiant deems appropriate. 207.1 (3) Except as provided in section 514.981, subdivision 6, 207.2 when the affidavit is filed or recorded, the life estate or 207.3 joint tenancy interest in real property that the affidavit 207.4 describes shall be terminated effective as of the date of filing 207.5 or recording. The termination shall be final and may not be set 207.6 aside for any reason. 207.7 [EFFECTIVE DATE.] This section takes effect on August 1, 207.8 2003, and applies to the estates of decedents who die on or 207.9 after that date. 207.10 Sec. 49. Minnesota Statutes 2002, section 256B.15, is 207.11 amended by adding a subdivision to read: 207.12 Subd. 1k. [FILING.] Any notice, lien, release, or other 207.13 document filed under subdivisions 1c to 1l, and any lien, 207.14 release of lien, or other documents relating to a lien filed 207.15 under subdivisions 1h, 1i, and 1j must be filed or recorded in 207.16 the office of the county recorder or registrar of titles, as 207.17 appropriate, in the county where the affected real property is 207.18 located. Notwithstanding section 386.77, the state or county 207.19 agency shall pay any applicable filing fee. An attestation, 207.20 certification, or acknowledgment is not required as a condition 207.21 of filing. If the property described in the filing is 207.22 registered property, the registrar of titles shall record the 207.23 filing on the certificate of title for each parcel of property 207.24 described in the filing. If the property described in the 207.25 filing is abstract property, the recorder shall file and index 207.26 the property in the county's grantor-grantee indexes and any 207.27 tract indexes the county maintains for each parcel of property 207.28 described in the filing. The recorder or registrar of titles 207.29 shall return the filed document to the party filing it at no 207.30 cost. If the party making the filing provides a duplicate copy 207.31 of the filing, the recorder or registrar of titles shall show 207.32 the recording or filing data on the copy and return it to the 207.33 party at no extra cost. 207.34 [EFFECTIVE DATE.] This section takes effect on August 1, 207.35 2003, and applies to the estates of decedents who die on or 207.36 after that date. 208.1 Sec. 50. Minnesota Statutes 2002, section 256B.15, 208.2 subdivision 3, is amended to read: 208.3 Subd. 3. [SURVIVING SPOUSE, MINOR, BLIND, OR DISABLED 208.4 CHILDREN.] If a decedentwhois survived by a spouse, or was 208.5 single,orwho wasthe surviving spouse of a married couple,and 208.6 is survived by a child who is under age 21 or blind or 208.7 permanently and totally disabled according to the supplemental 208.8 security income program criteria,noa claim shall be filed 208.9 against the estate according to this section. 208.10 [EFFECTIVE DATE.] This section is effective August 1, 2003, 208.11 and applies to decedents who die on or after that date. 208.12 Sec. 51. Minnesota Statutes 2002, section 256B.15, 208.13 subdivision 4, is amended to read: 208.14 Subd. 4. [OTHER SURVIVORS.] If the decedent who was single 208.15 or the surviving spouse of a married couple is survived by one 208.16 of the following persons, a claim exists against the estate in 208.17 an amount not to exceed the value of the nonhomestead property 208.18 included in the estate and the personal representative shall 208.19 make, execute, and deliver to the county agency a lien against 208.20 the homestead property in the estate for any unpaid balance of 208.21 the claim to the claimant as provided under this section: 208.22 (a) a sibling who resided in the decedent medical 208.23 assistance recipient's home at least one year before the 208.24 decedent's institutionalization and continuously since the date 208.25 of institutionalization; or 208.26 (b) a son or daughter or a grandchild who resided in the 208.27 decedent medical assistance recipient's home for at least two 208.28 years immediately before the parent's or grandparent's 208.29 institutionalization and continuously since the date of 208.30 institutionalization, and who establishes by a preponderance of 208.31 the evidence having provided care to the parent or grandparent 208.32 who received medical assistance, that the care was provided 208.33 before institutionalization, and that the care permitted the 208.34 parent or grandparent to reside at home rather than in an 208.35 institution. 208.36 [EFFECTIVE DATE.] This section is effective August 1, 2003, 209.1 and applies to decedents who die on or after that date. 209.2 Sec. 52. Minnesota Statutes 2002, section 256B.195, 209.3 subdivision 4, is amended to read: 209.4 Subd. 4. [ADJUSTMENTS PERMITTED.] (a) The commissioner may 209.5 adjust the intergovernmental transfers under subdivision 2 and 209.6 the payments under subdivision 3,and payments and transfers209.7under subdivision 5,based on the commissioner's determination 209.8 of Medicare upper payment limits, hospital-specific charge 209.9 limits, and hospital-specific limitations on disproportionate 209.10 share payments. Any adjustments must be made on a proportional 209.11 basis. If participation by a particular hospital under this 209.12 section is limited, the commissioner shall adjust the payments 209.13 that relate to that hospital under subdivisions 2,and 3, and 5209.14 on a proportional basis in order to allow the hospital to 209.15 participate under this section to the fullest extent possible 209.16 and shall increase other payments under subdivisions 2,and 3,209.17and 5to the extent allowable to maintain the overall level of 209.18 payments under this section. The commissioner may make 209.19 adjustments under this subdivision only after consultation with 209.20 the counties and hospitals identified in subdivisions 2 and 3,209.21and, if subdivision 5 receives federal approval, with the209.22hospital and educational institution identified in subdivision 5. 209.23 (b) The ratio of medical assistance payments specified in 209.24 subdivision 3 to the intergovernmental transfers specified in 209.25 subdivision 2 shall not be reduced except as provided under 209.26 paragraph (a). 209.27 Sec. 53. Minnesota Statutes 2002, section 256B.31, is 209.28 amended to read: 209.29 256B.31 [CONTINUED HOSPITAL CARE FOR LONG-TERM POLIO 209.30 PATIENT.] 209.31 A medical assistance recipient who has been a polio patient 209.32 in an acute care hospital for a period of not less than 25 209.33 consecutive years is eligible to continue receiving hospital 209.34 care, whether or not the care is medically necessary for 209.35 purposes of federal reimbursement. The cost of continued 209.36 hospital care not reimbursable by the federal government must be 210.1 paid with state money allocated for the medical assistance 210.2 program. The rate paid to the hospital is therate per day210.3established using Medicare principles for the hospital's fiscal210.4year ending December 31, 1981, adjusted each year by the annual210.5hospital cost index established under section 256.969,210.6subdivision 1, or by other limits in effect at the time of the210.7adjustmentaverage inpatient routine rate per day for non-MFIP 210.8 eligibles, excluding rehabilitation and neonate admissions but 210.9 including property, for hospitals located outside of a 210.10 metropolitan statistical area, as defined by the United States 210.11 Census Bureau. This section does not prohibit a voluntary move 210.12 to another living arrangement by a recipient whose care is 210.13 reimbursed under this section. 210.14 Sec. 54. Minnesota Statutes 2002, section 256B.32, 210.15 subdivision 1, is amended to read: 210.16 Subdivision 1. [FACILITY FEE PAYMENT.] (a) The 210.17 commissioner shall establish a facility fee payment mechanism 210.18 that will pay a facility fee to all enrolled outpatient 210.19 hospitals for each emergency room or outpatient clinic visit 210.20 provided on or after July 1, 1989. This payment mechanism may 210.21 not result in an overall increase in outpatient payment rates. 210.22 This section does not apply to federally mandated maximum 210.23 payment limits, department approved program packages, or 210.24 services billed using a nonoutpatient hospital provider number. 210.25 (b) For fee-for-service services provided on or after July 210.26 1, 2002, the total payment, before third-party liability and 210.27 spenddown, made to hospitals for outpatient hospital facility 210.28 services is reduced by .5 percent from the current statutory 210.29 rates. 210.30 (c) In addition to the reduction in paragraph (b), the 210.31 total payment for fee-for-service services provided on or after 210.32 July 1, 2003, made to hospitals for outpatient hospital facility 210.33 services before third-party liability and spenddown, is reduced 210.34 2.5 percent from the current statutory rates. Facilities 210.35 defined under section 256.969, subdivision 16, are excluded from 210.36 this paragraph. 211.1 Sec. 55. Minnesota Statutes 2002, section 256B.69, 211.2 subdivision 2, is amended to read: 211.3 Subd. 2. [DEFINITIONS.] For the purposes of this section, 211.4 the following terms have the meanings given. 211.5 (a) "Commissioner" means the commissioner of human services. 211.6 For the remainder of this section, the commissioner's 211.7 responsibilities for methods and policies for implementing the 211.8 project will be proposed by the project advisory committees and 211.9 approved by the commissioner. 211.10 (b) "Demonstration provider" means a health maintenance 211.11 organization, community integrated service network, or 211.12 accountable provider network authorized and operating under 211.13 chapter 62D, 62N, or 62T that participates in the demonstration 211.14 project according to criteria, standards, methods, and other 211.15 requirements established for the project and approved by the 211.16 commissioner. For purposes of this section, a county board, or 211.17 group of county boards operating under a joint powers agreement, 211.18 is considered a demonstration provider if the county or group of 211.19 county boards meets the requirements of section 256B.692. 211.20 Notwithstanding the above, Itasca county may continue to 211.21 participate as a demonstration provider until July 1, 2004. 211.22 (c) "Eligible individuals" means those persons eligible for 211.23 medical assistance benefits as defined in sections 256B.055, 211.24 256B.056, and 256B.06. 211.25 (d) "Limitation of choice" means suspending freedom of 211.26 choice while allowing eligible individuals to choose among the 211.27 demonstration providers. 211.28(e) This paragraph supersedes paragraph (c) as long as the211.29Minnesota health care reform waiver remains in effect. When the211.30waiver expires, this paragraph expires and the commissioner of211.31human services shall publish a notice in the State Register and211.32notify the revisor of statutes. "Eligible individuals" means211.33those persons eligible for medical assistance benefits as211.34defined in sections 256B.055, 256B.056, and 256B.06.211.35Notwithstanding sections 256B.055, 256B.056, and 256B.06, an211.36individual who becomes ineligible for the program because of212.1failure to submit income reports or recertification forms in a212.2timely manner, shall remain enrolled in the prepaid health plan212.3and shall remain eligible to receive medical assistance coverage212.4through the last day of the month following the month in which212.5the enrollee became ineligible for the medical assistance212.6program.212.7 [EFFECTIVE DATE.] This section is effective July 1, 2003. 212.8 Sec. 56. Minnesota Statutes 2002, section 256B.69, 212.9 subdivision 4, is amended to read: 212.10 Subd. 4. [LIMITATION OF CHOICE.] (a) The commissioner 212.11 shall develop criteria to determine when limitation of choice 212.12 may be implemented in the experimental counties. The criteria 212.13 shall ensure that all eligible individuals in the county have 212.14 continuing access to the full range of medical assistance 212.15 services as specified in subdivision 6. 212.16 (b) The commissioner shall exempt the following persons 212.17 from participation in the project, in addition to those who do 212.18 not meet the criteria for limitation of choice: 212.19 (1) persons eligible for medical assistance according to 212.20 section 256B.055, subdivision 1; 212.21 (2) persons eligible for medical assistance due to 212.22 blindness or disability as determined by the social security 212.23 administration or the state medical review team, unless: 212.24 (i) they are 65 years of age or older; or 212.25 (ii) they reside in Itasca county or they reside in a 212.26 county in which the commissioner conducts a pilot project under 212.27 a waiver granted pursuant to section 1115 of the Social Security 212.28 Act; 212.29 (3) recipients who currently have private coverage through 212.30 a health maintenance organization; 212.31 (4) recipients who are eligible for medical assistance by 212.32 spending down excess income for medical expenses other than the 212.33 nursing facility per diem expense; 212.34 (5) recipients who receive benefits under the Refugee 212.35 Assistance Program, established under United States Code, title 212.36 8, section 1522(e); 213.1 (6) children who are both determined to be severely 213.2 emotionally disturbed and receiving case management services 213.3 according to section 256B.0625, subdivision 20; 213.4 (7) adults who are both determined to be seriously and 213.5 persistently mentally ill and received case management services 213.6 according to section 256B.0625, subdivision 20;and213.7 (8) persons eligible for medical assistance according to 213.8 section 256B.057, subdivision 10; and 213.9 (9) persons with access to cost-effective 213.10 employer-sponsored private health insurance or persons enrolled 213.11 in an individual health plan determined to be cost-effective 213.12 according to section 256B.0625, subdivision 15. 213.13 Children under age 21 who are in foster placement may enroll in 213.14 the project on an elective basis. Individuals excluded under 213.15 clauses (6) and (7) may choose to enroll on an elective basis. 213.16 (c) The commissioner may allow persons with a one-month 213.17 spenddown who are otherwise eligible to enroll to voluntarily 213.18 enroll or remain enrolled, if they elect to prepay their monthly 213.19 spenddown to the state. 213.20 (d) The commissioner may require those individuals to 213.21 enroll in the prepaid medical assistance program who otherwise 213.22 would have been excluded under paragraph (b), clauses (1), (3), 213.23 and (8), and under Minnesota Rules, part 9500.1452, subpart 2, 213.24 items H, K, and L. 213.25 (e) Before limitation of choice is implemented, eligible 213.26 individuals shall be notified and after notification, shall be 213.27 allowed to choose only among demonstration providers. The 213.28 commissioner may assign an individual with private coverage 213.29 through a health maintenance organization, to the same health 213.30 maintenance organization for medical assistance coverage, if the 213.31 health maintenance organization is under contract for medical 213.32 assistance in the individual's county of residence. After 213.33 initially choosing a provider, the recipient is allowed to 213.34 change that choice only at specified times as allowed by the 213.35 commissioner. If a demonstration provider ends participation in 213.36 the project for any reason, a recipient enrolled with that 214.1 provider must select a new provider but may change providers 214.2 without cause once more within the first 60 days after 214.3 enrollment with the second provider. 214.4 Sec. 57. Minnesota Statutes 2002, section 256B.69, 214.5 subdivision 5a, is amended to read: 214.6 Subd. 5a. [MANAGED CARE CONTRACTS.] (a) Managed care 214.7 contracts under this section and sections 256L.12 and 256D.03, 214.8 shall be entered into or renewed on a calendar year basis 214.9 beginning January 1, 1996. Managed care contracts which were in 214.10 effect on June 30, 1995, and set to renew on July 1, 1995, shall 214.11 be renewed for the period July 1, 1995 through December 31, 1995 214.12 at the same terms that were in effect on June 30, 1995. 214.13 (b) A prepaid health plan providing covered health services 214.14 for eligible persons pursuant to chapters 256B, 256D, and 256L, 214.15 is responsible for complying with the terms of its contract with 214.16 the commissioner. Requirements applicable to managed care 214.17 programs under chapters 256B, 256D, and 256L, established after 214.18 the effective date of a contract with the commissioner take 214.19 effect when the contract is next issued or renewed. 214.20 (c) Effective for services rendered on or after January 1, 214.21 2003, the commissioner shall withhold five percent of managed 214.22 care plan payments under this section for the prepaid medical 214.23 assistance and general assistance medical care programs pending 214.24 completion of performance targets. Each performance target must 214.25 be quantifiable, objective, measurable, and reasonably 214.26 attainable. Criteria for assessment of each performance target 214.27 must be outlined in writing prior to the contract effective 214.28 date. The withheld funds must be returned no sooner than July 214.29 of the following year if performance targets in the contract are 214.30 achieved. The commissioner may exclude special demonstration 214.31 projects under subdivision 23. A managed care plan may include 214.32 as admitted assets under section 62D.044 any amount withheld 214.33 under this paragraph that is reasonably expected to be returned. 214.34 (d) The commissioner may exempt from paragraph (c) a 214.35 managed care plan that has entered into a managed care contract 214.36 with the commissioner in accordance with this section if the 215.1 contract was the initial contract between the managed care plan 215.2 and the commissioner, and it was entered into after January 1, 215.3 2000. This exemption shall apply for the first five years of 215.4 operation of the managed care plan. 215.5 [EFFECTIVE DATE.] This section is effective for services 215.6 rendered on or after July 1, 2003, except that the amendment to 215.7 paragraph (c) is effective for services rendered on or after 215.8 January 1, 2004. 215.9 Sec. 58. Minnesota Statutes 2002, section 256B.69, 215.10 subdivision 5c, is amended to read: 215.11 Subd. 5c. [MEDICAL EDUCATION AND RESEARCH FUND.] (a) The 215.12 commissioner of human services shall transfer each year to the 215.13 medical education and research fund established under section 215.14 62J.692, the following: 215.15 (1) an amount equal to the reduction in the prepaid medical 215.16 assistance and prepaid general assistance medical care payments 215.17 as specified in this clause. Until January 1, 2002, the county 215.18 medical assistance and general assistance medical care 215.19 capitation base rate prior to plan specific adjustments and 215.20 after the regional rate adjustments under section 256B.69, 215.21 subdivision 5b, is reduced 6.3 percent for Hennepin county, two 215.22 percent for the remaining metropolitan counties, and no 215.23 reduction for nonmetropolitan Minnesota counties; and after 215.24 January 1, 2002, the county medical assistance and general 215.25 assistance medical care capitation base rate prior to plan 215.26 specific adjustments is reduced 6.3 percent for Hennepin county, 215.27 two percent for the remaining metropolitan counties, and 1.6 215.28 percent for nonmetropolitan Minnesota counties. Nursing 215.29 facility and elderly waiver payments and demonstration project 215.30 payments operating under subdivision 23 are excluded from this 215.31 reduction. The amount calculated under this clause shall not be 215.32 adjusted for periods already paid due to subsequent changes to 215.33 the capitation payments; 215.34 (2) beginning July 1,2001, $2,537,0002003, $2,157,000 215.35 from the capitation rates paid under this section plus any 215.36 federal matching funds on this amount; 216.1 (3) beginning July 1, 2002, an additional $12,700,000 from 216.2 the capitation rates paid under this section; and 216.3 (4) beginning July 1, 2003, an additional $4,700,000 from 216.4 the capitation rates paid under this section. 216.5 (b) This subdivision shall be effective upon approval of a 216.6 federal waiver which allows federal financial participation in 216.7 the medical education and research fund. 216.8 (c) Effective July 1, 2003, the amount from general 216.9 assistance medical care under paragraph (a), clause (1), shall 216.10 be transferred to the general fund. 216.11 Sec. 59. Minnesota Statutes 2002, section 256B.69, is 216.12 amended by adding a subdivision to read: 216.13 Subd. 5h. [PAYMENT REDUCTION.] In addition to the 216.14 reduction in subdivision 5g, the total payment made to managed 216.15 care plans under the medical assistance program is reduced 0.5 216.16 percent for services provided on or after October 1, 2003, and 216.17 an additional 0.5 percent for services provided on or after 216.18 January 1, 2004. This provision excludes payments for nursing 216.19 home services, home and community-based waivers, and payments to 216.20 demonstration projects for persons with disabilities. 216.21 Sec. 60. Minnesota Statutes 2002, section 256B.69, is 216.22 amended by adding a subdivision to read: 216.23 Subd. 5i. [ACTUARIAL SOUNDNESS.] All payments made to 216.24 managed care plans under the medical assistance program shall be 216.25 actuarially sound pursuant to Code of Federal Regulations, title 216.26 42, section 438.6. In establishing payment rates for managed 216.27 care plans under the medical assistance program, payment rates 216.28 must incorporate at least the following factors: (1) individual 216.29 health plan annual performance; (2) rate relationships based on 216.30 actual health plan experience; (3) geographic payment 216.31 relativities; and (4) rate cell payment relativities. 216.32 Sec. 61. Minnesota Statutes 2002, section 256B.75, is 216.33 amended to read: 216.34 256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 216.35 (a) For outpatient hospital facility fee payments for 216.36 services rendered on or after October 1, 1992, the commissioner 217.1 of human services shall pay the lower of (1) submitted charge, 217.2 or (2) 32 percent above the rate in effect on June 30, 1992, 217.3 except for those services for which there is a federal maximum 217.4 allowable payment. Effective for services rendered on or after 217.5 January 1, 2000, payment rates for nonsurgical outpatient 217.6 hospital facility fees and emergency room facility fees shall be 217.7 increased by eight percent over the rates in effect on December 217.8 31, 1999, except for those services for which there is a federal 217.9 maximum allowable payment. Services for which there is a 217.10 federal maximum allowable payment shall be paid at the lower of 217.11 (1) submitted charge, or (2) the federal maximum allowable 217.12 payment. Total aggregate payment for outpatient hospital 217.13 facility fee services shall not exceed the Medicare upper 217.14 limit. If it is determined that a provision of this section 217.15 conflicts with existing or future requirements of the United 217.16 States government with respect to federal financial 217.17 participation in medical assistance, the federal requirements 217.18 prevail. The commissioner may, in the aggregate, prospectively 217.19 reduce payment rates to avoid reduced federal financial 217.20 participation resulting from rates that are in excess of the 217.21 Medicare upper limitations. 217.22 (b) Notwithstanding paragraph (a), payment for outpatient, 217.23 emergency, and ambulatory surgery hospital facility fee services 217.24 for critical access hospitals designated under section 144.1483, 217.25 clause (11), shall be paid on a cost-based payment system that 217.26 is based on the cost-finding methods and allowable costs of the 217.27 Medicare program. 217.28 (c) Effective for services provided on or after July 1, 217.29 2003, rates that are based on the Medicare outpatient 217.30 prospective payment system shall be replaced by a budget neutral 217.31 prospective payment system that is derived using medical 217.32 assistance data. The commissioner shall provide a proposal to 217.33 the 2003 legislature to define and implement this provision. 217.34 (d) For fee-for-service services provided on or after July 217.35 1, 2002, the total payment, before third-party liability and 217.36 spenddown, made to hospitals for outpatient hospital facility 218.1 services is reduced by .5 percent from the current statutory 218.2 rate. 218.3 (e) In addition to the reduction in paragraph (d), the 218.4 total payment for fee-for-service services provided on or after 218.5 July 1, 2003, made to hospitals for outpatient hospital facility 218.6 services before third-party liability and spenddown, is reduced 218.7 2.5 percent from the current statutory rates. Facilities 218.8 defined under section 256.969, subdivision 16, are excluded from 218.9 this paragraph. 218.10 Sec. 62. Minnesota Statutes 2002, section 256B.76, is 218.11 amended to read: 218.12 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 218.13 (a) Effective for services rendered on or after October 1, 218.14 1992, the commissioner shall make payments for physician 218.15 services as follows: 218.16 (1) payment for level one Centers for Medicare and Medicaid 218.17 Services' common procedural coding system codes titled "office 218.18 and other outpatient services," "preventive medicine new and 218.19 established patient," "delivery, antepartum, and postpartum 218.20 care," "critical care," cesarean delivery and pharmacologic 218.21 management provided to psychiatric patients, and level three 218.22 codes for enhanced services for prenatal high risk, shall be 218.23 paid at the lower of (i) submitted charges, or (ii) 25 percent 218.24 above the rate in effect on June 30, 1992. If the rate on any 218.25 procedure code within these categories is different than the 218.26 rate that would have been paid under the methodology in section 218.27 256B.74, subdivision 2, then the larger rate shall be paid; 218.28 (2) payments for all other services shall be paid at the 218.29 lower of (i) submitted charges, or (ii) 15.4 percent above the 218.30 rate in effect on June 30, 1992; 218.31 (3) all physician rates shall be converted from the 50th 218.32 percentile of 1982 to the 50th percentile of 1989, less the 218.33 percent in aggregate necessary to equal the above increases 218.34 except that payment rates for home health agency services shall 218.35 be the rates in effect on September 30, 1992; 218.36 (4) effective for services rendered on or after January 1, 219.1 2000, payment rates for physician and professional services 219.2 shall be increased by three percent over the rates in effect on 219.3 December 31, 1999, except for home health agency and family 219.4 planning agency services; and 219.5 (5) the increases in clause (4) shall be implemented 219.6 January 1, 2000, for managed care. 219.7 (b) Effective for services rendered on or after October 1, 219.8 1992, the commissioner shall make payments for dental services 219.9 as follows: 219.10 (1) dental services shall be paid at the lower of (i) 219.11 submitted charges, or (ii) 25 percent above the rate in effect 219.12 on June 30, 1992; 219.13 (2) dental rates shall be converted from the 50th 219.14 percentile of 1982 to the 50th percentile of 1989, less the 219.15 percent in aggregate necessary to equal the above increases; 219.16 (3) effective for services rendered on or after January 1, 219.17 2000, payment rates for dental services shall be increased by 219.18 three percent over the rates in effect on December 31, 1999; 219.19 (4) the commissioner shall award grants to community 219.20 clinics or other nonprofit community organizations, political 219.21 subdivisions, professional associations, or other organizations 219.22 that demonstrate the ability to provide dental services 219.23 effectively to public program recipients. Grants may be used to 219.24 fund the costs related to coordinating access for recipients, 219.25 developing and implementing patient care criteria, upgrading or 219.26 establishing new facilities, acquiring furnishings or equipment, 219.27 recruiting new providers, or other development costs that will 219.28 improve access to dental care in a region. In awarding grants, 219.29 the commissioner shall give priority to applicants that plan to 219.30 serve areas of the state in which the number of dental providers 219.31 is not currently sufficient to meet the needs of recipients of 219.32 public programs or uninsured individuals. The commissioner 219.33 shall consider the following in awarding the grants: 219.34 (i) potential to successfully increase access to an 219.35 underserved population; 219.36 (ii) the ability to raise matching funds; 220.1 (iii) the long-term viability of the project to improve 220.2 access beyond the period of initial funding; 220.3 (iv) the efficiency in the use of the funding; and 220.4 (v) the experience of the proposers in providing services 220.5 to the target population. 220.6 The commissioner shall monitor the grants and may terminate 220.7 a grant if the grantee does not increase dental access for 220.8 public program recipients. The commissioner shall consider 220.9 grants for the following: 220.10 (i) implementation of new programs or continued expansion 220.11 of current access programs that have demonstrated success in 220.12 providing dental services in underserved areas; 220.13 (ii) a pilot program for utilizing hygienists outside of a 220.14 traditional dental office to provide dental hygiene services; 220.15 and 220.16 (iii) a program that organizes a network of volunteer 220.17 dentists, establishes a system to refer eligible individuals to 220.18 volunteer dentists, and through that network provides donated 220.19 dental care services to public program recipients or uninsured 220.20 individuals; 220.21 (5) beginning October 1, 1999, the payment for tooth 220.22 sealants and fluoride treatments shall be the lower of (i) 220.23 submitted charge, or (ii) 80 percent of median 1997 charges; 220.24 (6) the increases listed in clauses (3) and (5) shall be 220.25 implemented January 1, 2000, for managed care; and 220.26 (7) effective for services provided on or after January 1, 220.27 2002, payment for diagnostic examinations and dental x-rays 220.28 provided to children under age 21 shall be the lower of (i) the 220.29 submitted charge, or (ii) 85 percent of median 1999 charges. 220.30 (c) Effective for dental services rendered on or after 220.31 January 1, 2002, the commissioner may, within the limits of 220.32 available appropriation, increase reimbursements to dentists and 220.33 dental clinics deemed by the commissioner to be critical access 220.34 dental providers. Reimbursement to a critical access dental 220.35 provider may be increased by not more than 50 percent above the 220.36 reimbursement rate that would otherwise be paid to the 221.1 provider. Payments to health plan companies shall be adjusted 221.2 to reflect increased reimbursements to critical access dental 221.3 providers as approved by the commissioner. In determining which 221.4 dentists and dental clinics shall be deemed critical access 221.5 dental providers, the commissioner shall review: 221.6 (1) the utilization rate in the service area in which the 221.7 dentist or dental clinic operates for dental services to 221.8 patients covered by medical assistance, general assistance 221.9 medical care, or MinnesotaCare as their primary source of 221.10 coverage; 221.11 (2) the level of services provided by the dentist or dental 221.12 clinic to patients covered by medical assistance, general 221.13 assistance medical care, or MinnesotaCare as their primary 221.14 source of coverage; and 221.15 (3) whether the level of services provided by the dentist 221.16 or dental clinic is critical to maintaining adequate levels of 221.17 patient access within the service area. 221.18 In the absence of a critical access dental provider in a service 221.19 area, the commissioner may designate a dentist or dental clinic 221.20 as a critical access dental provider if the dentist or dental 221.21 clinic is willing to provide care to patients covered by medical 221.22 assistance, general assistance medical care, or MinnesotaCare at 221.23 a level which significantly increases access to dental care in 221.24 the service area. 221.25 (d) Effective July 1, 2001, the medical assistance rates 221.26 for outpatient mental health services provided by an entity that 221.27 operates: 221.28 (1) a Medicare-certified comprehensive outpatient 221.29 rehabilitation facility; and 221.30 (2) a facility that was certified prior to January 1, 1993, 221.31 with at least 33 percent of the clients receiving rehabilitation 221.32 services in the most recent calendar year who are medical 221.33 assistance recipients, will be increased by 38 percent, when 221.34 those services are provided within the comprehensive outpatient 221.35 rehabilitation facility and provided to residents of nursing 221.36 facilities owned by the entity. 222.1 (e) An entity that operates both a Medicare certified 222.2 comprehensive outpatient rehabilitation facility and a facility 222.3 which was certified prior to January 1, 1993, that is licensed 222.4 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 222.5 whom at least 33 percent of the clients receiving rehabilitation 222.6 services in the most recent calendar year are medical assistance 222.7 recipients, shall be reimbursed by the commissioner for 222.8 rehabilitation services at rates that are 38 percent greater 222.9 than the maximum reimbursement rate allowed under paragraph (a), 222.10 clause (2), when those services are (1) provided within the 222.11 comprehensive outpatient rehabilitation facility and (2) 222.12 provided to residents of nursing facilities owned by the entity. 222.13 (f) Effective for services rendered on or after January 1, 222.14 2007, the commissioner shall make payments for physician and 222.15 professional services based on the Medicare relative value units 222.16 (RVUs). This change shall be budget neutral and the cost of 222.17 implementing RVUs will be incorporated in the established 222.18 conversion factor. 222.19 Sec. 63. Minnesota Statutes 2002, section 256D.03, 222.20 subdivision 3, is amended to read: 222.21 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 222.22 (a) General assistance medical care may be paid for any person 222.23 who is not eligible for medical assistance under chapter 256B, 222.24 including eligibility for medical assistance based on a 222.25 spenddown of excess income according to section 256B.056, 222.26 subdivision 5, or MinnesotaCare as defined in paragraph (b), 222.27 except as provided in paragraph (c);, and: 222.28 (1)who is receiving assistance under section 256D.05,222.29except for families with children who are eligible under222.30Minnesota family investment program (MFIP), who is having a222.31payment made on the person's behalf under sections 256I.01 to222.32256I.06, or who resides in group residential housing as defined222.33in chapter 256I and can meet a spenddown using the cost of222.34remedial services received through group residential housing; or222.35(2)(i)who is a resident of Minnesota; and whose equity in 222.36 assets is not in excess of$1,000 per assistance unit. Exempt223.1assets, the reduction of excess assets, and the waiver of excess223.2assets must conform to the medical assistance program in chapter223.3256B, with the following exception: the maximum amount of223.4undistributed funds in a trust that could be distributed to or223.5on behalf of the beneficiary by the trustee, assuming the full223.6exercise of the trustee's discretion under the terms of the223.7trust, must be applied toward the asset maximumthe limits in 223.8 section 256L.17, subdivision 2; and 223.9(ii)(2) who has gross countable income not in excess of 223.10the assistance standards established in section 256B.056,223.11subdivision 5c, paragraph (b), or whose excess income is spent223.12down to that standard using a six-month budget period. The223.13method for calculating earned income disregards and deductions223.14for a person who resides with a dependent child under age 21223.15shall follow the AFDC income disregard and deductions in effect223.16under the July 16, 1996, AFDC state plan. The earned income and223.17work expense deductions for a person who does not reside with a223.18dependent child under age 21 shall be the same as the method223.19used to determine eligibility for a person under section223.20256D.06, subdivision 1, except the disregard of the first $50 of223.21earned income is not allowed;223.22(3) who would be eligible for medical assistance except223.23that the person resides in a facility that is determined by the223.24commissioner or the federal Centers for Medicare and Medicaid223.25Services to be an institution for mental diseases; or223.26(4) who is ineligible for medical assistance under chapter223.27256B or general assistance medical care under any other223.28provision of this section, and is receiving care and223.29rehabilitation services from a nonprofit center established to223.30serve victims of torture. These individuals are eligible for223.31general assistance medical care only for the period during which223.32they are receiving services from the center. During this period223.33of eligibility, individuals eligible under this clause shall not223.34be required to participate in prepaid general assistance medical223.35care75 percent of the federal poverty guidelines for the family 223.36 size in effect on October 1, 2003. 224.1 (b) Beginning January 1, 2000, applicants or recipients who 224.2 meet all eligibility requirements of MinnesotaCare as defined in 224.3 sections 256L.01 to 256L.16, and are: 224.4 (i) adults with dependent children under 21 whose gross 224.5 family income is equal to or less than 275 percent of the 224.6 federal poverty guidelines; or 224.7 (ii) adults without children with earned income and whose 224.8 family gross income isbetweenequal to or less than 75 percent 224.9 of the federal poverty guidelinesand the amount set by section224.10256L.04, subdivision 7in effect on October 1, 2003, shall be 224.11 terminated from general assistance medical care upon enrollment 224.12 in MinnesotaCare. Earned income is deemed available to family 224.13 members as defined in section 256D.02, subdivision 8. 224.14 (c) Forservices rendered on or after July 1, 1997,224.15eligibility is limited to one month prior to application if the224.16person is determined eligible in the prior monthapplications 224.17 received on or after October 1, 2003, eligibility may begin no 224.18 earlier than the date of application. A redetermination of 224.19 eligibility must occur every 12 months. Beginning January 1, 224.20 2000, Minnesota health care program applications completed by 224.21 recipients and applicants who are persons described in paragraph 224.22 (b), may be returned to the county agency to be forwarded to the 224.23 department of human services or sent directly to the department 224.24 of human services for enrollment in MinnesotaCare. If all other 224.25 eligibility requirements of this subdivision are met, 224.26 eligibility for general assistance medical care shall be 224.27 available in any month during which a MinnesotaCare eligibility 224.28 determination and enrollment are pending. Upon notification of 224.29 eligibility for MinnesotaCare, notice of termination for 224.30 eligibility for general assistance medical care shall be sent to 224.31 an applicant or recipient. If all other eligibility 224.32 requirements of this subdivision are met, eligibility for 224.33 general assistance medical care shall be available until 224.34 enrollment in MinnesotaCare subject to the provisions of 224.35 paragraph (e). 224.36 (d) The date of an initial Minnesota health care program 225.1 application necessary to begin a determination of eligibility 225.2 shall be the date the applicant has provided a name, address, 225.3 and social security number, signed and dated, to the county 225.4 agency or the department of human services. If the applicant is 225.5 unable to provide an initial application when health care is 225.6 delivered due to a medical condition or disability, a health 225.7 care provider may act on the person's behalf to complete the 225.8 initial application. The applicant must complete the remainder 225.9 of the application and provide necessary verification before 225.10 eligibility can be determined. The county agency must assist 225.11 the applicant in obtaining verification if necessary.On the225.12basis of information provided on the completed application, an225.13applicant who meets the following criteria shall be determined225.14eligible beginning in the month of application:225.15(1) has gross income less than 90 percent of the applicable225.16income standard;225.17(2) has liquid assets that total within $300 of the asset225.18standard;225.19(3) does not reside in a long-term care facility; and225.20(4) meets all other eligibility requirements.225.21The applicant must provide all required verifications within 30225.22days' notice of the eligibility determination or eligibility225.23shall be terminated.225.24 (e) County agencies are authorized to use all automated 225.25 databases containing information regarding recipients' or 225.26 applicants' income in order to determine eligibility for general 225.27 assistance medical care or MinnesotaCare. Such use shall be 225.28 considered sufficient in order to determine eligibility and 225.29 premium payments by the county agency. 225.30 (f) General assistance medical care is not available for a 225.31 person in a correctional facility unless the person is detained 225.32 by law for less than one year in a county correctional or 225.33 detention facility as a person accused or convicted of a crime, 225.34 or admitted as an inpatient to a hospital on a criminal hold 225.35 order, and the person is a recipient of general assistance 225.36 medical care at the time the person is detained by law or 226.1 admitted on a criminal hold order and as long as the person 226.2 continues to meet other eligibility requirements of this 226.3 subdivision. 226.4 (g) General assistance medical care is not available for 226.5 applicants or recipients who do not cooperate with the county 226.6 agency to meet the requirements of medical assistance.General226.7assistance medical care is limited to payment of emergency226.8services only for applicants or recipients as described in226.9paragraph (b), whose MinnesotaCare coverage is denied or226.10terminated for nonpayment of premiums as required by sections226.11256L.06 and 256L.07.226.12 (h) In determining the amount of assets of an individual, 226.13 there shall be included any asset or interest in an asset, 226.14 including an asset excluded under paragraph (a), that was given 226.15 away, sold, or disposed of for less than fair market value 226.16 within the 60 months preceding application for general 226.17 assistance medical care or during the period of eligibility. 226.18 Any transfer described in this paragraph shall be presumed to 226.19 have been for the purpose of establishing eligibility for 226.20 general assistance medical care, unless the individual furnishes 226.21 convincing evidence to establish that the transaction was 226.22 exclusively for another purpose. For purposes of this 226.23 paragraph, the value of the asset or interest shall be the fair 226.24 market value at the time it was given away, sold, or disposed 226.25 of, less the amount of compensation received. For any 226.26 uncompensated transfer, the number of months of ineligibility, 226.27 including partial months, shall be calculated by dividing the 226.28 uncompensated transfer amount by the average monthly per person 226.29 payment made by the medical assistance program to skilled 226.30 nursing facilities for the previous calendar year. The 226.31 individual shall remain ineligible until this fixed period has 226.32 expired. The period of ineligibility may exceed 30 months, and 226.33 a reapplication for benefits after 30 months from the date of 226.34 the transfer shall not result in eligibility unless and until 226.35 the period of ineligibility has expired. The period of 226.36 ineligibility begins in the month the transfer was reported to 227.1 the county agency, or if the transfer was not reported, the 227.2 month in which the county agency discovered the transfer, 227.3 whichever comes first. For applicants, the period of 227.4 ineligibility begins on the date of the first approved 227.5 application. 227.6 (i) When determining eligibility for any state benefits 227.7 under this subdivision, the income and resources of all 227.8 noncitizens shall be deemed to include their sponsor's income 227.9 and resources as defined in the Personal Responsibility and Work 227.10 Opportunity Reconciliation Act of 1996, title IV, Public Law 227.11 Number 104-193, sections 421 and 422, and subsequently set out 227.12 in federal rules. 227.13 (j)(1) AnUndocumentednoncitizen or a nonimmigrant227.14isnoncitizens and nonimmigrants are ineligible for general 227.15 assistance medical careother than emergency services, except 227.16 for an individual eligible under paragraph (a), clause (4). For 227.17 purposes of this subdivision, a nonimmigrant is an individual in 227.18 one or more of the classes listed in United States Code, title 227.19 8, section 1101(a)(15), and an undocumented noncitizen is an 227.20 individual who resides in the United States without the approval 227.21 or acquiescence of the Immigration and Naturalization Service. 227.22(2) This paragraph does not apply to a child under age 18,227.23to a Cuban or Haitian entrant as defined in Public Law Number227.2496-422, section 501(e)(1) or (2)(a), or to a noncitizen who is227.25aged, blind, or disabled as defined in Code of Federal227.26Regulations, title 42, sections 435.520, 435.530, 435.531,227.27435.540, and 435.541, or effective October 1, 1998, to an227.28individual eligible for general assistance medical care under227.29paragraph (a), clause (4), who cooperates with the Immigration227.30and Naturalization Service to pursue any applicable immigration227.31status, including citizenship, that would qualify the individual227.32for medical assistance with federal financial participation.227.33 (k)For purposes of paragraphs (g) and (j), "emergency227.34services" has the meaning given in Code of Federal Regulations,227.35title 42, section 440.255(b)(1), except that it also means227.36services rendered because of suspected or actual pesticide228.1poisoning.228.2 (l) Notwithstanding any other provision of law, a 228.3 noncitizen who is ineligible for medical assistance due to the 228.4 deeming of a sponsor's income and resources, is ineligible for 228.5 general assistance medical care. 228.6 (m) Effective July 1, 2003, general assistance medical care 228.7 emergency services end. Effective October 1, 2004, the general 228.8 assistance medical care program ends. Persons enrolled in 228.9 general assistance medical care as of September 30, 2004, will 228.10 be converted to MinnesotaCare if they meet all the requirements 228.11 of chapter 256L. 228.12 [EFFECTIVE DATE.] (a) The amendments to paragraphs (a), 228.13 clauses (1) to (4), and (b) and (c), are effective October 1, 228.14 2003. 228.15 (b) The amendments to paragraphs (d), (j), (g), and (k), 228.16 are effective July 1, 2003. 228.17 Sec. 64. Minnesota Statutes 2002, section 256D.03, 228.18 subdivision 4, is amended to read: 228.19 Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 228.20 For a person who is eligible under subdivision 3, paragraph (a), 228.21 clause (3), general assistance medical care covers, except as 228.22 provided in paragraph (c): 228.23 (1) inpatient hospital services; 228.24 (2) outpatient hospital services; 228.25 (3) services provided by Medicare certified rehabilitation 228.26 agencies; 228.27 (4) prescription drugs and other products recommended 228.28 through the process established in section 256B.0625, 228.29 subdivision 13; 228.30 (5) equipment necessary to administer insulin and 228.31 diagnostic supplies and equipment for diabetics to monitor blood 228.32 sugar level; 228.33 (6) eyeglasses and eye examinations provided by a physician 228.34 or optometrist; 228.35 (7) hearing aids; 228.36 (8) prosthetic devices; 229.1 (9) laboratory and X-ray services; 229.2 (10) physician's services; 229.3 (11) medical transportation; 229.4 (12) chiropractic services as covered under the medical 229.5 assistance program; 229.6 (13) podiatric services; 229.7 (14) dental services and dentures, subject to the 229.8 limitations specified in section 256B.0625, subdivision 9, 229.9 except that a 25 percent coinsurance requirement applies to 229.10 basic restorative dental services; 229.11 (15) outpatient services provided by a mental health center 229.12 or clinic that is under contract with the county board and is 229.13 established under section 245.62; 229.14 (16) day treatment services for mental illness provided 229.15 under contract with the county board; 229.16 (17) prescribed medications for persons who have been 229.17 diagnosed as mentally ill as necessary to prevent more 229.18 restrictive institutionalization; 229.19 (18) psychological services, medical supplies and 229.20 equipment, and Medicare premiums, coinsurance and deductible 229.21 payments; 229.22 (19) medical equipment not specifically listed in this 229.23 paragraph when the use of the equipment will prevent the need 229.24 for costlier services that are reimbursable under this 229.25 subdivision; 229.26 (20) services performed by a certified pediatric nurse 229.27 practitioner, a certified family nurse practitioner, a certified 229.28 adult nurse practitioner, a certified obstetric/gynecological 229.29 nurse practitioner, a certified neonatal nurse practitioner, or 229.30 a certified geriatric nurse practitioner in independent 229.31 practice, if (1) the service is otherwise covered under this 229.32 chapter as a physician service, (2) the service provided on an 229.33 inpatient basis is not included as part of the cost for 229.34 inpatient services included in the operating payment rate, and 229.35 (3) the service is within the scope of practice of the nurse 229.36 practitioner's license as a registered nurse, as defined in 230.1 section 148.171; 230.2 (21) services of a certified public health nurse or a 230.3 registered nurse practicing in a public health nursing clinic 230.4 that is a department of, or that operates under the direct 230.5 authority of, a unit of government, if the service is within the 230.6 scope of practice of the public health nurse's license as a 230.7 registered nurse, as defined in section 148.171; and 230.8 (22) telemedicine consultations, to the extent they are 230.9 covered under section 256B.0625, subdivision 3b. 230.10 (b) Except as provided in paragraph (c), for a recipient 230.11 who is eligible under subdivision 3, paragraph (a), clause (1) 230.12 or (2), general assistance medical care covers the services 230.13 listed in paragraph (a) with the exception of special 230.14 transportation services. 230.15 (c) Gender reassignment surgery and related services are 230.16 not covered services under this subdivision unless the 230.17 individual began receiving gender reassignment services prior to 230.18 July 1, 1995. 230.19 (d) In order to contain costs, the commissioner of human 230.20 services shall select vendors of medical care who can provide 230.21 the most economical care consistent with high medical standards 230.22 and shall where possible contract with organizations on a 230.23 prepaid capitation basis to provide these services. The 230.24 commissioner shall consider proposals by counties and vendors 230.25 for prepaid health plans, competitive bidding programs, block 230.26 grants, or other vendor payment mechanisms designed to provide 230.27 services in an economical manner or to control utilization, with 230.28 safeguards to ensure that necessary services are provided. 230.29 Before implementing prepaid programs in counties with a county 230.30 operated or affiliated public teaching hospital or a hospital or 230.31 clinic operated by the University of Minnesota, the commissioner 230.32 shall consider the risks the prepaid program creates for the 230.33 hospital and allow the county or hospital the opportunity to 230.34 participate in the program in a manner that reflects the risk of 230.35 adverse selection and the nature of the patients served by the 230.36 hospital, provided the terms of participation in the program are 231.1 competitive with the terms of other participants considering the 231.2 nature of the population served. Payment for services provided 231.3 pursuant to this subdivision shall be as provided to medical 231.4 assistance vendors of these services under sections 256B.02, 231.5 subdivision 8, and 256B.0625. For payments made during fiscal 231.6 year 1990 and later years, the commissioner shall consult with 231.7 an independent actuary in establishing prepayment rates, but 231.8 shall retain final control over the rate methodology. 231.9Notwithstanding the provisions of subdivision 3, an individual231.10who becomes ineligible for general assistance medical care231.11because of failure to submit income reports or recertification231.12forms in a timely manner, shall remain enrolled in the prepaid231.13health plan and shall remain eligible for general assistance231.14medical care coverage through the last day of the month in which231.15the enrollee became ineligible for general assistance medical231.16care.231.17 (e)There shall be no copayment required of any recipient231.18of benefits for any services provided under this subdivision.A 231.19 hospital receiving a reduced payment as a result of this section 231.20 may apply the unpaid balance toward satisfaction of the 231.21 hospital's bad debts. 231.22 (f) Any county may, from its own resources, provide medical 231.23 payments for which state payments are not made. 231.24 (g) Chemical dependency services that are reimbursed under 231.25 chapter 254B must not be reimbursed under general assistance 231.26 medical care. 231.27 (h) The maximum payment for new vendors enrolled in the 231.28 general assistance medical care program after the base year 231.29 shall be determined from the average usual and customary charge 231.30 of the same vendor type enrolled in the base year. 231.31 (i) The conditions of payment for services under this 231.32 subdivision are the same as the conditions specified in rules 231.33 adopted under chapter 256B governing the medical assistance 231.34 program, unless otherwise provided by statute or rule. 231.35 Sec. 65. [256D.031] [GAMC CO-PAYMENTS AND COINSURANCE.] 231.36 Subdivision 1. [CO-PAYMENTS AND COINSURANCE.] (a) Except 232.1 as provided in subdivision 2, the general assistance medical 232.2 care benefit plan under section 256D.03, subdivision 3, shall 232.3 include the following co-payments for all recipients effective 232.4 for services provided on or after October 1, 2003: 232.5 (1) $3 per nonpreventive visit. For purposes of this 232.6 subdivision, a visit means an episode of service which is 232.7 required because of a recipient's symptoms, diagnosis, or 232.8 established illness, and which is delivered in an ambulatory 232.9 setting by a physician or physician ancillary, chiropractor, 232.10 podiatrist, nurse midwife, mental health professional, advanced 232.11 practice nurse, physical therapist, occupational therapist, 232.12 speech therapist, audiologist, optician, or optometrist; 232.13 (2) $25 for eyeglasses; 232.14 (3) $25 for nonemergency visits to a hospital-based 232.15 emergency room; and 232.16 (4) $3 per brand-name drug prescription and $1 per generic 232.17 drug prescription, subject to a $20 per month maximum for 232.18 prescription drug co-payments. 232.19 (b) Recipients of general assistance medical care are 232.20 responsible for all co-payments in this subdivision. 232.21 Subd. 2. [EXCEPTIONS.] Co-payments shall be subject to the 232.22 following exceptions: 232.23 (1) children under the age of 21; 232.24 (2) pregnant women for services that relate to the 232.25 pregnancy or any other medical condition that may complicate the 232.26 pregnancy; 232.27 (3) recipients expected to reside for at least 30 days in a 232.28 hospital, nursing home, or intermediate care facility for the 232.29 mentally retarded; 232.30 (4) recipients receiving hospice care; 232.31 (5) 100 percent federally funded services provided by an 232.32 Indian health service; 232.33 (6) emergency services; 232.34 (7) family planning services; 232.35 (8) services that are paid by Medicare, resulting in the 232.36 general assistance medical care program paying for the 233.1 coinsurance and deductible; and 233.2 (9) co-payments that exceed one per day per provider for 233.3 nonpreventive office visits, eyeglasses, and nonemergency visits 233.4 to a hospital-based emergency room. 233.5 Subd. 3. [COLLECTION.] The general assistance medical care 233.6 reimbursement to the provider shall be reduced by the amount of 233.7 the co-payment, except that reimbursement for prescription drugs 233.8 shall not be reduced once a recipient has reached the $20 per 233.9 month maximum for prescription drug co-payments. The provider 233.10 collects the co-payment from the recipient. Providers may not 233.11 deny services to recipients who are unable to pay the 233.12 co-payment, except as provided in subdivision 4. 233.13 Subd. 4. [UNCOLLECTED DEBT.] If it is the routine business 233.14 practice of a provider to refuse service to an individual with 233.15 uncollected debt, the provider may include uncollected 233.16 co-payments under this section. A provider must give advance 233.17 notice to a recipient with uncollected debt before services can 233.18 be denied. 233.19 Sec. 66. Minnesota Statutes 2002, section 256G.05, 233.20 subdivision 2, is amended to read: 233.21 Subd. 2. [NON-MINNESOTA RESIDENTS.] State residence is not 233.22 required for receiving emergency assistance in the Minnesota 233.23 supplemental aid program. The receipt of emergency assistance 233.24 must not be used as a factor in determining county or state 233.25 residence.Non-Minnesota residents are not eligible for233.26emergency general assistance medical care, except emergency233.27hospital services, and professional services incident to the233.28hospital services, for the treatment of acute trauma resulting233.29from an accident occurring in Minnesota. To be eligible under233.30this subdivision a non-Minnesota resident must verify that they233.31are not eligible for coverage under any other health care233.32program, including coverage from a program in their state of233.33residence.233.34 [EFFECTIVE DATE.] This section is effective July 1, 2003. 233.35 Sec. 67. Minnesota Statutes 2002, section 256L.02, is 233.36 amended by adding a subdivision to read: 234.1 Subd. 3a. [FUNDING SOURCE.] Beginning July 1, 2005, all 234.2 MinnesotaCare obligations shall be funded out of the general 234.3 fund. 234.4 Sec. 68. Minnesota Statutes 2002, section 256L.03, 234.5 subdivision 1, is amended to read: 234.6 Subdivision 1. [COVERED HEALTH SERVICES.] "Covered health 234.7 services" means the health services reimbursed under chapter 234.8 256B, with the exception of inpatient hospital services, special 234.9 education services, private duty nursing services, adult dental 234.10 care services other thanpreventive servicesservices covered 234.11 under section 256B.0625, subdivision 9, paragraph (b), 234.12 orthodontic services, nonemergency medical transportation 234.13 services, personal care assistant and case management services, 234.14 nursing home or intermediate care facilities services, inpatient 234.15 mental health services, and chemical dependency 234.16 services.Effective July 1, 1998, adult dental care for234.17nonpreventive services with the exception of orthodontic234.18services is available to persons who qualify under section234.19256L.04, subdivisions 1 to 7, with family gross income equal to234.20or less than 175 percent of the federal poverty guidelines.234.21 Outpatient mental health services covered under the 234.22 MinnesotaCare program are limited to diagnostic assessments, 234.23 psychological testing, explanation of findings, medication 234.24 management by a physician, day treatment, partial 234.25 hospitalization, and individual, family, and group psychotherapy. 234.26 No public funds shall be used for coverage of abortion 234.27 under MinnesotaCare except where the life of the female would be 234.28 endangered or substantial and irreversible impairment of a major 234.29 bodily function would result if the fetus were carried to term; 234.30 or where the pregnancy is the result of rape or incest. 234.31 Covered health services shall be expanded as provided in 234.32 this section. 234.33 Sec. 69. Minnesota Statutes 2002, section 256L.03, 234.34 subdivision 3, is amended to read: 234.35 Subd. 3. [INPATIENT HOSPITAL SERVICES.] (a) Covered health 234.36 services shall include inpatient hospital services, including 235.1 inpatient hospital mental health services and inpatient hospital 235.2 and residential chemical dependency treatment, subject to those 235.3 limitations necessary to coordinate the provision of these 235.4 services with eligibility under the medical assistance 235.5 spenddown. Prior to July 1, 1997, the inpatient hospital 235.6 benefit for adult enrollees is subject to an annual benefit 235.7 limit of $10,000. The inpatient hospital benefit for adult 235.8 enrollees who qualify under section 256L.04, subdivision 7, or 235.9 who qualify under section 256L.04, subdivisions 1 and 2, with 235.10 family gross income that exceeds 175 percent of the federal 235.11 poverty guidelines and who are not pregnant, is subject to an 235.12 annual limit of $10,000. For services provided on or after 235.13 October 1, 2004, the annual limit of $10,000 does not apply to 235.14 adults who qualify under section 256L.04, subdivision 7, whose 235.15 gross income is at or below 75 percent of the federal poverty 235.16 guidelines. 235.17 (b) Admissions for inpatient hospital services paid for 235.18 under section 256L.11, subdivision 3, must be certified as 235.19 medically necessary in accordance with Minnesota Rules, parts 235.20 9505.0500 to 9505.0540, except as provided in clauses (1) and 235.21 (2): 235.22 (1) all admissions must be certified, except those 235.23 authorized under rules established under section 254A.03, 235.24 subdivision 3, or approved under Medicare; and 235.25 (2) payment under section 256L.11, subdivision 3, shall be 235.26 reduced by five percent for admissions for which certification 235.27 is requested more than 30 days after the day of admission. The 235.28 hospital may not seek payment from the enrollee for the amount 235.29 of the payment reduction under this clause. 235.30 Sec. 70. Minnesota Statutes 2002, section 256L.03, 235.31 subdivision 5, is amended to read: 235.32 Subd. 5. [COPAYMENTS AND COINSURANCE.] (a) Except as 235.33 provided in paragraphs (b) and (c), the MinnesotaCare benefit 235.34 plan shall include the following copayments and coinsurance 235.35 requirements for all enrollees effective for services provided 235.36 on or after October 1, 2003: 236.1 (1) ten percent of the paid charges for inpatient hospital 236.2 services for adult enrollees, subject to an annual inpatient 236.3 out-of-pocket maximum of $1,000 per individual and $3,000 per 236.4 family; 236.5 (2) $3 perprescription for adult enrolleesnonpreventive 236.6 visit. For purposes of this subdivision, a visit means an 236.7 episode of service which is required because of a recipient's 236.8 symptoms, diagnosis, or established illness, and which is 236.9 delivered in an ambulatory setting by a physician or physician 236.10 ancillary, chiropractor, podiatrist, nurse, midwife, mental 236.11 health professional, advanced practice nurse, physical 236.12 therapist, occupational therapist, speech therapist, 236.13 audiologist, optician, or optometrist; 236.14 (3) $25 for eyeglasses for adult enrollees; 236.15 (4) $6 for nonemergency visits to a hospital-based 236.16 emergency room, except that a $25 co-payment applies to parents 236.17 with incomes exceeding 100 percent of the federal poverty 236.18 guidelines for nonemergency visits to a hospital-based emergency 236.19 room;and236.20(4) 50 percent of the fee-for-service rate for adult dental236.21care services other than preventive care services for persons236.22eligible under section 256L.04, subdivisions 1 to 7, with income236.23equal to or less than 175 percent of the federal poverty236.24guidelines(5) $3 per prescription, subject to a $20 per month 236.25 maximum for prescription drug co-payments; and 236.26 (6) basic restorative dental services for adults age 21 and 236.27 over who are not pregnant are subject to a 25 percent 236.28 coinsurance requirement. 236.29 (b) Paragraph (a), clause (1), does not apply to parents 236.30 and relative caretakers of children under the age of 21 in 236.31 households with family income equal to or less than 175 percent 236.32 of the federal poverty guidelines. Paragraph (a), clause (1), 236.33 does not apply to parents and relative caretakers of children 236.34 under the age of 21 in households with family income greater 236.35 than 175 percent of the federal poverty guidelines for inpatient 236.36 hospital admissions occurring on or after January 1, 237.1 2001. Effective for services provided on or after October 1, 237.2 2004, paragraph (a), clause (1), does not apply to single adults 237.3 and households without children whose gross income is at or 237.4 below 75 percent of the federal poverty guidelines. 237.5 (c) Paragraph (a), clauses (1) to(4)(6), do not apply to 237.6pregnant women and children under the age of 21.: 237.7 (1) children under the age of 21; 237.8 (2) pregnant women for services that relate to the 237.9 pregnancy or any other medical condition that may complicate the 237.10 pregnancy; 237.11 (3) enrollees expected to reside for at least 30 days in a 237.12 hospital, nursing home, or intermediate care facility for the 237.13 mentally retarded; 237.14 (4) enrollees receiving hospice care; 237.15 (5) 100 percent federally funded services provided by an 237.16 Indian Health Service; 237.17 (6) emergency services; 237.18 (7) family planning services; and 237.19 (8) co-payments that exceed one per day per provider for 237.20 nonpreventive office visits, eyeglasses, and nonemergency visits 237.21 to a hospital emergency room. 237.22 (d) Adult enrollees with family gross income that exceeds 237.23 175 percent of the federal poverty guidelines and who are not 237.24 pregnant shall be financially responsible for the coinsurance 237.25 amount, if applicable, and amounts which exceed the $10,000 237.26 inpatient hospital benefit limit. 237.27 (e) When a MinnesotaCare enrollee becomes a member of a 237.28 prepaid health plan, or changes from one prepaid health plan to 237.29 another during a calendar year, any charges submitted towards 237.30 the $10,000 annual inpatient benefit limit, and any 237.31 out-of-pocket expenses incurred by the enrollee for inpatient 237.32 services, that were submitted or incurred prior to enrollment, 237.33 or prior to the change in health plans, shall be disregarded. 237.34 (f) Enrollees are responsible for all co-payments and 237.35 coinsurance in this subdivision. 237.36 (g) The MinnesotaCare reimbursement to the provider shall 238.1 be reduced by the amount of the co-payment, except that 238.2 reimbursement for prescription drugs shall not be reduced once a 238.3 recipient has reached the $20 per month maximum for prescription 238.4 drug co-payments. The provider collects the co-payment from the 238.5 enrollee and may not deny services to enrollees who are unable 238.6 to pay the co-payment, except as provided in paragraph (h). 238.7 (h) If it is the routine business practice of a provider to 238.8 refuse service to an individual with uncollected debt, the 238.9 provider may include uncollected co-payments under this 238.10 section. A provider must give advance notice to a recipient 238.11 with uncollected debt before services can be denied. 238.12 Sec. 71. Minnesota Statutes 2002, section 256L.04, 238.13 subdivision 1, is amended to read: 238.14 Subdivision 1. [FAMILIES WITH CHILDREN.] (a) Families with 238.15 children with family income equal to or less than 275 percent of 238.16 the federal poverty guidelines for the applicable family size 238.17 shall be eligible for MinnesotaCare according to this section. 238.18 All other provisions of sections 256L.01 to 256L.18, including 238.19 the insurance-related barriers to enrollment under section 238.20 256L.07, shall apply unless otherwise specified. 238.21 (b) Parents who enroll in the MinnesotaCare program must 238.22 also enroll their childrenand dependent siblings, if the 238.23 childrenand their dependent siblingsare eligible. Children 238.24and dependent siblingsmay be enrolled separately without 238.25 enrollment by parents. However, if one parent in the household 238.26 enrolls, both parents must enroll, unless other insurance is 238.27 available. If one child from a family is enrolled, all children 238.28 must be enrolled, unless other insurance is available. If one 238.29 spouse in a household enrolls, the other spouse in the household 238.30 must also enroll, unless other insurance is available. Families 238.31 cannot choose to enroll only certain uninsured members. 238.32 (c) Beginning February 1, 2004, the dependent sibling 238.33 definition no longer applies to the MinnesotaCare program. 238.34 These persons are no longer counted in the parental household 238.35 and may apply as a separate household. 238.36 (d) Beginning July 1, 2003, parents are not eligible for 239.1 MinnesotaCare if their gross income exceeds $50,000. 239.2 [EFFECTIVE DATE.] This section is effective February 1, 239.3 2004, unless the statutory language specifies a different 239.4 effective date. 239.5 Sec. 72. Minnesota Statutes 2002, section 256L.05, 239.6 subdivision 1, is amended to read: 239.7 Subdivision 1. [APPLICATION AND INFORMATION AVAILABILITY.] 239.8 Applications and other information must be made available to 239.9 provider offices, local human services agencies, school 239.10 districts, public and private elementary schools in which 25 239.11 percent or more of the students receive free or reduced price 239.12 lunches, community health offices, and Women, Infants and 239.13 Children (WIC) program sites. These sites may accept 239.14 applications and forward the forms to the commissioner. 239.15 Otherwise, applicants may apply directly to the commissioner. 239.16 Beginning January 1, 2000, MinnesotaCare enrollment sites will 239.17 be expanded to include local county human services agencies 239.18 which choose to participate. Beginning October 1, 2004, all 239.19 local county human service agencies must accept and process 239.20 applications and renewals for single adults and households 239.21 without children with income at or below 75 percent of the 239.22 federal poverty guidelines who choose to have the county 239.23 administer their case. 239.24 Sec. 73. Minnesota Statutes 2002, section 256L.05, 239.25 subdivision 3, is amended to read: 239.26 Subd. 3. [EFFECTIVE DATE OF COVERAGE.] (a) The effective 239.27 date of coverage is the first day of the month following the 239.28 month in which eligibility is approved and the first premium 239.29 payment has been received. As provided in section 256B.057, 239.30 coverage for newborns is automatic from the date of birth and 239.31 must be coordinated with other health coverage. The effective 239.32 date of coverage for eligible newly adoptive children added to a 239.33 family receiving covered health services is the date of entry 239.34 into the family. The effective date of coverage for other new 239.35 recipients added to the family receiving covered health services 239.36 is the first day of the month following the month in which 240.1 eligibility is approved or at renewal, whichever the family 240.2 receiving covered health services prefers. All eligibility 240.3 criteria must be met by the family at the time the new family 240.4 member is added. The income of the new family member is 240.5 included with the family's gross income and the adjusted premium 240.6 begins in the month the new family member is added. 240.7 (b) The initial premium must be received by the last 240.8 working day of the month for coverage to begin the first day of 240.9 the following month. 240.10 (c) Benefits are not available until the day following 240.11 discharge if an enrollee is hospitalized on the first day of 240.12 coverage. 240.13 (d) Notwithstanding any other law to the contrary, benefits 240.14 under sections 256L.01 to 256L.18 are secondary to a plan of 240.15 insurance or benefit program under which an eligible person may 240.16 have coverage and the commissioner shall use cost avoidance 240.17 techniques to ensure coordination of any other health coverage 240.18 for eligible persons. The commissioner shall identify eligible 240.19 persons who may have coverage or benefits under other plans of 240.20 insurance or who become eligible for medical assistance. 240.21 (e) Notwithstanding paragraphs (a) and (b), effective 240.22 October 1, 2004, coverage begins for single adults and 240.23 households without children with gross family income at or below 240.24 75 percent of the federal poverty guidelines the first day of 240.25 the month following approval. 240.26 (f) Effective October 1, 2004, the date of an initial 240.27 application necessary to begin a determination of eligibility 240.28 for single adults and households without children with gross 240.29 family income at or below 75 percent of the federal poverty 240.30 guidelines shall be the date the applicant has provided a name, 240.31 address, and social security number, signed and dated, to the 240.32 county agency or the department of human services. If the 240.33 applicant is unable to provide an initial application when 240.34 health care is delivered due to a medical condition or 240.35 disability, a health care provider may act on the person's 240.36 behalf to complete the initial application. The applicant must 241.1 complete the remainder of the application and provide necessary 241.2 verification before eligibility can be determined. The county 241.3 agency must assist the applicant in obtaining verification if 241.4 necessary. 241.5 Sec. 74. Minnesota Statutes 2002, section 256L.05, 241.6 subdivision 3a, is amended to read: 241.7 Subd. 3a. [RENEWAL OF ELIGIBILITY.] (a) Beginning January 241.8 1, 1999, an enrollee's eligibility must be renewed every 12 241.9 months. The 12-month period begins in the month after the month 241.10 the application is approved. 241.11 (b) Beginning October 1, 2004, an enrollee's eligibility 241.12 must be renewed every six months. The first six-month period of 241.13 eligibility begins in the month after the month the application 241.14 is approved. Each new period of eligibility must take into 241.15 account any changes in circumstances that impact eligibility and 241.16 premium amount. An enrollee must provide all the information 241.17 needed to redetermine eligibility by the first day of the month 241.18 that ends the eligibility period. The premium for the new 241.19 period of eligibility must be received as provided in section 241.20 256L.06 in order for eligibility to continue. 241.21 Sec. 75. Minnesota Statutes 2002, section 256L.05, 241.22 subdivision 3c, is amended to read: 241.23 Subd. 3c. [RETROACTIVE COVERAGE.] Notwithstanding 241.24 subdivision 3, the effective date of coverage shall be the first 241.25 day of the month following termination from medical assistance 241.26or general assistance medical carefor families and individuals 241.27 who are eligible for MinnesotaCare and who submitted a written 241.28 request for retroactive MinnesotaCare coverage with a completed 241.29 application within 30 days of the mailing of notification of 241.30 termination from medical assistanceor general assistance241.31medical care. The applicant must provide all required 241.32 verifications within 30 days of the written request for 241.33 verification. For retroactive coverage, premiums must be paid 241.34 in full for any retroactive month, current month, and next month 241.35 within 30 days of the premium billing. 241.36 [EFFECTIVE DATE.] This section is effective November 1, 242.1 2004. 242.2 Sec. 76. Minnesota Statutes 2002, section 256L.05, 242.3 subdivision 4, is amended to read: 242.4 Subd. 4. [APPLICATION PROCESSING.] The commissioner of 242.5 human services shall determine an applicant's eligibility for 242.6 MinnesotaCare no more than 30 days from the date that the 242.7 application is received by the department of human services. 242.8 Beginning January 1, 2000, this requirement also applies to 242.9 local county human services agencies that determine eligibility 242.10 for MinnesotaCare.Once annually at application or242.11reenrollment, to prevent processing delays, applicants or242.12enrollees who, from the information provided on the application,242.13appear to meet eligibility requirements shall be enrolled upon242.14timely payment of premiums. The enrollee must provide all242.15required verifications within 30 days of notification of the242.16eligibility determination or coverage from the program shall be242.17terminated. Enrollees who are determined to be ineligible when242.18verifications are provided shall be disenrolled from the program.242.19 [EFFECTIVE DATE.] This section is effective July 1, 2003. 242.20 Sec. 77. Minnesota Statutes 2002, section 256L.06, 242.21 subdivision 3, is amended to read: 242.22 Subd. 3. [COMMISSIONER'S DUTIES AND PAYMENT.] (a) Premiums 242.23 are dedicated to the commissioner for MinnesotaCare. 242.24 (b) The commissioner shall develop and implement procedures 242.25 to: (1) require enrollees to report changes in income; (2) 242.26 adjust sliding scale premium payments, based upon changes in 242.27 enrollee income; and (3) disenroll enrollees from MinnesotaCare 242.28 for failure to pay required premiums. Failure to pay includes 242.29 payment with a dishonored check, a returned automatic bank 242.30 withdrawal, or a refused credit card or debit card payment. The 242.31 commissioner may demand a guaranteed form of payment, including 242.32 a cashier's check or a money order, as the only means to replace 242.33 a dishonored, returned, or refused payment. 242.34 (c) Premiums are calculated on a calendar month basis and 242.35 may be paid on a monthly, quarterly, orannualsemiannual basis, 242.36 with the first payment due upon notice from the commissioner of 243.1 the premium amount required. The commissioner shall inform 243.2 applicants and enrollees of these premium payment options. 243.3 Premium payment is required before enrollment is complete and to 243.4 maintain eligibility in MinnesotaCare. Premium payments 243.5 received before noon are credited the same day. Premium 243.6 payments received after noon are credited on the next working 243.7 day. 243.8 (d) Nonpayment of the premium will result in disenrollment 243.9 from the plan effective for the calendar month for which the 243.10 premium was due. Persons disenrolled for nonpayment or who 243.11 voluntarily terminate coverage from the program may not reenroll 243.12 until four calendar months have elapsed. Persons disenrolled 243.13 for nonpayment who pay all past due premiums as well as current 243.14 premiums due, including premiums due for the period of 243.15 disenrollment, within 20 days of disenrollment, shall be 243.16 reenrolled retroactively to the first day of disenrollment. 243.17 Persons disenrolled for nonpayment or who voluntarily terminate 243.18 coverage from the program may not reenroll for four calendar 243.19 months unless the person demonstrates good cause for 243.20 nonpayment. Good cause does not exist if a person chooses to 243.21 pay other family expenses instead of the premium. The 243.22 commissioner shall define good cause in rule. 243.23 [EFFECTIVE DATE.] This section is effective October 1, 2004. 243.24 Sec. 78. Minnesota Statutes 2002, section 256L.07, 243.25 subdivision 1, is amended to read: 243.26 Subdivision 1. [GENERAL REQUIREMENTS.] (a) Children 243.27 enrolled in the original children's health plan as of September 243.28 30, 1992, children who enrolled in the MinnesotaCare program 243.29 after September 30, 1992, pursuant to Laws 1992, chapter 549, 243.30 article 4, section 17, and children who have family gross 243.31 incomes that are equal to or less than175150 percent of the 243.32 federal poverty guidelines are eligible without meeting the 243.33 requirements of subdivision 2 and the four-month requirement in 243.34 subdivision 3, as long as they maintain continuous coverage in 243.35 the MinnesotaCare program or medical assistance. Children who 243.36 apply for MinnesotaCare on or after the implementation date of 244.1 the employer-subsidized health coverage program as described in 244.2 Laws 1998, chapter 407, article 5, section 45, who have family 244.3 gross incomes that are equal to or less than175150 percent of 244.4 the federal poverty guidelines, must meet the requirements of 244.5 subdivision 2 to be eligible for MinnesotaCare. 244.6 (b) Families enrolled in MinnesotaCare under section 244.7 256L.04, subdivision 1, whose income increases above 275 percent 244.8 of the federal poverty guidelines, are no longer eligible for 244.9 the program and shall be disenrolled by the commissioner. 244.10 Individuals enrolled in MinnesotaCare under section 256L.04, 244.11 subdivision 7, whose income increases above 175 percent of the 244.12 federal poverty guidelines are no longer eligible for the 244.13 program and shall be disenrolled by the commissioner. For 244.14 persons disenrolled under this subdivision, MinnesotaCare 244.15 coverage terminates the last day of the calendar month following 244.16 the month in which the commissioner determines that the income 244.17 of a family or individual exceeds program income limits. 244.18 (c)(1) Notwithstanding paragraph (b),individuals and244.19 families enrolled in MinnesotaCare under section 256L.04, 244.20 subdivision 1, may remain enrolled in MinnesotaCare if ten 244.21 percent of their annual income is less than the annual premium 244.22 for a policy with a $500 deductible available through the 244.23 Minnesota comprehensive health association.Individuals and244.24 Families who are no longer eligible for MinnesotaCare under this 244.25 subdivision shall be given an 18-month notice period from the 244.26 date that ineligibility is determined before 244.27 disenrollment. This clause expires February 1, 2004. 244.28 (2) Effective February 1, 2004, notwithstanding paragraph 244.29 (b), children may remain enrolled in MinnesotaCare if ten 244.30 percent of their annual family income is less than the annual 244.31 premium for a policy with a $500 deductible available through 244.32 the Minnesota comprehensive health association. Children who 244.33 are no longer eligible for MinnesotaCare under this clause shall 244.34 be given a 12-month notice period from the date that 244.35 ineligibility is determined before disenrollment. The premium 244.36 for children remaining eligible under this clause shall be the 245.1 maximum premium determined under section 256L.15, subdivision 2, 245.2 paragraph (b), until July 1, 2005, when the premium shall be 245.3 determined by section 256L.15, subdivision 2, paragraph (c). 245.4 [EFFECTIVE DATE.] The amendments to paragraph (a) are 245.5 effective July 1, 2003. The amendments to paragraph (c), clause 245.6 (1), are effective October 1, 2003. 245.7 Sec. 79. Minnesota Statutes 2002, section 256L.07, 245.8 subdivision 2, is amended to read: 245.9 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 245.10 COVERAGE.] (a) To be eligible, a family or individual must not 245.11 have access to subsidized health coverage through an employer 245.12 and must not have had access to employer-subsidized coverage 245.13 through a current employer for 18 months prior to application or 245.14 reapplication. A family or individual whose employer-subsidized 245.15 coverage is lost due to an employer terminating health care 245.16 coverage as an employee benefit during the previous 18 months is 245.17 not eligible. 245.18 (b) This subdivision does not apply to a family or 245.19 individual who was enrolled in MinnesotaCare within six months 245.20 or less of reapplication and who no longer has 245.21 employer-subsidized coverage due to the employer terminating 245.22 health care coverage as an employee benefit. 245.23 (c) For purposes of this requirement, subsidized health 245.24 coverage means health coverage for which the employer pays at 245.25 least 50 percent of the cost of coverage for the employee or 245.26 dependent, or a higher percentage as specified by the 245.27 commissioner. Children are eligible for employer-subsidized 245.28 coverage through either parent, including the noncustodial 245.29 parent. The commissioner must treat employer contributions to 245.30 Internal Revenue Code Section 125 plans and any other employer 245.31 benefits intended to pay health care costs as qualified employer 245.32 subsidies toward the cost of health coverage for employees for 245.33 purposes of this subdivision. 245.34 (d) Notwithstanding paragraph (c), beginning February 1, 245.35 2004, health coverage for single adults and households without 245.36 children and adults in families with children shall be 246.1 considered to be subsidized health coverage if the employer 246.2 contributes any amount towards the cost of coverage. 246.3 Sec. 80. Minnesota Statutes 2002, section 256L.07, 246.4 subdivision 3, is amended to read: 246.5 Subd. 3. [OTHER HEALTH COVERAGE.] (a) Families and 246.6 individuals enrolled in the MinnesotaCare program must have no 246.7 health coverage while enrolled or for at least four months prior 246.8 to application and renewal. Children enrolled in the original 246.9 children's health plan and children in families with income 246.10 equal to or less than175150 percent of the federal poverty 246.11 guidelines, who have other health insurance, are eligible if the 246.12 coverage: 246.13 (1) lacks two or more of the following: 246.14 (i) basic hospital insurance; 246.15 (ii) medical-surgical insurance; or 246.16 (iii) prescription drug coverage; 246.17 (iv) dental coverage; or 246.18 (v) vision coverage; 246.19 (2) requires a deductible of $100 or more per person per 246.20 year; or 246.21 (3) lacks coverage because the child has exceeded the 246.22 maximum coverage for a particular diagnosis or the policy 246.23 excludes a particular diagnosis. 246.24 The commissioner may change this eligibility criterion for 246.25 sliding scale premiums in order to remain within the limits of 246.26 available appropriations. The requirement of no health coverage 246.27 does not apply to newborns. 246.28 (b) Medical assistance, general assistance medical care, 246.29 and the Civilian Health and Medical Program of the Uniformed 246.30 Service, CHAMPUS, or other coverage provided under United States 246.31 Code, title 10, subtitle A, part II, chapter 55, are not 246.32 considered insurance or health coverage for purposes of the 246.33 four-month requirement described in this subdivision. 246.34 (c) For purposes of this subdivision, Medicare Part A or B 246.35 coverage under title XVIII of the Social Security Act, United 246.36 States Code, title 42, sections 1395c to 1395w-4, is considered 247.1 health coverage. An applicant or enrollee may not refuse 247.2 Medicare coverage to establish eligibility for MinnesotaCare. 247.3 (d) Applicants who were recipients of medical assistance or 247.4 general assistance medical care within one month of application 247.5 must meet the provisions of this subdivision and subdivision 2. 247.6 (e) Effective October 1, 2003, applicants who were 247.7 recipients of medical assistance and had cost-effective health 247.8 insurance which was paid for by medical assistance are exempt 247.9 from the four-month requirement under this section. 247.10 (f) Notwithstanding paragraph (a), effective October 1, 247.11 2004, individuals enrolled in the MinnesotaCare program under 247.12 section 256L.04, subdivision 7, who have gross family income at 247.13 or below 75 percent are not subject to the requirement of having 247.14 no other health coverage for four months prior to application 247.15 and renewal. 247.16 [EFFECTIVE DATE.] This section is effective July 1, 2003, 247.17 except where a different effective date is specified in the text. 247.18 Sec. 81. Minnesota Statutes 2002, section 256L.09, 247.19 subdivision 4, is amended to read: 247.20 Subd. 4. [ELIGIBILITY AS MINNESOTA RESIDENT.] (a) For 247.21 purposes of this section, a permanent Minnesota resident is a 247.22 person who has demonstrated, through persuasive and objective 247.23 evidence, that the person is domiciled in the state and intends 247.24 to live in the state permanently. 247.25 (b) To be eligible as a permanent resident, an applicant 247.26 must demonstrate the requisite intent to live in the state 247.27 permanently by: 247.28 (1) showing that the applicant maintains a residence at a 247.29 verified address other than a place of public accommodation, 247.30 through the use of evidence of residence described in section 247.31 256D.02, subdivision 12a, clause (1); 247.32 (2) demonstrating that the applicant has been continuously 247.33 domiciled in the state for no less than 180 days immediately 247.34 before the application;and247.35 (3) signing an affidavit declaring that (A) the applicant 247.36 currently resides in the state and intends to reside in the 248.1 state permanently; and (B) the applicant did not come to the 248.2 state for the primary purpose of obtaining medical coverage or 248.3 treatment; 248.4 (4) effective October 1, 2004, single adults and adults in 248.5 households without children who have gross family income at or 248.6 below 75 percent of the federal poverty guidelines are exempt 248.7 from the requirements of clause (1); 248.8 (5) effective October 1, 2004, single adults and adults in 248.9 households without children who have gross family income at or 248.10 below 75 percent of the federal poverty guidelines are exempt 248.11 from clause (2), but shall demonstrate that they have been 248.12 continuously domiciled in the state for no less than 30 days 248.13 before the date of application. In cases of medical 248.14 emergencies, the 30-day residency requirement is waived; and 248.15 (6) effective October 1, 2004, migrant workers as defined 248.16 in section 256J.08 who are single adults and adults in 248.17 households without children who have gross family income at or 248.18 below 75 percent of the federal poverty guidelines are exempt 248.19 from the residency requirements of this section, provided the 248.20 migrant worker provides verification that the migrant family 248.21 worked in this state within the last 12 months and earned at 248.22 least $1,000 in gross wages during the time the migrant worker 248.23 worked in this state. 248.24 (c) A person who is temporarily absent from the state does 248.25 not lose eligibility for MinnesotaCare. "Temporarily absent 248.26 from the state" means the person is out of the state for a 248.27 temporary purpose and intends to return when the purpose of the 248.28 absence has been accomplished. A person is not temporarily 248.29 absent from the state if another state has determined that the 248.30 person is a resident for any purpose. If temporarily absent 248.31 from the state, the person must follow the requirements of the 248.32 health plan in which the person is enrolled to receive services. 248.33 Sec. 82. Minnesota Statutes 2002, section 256L.12, 248.34 subdivision 6, is amended to read: 248.35 Subd. 6. [COPAYMENTS AND BENEFIT LIMITS.] Enrollees are 248.36 responsible for all copayments in section 256L.03, subdivision4249.1 5, and shall pay copayments to the managed care plan or to its 249.2 participating providers. The enrollee is also responsible for 249.3 payment of inpatient hospital charges which exceed the 249.4 MinnesotaCare benefit limit. 249.5 Sec. 83. Minnesota Statutes 2002, section 256L.12, 249.6 subdivision 9, is amended to read: 249.7 Subd. 9. [RATE SETTING; PERFORMANCE WITHHOLDS.] (a) Rates 249.8 will be prospective, per capita, where possible. The 249.9 commissioner may allow health plans to arrange for inpatient 249.10 hospital services on a risk or nonrisk basis. The commissioner 249.11 shall consult with an independent actuary to determine 249.12 appropriate rates. 249.13 (b) For services rendered on or after January 1, 2003, to 249.14 December 31, 2003, the commissioner shall withhold .5 percent of 249.15 managed care plan payments under this section pending completion 249.16 of performance targets. The withheld funds must be returned no 249.17 sooner than July 1 and no later than July 31 of the following 249.18 year if performance targets in the contract are achieved. A 249.19 managed care plan may include as admitted assets under section 249.20 62D.044 any amount withheld under this paragraph that is 249.21 reasonably expected to be returned. 249.22 (c) For services rendered on or after January 1, 2004, the 249.23 commissioner shall withhold five percent of managed care plan 249.24 payments under this section pending completion of performance 249.25 targets. Each performance target must be quantifiable, 249.26 objective, measurable, and reasonably attainable. Criteria for 249.27 assessment of each performance target must be outlined in 249.28 writing prior to the contract effective date. The withheld 249.29 funds must be returned no sooner than July 1 and no later than 249.30 July 31 of the following calendar year if performance targets in 249.31 the contract are achieved. A managed care plan may include as 249.32 admitted assets under section 62D.044 any amount withheld under 249.33 this paragraph that is reasonably expected to be returned. 249.34 (d) The commissioner may exempt from paragraph (b) a 249.35 managed care plan that has entered into a managed care contract 249.36 with the commissioner in accordance with this section if the 250.1 contract was the initial contract between the managed care plan 250.2 and the commissioner, and it was entered into after January 1, 250.3 2000. This exemption shall apply for five years after the 250.4 initial contract was entered into by the managed care plan. 250.5 [EFFECTIVE DATE.] This section is effective for services 250.6 rendered on or after July 1, 2003, except as otherwise provided 250.7 in the statutory language. 250.8 Sec. 84. Minnesota Statutes 2002, section 256L.12, is 250.9 amending by adding a subdivision to read: 250.10 Subd. 9a. [RATE SETTING; RATABLE REDUCTION.] For services 250.11 rendered on or after October 1, 2003, the total payment made to 250.12 managed care plans under the MinnesotaCare program is reduced 250.13 0.5 percent. 250.14 Sec. 85. Minnesota Statutes 2002, section 256L.12, is 250.15 amended by adding a subdivision to read: 250.16 Subd. 9b. [ACTUARIAL SOUNDNESS.] All payments to managed 250.17 care plans under the MinnesotaCare program shall be actuarially 250.18 sound pursuant to Code of Federal Regulations, title 42, section 250.19 438.6. In establishing payment rates under the MinnesotaCare 250.20 program, payment rates must incorporate at least the following 250.21 factors: (1) individual health plan annual performance; (2) 250.22 rate relationships based on actual health plan experience; (3) 250.23 geographic payment relativities; and (4) rate cell payment 250.24 relativities. 250.25 Sec. 86. Minnesota Statutes 2002, section 256L.15, 250.26 subdivision 1, is amended to read: 250.27 Subdivision 1. [PREMIUM DETERMINATION.] (a) Families with 250.28 children and individuals shall pay a premium determined 250.29 according toa sliding fee based on a percentage of the family's250.30gross family incomesubdivision 2. 250.31 (b) Pregnant women and children under age two are exempt 250.32 from the provisions of section 256L.06, subdivision 3, paragraph 250.33 (b), clause (3), requiring disenrollment for failure to pay 250.34 premiums. For pregnant women, this exemption continues until 250.35 the first day of the month following the 60th day postpartum. 250.36 Women who remain enrolled during pregnancy or the postpartum 251.1 period, despite nonpayment of premiums, shall be disenrolled on 251.2 the first of the month following the 60th day postpartum for the 251.3 penalty period that otherwise applies under section 256L.06, 251.4 unless they begin paying premiums. 251.5 (c) Effective October 1, 2004, single adults and households 251.6 without children with gross family income at or below 75 percent 251.7 of the federal poverty guidelines who are eligible under section 251.8 256L.04, subdivision 7, do not have a premium obligation. 251.9 Sec. 87. Minnesota Statutes 2002, section 256L.15, 251.10 subdivision 2, is amended to read: 251.11 Subd. 2. [SLIDING FEE SCALE TO DETERMINE PERCENTAGE OF 251.12 GROSS INDIVIDUAL OR FAMILY INCOME.] (a) The commissioner shall 251.13 establish a sliding fee scale to determine the percentage of 251.14 grossindividual orfamily income that households at different 251.15 income levels must pay to obtain coverage through the 251.16 MinnesotaCare program. The sliding fee scale must be based on 251.17 the enrollee's grossindividual orfamily income. The sliding 251.18 fee scale must contain separate tables based on enrollment of 251.19 one, two, or three or more persons. The sliding fee scale 251.20 begins with a premium of 1.5 percent of grossindividual or251.21 family income forindividuals orfamilies with incomes below the 251.22 limits for the medical assistance program for families and 251.23 children in effect on January 1, 1999, and proceeds through the 251.24 following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 251.25 7.4, and 8.8 percent. These percentages are matched to evenly 251.26 spaced income steps ranging from the medical assistance income 251.27 limit for families and children in effect on January 1, 1999, to 251.28 275 percent of the federal poverty guidelines for the applicable 251.29 family size, up to a family size of five. The sliding fee scale 251.30 for a family of five must be used for families of more than 251.31 five. Effective October 1, 2003, the commissioner shall 251.32 increase each percentage by 0.5 percentage points for families 251.33 and children with incomes greater than 100 percent but not 251.34 exceeding 200 percent of the federal poverty guidelines and 251.35 shall increase each percentage by 1.0 percentage points for 251.36 families and children with incomes greater than 200 percent of 252.1 the federal poverty guidelines. The sliding fee scale and 252.2 percentages are not subject to the provisions of chapter 14. If 252.3 a familyor individualreports increased income after 252.4 enrollment, premiums shall not be adjusted until eligibility 252.5 renewal. 252.6 (b)(1) Enrolledindividuals andfamilies whose gross annual 252.7 income increases above 275 percent of the federal poverty 252.8 guideline shall pay the maximum premium. This clause expires 252.9 effective February 1, 2004. 252.10 (2) Effective October 1, 2003, enrolled single adults and 252.11 households without children who have gross family income above 252.12 75 percent of the federal poverty guidelines shall pay the 252.13 maximum premium. 252.14 (3) Effective February 1, 2004, adults in families with 252.15 children whose gross income is above 200 percent of the federal 252.16 poverty guidelines shall pay the maximum premium. 252.17 (4) The maximum premium is defined as a base charge for 252.18 one, two, or three or more enrollees so that if all 252.19 MinnesotaCare cases paid the maximum premium, the total revenue 252.20 would equal the total cost of MinnesotaCare medical coverage and 252.21 administration. In this calculation, administrative costs shall 252.22 be assumed to equal ten percent of the total. The costs of 252.23 medical coverage for pregnant women and children under age two 252.24 and the enrollees in these groups shall be excluded from the 252.25 total. The maximum premium for two enrollees shall be twice the 252.26 maximum premium for one, and the maximum premium for three or 252.27 more enrollees shall be three times the maximum premium for one. 252.28 (c) Effective July 1, 2005, single adults and households 252.29 without children who have gross family income above 75 percent 252.30 of the federal poverty guidelines and adults in families with 252.31 children whose gross income is above 200 percent of the federal 252.32 poverty guidelines shall pay the full cost premium. The full 252.33 cost premium is defined as a base charge for one, two, or three 252.34 or more enrollees so that if the base charge were paid by all 252.35 MinnesotaCare cases subject to the full cost premium, the total 252.36 revenue would approximately equal the total cost of 253.1 MinnesotaCare medical coverage and administration for cases 253.2 subject to the full cost premium. In this calculation, 253.3 administrative costs shall be assumed to equal ten percent of 253.4 the total. The full cost premium for two enrollees shall be 253.5 twice the full cost premium for one, and the full cost premium 253.6 for three or more enrollees shall be three times the full cost 253.7 premium for one. 253.8 [EFFECTIVE DATE.] The amendments to this section are 253.9 effective October 1, 2003, unless specified otherwise in the 253.10 statutory text. 253.11 Sec. 88. Minnesota Statutes 2002, section 256L.15, 253.12 subdivision 3, is amended to read: 253.13 Subd. 3. [EXCEPTIONS TO SLIDING SCALE.] An annual premium 253.14 of $48 is required for all children in families with income at 253.15 or less than175150 percent of federal poverty guidelines. 253.16 [EFFECTIVE DATE.] This section is effective July 1, 2003. 253.17 Sec. 89. Minnesota Statutes 2002, section 256L.17, 253.18 subdivision 2, is amended to read: 253.19 Subd. 2. [LIMIT ON TOTAL ASSETS.](a)Effective July 1, 253.20 2002, or upon federal approval, whichever is later, in order to 253.21 be eligible for the MinnesotaCare program, a household of two or 253.22 more persons must not own more than $30,000 in total net assets, 253.23 and a household of one person must not own more than $15,000 in 253.24 total net assets. 253.25(b) For purposes of this subdivision, assets are determined253.26according to section 256B.056, subdivision 3c.In addition to 253.27 these maximum amounts, an eligible individual or family may 253.28 accrue interest on these amounts, but they must be reduced to 253.29 the maximum at the time of an eligibility redetermination. The 253.30 value of assets that are not considered in determining 253.31 eligibility is the value of those assets excluded under the AFDC 253.32 state plan as of July 16, 1996, as required by the Personal 253.33 Responsibility and Work Opportunity Reconciliation Act of 1996 253.34 (PRWORA), Public Law 104-193, with the following exceptions: 253.35 (1) household goods and personal effects are not 253.36 considered; 254.1 (2) capital and operating assets of a trade or business up 254.2 to $200,000 are not considered; 254.3 (3) one motor vehicle is excluded for each person of legal 254.4 driving age who is employed or seeking employment; 254.5 (4) one burial plot and all other burial expenses equal to 254.6 the supplemental security income program asset limit are not 254.7 considered for each individual; 254.8 (5) court-ordered settlements up to $10,000 are not 254.9 considered; 254.10 (6) individual retirement accounts and funds are not 254.11 considered; and 254.12 (7) assets owned by children are not considered. 254.13 [EFFECTIVE DATE.] This section is effective July 1, 2003. 254.14 Sec. 90. Minnesota Statutes 2002, section 295.58, is 254.15 amended to read: 254.16 295.58 [DEPOSIT OF REVENUES AND PAYMENT OF REFUNDS.] 254.17 The commissioner shall deposit all revenues, including 254.18 penalties and interest, derived from the taxes imposed by 254.19 sections 295.50 to 295.57 and from the insurance premiums tax 254.20 imposed by section 297I.05, subdivision 5, on health maintenance 254.21 organizations, community integrated service networks, and 254.22 nonprofit health service plan corporations in the health care 254.23 access fund. There is annually appropriated from the health 254.24 care access fund to the commissioner of revenue the amount 254.25 necessary to make refunds under this chapter. Beginning July 1, 254.26 2005, the commissioner shall deposit all revenues, including 254.27 penalties and interest, derived from the taxes imposed by 254.28 sections 295.50 to 295.57 and from the insurance premiums tax 254.29 imposed by section 297I.05, subdivision 5, on health maintenance 254.30 organizations, community integrated service networks, and 254.31 nonprofit health service plan corporations in the general fund. 254.32 There is annually appropriated from the general fund to the 254.33 commissioner of revenue the amount necessary to make refunds 254.34 under this chapter. 254.35 Sec. 91. Minnesota Statutes 2002, section 514.981, 254.36 subdivision 6, is amended to read: 255.1 Subd. 6. [TIME LIMITS; CLAIM LIMITS; LIENS ON LIFE ESTATES 255.2 AND JOINT TENANCIES.] (a) A medical assistance lien is a lien on 255.3 the real property it describes for a period of ten years from 255.4 the date it attaches according to section 514.981, subdivision 255.5 2, paragraph (a), except as otherwise provided for in sections 255.6 514.980 to 514.985. The agency may renew a medical assistance 255.7 lien for an additional ten years from the date it would 255.8 otherwise expire by recording or filing a certificate of renewal 255.9 before the lien expires. The certificate shall be recorded or 255.10 filed in the office of the county recorder or registrar of 255.11 titles for the county in which the lien is recorded or filed. 255.12 The certificate must refer to the recording or filing data for 255.13 the medical assistance lien it renews. The certificate need not 255.14 be attested, certified, or acknowledged as a condition for 255.15 recording or filing. The registrar of titles or the recorder 255.16 shall file, record, index, and return the certificate of renewal 255.17 in the same manner as provided for medical assistance liens in 255.18 section 514.982, subdivision 2. 255.19 (b) A medical assistance lien is not enforceable against 255.20 the real property of an estate to the extent there is a 255.21 determination by a court of competent jurisdiction, or by an 255.22 officer of the court designated for that purpose, that there are 255.23 insufficient assets in the estate to satisfy the agency's 255.24 medical assistance lien in whole or in part because of the 255.25 homestead exemption under section 256B.15, subdivision 4, the 255.26 rights of the surviving spouse or minor children under section 255.27 524.2-403, paragraphs (a) and (b), or claims with a priority 255.28 under section 524.3-805, paragraph (a), clauses (1) to (4). For 255.29 purposes of this section, the rights of the decedent's adult 255.30 children to exempt property under section 524.2-403, paragraph 255.31 (b), shall not be considered costs of administration under 255.32 section 524.3-805, paragraph (a), clause (1). 255.33 (c) Notwithstanding any law or rule to the contrary, the 255.34 provisions in clauses (1) to (7) apply if a life estate subject 255.35 to a medical assistance lien ends according to its terms, or if 255.36 a medical assistance recipient who owns a life estate or any 256.1 interest in real property as a joint tenant that is subject to a 256.2 medical assistance lien dies. 256.3 (1) The medical assistance recipient's life estate or joint 256.4 tenancy interest in the real property shall not end upon the 256.5 recipient's death but shall merge into the remainder interest or 256.6 other interest in real property the medical assistance recipient 256.7 owned in joint tenancy with others. The medical assistance lien 256.8 shall attach to and run with the remainder or other interest in 256.9 the real property to the extent of the medical assistance 256.10 recipient's interest in the property at the time of the 256.11 recipient's death as determined under this section. 256.12 (2) If the medical assistance recipient's interest was a 256.13 life estate in real property, the lien shall be a lien against 256.14 the portion of the remainder equal to the percentage factor for 256.15 the life estate of a person the medical assistance recipient's 256.16 age on the date the life estate ended according to its terms or 256.17 the date of the medical assistance recipient's death as listed 256.18 in the Life Estate Mortality Table in the health care program's 256.19 manual. 256.20 (3) If the medical assistance recipient owned the interest 256.21 in real property in joint tenancy with others, the lien shall be 256.22 a lien against the portion of that interest equal to the 256.23 fractional interest the medical assistance recipient would have 256.24 owned in the jointly owned interest had the medical assistance 256.25 recipient and the other owners held title to that interest as 256.26 tenants in common on the date the medical assistance recipient 256.27 died. 256.28 (4) The medical assistance lien shall remain a lien against 256.29 the remainder or other jointly owned interest for the length of 256.30 time and be renewable as provided in paragraph (a). 256.31 (5) Section 514.981, subdivision 5, paragraphs (a), clause 256.32 (4), (b), clauses (1) and (2); and subdivision 6, paragraph (b), 256.33 do not apply to medical assistance liens which attach to 256.34 interests in real property as provided under this subdivision. 256.35 (6) The continuation of a medical assistance recipient's 256.36 life estate or joint tenancy interest in real property after the 257.1 medical assistance recipient's death for the purpose of 257.2 recovering medical assistance provided for in sections 514.980 257.3 to 514.985 modifies common law principles holding that these 257.4 interests terminate on the death of the holder. 257.5 (7) Notwithstanding any law or rule to the contrary, no 257.6 release, satisfaction, discharge, or affidavit under section 257.7 256B.15 shall extinguish or terminate the life estate or joint 257.8 tenancy interest of a medical assistance recipient subject to a 257.9 lien under sections 514.980 to 514.985 on the date the recipient 257.10 dies. 257.11 (8) The provisions of clauses (1) to (7) do not apply to a 257.12 homestead owned of record, on the date the recipient dies, by 257.13 the recipient and the recipient's spouse as joint tenants with a 257.14 right of survivorship. 257.15 [EFFECTIVE DATE.] This section is effective August 1, 2003, 257.16 and applies to all medical assistance liens recorded or filed on 257.17 or after that date. 257.18 Sec. 92. [PHARMACY PLUS WAIVER.] 257.19 The commissioner of human services shall seek a pharmacy 257.20 plus waiver from the Department of Health and Human Services 257.21 that uses the accumulated savings from all pharmacy and asset 257.22 transfer provisions in this act and previously adopted pharmacy 257.23 savings strategies as the factor to prove fiscal neutrality. 257.24 The commissioner shall expand eligibility for seniors and the 257.25 disabled up to 135 percent of the federal poverty guidelines for 257.26 the prescription drug program under Minnesota Statutes, section 257.27 256.955, to the extent that the new federal funding under this 257.28 waiver allows an expansion without an additional state 257.29 appropriation. 257.30 Sec. 93. [REVIEW OF SPECIAL TRANSPORTATION ELIGIBILITY 257.31 CRITERIA AND POTENTIAL COST SAVINGS.] 257.32 The commissioner of human services, in consultation with 257.33 the commissioner of transportation and special transportation 257.34 service providers, shall review eligibility criteria for medical 257.35 assistance special transportation services and shall evaluate 257.36 whether the level of special transportation services provided 258.1 should be based on the degree of impairment of the client, as 258.2 well as the medical diagnosis. The commissioner shall also 258.3 evaluate methods for reducing the cost of special transportation 258.4 services, including, but not limited to: 258.5 (1) requiring providers to maintain a daily log book 258.6 confirming delivery of clients to medical facilities; 258.7 (2) requiring providers to implement commercially available 258.8 computer mapping programs to calculate mileage for purposes of 258.9 reimbursement; and 258.10 (3) restricting special transportation service from being 258.11 provided solely for trips to pharmacies. 258.12 The commissioner shall present recommendations for changes 258.13 in the eligibility criteria and potential cost-savings for 258.14 special transportation services to the chairs and ranking 258.15 minority members of the house and senate committees having 258.16 jurisdiction over health and human services spending by January 258.17 15, 2004. The commissioner is prohibited from using a broker or 258.18 coordinator to manage special transportation services. 258.19 Sec. 94. [REBATES FOR MANAGED CARE.] 258.20 The commissioner of human services shall develop a proposal 258.21 to obtain increased pharmacy rebate revenue for recipients 258.22 served through the prepaid medical assistance program and the 258.23 MinnesotaCare program. The commissioner may recommend excluding 258.24 coverage for prescription drugs from prepaid medical assistance 258.25 programs and MinnesotaCare contracts, or may propose other 258.26 methods to obtain supplemental drug rebates for this 258.27 population. The commissioner shall present the proposal to the 258.28 chairs and ranking minority members of the house and senate 258.29 committees with jurisdiction over health and human services 258.30 finance issues. 258.31 Sec. 95. [FEDERAL APPROVAL.] 258.32 If the amendments to Minnesota Statutes, sections 256.046, 258.33 subdivision 1, and 256.98, subdivision 8, are not effective 258.34 because of prohibitions in federal law, the commissioner of 258.35 human services shall seek the federal waivers and authority 258.36 necessary to implement the provisions. 259.1 Sec. 96. [REVISOR'S INSTRUCTION.] 259.2 For sections in Minnesota Statutes and Minnesota Rules 259.3 affected by the repealed sections in this article, the revisor 259.4 shall delete internal cross-references where appropriate and 259.5 make changes necessary to correct the punctuation, grammar, or 259.6 structure of the remaining text and preserve its meaning. 259.7 Sec. 97. [REPEALER.] 259.8 (a) Minnesota Statutes 2002, sections 256.955, subdivision 259.9 8; 256B.056, subdivision 3c; 256B.057, subdivision 1b; and 259.10 256B.195, subdivision 5, are repealed July 1, 2003. 259.11 (b) Minnesota Statutes 2002, section 256L.04, subdivision 259.12 9, is repealed October 1, 2004. 259.13 (c) Minnesota Statutes 2002, section 256B.055, subdivision 259.14 10a, is repealed July 1, 2003, or upon federal approval, 259.15 whichever is later. 259.16 (d) Minnesota Statutes 2002, section 256L.02, subdivision 259.17 3, is repealed June 30, 2005. 259.18 ARTICLE 3 259.19 LONG-TERM CARE 259.20 Section 1. Minnesota Statutes 2002, section 61A.072, 259.21 subdivision 6, is amended to read: 259.22 Subd. 6. [ACCELERATED BENEFITS.] (a) "Accelerated 259.23 benefits" covered under this section are benefits payable under 259.24 the life insurance contract: 259.25 (1) to a policyholder or certificate holder, during the 259.26 lifetime of the insured,in anticipation of deathupon the 259.27 occurrence of a specified life-threatening or catastrophic 259.28 condition as defined by the policy or rider; 259.29 (2) that reduce the death benefit otherwise payable under 259.30 the life insurance contract; and 259.31 (3) that are payable upon the occurrence of a single 259.32 qualifying event that results in the payment of a benefit amount 259.33 fixed at the time of acceleration. 259.34 (b) "Qualifying event" means one or more of the following: 259.35 (1) a medical condition that would result in a drastically 259.36 limited life span as specified in the contract; 260.1 (2) a medical condition that has required or requires 260.2 extraordinary medical intervention, such as, but not limited to, 260.3 major organ transplant or continuous artificial life support 260.4 without which the insured would die;or260.5 (3) a condition that requires continuous confinement in an 260.6 eligible institution as defined in the contract if the insured 260.7 is expected to remain there for the rest of the insured's life; 260.8 (4) a long-term care illness or physical condition that 260.9 results in cognitive impairment or the inability to perform the 260.10 activities of daily life or the substantial and material duties 260.11 of any occupation; or 260.12 (5) other qualifying events that the commissioner approves 260.13 for a particular filing. 260.14 [EFFECTIVE DATE.] This section is effective the day 260.15 following final enactment and applies to policies issued on or 260.16 after that date. 260.17 Sec. 2. Minnesota Statutes 2002, section 62A.315, is 260.18 amended to read: 260.19 62A.315 [EXTENDED BASIC MEDICARE SUPPLEMENT PLAN; 260.20 COVERAGE.] 260.21 The extended basic Medicare supplement plan must have a 260.22 level of coverage so that it will be certified as a qualified 260.23 plan pursuant to section 62E.07, and will provide: 260.24 (1) coverage for all of the Medicare part A inpatient 260.25 hospital deductible and coinsurance amounts, and 100 percent of 260.26 all Medicare part A eligible expenses for hospitalization not 260.27 covered by Medicare; 260.28 (2) coverage for the daily copayment amount of Medicare 260.29 part A eligible expenses for the calendar year incurred for 260.30 skilled nursing facility care; 260.31 (3) coverage for the copayment amount of Medicare eligible 260.32 expenses under Medicare part B regardless of hospital 260.33 confinement, and the Medicare part B deductible amount; 260.34 (4) 80 percent of the usual and customary hospital and 260.35 medical expenses and supplies described in section 62E.06, 260.36 subdivision 1, not to exceed any charge limitation established 261.1 by the Medicare program or state law, the usual and customary 261.2 hospital and medical expenses and supplies, described in section 261.3 62E.06, subdivision 1, while in a foreign country, and 261.4 prescription drug expenses, not covered by Medicare; 261.5 (5) coverage for the reasonable cost of the first three 261.6 pints of blood, or equivalent quantities of packed red blood 261.7 cells as defined under federal regulations under Medicare parts 261.8 A and B, unless replaced in accordance with federal regulations; 261.9 (6) 100 percent of the cost of immunizations and routine 261.10 screening procedures for cancer, including mammograms and pap 261.11 smears; 261.12 (7) preventive medical care benefit: coverage for the 261.13 following preventive health services: 261.14 (i) an annual clinical preventive medical history and 261.15 physical examination that may include tests and services from 261.16 clause (ii) and patient education to address preventive health 261.17 care measures; 261.18 (ii) any one or a combination of the following preventive 261.19 screening tests or preventive services, the frequency of which 261.20 is considered medically appropriate: 261.21 (A) fecal occult blood test and/or digital rectal 261.22 examination; 261.23 (B) dipstick urinalysis for hematuria, bacteriuria, and 261.24 proteinuria; 261.25 (C) pure tone (air only) hearing screening test 261.26 administered or ordered by a physician; 261.27 (D) serum cholesterol screening every five years; 261.28 (E) thyroid function test; 261.29 (F) diabetes screening; 261.30 (iii) any other tests or preventive measures determined 261.31 appropriate by the attending physician. 261.32 Reimbursement shall be for the actual charges up to 100 261.33 percent of the Medicare-approved amount for each service as if 261.34 Medicare were to cover the service as identified in American 261.35 Medical Association current procedural terminology (AMA CPT) 261.36 codes to a maximum of $120 annually under this benefit. This 262.1 benefit shall not include payment for any procedure covered by 262.2 Medicare; 262.3 (8) at-home recovery benefit: coverage for services to 262.4 provide short-term at-home assistance with activities of daily 262.5 living for those recovering from an illness, injury, or surgery: 262.6 (i) for purposes of this benefit, the following definitions 262.7 shall apply: 262.8 (A) "activities of daily living" include, but are not 262.9 limited to, bathing, dressing, personal hygiene, transferring, 262.10 eating, ambulating, assistance with drugs that are normally 262.11 self-administered, and changing bandages or other dressings; 262.12 (B) "care provider" means a duly qualified or licensed home 262.13 health aide/homemaker, personal care aide, or nurse provided 262.14 through a licensed home health care agency or referred by a 262.15 licensed referral agency or licensed nurses registry; 262.16 (C) "home" means a place used by the insured as a place of 262.17 residence, provided that the place would qualify as a residence 262.18 for home health care services covered by Medicare. A hospital 262.19 or skilled nursing facility shall not be considered the 262.20 insured's place of residence; 262.21 (D) "at-home recovery visit" means the period of a visit 262.22 required to provide at-home recovery care, without limit on the 262.23 duration of the visit, except each consecutive four hours in a 262.24 24-hour period of services provided by a care provider is one 262.25 visit; 262.26 (ii) coverage requirements and limitations: 262.27 (A) at-home recovery services provided must be primarily 262.28 services that assist in activities of daily living; 262.29 (B) the insured's attending physician must certify that the 262.30 specific type and frequency of at-home recovery services are 262.31 necessary because of a condition for which a home care plan of 262.32 treatment was approved by Medicare; 262.33 (C) coverage is limited to: 262.34 (I) no more than the number and type of at-home recovery 262.35 visits certified as medically necessary by the insured's 262.36 attending physician. The total number of at-home recovery 263.1 visits shall not exceed the number of Medicare-approved home 263.2 health care visits under a Medicare-approved home care plan of 263.3 treatment; 263.4 (II) the actual charges for each visit up to a maximum 263.5 reimbursement of$40$100 per visit; 263.6 (III)$1,600$4,000 per calendar year; 263.7 (IV) seven visits in any one week; 263.8 (V) care furnished on a visiting basis in the insured's 263.9 home; 263.10 (VI) services provided by a care provider as defined in 263.11 this section; 263.12 (VII) at-home recovery visits while the insured is covered 263.13 under the policy or certificate and not otherwise excluded; 263.14 (VIII) at-home recovery visits received during the period 263.15 the insured is receiving Medicare-approved home care services or 263.16 no more than eight weeks after the service date of the last 263.17 Medicare-approved home health care visit; 263.18 (iii) coverage is excluded for: 263.19 (A) home care visits paid for by Medicare or other 263.20 government programs; and 263.21 (B) care provided byfamily members,unpaid volunteers,or 263.22 providers who are not care providers. 263.23 [EFFECTIVE DATE.] This section is effective January 1, 263.24 2004, and applies to policies issued on or after that date. 263.25 Sec. 3. Minnesota Statutes 2002, section 62A.48, is 263.26 amended by adding a subdivision to read: 263.27 Subd. 12. [REGULATORY FLEXIBILITY.] The commissioner may 263.28 upon written request issue an order to modify or suspend a 263.29 specific provision or provisions of sections 62A.46 to 62A.56 263.30 with respect to a specific long-term care insurance policy or 263.31 certificate upon a written finding that: 263.32 (1) the modification or suspension is in the best interest 263.33 of the insureds; 263.34 (2) the purpose to be achieved could not be effectively or 263.35 efficiently achieved without the modifications or suspension; 263.36 and 264.1 (3)(i) the modification or suspension is necessary to the 264.2 development of an innovative and reasonable approach for 264.3 insuring long-term care; 264.4 (ii) the policy or certificate is to be issued to residents 264.5 of a life care or continuing care retirement community or some 264.6 other residential community for the elderly and the modification 264.7 or suspension is reasonably related to the special needs or 264.8 nature of such a community; or 264.9 (iii) the modification or suspension is necessary to permit 264.10 long-term care insurance to be sold as part of, or in 264.11 conjunction with, another insurance product. 264.12 [EFFECTIVE DATE.] This section is effective January 1, 264.13 2004, and applies to policies issued on or after that date. 264.14 Sec. 4. Minnesota Statutes 2002, section 62A.49, is 264.15 amended by adding a subdivision to read: 264.16 Subd. 3. [PROHIBITED LIMITATIONS.] A long-term care 264.17 insurance policy or certificate shall not, if it provides 264.18 benefits for home health care or community care services, limit 264.19 or exclude benefits by: 264.20 (1) requiring that the insured would need care in a skilled 264.21 nursing facility if home health care services were not provided; 264.22 (2) requiring that the insured first or simultaneously 264.23 receive nursing or therapeutic services in a home, community, or 264.24 institutional setting before home health care services are 264.25 covered; 264.26 (3) limiting eligible services to services provided by a 264.27 registered nurse or licensed practical nurse; 264.28 (4) requiring that a nurse or therapist provide services 264.29 covered by the policy that can be provided by a home health aide 264.30 or other licensed or certified home care worker acting within 264.31 the scope of licensure or certification; 264.32 (5) excluding coverage for personal care services provided 264.33 by a home health aide; 264.34 (6) requiring that the provision of home health care 264.35 services be at a level of certification or licensure greater 264.36 than that required by the eligible service; 265.1 (7) requiring that the insured have an acute condition 265.2 before home health care services are covered; 265.3 (8) limiting benefits to services provided by 265.4 Medicare-certified agencies or providers; 265.5 (9) excluding coverage for adult day care services; or 265.6 (10) excluding coverage based upon location or type of 265.7 residence in which the home health care services would be 265.8 provided. 265.9 [EFFECTIVE DATE.] This section is effective January 1, 265.10 2004, and applies to policies issued on or after that date. 265.11 Sec. 5. Minnesota Statutes 2002, section 62S.22, 265.12 subdivision 1, is amended to read: 265.13 Subdivision 1. [PROHIBITED LIMITATIONS.] A long-term care 265.14 insurance policy or certificate shall not, if it provides 265.15 benefits for home health care or community care services, limit 265.16 or exclude benefits by: 265.17 (1) requiring that the insured would need care in a skilled 265.18 nursing facility if home health care services were not provided; 265.19 (2) requiring that the insured first or simultaneously 265.20 receive nursing or therapeutic services in a home, community, or 265.21 institutional setting before home health care services are 265.22 covered; 265.23 (3) limiting eligible services to services provided by a 265.24 registered nurse or licensed practical nurse; 265.25 (4) requiring that a nurse or therapist provide services 265.26 covered by the policy that can be provided by a home health aide 265.27 or other licensed or certified home care worker acting within 265.28 the scope of licensure or certification; 265.29 (5) excluding coverage for personal care services provided 265.30 by a home health aide; 265.31 (6) requiring that the provision of home health care 265.32 services be at a level of certification or licensure greater 265.33 than that required by the eligible service; 265.34 (7) requiring that the insured have an acute condition 265.35 before home health care services are covered; 265.36 (8) limiting benefits to services provided by 266.1 Medicare-certified agencies or providers;or266.2 (9) excluding coverage for adult day care services; or 266.3 (10) excluding coverage based upon location or type of 266.4 residence in which the home health care services would be 266.5 provided. 266.6 [EFFECTIVE DATE.] This section is effective January 1, 266.7 2004, and applies to policies issued on or after that date. 266.8 Sec. 6. [62S.34] [REGULATORY FLEXIBILITY.] 266.9 The commissioner may upon written request issue an order to 266.10 modify or suspend a specific provision or provisions of this 266.11 chapter with respect to a specific long-term care insurance 266.12 policy or certificate upon a written finding that: 266.13 (1) the modification or suspension is in the best interest 266.14 of the insureds; 266.15 (2) the purpose to be achieved could not be effectively or 266.16 efficiently achieved without the modifications or suspension; 266.17 and 266.18 (3)(i) the modification or suspension is necessary to the 266.19 development of an innovative and reasonable approach for 266.20 insuring long-term care; 266.21 (ii) the policy or certificate is to be issued to residents 266.22 of a life care or continuing care retirement community or some 266.23 other residential community for the elderly and the modification 266.24 or suspension is reasonably related to the special needs or 266.25 nature of such a community; or 266.26 (iii) the modification or suspension is necessary to permit 266.27 long-term care insurance to be sold as part of, or in 266.28 conjunction with, another insurance product. 266.29 [EFFECTIVE DATE.] This section is effective January 1, 266.30 2004, and applies to policies issued on or after that date. 266.31 Sec. 7. Minnesota Statutes 2002, section 144A.04, 266.32 subdivision 3, is amended to read: 266.33 Subd. 3. [STANDARDS.] (a) The facility must meet the 266.34 minimum health, sanitation, safety and comfort standards 266.35 prescribed by the rules of the commissioner of health with 266.36 respect to the construction, equipment, maintenance and 267.1 operation of a nursing home. The commissioner of health may 267.2 temporarily waive compliance with one or more of the standards 267.3 if the commissioner determines that: 267.4(a)(1) temporary noncompliance with the standard will not 267.5 create an imminent risk of harm to a nursing home resident; and 267.6(b)(2) a controlling person on behalf of all other 267.7 controlling persons: 267.8(1)(i) has entered into a contract to obtain the materials 267.9 or labor necessary to meet the standard set by the commissioner 267.10 of health, but the supplier or other contractor has failed to 267.11 perform the terms of the contract and the inability of the 267.12 nursing home to meet the standard is due solely to that failure; 267.13 or 267.14(2)(ii) is otherwise making a diligent good faith effort 267.15 to meet the standard. 267.16 The commissioner shall make available to other nursing 267.17 homes information on facility-specific waivers related to 267.18 technology or physical plant that are granted. The commissioner 267.19 shall, upon the request of a facility, extend a waiver granted 267.20 to a specific facility related to technology or physical plant 267.21 to the facility making the request, if the commissioner 267.22 determines that the facility also satisfies clauses (1) and (2) 267.23 and any other terms and conditions of the waiver. 267.24 The commissioner of health shall allow, by rule, a nursing 267.25 home to provide fewer hours of nursing care to intermediate care 267.26 residents of a nursing home than required by the present rules 267.27 of the commissioner if the commissioner determines that the 267.28 needs of the residents of the home will be adequately met by a 267.29 lesser amount of nursing care. 267.30 (b) A facility is not required to seek a waiver for room 267.31 furniture or equipment under paragraph (a) when responding to 267.32 resident-specific requests, if the facility has discussed health 267.33 and safety concerns with the resident and the resident request 267.34 and discussion of health and safety concerns are documented in 267.35 the resident's patient record. 267.36 [EFFECTIVE DATE.] This section is effective July 1, 2003. 268.1 Sec. 8. Minnesota Statutes 2002, section 144A.04, is 268.2 amended by adding a subdivision to read: 268.3 Subd. 11. [INCONTINENT RESIDENTS.] Notwithstanding 268.4 Minnesota Rules, part 4658.0520, an incontinent resident must be 268.5 checked according to a specific time interval written in the 268.6 resident's care plan. The resident's attending physician must 268.7 authorize in writing any interval longer than two hours unless 268.8 the resident, if competent, or a family member or legally 268.9 appointed conservator, guardian, or health care agent of a 268.10 resident who is not competent, agrees in writing to waive 268.11 physician involvement in determining this interval. 268.12 [EFFECTIVE DATE.] This section is effective July 1, 2003. 268.13 Sec. 9. Minnesota Statutes 2002, section 144A.071, 268.14 subdivision 4a, is amended to read: 268.15 Subd. 4a. [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the 268.16 best interest of the state to ensure that nursing homes and 268.17 boarding care homes continue to meet the physical plant 268.18 licensing and certification requirements by permitting certain 268.19 construction projects. Facilities should be maintained in 268.20 condition to satisfy the physical and emotional needs of 268.21 residents while allowing the state to maintain control over 268.22 nursing home expenditure growth. 268.23 The commissioner of health in coordination with the 268.24 commissioner of human services, may approve the renovation, 268.25 replacement, upgrading, or relocation of a nursing home or 268.26 boarding care home, under the following conditions: 268.27 (a) to license or certify beds in a new facility 268.28 constructed to replace a facility or to make repairs in an 268.29 existing facility that was destroyed or damaged after June 30, 268.30 1987, by fire, lightning, or other hazard provided: 268.31 (i) destruction was not caused by the intentional act of or 268.32 at the direction of a controlling person of the facility; 268.33 (ii) at the time the facility was destroyed or damaged the 268.34 controlling persons of the facility maintained insurance 268.35 coverage for the type of hazard that occurred in an amount that 268.36 a reasonable person would conclude was adequate; 269.1 (iii) the net proceeds from an insurance settlement for the 269.2 damages caused by the hazard are applied to the cost of the new 269.3 facility or repairs; 269.4 (iv) the new facility is constructed on the same site as 269.5 the destroyed facility or on another site subject to the 269.6 restrictions in section 144A.073, subdivision 5; 269.7 (v) the number of licensed and certified beds in the new 269.8 facility does not exceed the number of licensed and certified 269.9 beds in the destroyed facility; and 269.10 (vi) the commissioner determines that the replacement beds 269.11 are needed to prevent an inadequate supply of beds. 269.12 Project construction costs incurred for repairs authorized under 269.13 this clause shall not be considered in the dollar threshold 269.14 amount defined in subdivision 2; 269.15 (b) to license or certify beds that are moved from one 269.16 location to another within a nursing home facility, provided the 269.17 total costs of remodeling performed in conjunction with the 269.18 relocation of beds does not exceed $1,000,000; 269.19 (c) to license or certify beds in a project recommended for 269.20 approval under section 144A.073; 269.21 (d) to license or certify beds that are moved from an 269.22 existing state nursing home to a different state facility, 269.23 provided there is no net increase in the number of state nursing 269.24 home beds; 269.25 (e) to certify and license as nursing home beds boarding 269.26 care beds in a certified boarding care facility if the beds meet 269.27 the standards for nursing home licensure, or in a facility that 269.28 was granted an exception to the moratorium under section 269.29 144A.073, and if the cost of any remodeling of the facility does 269.30 not exceed $1,000,000. If boarding care beds are licensed as 269.31 nursing home beds, the number of boarding care beds in the 269.32 facility must not increase beyond the number remaining at the 269.33 time of the upgrade in licensure. The provisions contained in 269.34 section 144A.073 regarding the upgrading of the facilities do 269.35 not apply to facilities that satisfy these requirements; 269.36 (f) to license and certify up to 40 beds transferred from 270.1 an existing facility owned and operated by the Amherst H. Wilder 270.2 Foundation in the city of St. Paul to a new unit at the same 270.3 location as the existing facility that will serve persons with 270.4 Alzheimer's disease and other related disorders. The transfer 270.5 of beds may occur gradually or in stages, provided the total 270.6 number of beds transferred does not exceed 40. At the time of 270.7 licensure and certification of a bed or beds in the new unit, 270.8 the commissioner of health shall delicense and decertify the 270.9 same number of beds in the existing facility. As a condition of 270.10 receiving a license or certification under this clause, the 270.11 facility must make a written commitment to the commissioner of 270.12 human services that it will not seek to receive an increase in 270.13 its property-related payment rate as a result of the transfers 270.14 allowed under this paragraph; 270.15 (g) to license and certify nursing home beds to replace 270.16 currently licensed and certified boarding care beds which may be 270.17 located either in a remodeled or renovated boarding care or 270.18 nursing home facility or in a remodeled, renovated, newly 270.19 constructed, or replacement nursing home facility within the 270.20 identifiable complex of health care facilities in which the 270.21 currently licensed boarding care beds are presently located, 270.22 provided that the number of boarding care beds in the facility 270.23 or complex are decreased by the number to be licensed as nursing 270.24 home beds and further provided that, if the total costs of new 270.25 construction, replacement, remodeling, or renovation exceed ten 270.26 percent of the appraised value of the facility or $200,000, 270.27 whichever is less, the facility makes a written commitment to 270.28 the commissioner of human services that it will not seek to 270.29 receive an increase in its property-related payment rate by 270.30 reason of the new construction, replacement, remodeling, or 270.31 renovation. The provisions contained in section 144A.073 270.32 regarding the upgrading of facilities do not apply to facilities 270.33 that satisfy these requirements; 270.34 (h) to license as a nursing home and certify as a nursing 270.35 facility a facility that is licensed as a boarding care facility 270.36 but not certified under the medical assistance program, but only 271.1 if the commissioner of human services certifies to the 271.2 commissioner of health that licensing the facility as a nursing 271.3 home and certifying the facility as a nursing facility will 271.4 result in a net annual savings to the state general fund of 271.5 $200,000 or more; 271.6 (i) to certify, after September 30, 1992, and prior to July 271.7 1, 1993, existing nursing home beds in a facility that was 271.8 licensed and in operation prior to January 1, 1992; 271.9 (j) to license and certify new nursing home beds to replace 271.10 beds in a facility acquired by the Minneapolis community 271.11 development agency as part of redevelopment activities in a city 271.12 of the first class, provided the new facility is located within 271.13 three miles of the site of the old facility. Operating and 271.14 property costs for the new facility must be determined and 271.15 allowed under section 256B.431 or 256B.434; 271.16 (k) to license and certify up to 20 new nursing home beds 271.17 in a community-operated hospital and attached convalescent and 271.18 nursing care facility with 40 beds on April 21, 1991, that 271.19 suspended operation of the hospital in April 1986. The 271.20 commissioner of human services shall provide the facility with 271.21 the same per diem property-related payment rate for each 271.22 additional licensed and certified bed as it will receive for its 271.23 existing 40 beds; 271.24 (l) to license or certify beds in renovation, replacement, 271.25 or upgrading projects as defined in section 144A.073, 271.26 subdivision 1, so long as the cumulative total costs of the 271.27 facility's remodeling projects do not exceed $1,000,000; 271.28 (m) to license and certify beds that are moved from one 271.29 location to another for the purposes of converting up to five 271.30 four-bed wards to single or double occupancy rooms in a nursing 271.31 home that, as of January 1, 1993, was county-owned and had a 271.32 licensed capacity of 115 beds; 271.33 (n) to allow a facility that on April 16, 1993, was a 271.34 106-bed licensed and certified nursing facility located in 271.35 Minneapolis to layaway all of its licensed and certified nursing 271.36 home beds. These beds may be relicensed and recertified in a 272.1 newly-constructed teaching nursing home facility affiliated with 272.2 a teaching hospital upon approval by the legislature. The 272.3 proposal must be developed in consultation with the interagency 272.4 committee on long-term care planning. The beds on layaway 272.5 status shall have the same status as voluntarily delicensed and 272.6 decertified beds, except that beds on layaway status remain 272.7 subject to the surcharge in section 256.9657. This layaway 272.8 provision expires July 1, 1998; 272.9 (o) to allow a project which will be completed in 272.10 conjunction with an approved moratorium exception project for a 272.11 nursing home in southern Cass county and which is directly 272.12 related to that portion of the facility that must be repaired, 272.13 renovated, or replaced, to correct an emergency plumbing problem 272.14 for which a state correction order has been issued and which 272.15 must be corrected by August 31, 1993; 272.16 (p) to allow a facility that on April 16, 1993, was a 272.17 368-bed licensed and certified nursing facility located in 272.18 Minneapolis to layaway, upon 30 days prior written notice to the 272.19 commissioner, up to 30 of the facility's licensed and certified 272.20 beds by converting three-bed wards to single or double 272.21 occupancy. Beds on layaway status shall have the same status as 272.22 voluntarily delicensed and decertified beds except that beds on 272.23 layaway status remain subject to the surcharge in section 272.24 256.9657, remain subject to the license application and renewal 272.25 fees under section 144A.07 and shall be subject to a $100 per 272.26 bed reactivation fee. In addition, at any time within three 272.27 years of the effective date of the layaway, the beds on layaway 272.28 status may be: 272.29 (1) relicensed and recertified upon relocation and 272.30 reactivation of some or all of the beds to an existing licensed 272.31 and certified facility or facilities located in Pine River, 272.32 Brainerd, or International Falls; provided that the total 272.33 project construction costs related to the relocation of beds 272.34 from layaway status for any facility receiving relocated beds 272.35 may not exceed the dollar threshold provided in subdivision 2 272.36 unless the construction project has been approved through the 273.1 moratorium exception process under section 144A.073; 273.2 (2) relicensed and recertified, upon reactivation of some 273.3 or all of the beds within the facility which placed the beds in 273.4 layaway status, if the commissioner has determined a need for 273.5 the reactivation of the beds on layaway status. 273.6 The property-related payment rate of a facility placing 273.7 beds on layaway status must be adjusted by the incremental 273.8 change in its rental per diem after recalculating the rental per 273.9 diem as provided in section 256B.431, subdivision 3a, paragraph 273.10 (c). The property-related payment rate for a facility 273.11 relicensing and recertifying beds from layaway status must be 273.12 adjusted by the incremental change in its rental per diem after 273.13 recalculating its rental per diem using the number of beds after 273.14 the relicensing to establish the facility's capacity day 273.15 divisor, which shall be effective the first day of the month 273.16 following the month in which the relicensing and recertification 273.17 became effective. Any beds remaining on layaway status more 273.18 than three years after the date the layaway status became 273.19 effective must be removed from layaway status and immediately 273.20 delicensed and decertified; 273.21 (q) to license and certify beds in a renovation and 273.22 remodeling project to convert 12 four-bed wards into 24 two-bed 273.23 rooms, expand space, and add improvements in a nursing home 273.24 that, as of January 1, 1994, met the following conditions: the 273.25 nursing home was located in Ramsey county; had a licensed 273.26 capacity of 154 beds; and had been ranked among the top 15 273.27 applicants by the 1993 moratorium exceptions advisory review 273.28 panel. The total project construction cost estimate for this 273.29 project must not exceed the cost estimate submitted in 273.30 connection with the 1993 moratorium exception process; 273.31 (r) to license and certify up to 117 beds that are 273.32 relocated from a licensed and certified 138-bed nursing facility 273.33 located in St. Paul to a hospital with 130 licensed hospital 273.34 beds located in South St. Paul, provided that the nursing 273.35 facility and hospital are owned by the same or a related 273.36 organization and that prior to the date the relocation is 274.1 completed the hospital ceases operation of its inpatient 274.2 hospital services at that hospital. After relocation, the 274.3 nursing facility's status under section 256B.431, subdivision 274.4 2j, shall be the same as it was prior to relocation. The 274.5 nursing facility's property-related payment rate resulting from 274.6 the project authorized in this paragraph shall become effective 274.7 no earlier than April 1, 1996. For purposes of calculating the 274.8 incremental change in the facility's rental per diem resulting 274.9 from this project, the allowable appraised value of the nursing 274.10 facility portion of the existing health care facility physical 274.11 plant prior to the renovation and relocation may not exceed 274.12 $2,490,000; 274.13 (s) to license and certify two beds in a facility to 274.14 replace beds that were voluntarily delicensed and decertified on 274.15 June 28, 1991; 274.16 (t) to allow 16 licensed and certified beds located on July 274.17 1, 1994, in a 142-bed nursing home and 21-bed boarding care home 274.18 facility in Minneapolis, notwithstanding the licensure and 274.19 certification after July 1, 1995, of the Minneapolis facility as 274.20 a 147-bed nursing home facility after completion of a 274.21 construction project approved in 1993 under section 144A.073, to 274.22 be laid away upon 30 days' prior written notice to the 274.23 commissioner. Beds on layaway status shall have the same status 274.24 as voluntarily delicensed or decertified beds except that they 274.25 shall remain subject to the surcharge in section 256.9657. The 274.26 16 beds on layaway status may be relicensed as nursing home beds 274.27 and recertified at any time within five years of the effective 274.28 date of the layaway upon relocation of some or all of the beds 274.29 to a licensed and certified facility located in Watertown, 274.30 provided that the total project construction costs related to 274.31 the relocation of beds from layaway status for the Watertown 274.32 facility may not exceed the dollar threshold provided in 274.33 subdivision 2 unless the construction project has been approved 274.34 through the moratorium exception process under section 144A.073. 274.35 The property-related payment rate of the facility placing 274.36 beds on layaway status must be adjusted by the incremental 275.1 change in its rental per diem after recalculating the rental per 275.2 diem as provided in section 256B.431, subdivision 3a, paragraph 275.3 (c). The property-related payment rate for the facility 275.4 relicensing and recertifying beds from layaway status must be 275.5 adjusted by the incremental change in its rental per diem after 275.6 recalculating its rental per diem using the number of beds after 275.7 the relicensing to establish the facility's capacity day 275.8 divisor, which shall be effective the first day of the month 275.9 following the month in which the relicensing and recertification 275.10 became effective. Any beds remaining on layaway status more 275.11 than five years after the date the layaway status became 275.12 effective must be removed from layaway status and immediately 275.13 delicensed and decertified; 275.14 (u) to license and certify beds that are moved within an 275.15 existing area of a facility or to a newly constructed addition 275.16 which is built for the purpose of eliminating three- and 275.17 four-bed rooms and adding space for dining, lounge areas, 275.18 bathing rooms, and ancillary service areas in a nursing home 275.19 that, as of January 1, 1995, was located in Fridley and had a 275.20 licensed capacity of 129 beds; 275.21 (v) to relocate 36 beds in Crow Wing county and four beds 275.22 from Hennepin county to a 160-bed facility in Crow Wing county, 275.23 provided all the affected beds are under common ownership; 275.24 (w) to license and certify a total replacement project of 275.25 up to 49 beds located in Norman county that are relocated from a 275.26 nursing home destroyed by flood and whose residents were 275.27 relocated to other nursing homes. The operating cost payment 275.28 rates for the new nursing facility shall be determined based on 275.29 the interim and settle-up payment provisions of Minnesota Rules, 275.30 part 9549.0057, and the reimbursement provisions of section 275.31 256B.431, except that subdivision 26, paragraphs (a) and (b), 275.32 shall not apply until the second rate year after the settle-up 275.33 cost report is filed. Property-related reimbursement rates 275.34 shall be determined under section 256B.431, taking into account 275.35 any federal or state flood-related loans or grants provided to 275.36 the facility; 276.1 (x) to license and certify a total replacement project of 276.2 up to 129 beds located in Polk county that are relocated from a 276.3 nursing home destroyed by flood and whose residents were 276.4 relocated to other nursing homes. The operating cost payment 276.5 rates for the new nursing facility shall be determined based on 276.6 the interim and settle-up payment provisions of Minnesota Rules, 276.7 part 9549.0057, and the reimbursement provisions of section 276.8 256B.431, except that subdivision 26, paragraphs (a) and (b), 276.9 shall not apply until the second rate year after the settle-up 276.10 cost report is filed. Property-related reimbursement rates 276.11 shall be determined under section 256B.431, taking into account 276.12 any federal or state flood-related loans or grants provided to 276.13 the facility; 276.14 (y) to license and certify beds in a renovation and 276.15 remodeling project to convert 13 three-bed wards into 13 two-bed 276.16 rooms and 13 single-bed rooms, expand space, and add 276.17 improvements in a nursing home that, as of January 1, 1994, met 276.18 the following conditions: the nursing home was located in 276.19 Ramsey county, was not owned by a hospital corporation, had a 276.20 licensed capacity of 64 beds, and had been ranked among the top 276.21 15 applicants by the 1993 moratorium exceptions advisory review 276.22 panel. The total project construction cost estimate for this 276.23 project must not exceed the cost estimate submitted in 276.24 connection with the 1993 moratorium exception process; 276.25 (z) to license and certify up to 150 nursing home beds to 276.26 replace an existing 285 bed nursing facility located in St. 276.27 Paul. The replacement project shall include both the renovation 276.28 of existing buildings and the construction of new facilities at 276.29 the existing site. The reduction in the licensed capacity of 276.30 the existing facility shall occur during the construction 276.31 project as beds are taken out of service due to the construction 276.32 process. Prior to the start of the construction process, the 276.33 facility shall provide written information to the commissioner 276.34 of health describing the process for bed reduction, plans for 276.35 the relocation of residents, and the estimated construction 276.36 schedule. The relocation of residents shall be in accordance 277.1 with the provisions of law and rule; 277.2 (aa) to allow the commissioner of human services to license 277.3 an additional 36 beds to provide residential services for the 277.4 physically handicapped under Minnesota Rules, parts 9570.2000 to 277.5 9570.3400, in a 198-bed nursing home located in Red Wing, 277.6 provided that the total number of licensed and certified beds at 277.7 the facility does not increase; 277.8 (bb) to license and certify a new facility in St. Louis 277.9 county with 44 beds constructed to replace an existing facility 277.10 in St. Louis county with 31 beds, which has resident rooms on 277.11 two separate floors and an antiquated elevator that creates 277.12 safety concerns for residents and prevents nonambulatory 277.13 residents from residing on the second floor. The project shall 277.14 include the elimination of three- and four-bed rooms; 277.15 (cc) to license and certify four beds in a 16-bed certified 277.16 boarding care home in Minneapolis to replace beds that were 277.17 voluntarily delicensed and decertified on or before March 31, 277.18 1992. The licensure and certification is conditional upon the 277.19 facility periodically assessing and adjusting its resident mix 277.20 and other factors which may contribute to a potential 277.21 institution for mental disease declaration. The commissioner of 277.22 human services shall retain the authority to audit the facility 277.23 at any time and shall require the facility to comply with any 277.24 requirements necessary to prevent an institution for mental 277.25 disease declaration, including delicensure and decertification 277.26 of beds, if necessary; 277.27 (dd) to license and certify 72 beds in an existing facility 277.28 in Mille Lacs county with 80 beds as part of a renovation 277.29 project. The renovation must include construction of an 277.30 addition to accommodate ten residents with beginning and 277.31 midstage dementia in a self-contained living unit; creation of 277.32 three resident households where dining, activities, and support 277.33 spaces are located near resident living quarters; designation of 277.34 four beds for rehabilitation in a self-contained area; 277.35 designation of 30 private rooms; and other improvements; 277.36 (ee) to license and certify beds in a facility that has 278.1 undergone replacement or remodeling as part of a planned closure 278.2 under section 256B.437; 278.3 (ff) to license and certify a total replacement project of 278.4 up to 124 beds located in Wilkin county that are in need of 278.5 relocation from a nursing home significantly damaged by flood. 278.6 The operating cost payment rates for the new nursing facility 278.7 shall be determined based on the interim and settle-up payment 278.8 provisions of Minnesota Rules, part 9549.0057, and the 278.9 reimbursement provisions of section 256B.431, except that 278.10 section 256B.431, subdivision 26, paragraphs (a) and (b), shall 278.11 not apply until the second rate year after the settle-up cost 278.12 report is filed. Property-related reimbursement rates shall be 278.13 determined under section 256B.431, taking into account any 278.14 federal or state flood-related loans or grants provided to the 278.15 facility; 278.16 (gg) to allow the commissioner of human services to license 278.17 an additional nine beds to provide residential services for the 278.18 physically handicapped under Minnesota Rules, parts 9570.2000 to 278.19 9570.3400, in a 240-bed nursing home located in Duluth, provided 278.20 that the total number of licensed and certified beds at the 278.21 facility does not increase; 278.22 (hh) to license and certify up to 120 new nursing facility 278.23 beds to replace beds in a facility in Anoka county, which was 278.24 licensed for 98 beds as of July 1, 2000, provided the new 278.25 facility is located within four miles of the existing facility 278.26 and is in Anoka county. Operating and property rates shall be 278.27 determined and allowed under section 256B.431 and Minnesota 278.28 Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or 278.29 256B.435. The provisions of section 256B.431, subdivision 26, 278.30 paragraphs (a) and (b), do not apply until the second rate year 278.31 following settle-up;or278.32 (ii) to transfer up to 98 beds of a 129-licensed bed 278.33 facility located in Anoka county that, as of March 25, 2001, is 278.34 in the active process of closing, to a 122-licensed bed 278.35 nonprofit nursing facility located in the city of Columbia 278.36 Heights or its affiliate. The transfer is effective when the 279.1 receiving facility notifies the commissioner in writing of the 279.2 number of beds accepted. The commissioner shall place all 279.3 transferred beds on layaway status held in the name of the 279.4 receiving facility. The layaway adjustment provisions of 279.5 section 256B.431, subdivision 30, do not apply to this layaway. 279.6 The receiving facility may only remove the beds from layaway for 279.7 recertification and relicensure at the receiving facility's 279.8 current site, or at a newly constructed facility located in 279.9 Anoka county. The receiving facility must receive statutory 279.10 authorization before removing these beds from layaway status; or 279.11 (jj) to license and certify beds as part of a project 279.12 involving the construction of a new addition, conversion of 279.13 existing space to a special care unit and short-term 279.14 rehabilitation unit, expansion of dining and activity 279.15 facilities, and related remodeling and improvements, in a 279.16 nursing facility located in Hubbard county licensed for 124 beds 279.17 as of March 3, 2003, provided that the total number of licensed 279.18 and certified beds at the facility does not increase. 279.19 Sec. 10. Minnesota Statutes 2002, section 144A.10, is 279.20 amended by adding a subdivision to read: 279.21 Subd. 16. [INDEPENDENT INFORMAL DISPUTE RESOLUTION.] (a) 279.22 Notwithstanding subdivision 15, a facility certified under the 279.23 federal Medicare or Medicaid programs may request from the 279.24 commissioner, in writing, an independent informal dispute 279.25 resolution process regarding any deficiency citation issued to 279.26 the facility. The facility must specify in its written request 279.27 each deficiency citation that it disputes. The commissioner 279.28 shall provide a hearing under sections 14.57 to 14.62. Upon the 279.29 written request of the facility, the parties must submit the 279.30 issues raised to arbitration by an administrative law judge. 279.31 (b) Upon receipt of a written request for an arbitration 279.32 proceeding, the commissioner shall file with the office of 279.33 administrative hearings a request for the appointment of an 279.34 arbitrator and simultaneously serve the facility with notice of 279.35 the request. The arbitrator for the dispute shall be an 279.36 administrative law judge appointed by the office of 280.1 administrative hearings. The disclosure provisions of section 280.2 572.10 and the notice provisions of section 572.12 apply. The 280.3 facility and the commissioner have the right to be represented 280.4 by an attorney. 280.5 (c) The commissioner and the facility may present written 280.6 evidence, depositions, and oral statements and arguments at the 280.7 arbitration proceeding. Oral statements and arguments may be 280.8 made by telephone. 280.9 (d) Within ten working days of the close of the arbitration 280.10 proceeding, the administrative law judge shall issue findings 280.11 regarding each of the deficiencies in dispute. The findings 280.12 shall be one or more of the following: 280.13 (1) Supported in full. The citation is supported in full, 280.14 with no deletion of findings and no change in the scope or 280.15 severity assigned to the deficiency citation. 280.16 (2) Supported in substance. The citation is supported, but 280.17 one or more findings are deleted without any change in the scope 280.18 or severity assigned to the deficiency. 280.19 (3) Deficient practice cited under wrong requirement of 280.20 participation. The citation is amended by moving it to the 280.21 correct requirement of participation. 280.22 (4) Scope not supported. The citation is amended through a 280.23 change in the scope assigned to the citation. 280.24 (5) Severity not supported. The citation is amended 280.25 through a change in the severity assigned to the citation. 280.26 (6) No deficient practice. The citation is deleted because 280.27 the findings did not support the citation or the negative 280.28 resident outcome was unavoidable. The findings of the 280.29 arbitrator are not binding on the commissioner. 280.30 (e) The commissioner shall reimburse the office of 280.31 administrative hearings for the costs incurred by that office 280.32 for the arbitration proceeding. The facility shall reimburse 280.33 the commissioner for the proportion of the costs that represent 280.34 the sum of deficiency citations supported in full under 280.35 paragraph (d), clause (1), or in substance under paragraph (d), 280.36 clause (2), divided by the total number of deficiencies 281.1 disputed. A deficiency citation for which the administrative 281.2 law judge's sole finding is that the deficient practice was 281.3 cited under the wrong requirements of participation shall not be 281.4 counted in the numerator or denominator in the calculation of 281.5 the proportion of costs. 281.6 [EFFECTIVE DATE.] This section is effective July 1, 2003. 281.7 Sec. 11. [144A.351] [BALANCING LONG-TERM CARE: REPORT 281.8 REQUIRED.] 281.9 The commissioners of health and human services, with the 281.10 cooperation of counties and regional entities, shall prepare a 281.11 report to the legislature by January 15, 2004, and biennially 281.12 thereafter, regarding the status of the full range of long-term 281.13 care services for the elderly in Minnesota. The report shall 281.14 address: 281.15 (1) demographics and need for long-term care in Minnesota; 281.16 (2) summary of county and regional reports on long-term 281.17 care gaps, surpluses, imbalances, and corrective action plans; 281.18 (3) status of long-term care services by county and region 281.19 including: 281.20 (i) changes in availability of the range of long-term care 281.21 services and housing options; 281.22 (ii) access problems regarding long-term care; and 281.23 (iii) comparative measures of long-term care availability 281.24 and progress over time; and 281.25 (4) recommendations regarding goals for the future of 281.26 long-term care services, policy changes, and resource needs. 281.27 Sec. 12. Minnesota Statutes 2002, section 144A.4605, 281.28 subdivision 4, is amended to read: 281.29 Subd. 4. [LICENSE REQUIRED.] (a) A housing with services 281.30 establishment registered under chapter 144D that is required to 281.31 obtain a home care license must obtain an assisted living home 281.32 care license according to this section or a class A or class E 281.33 license according to rule. A housing with services 281.34 establishment that obtains a class E license under this 281.35 subdivision remains subject to the payment limitations in 281.36 sections 256B.0913, subdivision55f, paragraph(h)(b), and 282.1 256B.0915, subdivision3, paragraph (g)3d. 282.2 (b) A board and lodging establishment registered for 282.3 special services as of December 31, 1996, and also registered as 282.4 a housing with services establishment under chapter 144D, must 282.5 deliver home care services according to sections 144A.43 to 282.6 144A.47, and may apply for a waiver from requirements under 282.7 Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a 282.8 licensed agency under the standards of section 157.17. Such 282.9 waivers as may be granted by the department will expire upon 282.10 promulgation of home care rules implementing section 144A.4605. 282.11 (c) An adult foster care provider licensed by the 282.12 department of human services and registered under chapter 144D 282.13 may continue to provide health-related services under its foster 282.14 care license until the promulgation of home care rules 282.15 implementing this section. 282.16 (d) An assisted living home care provider licensed under 282.17 this section must comply with the disclosure provisions of 282.18 section 325F.72 to the extent they are applicable. 282.19 Sec. 13. Minnesota Statutes 2002, section 245A.04, 282.20 subdivision 3b, is amended to read: 282.21 Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a) The 282.22 individual who is the subject of the disqualification may 282.23 request a reconsideration of the disqualification. 282.24 The individual must submit the request for reconsideration 282.25 to the commissioner in writing. A request for reconsideration 282.26 for an individual who has been sent a notice of disqualification 282.27 under subdivision 3a, paragraph (b), clause (1) or (2), must be 282.28 submitted within 30 calendar days of the disqualified 282.29 individual's receipt of the notice of disqualification. Upon 282.30 showing that the information in clause (1) or (2) cannot be 282.31 obtained within 30 days, the disqualified individual may request 282.32 additional time, not to exceed 30 days, to obtain that 282.33 information. A request for reconsideration for an individual 282.34 who has been sent a notice of disqualification under subdivision 282.35 3a, paragraph (b), clause (3), must be submitted within 15 282.36 calendar days of the disqualified individual's receipt of the 283.1 notice of disqualification. An individual who was determined to 283.2 have maltreated a child under section 626.556 or a vulnerable 283.3 adult under section 626.557, and who was disqualified under this 283.4 section on the basis of serious or recurring maltreatment, may 283.5 request reconsideration of both the maltreatment and the 283.6 disqualification determinations. The request for 283.7 reconsideration of the maltreatment determination and the 283.8 disqualification must be submitted within 30 calendar days of 283.9 the individual's receipt of the notice of disqualification. 283.10 Removal of a disqualified individual from direct contact shall 283.11 be ordered if the individual does not request reconsideration 283.12 within the prescribed time, and for an individual who submits a 283.13 timely request for reconsideration, if the disqualification is 283.14 not set aside. The individual must present information showing 283.15 that: 283.16 (1) the information the commissioner relied upon in 283.17 determining that the underlying conduct giving rise to the 283.18 disqualification occurred, and for maltreatment, that the 283.19 maltreatment was serious or recurring, is incorrect; or 283.20 (2) the subject of the study does not pose a risk of harm 283.21 to any person served by the applicant, license holder, or 283.22 registrant under section 144A.71, subdivision 1. 283.23 (b) The commissioner shall rescind the disqualification if 283.24 the commissioner finds that the information relied on to 283.25 disqualify the subject is incorrect. The commissioner may set 283.26 aside the disqualification under this section if the 283.27 commissioner finds that the individual does not pose a risk of 283.28 harm to any person served by the applicant, license holder, or 283.29 registrant under section 144A.71, subdivision 1. In determining 283.30 that an individual does not pose a risk of harm, the 283.31 commissioner shall consider the nature, severity, and 283.32 consequences of the event or events that lead to 283.33 disqualification, whether there is more than one disqualifying 283.34 event, the age and vulnerability of the victim at the time of 283.35 the event, the harm suffered by the victim, the similarity 283.36 between the victim and persons served by the program, the time 284.1 elapsed without a repeat of the same or similar event, 284.2 documentation of successful completion by the individual studied 284.3 of training or rehabilitation pertinent to the event, and any 284.4 other information relevant to reconsideration. In reviewing a 284.5 disqualification under this section, the commissioner shall give 284.6 preeminent weight to the safety of each person to be served by 284.7 the license holder, applicant, or registrant under section 284.8 144A.71, subdivision 1, over the interests of the license 284.9 holder, applicant, or registrant under section 144A.71, 284.10 subdivision 1. 284.11 (c) Unless the information the commissioner relied on in 284.12 disqualifying an individual is incorrect, the commissioner may 284.13 not set aside the disqualification of an individual in 284.14 connection with a license to provide family day care for 284.15 children, foster care for children in the provider's own home, 284.16 or foster care or day care services for adults in the provider's 284.17 own home if: 284.18 (1) less than ten years have passed since the discharge of 284.19 the sentence imposed for the offense; and the individual has 284.20 been convicted of a violation of any offense listed in sections 284.21 609.165 (felon ineligible to possess firearm), criminal 284.22 vehicular homicide under 609.21 (criminal vehicular homicide and 284.23 injury), 609.215 (aiding suicide or aiding attempted suicide), 284.24 felony violations under 609.223 or 609.2231 (assault in the 284.25 third or fourth degree), 609.713 (terroristic threats), 609.235 284.26 (use of drugs to injure or to facilitate crime), 609.24 (simple 284.27 robbery), 609.255 (false imprisonment), 609.562 (arson in the 284.28 second degree), 609.71 (riot), 609.498, subdivision 1 or1a284.29 1b (aggravated first degree or first degree tampering with a 284.30 witness), burglary in the first or second degree under 609.582 284.31 (burglary), 609.66 (dangerous weapon), 609.665 (spring guns), 284.32 609.67 (machine guns and short-barreled shotguns), 609.749, 284.33 subdivision 2 (gross misdemeanor harassment; stalking), 152.021 284.34 or 152.022 (controlled substance crime in the first or second 284.35 degree), 152.023, subdivision 1, clause (3) or (4), or 284.36 subdivision 2, clause (4) (controlled substance crime in the 285.1 third degree), 152.024, subdivision 1, clause (2), (3), or (4) 285.2 (controlled substance crime in the fourth degree), 609.224, 285.3 subdivision 2, paragraph (c) (fifth-degree assault by a 285.4 caregiver against a vulnerable adult), 609.23 (mistreatment of 285.5 persons confined), 609.231 (mistreatment of residents or 285.6 patients), 609.2325 (criminal abuse of a vulnerable adult), 285.7 609.233 (criminal neglect of a vulnerable adult), 609.2335 285.8 (financial exploitation of a vulnerable adult), 609.234 (failure 285.9 to report), 609.265 (abduction), 609.2664 to 609.2665 285.10 (manslaughter of an unborn child in the first or second degree), 285.11 609.267 to 609.2672 (assault of an unborn child in the first, 285.12 second, or third degree), 609.268 (injury or death of an unborn 285.13 child in the commission of a crime), 617.293 (disseminating or 285.14 displaying harmful material to minors), a felony level 285.15 conviction involving alcohol or drug use, a gross misdemeanor 285.16 offense under 609.324, subdivision 1 (other prohibited acts), a 285.17 gross misdemeanor offense under 609.378 (neglect or endangerment 285.18 of a child), a gross misdemeanor offense under 609.377 285.19 (malicious punishment of a child), 609.72, subdivision 3 285.20 (disorderly conduct against a vulnerable adult); or an attempt 285.21 or conspiracy to commit any of these offenses, as each of these 285.22 offenses is defined in Minnesota Statutes; or an offense in any 285.23 other state, the elements of which are substantially similar to 285.24 the elements of any of the foregoing offenses; 285.25 (2) regardless of how much time has passed since the 285.26 involuntary termination of parental rights under section 285.27 260C.301 or the discharge of the sentence imposed for the 285.28 offense, the individual was convicted of a violation of any 285.29 offense listed in sections 609.185 to 609.195 (murder in the 285.30 first, second, or third degree), 609.20 (manslaughter in the 285.31 first degree), 609.205 (manslaughter in the second degree), 285.32 609.245 (aggravated robbery), 609.25 (kidnapping), 609.561 285.33 (arson in the first degree), 609.749, subdivision 3, 4, or 5 285.34 (felony-level harassment; stalking), 609.228 (great bodily harm 285.35 caused by distribution of drugs), 609.221 or 609.222 (assault in 285.36 the first or second degree), 609.66, subdivision 1e (drive-by 286.1 shooting), 609.855, subdivision 5 (shooting in or at a public 286.2 transit vehicle or facility), 609.2661 to 609.2663 (murder of an 286.3 unborn child in the first, second, or third degree), a felony 286.4 offense under 609.377 (malicious punishment of a child), a 286.5 felony offense under 609.324, subdivision 1 (other prohibited 286.6 acts), a felony offense under 609.378 (neglect or endangerment 286.7 of a child), 609.322 (solicitation, inducement, and promotion of 286.8 prostitution), 609.342 to 609.345 (criminal sexual conduct in 286.9 the first, second, third, or fourth degree), 609.352 286.10 (solicitation of children to engage in sexual conduct), 617.246 286.11 (use of minors in a sexual performance), 617.247 (possession of 286.12 pictorial representations of a minor), 609.365 (incest), a 286.13 felony offense under sections 609.2242 and 609.2243 (domestic 286.14 assault), a felony offense of spousal abuse, a felony offense of 286.15 child abuse or neglect, a felony offense of a crime against 286.16 children, or an attempt or conspiracy to commit any of these 286.17 offenses as defined in Minnesota Statutes, or an offense in any 286.18 other state, the elements of which are substantially similar to 286.19 any of the foregoing offenses; 286.20 (3) within the seven years preceding the study, the 286.21 individual committed an act that constitutes maltreatment of a 286.22 child under section 626.556, subdivision 10e, and that resulted 286.23 in substantial bodily harm as defined in section 609.02, 286.24 subdivision 7a, or substantial mental or emotional harm as 286.25 supported by competent psychological or psychiatric evidence; or 286.26 (4) within the seven years preceding the study, the 286.27 individual was determined under section 626.557 to be the 286.28 perpetrator of a substantiated incident of maltreatment of a 286.29 vulnerable adult that resulted in substantial bodily harm as 286.30 defined in section 609.02, subdivision 7a, or substantial mental 286.31 or emotional harm as supported by competent psychological or 286.32 psychiatric evidence. 286.33 In the case of any ground for disqualification under 286.34 clauses (1) to (4), if the act was committed by an individual 286.35 other than the applicant, license holder, or registrant under 286.36 section 144A.71, subdivision 1, residing in the applicant's or 287.1 license holder's home, or the home of a registrant under section 287.2 144A.71, subdivision 1, the applicant, license holder, or 287.3 registrant under section 144A.71, subdivision 1, may seek 287.4 reconsideration when the individual who committed the act no 287.5 longer resides in the home. 287.6 The disqualification periods provided under clauses (1), 287.7 (3), and (4) are the minimum applicable disqualification 287.8 periods. The commissioner may determine that an individual 287.9 should continue to be disqualified from licensure or 287.10 registration under section 144A.71, subdivision 1, because the 287.11 license holder, applicant, or registrant under section 144A.71, 287.12 subdivision 1, poses a risk of harm to a person served by that 287.13 individual after the minimum disqualification period has passed. 287.14 (d) The commissioner shall respond in writing or by 287.15 electronic transmission to all reconsideration requests for 287.16 which the basis for the request is that the information relied 287.17 upon by the commissioner to disqualify is incorrect or 287.18 inaccurate within 30 working days of receipt of a request and 287.19 all relevant information. If the basis for the request is that 287.20 the individual does not pose a risk of harm, the commissioner 287.21 shall respond to the request within 15 working days after 287.22 receiving the request for reconsideration and all relevant 287.23 information. If the request is based on both the correctness or 287.24 accuracy of the information relied on to disqualify the 287.25 individual and the risk of harm, the commissioner shall respond 287.26 to the request within 45 working days after receiving the 287.27 request for reconsideration and all relevant information. If 287.28 the disqualification is set aside, the commissioner shall notify 287.29 the applicant or license holder in writing or by electronic 287.30 transmission of the decision. 287.31 (e) Except as provided in subdivision 3c, if a 287.32 disqualification for which reconsideration was requested is not 287.33 set aside or is not rescinded, an individual who was 287.34 disqualified on the basis of a preponderance of evidence that 287.35 the individual committed an act or acts that meet the definition 287.36 of any of the crimes listed in subdivision 3d, paragraph (a), 288.1 clauses (1) to (4); or for failure to make required reports 288.2 under section 626.556, subdivision 3, or 626.557, subdivision 3, 288.3 pursuant to subdivision 3d, paragraph (a), clause (4), may 288.4 request a fair hearing under section 256.045. Except as 288.5 provided under subdivision 3c, the fair hearing is the only 288.6 administrative appeal of the final agency determination, 288.7 specifically, including a challenge to the accuracy and 288.8 completeness of data under section 13.04. 288.9 (f) Except as provided under subdivision 3c, if an 288.10 individual was disqualified on the basis of a determination of 288.11 maltreatment under section 626.556 or 626.557, which was serious 288.12 or recurring, and the individual has requested reconsideration 288.13 of the maltreatment determination under section 626.556, 288.14 subdivision 10i, or 626.557, subdivision 9d, and also requested 288.15 reconsideration of the disqualification under this subdivision, 288.16 reconsideration of the maltreatment determination and 288.17 reconsideration of the disqualification shall be consolidated 288.18 into a single reconsideration. For maltreatment and 288.19 disqualification determinations made by county agencies, the 288.20 consolidated reconsideration shall be conducted by the county 288.21 agency. If the county agency has disqualified an individual on 288.22 multiple bases, one of which is a county maltreatment 288.23 determination for which the individual has a right to request 288.24 reconsideration, the county shall conduct the reconsideration of 288.25 all disqualifications. Except as provided under subdivision 3c, 288.26 if an individual who was disqualified on the basis of serious or 288.27 recurring maltreatment requests a fair hearing on the 288.28 maltreatment determination under section 626.556, subdivision 288.29 10i, or 626.557, subdivision 9d, and requests a fair hearing on 288.30 the disqualification, which has not been set aside or rescinded 288.31 under this subdivision, the scope of the fair hearing under 288.32 section 256.045 shall include the maltreatment determination and 288.33 the disqualification. Except as provided under subdivision 3c, 288.34 a fair hearing is the only administrative appeal of the final 288.35 agency determination, specifically, including a challenge to the 288.36 accuracy and completeness of data under section 13.04. 289.1 (g) In the notice from the commissioner that a 289.2 disqualification has been set aside, the license holder must be 289.3 informed that information about the nature of the 289.4 disqualification and which factors under paragraph (b) were the 289.5 bases of the decision to set aside the disqualification is 289.6 available to the license holder upon request without consent of 289.7 the background study subject. With the written consent of a 289.8 background study subject, the commissioner may release to the 289.9 license holder copies of all information related to the 289.10 background study subject's disqualification and the 289.11 commissioner's decision to set aside the disqualification as 289.12 specified in the written consent. 289.13 Sec. 14. Minnesota Statutes 2002, section 256.9657, 289.14 subdivision 1, is amended to read: 289.15 Subdivision 1. [NURSING HOME LICENSE SURCHARGE.] (a) 289.16 Effective July 1, 1993, each non-state-operated nursing home 289.17 licensed under chapter 144A shall pay to the commissioner an 289.18 annual surcharge according to the schedule in subdivision 4. 289.19 The surcharge shall be calculated as $620 per licensed bed. If 289.20 the number of licensed beds is reduced, the surcharge shall be 289.21 based on the number of remaining licensed beds the second month 289.22 following the receipt of timely notice by the commissioner of 289.23 human services that beds have been delicensed. The nursing home 289.24 must notify the commissioner of health in writing when beds are 289.25 delicensed. The commissioner of health must notify the 289.26 commissioner of human services within ten working days after 289.27 receiving written notification. If the notification is received 289.28 by the commissioner of human services by the 15th of the month, 289.29 the invoice for the second following month must be reduced to 289.30 recognize the delicensing of beds. Beds on layaway status 289.31 continue to be subject to the surcharge. The commissioner of 289.32 human services must acknowledge a medical care surcharge appeal 289.33 within 30 days of receipt of the written appeal from the 289.34 provider. 289.35 (b) Effective July 1, 1994, the surcharge in paragraph (a) 289.36 shall be increased to $625. 290.1 (c) Effective August 15, 2002, the surcharge under 290.2 paragraph (b) shall be increased to $990. 290.3 (d) Effective July 15, 2003, the surcharge under paragraph 290.4 (c) shall be increased to $2,700. 290.5 (e) The commissioner may reduce, and may subsequently 290.6 restore, the surcharge under paragraph (d) based on the 290.7 commissioner's determination of a permissible surcharge. 290.8 (f) Between April 1, 2002, and August 15,20032004, a 290.9 facility governed by this subdivision may elect to assume full 290.10 participation in the medical assistance program by agreeing to 290.11 comply with all of the requirements of the medical assistance 290.12 program, including the rate equalization law in section 256B.48, 290.13 subdivision 1, paragraph (a), and all other requirements 290.14 established in law or rule, and to begin intake of new medical 290.15 assistance recipients. Rates will be determined under Minnesota 290.16 Rules, parts 9549.0010 to 9549.0080. Notwithstanding section 290.17 256B.431, subdivision 27, paragraph (i), rate calculations will 290.18 be subject to limits as prescribed in rule and law. Other than 290.19 the adjustments in sections 256B.431, subdivisions 30 and 32; 290.20 256B.437, subdivision 3, paragraph (b), Minnesota Rules, part 290.21 9549.0057, and any other applicable legislation enacted prior to 290.22 the finalization of rates, facilities assuming full 290.23 participation in medical assistance under this paragraph are not 290.24 eligible for any rate adjustments until the July 1 following 290.25 their settle-up period. 290.26 [EFFECTIVE DATE.] This section is effective June 30, 2003. 290.27 Sec. 15. Minnesota Statutes 2002, section 256.9657, is 290.28 amended by adding a subdivision to read: 290.29 Subd. 3a. [ICF/MR LICENSE SURCHARGE.] Effective July 1, 290.30 2003, each nonstate-operated facility as defined under section 290.31 256B.501, subdivision 1, shall pay to the commissioner an annual 290.32 surcharge according to the schedule in subdivision 4, paragraph 290.33 (d). The annual surcharge shall be $1,040 per licensed bed. If 290.34 the number of licensed beds is reduced, the surcharge shall be 290.35 based on the number of remaining licensed beds the second month 290.36 following the receipt of timely notice by the commissioner of 291.1 human services that beds have been delicensed. The facility 291.2 must notify the commissioner of health in writing when beds are 291.3 delicensed. The commissioner of health must notify the 291.4 commissioner of human services within ten working days after 291.5 receiving written notification. If the notification is received 291.6 by the commissioner of human services by the 15th of the month, 291.7 the invoice for the second following month must be reduced to 291.8 recognize the delicensing of beds. The commissioner may reduce, 291.9 and may subsequently restore, the surcharge under this 291.10 subdivision based on the commissioner's determination of a 291.11 permissible surcharge. 291.12 Sec. 16. Minnesota Statutes 2002, section 256.9657, 291.13 subdivision 4, is amended to read: 291.14 Subd. 4. [PAYMENTS INTO THE ACCOUNT.] (a) Payments to the 291.15 commissioner under subdivisions 1 to 3 must be paid in monthly 291.16 installments due on the 15th of the month beginning October 15, 291.17 1992. The monthly payment must be equal to the annual surcharge 291.18 divided by 12. Payments to the commissioner under subdivisions 291.19 2 and 3 for fiscal year 1993 must be based on calendar year 1990 291.20 revenues. Effective July 1 of each year, beginning in 1993, 291.21 payments under subdivisions 2 and 3 must be based on revenues 291.22 earned in the second previous calendar year. 291.23 (b) Effective October 1, 1995, and each October 1 291.24 thereafter, the payments in subdivisions 2 and 3 must be based 291.25 on revenues earned in the previous calendar year. 291.26 (c) If the commissioner of health does not provide by 291.27 August 15 of any year data needed to update the base year for 291.28 the hospital and health maintenance organization surcharges, the 291.29 commissioner of human services may estimate base year revenue 291.30 and use that estimate for the purposes of this section until 291.31 actual data is provided by the commissioner of health. 291.32 (d) Payments to the commissioner under subdivision 3a must 291.33 be paid in monthly installments due on the 15th of the month 291.34 beginning August 15, 2003. The monthly payment must be equal to 291.35 the annual surcharge divided by 12. 291.36 Sec. 17. Minnesota Statutes 2002, section 256.9754, 292.1 subdivision 2, is amended to read: 292.2 Subd. 2. [CREATION.]The community services development292.3grants programThere is createdunder the administration of the292.4commissioner of human servicesthe consolidated ElderCare 292.5 development grant fund for the purpose of rebalancing the 292.6 long-term care system and increasing home and community-based 292.7 care alternatives that sustain independent living. 292.8 Sec. 18. Minnesota Statutes 2002, section 256.9754, 292.9 subdivision 3, is amended to read: 292.10 Subd. 3. [PROVISION OF GRANTS.]The commissioner shall292.11make grants available to communities, providers of older adult292.12services identified in subdivision 1, or to a consortium of292.13providers of older adult services, to establish older adult292.14services.Grants may be provided for capital and other costs 292.15 including, but not limited to, start-up and training costs, 292.16 equipment, and supplies related to older adult services or other 292.17 residential or service alternatives to nursing facility care. 292.18 Grants may also be made to renovate current buildings, provide 292.19 transportation services, fund programs that would allow older 292.20 adults or disabled individuals to stay in their own homes by 292.21 sharing a home, fund programs that coordinate and manage formal 292.22 and informal services to older adults in their homes to enable 292.23 them to live as independently as possible in their own homes as 292.24 an alternative to nursing home care, or expand state-funded 292.25 programs in the area. Other services eligible for funding 292.26 include: transportation; chore services and homemaking; home 292.27 health care and personal care assistance; care coordination; 292.28 housing with services, such as assisted living and foster care; 292.29 home modification; adult day services; caregiver support and 292.30 respite; living-at-home block nurse; service integration and 292.31 development; telemedicine, telehomecare, or other 292.32 technology-based solutions; grocery shopping; and services 292.33 identified as needed for community transition. 292.34 Sec. 19. Minnesota Statutes 2002, section 256.9754, 292.35 subdivision 4, is amended to read: 292.36 Subd. 4. [ELIGIBILITY.] Grants may be awarded only to 293.1 communities and providers, including for-profits, nonprofits, 293.2 and governmental units, or to a consortium of providers that 293.3 have a local match of 25 percent in the form of cash or in-kind 293.4 services, except that for capital costs the match is 50 percent 293.5of the costs for the project in the form of donations, local tax293.6dollars, in-kind donations, fund-raising, or other local matches. 293.7 Sec. 20. Minnesota Statutes 2002, section 256.9754, 293.8 subdivision 5, is amended to read: 293.9 Subd. 5. [GRANT PREFERENCE.] The commissionerof human293.10servicesshall give preference when awarding grants under this 293.11 section to areas where nursing facility closures have occurred 293.12 or are occurring. The commissioner may award grants to the 293.13 extent grant funds are available and to the extent applications 293.14 are approved by the commissioner. Denial of approval of an 293.15 application in one year does not preclude submission of an 293.16 application in a subsequent year.The maximum grant amount is293.17limited to $750,000.293.18 Sec. 21. Minnesota Statutes 2002, section 256B.056, 293.19 subdivision 6, is amended to read: 293.20 Subd. 6. [ASSIGNMENT OF BENEFITS.] To be eligible for 293.21 medical assistance a person must have applied or must agree to 293.22 apply all proceeds received or receivable by the person or the 293.23 person'sspouselegal representative from any thirdpersonparty 293.24 liable for the costs of medical carefor the person, the spouse,293.25and children.The state agency shall require from any applicant293.26or recipient of medical assistance the assignment of any rights293.27to medical support and third party payments.By accepting or 293.28 receiving assistance, the person is deemed to have assigned the 293.29 person's rights to medical support and third party payments as 293.30 required by Title 19 of the Social Security Act. Persons must 293.31 cooperate with the state in establishing paternity and obtaining 293.32 third party payments. Bysigning an application foraccepting 293.33 medical assistance, a person assigns to the department of human 293.34 services all rights the person may have to medical support or 293.35 payments for medical expenses from any other person or entity on 293.36 their own or their dependent's behalf and agrees to cooperate 294.1 with the state in establishing paternity and obtaining third 294.2 party payments. Any rights or amounts so assigned shall be 294.3 applied against the cost of medical care paid for under this 294.4 chapter. Any assignment takes effect upon the determination 294.5 that the applicant is eligible for medical assistance and up to 294.6 three months prior to the date of application if the applicant 294.7 is determined eligible for and receives medical assistance 294.8 benefits. The application must contain a statement explaining 294.9 this assignment.Any assignment shall not be effective as to294.10benefits paid or provided under automobile accident coverage and294.11private health care coverage prior to notification of the294.12assignment by the person or organization providing the294.13benefits.For the purposes of this section, "the department of 294.14 human services or the state" includes prepaid health plans under 294.15 contract with the commissioner according to sections 256B.031, 294.16 256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 294.17 children's mental health collaboratives under section 245.493; 294.18 demonstration projects for persons with disabilities under 294.19 section 256B.77; nursing facilities under the alternative 294.20 payment demonstration project under section 256B.434; and the 294.21 county-based purchasing entities under section 256B.692. 294.22 Sec. 22. Minnesota Statutes 2002, section 256B.064, 294.23 subdivision 2, is amended to read: 294.24 Subd. 2. [IMPOSITION OF MONETARY RECOVERY AND SANCTIONS.] 294.25 (a) The commissioner shall determine any monetary amounts to be 294.26 recovered and sanctions to be imposed upon a vendor of medical 294.27 care under this section. Except as provided in 294.28paragraphparagraphs (b) and (d), neither a monetary recovery 294.29 nor a sanction will be imposed by the commissioner without prior 294.30 notice and an opportunity for a hearing, according to chapter 294.31 14, on the commissioner's proposed action, provided that the 294.32 commissioner may suspend or reduce payment to a vendor of 294.33 medical care, except a nursing home or convalescent care 294.34 facility, after notice and prior to the hearing if in the 294.35 commissioner's opinion that action is necessary to protect the 294.36 public welfare and the interests of the program. 295.1 (b) Except for a nursing home or convalescent care 295.2 facility, the commissioner may withhold or reduce payments to a 295.3 vendor of medical care without providing advance notice of such 295.4 withholding or reduction if either of the following occurs: 295.5 (1) the vendor is convicted of a crime involving the 295.6 conduct described in subdivision 1a; or 295.7 (2) the commissioner receives reliable evidence of fraud or 295.8 willful misrepresentation by the vendor. 295.9 (c) The commissioner must send notice of the withholding or 295.10 reduction of payments under paragraph (b) within five days of 295.11 taking such action. The notice must: 295.12 (1) state that payments are being withheld according to 295.13 paragraph (b); 295.14 (2) except in the case of a conviction for conduct 295.15 described in subdivision 1a, state that the withholding is for a 295.16 temporary period and cite the circumstances under which 295.17 withholding will be terminated; 295.18 (3) identify the types of claims to which the withholding 295.19 applies; and 295.20 (4) inform the vendor of the right to submit written 295.21 evidence for consideration by the commissioner. 295.22 The withholding or reduction of payments will not continue 295.23 after the commissioner determines there is insufficient evidence 295.24 of fraud or willful misrepresentation by the vendor, or after 295.25 legal proceedings relating to the alleged fraud or willful 295.26 misrepresentation are completed, unless the commissioner has 295.27 sent notice of intention to impose monetary recovery or 295.28 sanctions under paragraph (a). 295.29 (d) The commissioner may suspend or terminate a vendor's 295.30 participation in the program without providing advance notice 295.31 and an opportunity for a hearing when the suspension or 295.32 termination is required because of the vendor's exclusion from 295.33 participation in Medicare. Within five days of taking such 295.34 action, the commissioner must send notice of the suspension or 295.35 termination. The notice must: 295.36 (1) state that suspension or termination is the result of 296.1 the vendor's exclusion from Medicare; 296.2 (2) identify the effective date of the suspension or 296.3 termination; 296.4 (3) inform the vendor of the need to be reinstated to 296.5 Medicare before reapplying for participation in the program; and 296.6 (4) inform the vendor of the right to submit written 296.7 evidence for consideration by the commissioner. 296.8 (e) Upon receipt of a notice under paragraph (a) that a 296.9 monetary recovery or sanction is to be imposed, a vendor may 296.10 request a contested case, as defined in section 14.02, 296.11 subdivision 3, by filing with the commissioner a written request 296.12 of appeal. The appeal request must be received by the 296.13 commissioner no later than 30 days after the date the 296.14 notification of monetary recovery or sanction was mailed to the 296.15 vendor. The appeal request must specify: 296.16 (1) each disputed item, the reason for the dispute, and an 296.17 estimate of the dollar amount involved for each disputed item; 296.18 (2) the computation that the vendor believes is correct; 296.19 (3) the authority in statute or rule upon which the vendor 296.20 relies for each disputed item; 296.21 (4) the name and address of the person or entity with whom 296.22 contacts may be made regarding the appeal; and 296.23 (5) other information required by the commissioner. 296.24 Sec. 23. Minnesota Statutes 2002, section 256B.0913, 296.25 subdivision 2, is amended to read: 296.26 Subd. 2. [ELIGIBILITY FOR SERVICES.] Alternative care 296.27 services are available to Minnesotans age 65 or olderwho are296.28not eligible for medical assistance without a spenddown or296.29waiver obligation butwho would be eligible for medical 296.30 assistance within 180 days of admission to a nursing facility 296.31 and subject to subdivisions 4 to 13. 296.32 Sec. 24. Minnesota Statutes 2002, section 256B.0913, 296.33 subdivision 4, is amended to read: 296.34 Subd. 4. [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 296.35 NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 296.36 under the alternative care program is available to persons who 297.1 meet the following criteria: 297.2 (1) the person has been determined by a community 297.3 assessment under section 256B.0911 to be a person who would 297.4 require the level of care provided in a nursing facility, but 297.5 for the provision of services under the alternative care 297.6 program; 297.7 (2) the person is age 65 or older; 297.8 (3) the person would be eligible for medical assistance 297.9 within 180 days of admission to a nursing facility; 297.10 (4) the person is not ineligible for the medical assistance 297.11 program due to an asset transfer penalty; 297.12 (5) the person needs services that are not funded through 297.13 other state or federal funding;and297.14 (6) the monthly cost of the alternative care services 297.15 funded by the program for this person does not exceed 75 percent 297.16 of thestatewide weighted average monthly nursing facility rate297.17of the case mix resident class to which the individual297.18alternative care client would be assigned under Minnesota Rules,297.19parts 9549.0050 to 9549.0059, less the recipient's maintenance297.20needs allowance as described in section 256B.0915, subdivision297.211d, paragraph (a), until the first day of the state fiscal year297.22in which the resident assessment system, under section 256B.437,297.23for nursing home rate determination is implemented. Effective297.24on the first day of the state fiscal year in which a resident297.25assessment system, under section 256B.437, for nursing home rate297.26determination is implemented and the first day of each297.27subsequent state fiscal year, the monthly cost of alternative297.28care services for this person shall not exceed the alternative297.29care monthly cap for the case mix resident class to which the297.30alternative care client would be assigned under Minnesota Rules,297.31parts 9549.0050 to 9549.0059, which was in effect on the last297.32day of the previous state fiscal year, and adjusted by the297.33greater of any legislatively adopted home and community-based297.34services cost-of-living percentage increase or any legislatively297.35adopted statewide percent rate increase for nursing297.36facilitiesmonthly limit described under section 256B.0915, 298.1 subdivision 3a. This monthly limit does not prohibit the 298.2 alternative care client from payment for additional services, 298.3 but in no case may the cost of additional services purchased 298.4 under this section exceed the difference between the client's 298.5 monthly service limit defined under section 256B.0915, 298.6 subdivision 3, and the alternative care program monthly service 298.7 limit defined in this paragraph. If medical supplies and 298.8 equipment or environmental modifications are or will be 298.9 purchased for an alternative care services recipient, the costs 298.10 may be prorated on a monthly basis for up to 12 consecutive 298.11 months beginning with the month of purchase. If the monthly 298.12 cost of a recipient's other alternative care services exceeds 298.13 the monthly limit established in this paragraph, the annual cost 298.14 of the alternative care services shall be determined. In this 298.15 event, the annual cost of alternative care services shall not 298.16 exceed 12 times the monthly limit described in this paragraph.; 298.17 and 298.18 (7) the person is making timely payments of the assessed 298.19 monthly premium charge. A person is ineligible if payment or 298.20 the assessed monthly premium charge is over 60 days past due. 298.21 Following disenrollment due to nonpayment of a monthly premium, 298.22 eligibility shall not be reinstated for a period of 90 days 298.23 pending eligibility redetermination. 298.24 (b) Alternative care funding under this subdivision is not 298.25 available for a person who is a medical assistance recipient or 298.26 who would be eligible for medical assistance without a spenddown 298.27 or waiver obligation. A person whose initial application for 298.28 medical assistance and the elderly waiver program is being 298.29 processed may be served under the alternative care program for a 298.30 period up to 60 days. If the individual is found to be eligible 298.31 for medical assistance, medical assistance must be billed for 298.32 services payable under the federally approved elderly waiver 298.33 plan and delivered from the date the individual was found 298.34 eligible for the federally approved elderly waiver plan. 298.35 Notwithstanding this provision,upon federal approval,298.36 alternative care funds may not be used to pay for any service 299.1 the cost of which: (i) is payable by medical assistanceor299.2which; (ii) is used by a recipient to meet amedical assistance299.3income spenddown orwaiver obligation; or (iii) is used to pay a 299.4 medical assistance income spenddown for a person who is eligible 299.5 to participate in the federally approved elderly waiver program 299.6 under the special income standard provision. 299.7 (c) Alternative care funding is not available for a person 299.8 who resides in a licensed nursing home, certified boarding care 299.9 home, hospital, or intermediate care facility, except for case 299.10 management services which are provided in support of the 299.11 discharge planning processtofor a nursing home resident or 299.12 certified boarding care home resident to assist with a 299.13 relocation process to a community-based setting. 299.14 (d) Alternative care funding is not available for a person 299.15 whose income is greater than the maintenance needs allowance 299.16 under section 256B.0915, subdivision 1d, but equal to or less 299.17 than 120 percent of the federal poverty guideline effective July 299.18 1, in the year for which alternative care eligibility is 299.19 determined, who would be eligible for the elderly waiver with a 299.20 waiver obligation. 299.21 Sec. 25. Minnesota Statutes 2002, section 256B.0913, 299.22 subdivision 5, is amended to read: 299.23 Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.](a)299.24 Alternative care funding may be used for payment of costs of: 299.25 (1) adult foster care; 299.26 (2) adult day care; 299.27 (3) home health aide; 299.28 (4) homemaker services; 299.29 (5) personal care; 299.30 (6) case management; 299.31 (7) respite care; 299.32 (8) assisted living; 299.33 (9) residential care services; 299.34 (10) care-related supplies and equipment; 299.35 (11) meals delivered to the home; 299.36 (12) transportation; 300.1 (13) nursing services; 300.2 (14) chore services; 300.3 (15) companion services; 300.4 (16) nutrition services; 300.5 (17) training for direct informal caregivers; 300.6 (18) telehome caredevicestomonitor recipientsprovide 300.7 services in their own homesas an alternative to hospital care,300.8nursing home care, or homein conjunction with in-home visits; 300.9 (19)other services which includesdiscretionaryfunds and300.10direct cash payments to clients,services, for which counties 300.11 may make payment from their alternative care program allocation 300.12 or services not otherwise defined in this section or section 300.13 256B.0625, following approval by the commissioner, subject to300.14the provisions of paragraph (j). Total annual payments for300.15"other services" for all clients within a county may not exceed300.1625 percent of that county's annual alternative care program base300.17allocation;and300.18 (20) environmental modifications.; and 300.19 (21) direct cash payments for which counties may make 300.20 payment from their alternative care program allocation to 300.21 clients for the purpose of purchasing services, following 300.22 approval by the commissioner, and subject to the provisions of 300.23 subdivision 5h, until approval and implementation of 300.24 consumer-directed services through the federally approved 300.25 elderly waiver plan. Upon implementation, consumer-directed 300.26 services under the alternative care program are available 300.27 statewide and limited to the average monthly expenditures 300.28 representative of all alternative care program participants for 300.29 the same case mix resident class assigned in the most recent 300.30 fiscal year for which complete expenditure data is available. 300.31 Total annual payments for discretionary services and direct 300.32 cash payments, until the federally approved consumer-directed 300.33 service option is implemented statewide, for all clients within 300.34 a county may not exceed 25 percent of that county's annual 300.35 alternative care program base allocation. Thereafter, 300.36 discretionary services are limited to 25 percent of the county's 301.1 annual alternative care program base allocation. 301.2 Subd. 5a. [SERVICES; SERVICE DEFINITIONS; SERVICE 301.3 STANDARDS.] (a) Unless specified in statute, the services, 301.4 service definitions, and standards for alternative care services 301.5 shall be the same as the services, service definitions, and 301.6 standards specified in the federally approved elderly waiver 301.7 plan, except for transitional support services. 301.8 (b) The county agency must ensure that the funds are not 301.9 used to supplant services available through other public 301.10 assistance or services programs. 301.11(c) Unless specified in statute, the services, service301.12definitions, and standards for alternative care services shall301.13be the same as the services, service definitions, and standards301.14specified in the federally approved elderly waiver plan. Except301.15for the county agencies' approval of direct cash payments to301.16clients as described in paragraph (j) orFor a provider of 301.17 supplies and equipment when the monthly cost of the supplies and 301.18 equipment is less than $250, persons or agencies must be 301.19 employed by or under a contract with the county agency or the 301.20 public health nursing agency of the local board of health in 301.21 order to receive funding under the alternative care program. 301.22 Supplies and equipment may be purchased from a vendor not 301.23 certified to participate in the Medicaid program if the cost for 301.24 the item is less than that of a Medicaid vendor. 301.25 (c) Personal care services must meet the service standards 301.26 defined in the federally approved elderly waiver plan, except 301.27 that a county agency may contract with a client's relative who 301.28 meets the relative hardship waiver requirements or a relative 301.29 who meets the criteria and is also the responsible party under 301.30 an individual service plan that ensures the client's health and 301.31 safety and supervision of the personal care services by a 301.32 qualified professional as defined in section 256B.0625, 301.33 subdivision 19c. Relative hardship is established by the county 301.34 when the client's care causes a relative caregiver to do any of 301.35 the following: resign from a paying job, reduce work hours 301.36 resulting in lost wages, obtain a leave of absence resulting in 302.1 lost wages, incur substantial client-related expenses, provide 302.2 services to address authorized, unstaffed direct care time, or 302.3 meet special needs of the client unmet in the formal service 302.4 plan. 302.5(d)Subd. 5b. [ADULT FOSTER CARE RATE.] The adult foster 302.6 care rate shall be considered a difficulty of care payment and 302.7 shall not include room and board. The adult foster care rate 302.8 shall be negotiated between the county agency and the foster 302.9 care provider. The alternative care payment for the foster care 302.10 service in combination with the payment for other alternative 302.11 care services, including case management, must not exceed the 302.12 limit specified in subdivision 4, paragraph (a), clause (6). 302.13(e) Personal care services must meet the service standards302.14defined in the federally approved elderly waiver plan, except302.15that a county agency may contract with a client's relative who302.16meets the relative hardship waiver requirement as defined in302.17section 256B.0627, subdivision 4, paragraph (b), clause (10), to302.18provide personal care services if the county agency ensures302.19supervision of this service by a qualified professional as302.20defined in section 256B.0625, subdivision 19c.302.21(f)Subd. 5c. [RESIDENTIAL CARE SERVICES; SUPPORTIVE 302.22 SERVICES; HEALTH-RELATED SERVICES.] For purposes of this 302.23 section, residential care services are services which are 302.24 provided to individuals living in residential care homes. 302.25 Residential care homes are currently licensed as board and 302.26 lodging establishments under section 157.16, and are registered 302.27 with the department of health as providing special services 302.28 under section 157.17and are not subject to registrationexcept 302.29 settings that are currently registered under chapter 144D. 302.30 Residential care services are defined as "supportive services" 302.31 and "health-related services." "Supportive services" meansthe302.32provision of up to 24-hour supervision and oversight.302.33Supportive services includes: (1) transportation, when provided302.34by the residential care home only; (2) socialization, when302.35socialization is part of the plan of care, has specific goals302.36and outcomes established, and is not diversional or recreational303.1in nature; (3) assisting clients in setting up meetings and303.2appointments; (4) assisting clients in setting up medical and303.3social services; (5) providing assistance with personal laundry,303.4such as carrying the client's laundry to the laundry room.303.5Assistance with personal laundry does not include any laundry,303.6such as bed linen, that is included in the room and board rate303.7 services as defined in section 157.17, subdivision 1, paragraph 303.8 (a). "Health-related services"are limited to minimal303.9assistance with dressing, grooming, and bathing and providing303.10reminders to residents to take medications that are303.11self-administered or providing storage for medications, if303.12requestedmeans services covered in section 157.17, subdivision 303.13 1, paragraph (b). Individuals receiving residential care 303.14 services cannot receive homemaking services funded under this 303.15 section. 303.16(g)Subd. 5d. [ASSISTED LIVING SERVICES.] For the purposes 303.17 of this section, "assisted living" refers to supportive services 303.18 provided by a single vendor to clients who reside in the same 303.19 apartment building of three or more units which are not subject 303.20 to registration under chapter 144D and are licensed by the 303.21 department of health as a class A home care provider or a class 303.22 E home care provider. Assisted living services are defined as 303.23 up to 24-hour supervision,andoversight, and supportive 303.24 services as defined inclause (1)section 157.17, subdivision 1, 303.25 paragraph (a), individualized home care aide tasks as defined in 303.26clause (2)Minnesota Rules, part 4668.0110, and individualized 303.27 home management tasks as defined inclause (3)Minnesota Rules, 303.28 part 4668.0120 provided to residents of a residential center 303.29 living in their units or apartments with a full kitchen and 303.30 bathroom. A full kitchen includes a stove, oven, refrigerator, 303.31 food preparation counter space, and a kitchen utensil storage 303.32 compartment. Assisted living services must be provided by the 303.33 management of the residential center or by providers under 303.34 contract with the management or with the county. 303.35(1) Supportive services include:303.36(i) socialization, when socialization is part of the plan304.1of care, has specific goals and outcomes established, and is not304.2diversional or recreational in nature;304.3(ii) assisting clients in setting up meetings and304.4appointments; and304.5(iii) providing transportation, when provided by the304.6residential center only.304.7(2) Home care aide tasks means:304.8(i) preparing modified diets, such as diabetic or low304.9sodium diets;304.10(ii) reminding residents to take regularly scheduled304.11medications or to perform exercises;304.12(iii) household chores in the presence of technically304.13sophisticated medical equipment or episodes of acute illness or304.14infectious disease;304.15(iv) household chores when the resident's care requires the304.16prevention of exposure to infectious disease or containment of304.17infectious disease; and304.18(v) assisting with dressing, oral hygiene, hair care,304.19grooming, and bathing, if the resident is ambulatory, and if the304.20resident has no serious acute illness or infectious disease.304.21Oral hygiene means care of teeth, gums, and oral prosthetic304.22devices.304.23(3) Home management tasks means:304.24(i) housekeeping;304.25(ii) laundry;304.26(iii) preparation of regular snacks and meals; and304.27(iv) shopping.304.28 Subd. 5e. [FURTHER ASSISTED LIVING REQUIREMENTS.] (a) 304.29 Individuals receiving assisted living services shall not receive 304.30 both assisted living services and homemaking services. 304.31 Individualized means services are chosen and designed 304.32 specifically for each resident's needs, rather than provided or 304.33 offered to all residents regardless of their illnesses, 304.34 disabilities, or physical conditions. Assisted living services 304.35 as defined in this section shall not be authorized in boarding 304.36 and lodging establishments licensed according to sections 305.1 157.011 and 157.15 to 157.22. 305.2(h)(b) For establishments registered under chapter 144D, 305.3 assisted living services under this section means either the 305.4 services described inparagraph (g)subdivision 5d and delivered 305.5 by a class E home care provider licensed by the department of 305.6 health or the services described under section 144A.4605 and 305.7 delivered by an assisted living home care provider or a class A 305.8 home care provider licensed by the commissioner of health. 305.9(i)Subd. 5f. [PAYMENT RATES FOR ASSISTED LIVING SERVICES 305.10 AND RESIDENTIAL CARE.] (a) Payment for assisted living services 305.11 and residential care services shall be a monthly rate negotiated 305.12 and authorized by the county agency based on an individualized 305.13 service plan for each resident and may not cover direct rent or 305.14 food costs. 305.15(1)(b) The individualized monthly negotiated payment for 305.16 assisted living services as described inparagraph305.17(g)subdivision 5d or(h)5e, paragraph (b), and residential 305.18 care services as described inparagraph (f)subdivision 5c, 305.19 shall not exceed the nonfederal share in effect on July 1 of the 305.20 state fiscal year for which the rate limit is being calculated 305.21 of the greater of either the statewide or any of the geographic 305.22groups' weighted average monthly nursing facility payment rate305.23of the case mix resident class to which the alternative care305.24eligible client would be assigned under Minnesota Rules, parts305.259549.0050 to 9549.0059, less the maintenance needs allowance as305.26described in section 256B.0915, subdivision 1d, paragraph (a),305.27until the first day of the state fiscal year in which a resident305.28assessment system, under section 256B.437, of nursing home rate305.29determination is implemented. Effective on the first day of the305.30state fiscal year in which a resident assessment system, under305.31section 256B.437, of nursing home rate determination is305.32implemented and the first day of each subsequent state fiscal305.33year, the individualized monthly negotiated payment for the305.34services described in this clause shall not exceed the limit305.35described in this clause which was in effect on the last day of305.36the previous state fiscal year and which has been adjusted by306.1the greater of any legislatively adopted home and306.2community-based services cost-of-living percentage increase or306.3any legislatively adopted statewide percent rate increase for306.4nursing facilitiesgroups according to subdivision 4, paragraph 306.5 (a), clause (6). 306.6(2)(c) The individualized monthly negotiated payment for 306.7 assisted living services described under section 144A.4605 and 306.8 delivered by a provider licensed by the department of health as 306.9 a class A home care provider or an assisted living home care 306.10 provider and provided in a building that is registered as a 306.11 housing with services establishment under chapter 144D and that 306.12 provides 24-hour supervision in combination with the payment for 306.13 other alternative care services, including case management, must 306.14 not exceed the limit specified in subdivision 4, paragraph (a), 306.15 clause (6). 306.16(j)Subd. 5g. [PROVISIONS GOVERNING DIRECT CASH PAYMENTS.] 306.17 A county agency may make payment from their alternative care 306.18 program allocation for"other services" which include use of306.19"discretionary funds" for services that are not otherwise306.20defined in this section anddirect cash payments to the client 306.21 for the purpose of purchasing the services. The following 306.22 provisions apply to payments under thisparagraphsubdivision: 306.23 (1) a cash payment to a client under this provision cannot 306.24 exceed the monthly payment limit for that client as specified in 306.25 subdivision 4, paragraph (a), clause (6); and 306.26 (2) a county may not approve any cash payment for a client 306.27 who meets either of the following: 306.28 (i) has been assessed as having a dependency in 306.29 orientation, unless the client has an authorized 306.30 representative. An "authorized representative" means an 306.31 individual who is at least 18 years of age and is designated by 306.32 the person or the person's legal representative to act on the 306.33 person's behalf. This individual may be a family member, 306.34 guardian, representative payee, or other individual designated 306.35 by the person or the person's legal representative, if any, to 306.36 assist in purchasing and arranging for supports; or 307.1 (ii) is concurrently receiving adult foster care, 307.2 residential care, or assisted living services;. 307.3(3)Subd. 5h. [CASH PAYMENTS TO PERSONS.] (a) Cash 307.4 payments to a person or a person's family will be provided 307.5 through a monthly payment and be in the form of cash, voucher, 307.6 or direct county payment to a vendor. Fees or premiums assessed 307.7 to the person for eligibility for health and human services are 307.8 not reimbursable through this service option. Services and 307.9 goods purchased through cash payments must be identified in the 307.10 person's individualized care plan and must meet all of the 307.11 following criteria: 307.12(i)(1) they must be over and above the normal cost of 307.13 caring for the person if the person did not have functional 307.14 limitations; 307.15(ii)(2) they must be directly attributable to the person's 307.16 functional limitations; 307.17(iii)(3) they must have the potential to be effective at 307.18 meeting the goals of the program; and 307.19(iv)(4) they must be consistent with the needs identified 307.20 in the individualized service plan. The service plan shall 307.21 specify the needs of the person and family, the form and amount 307.22 of payment, the items and services to be reimbursed, and the 307.23 arrangements for management of the individual grant; and. 307.24(v)(b) The person, the person's family, or the legal 307.25 representative shall be provided sufficient information to 307.26 ensure an informed choice of alternatives. The local agency 307.27 shall document this information in the person's care plan, 307.28 including the type and level of expenditures to be reimbursed;. 307.29 (c) Persons receiving grants under this section shall have 307.30 the following responsibilities: 307.31 (1) spend the grant money in a manner consistent with their 307.32 individualized service plan with the local agency; 307.33 (2) notify the local agency of any necessary changes in the 307.34 grant expenditures; 307.35 (3) arrange and pay for supports; and 307.36 (4) inform the local agency of areas where they have 308.1 experienced difficulty securing or maintaining supports. 308.2 (d) The county shall report client outcomes, services, and 308.3 costs under this paragraph in a manner prescribed by the 308.4 commissioner. 308.5(4)Subd. 5i. [IMMUNITY.] The state of Minnesota, county, 308.6 lead agency under contract, or tribal government under contract 308.7 to administer the alternative care program shall not be liable 308.8 for damages, injuries, or liabilities sustained through the 308.9 purchase of direct supports or goods by the person, the person's 308.10 family, or the authorized representative with funds received 308.11 through the cash payments under this section. Liabilities 308.12 include, but are not limited to, workers' compensation, the 308.13 Federal Insurance Contributions Act (FICA), or the Federal 308.14 Unemployment Tax Act (FUTA);. 308.15(5) persons receiving grants under this section shall have308.16the following responsibilities:308.17(i) spend the grant money in a manner consistent with their308.18individualized service plan with the local agency;308.19(ii) notify the local agency of any necessary changes in308.20the grant expenditures;308.21(iii) arrange and pay for supports; and308.22(iv) inform the local agency of areas where they have308.23experienced difficulty securing or maintaining supports; and308.24(6) the county shall report client outcomes, services, and308.25costs under this paragraph in a manner prescribed by the308.26commissioner.308.27 Sec. 26. Minnesota Statutes 2002, section 256B.0913, 308.28 subdivision 6, is amended to read: 308.29 Subd. 6. [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] (a) 308.30 The alternative care program is administered by the county 308.31 agency. This agency is the lead agency responsible for the 308.32 local administration of the alternative care program as 308.33 described in this section. However, it may contract with the 308.34 public health nursing service to be the lead agency. The 308.35 commissioner may contract with federally recognized Indian 308.36 tribes with a reservation in Minnesota to serve as the lead 309.1 agency responsible for the local administration of the 309.2 alternative care program as described in the contract. 309.3 (b) Alternative care pilot projects operate according to 309.4 this section and the provisions of Laws 1993, First Special 309.5 Session chapter 1, article 5, section 133, under agreement with 309.6 the commissioner. Each pilot project agreement period shall 309.7 begin no later than the first payment cycle of the state fiscal 309.8 year and continue through the last payment cycle of the state 309.9 fiscal year. 309.10 Sec. 27. Minnesota Statutes 2002, section 256B.0913, 309.11 subdivision 7, is amended to read: 309.12 Subd. 7. [CASE MANAGEMENT.]Providers of case management309.13services for persons receiving services funded by the309.14alternative care program must meet the qualification309.15requirements and standards specified in section 256B.0915,309.16subdivision 1b.The case manager must not approve alternative 309.17 care funding for a client in any setting in which the case 309.18 manager cannot reasonably ensure the client's health and 309.19 safety. The case manager is responsible for the 309.20 cost-effectiveness of the alternative care individual care plan 309.21 and must not approve any care plan in which the cost of services 309.22 funded by alternative care and client contributions exceeds the 309.23 limit specified in section 256B.0915, subdivision 3, paragraph 309.24 (b).The county may allow a case manager employed by the county309.25to delegate certain aspects of the case management activity to309.26another individual employed by the county provided there is309.27oversight of the individual by the case manager. The case309.28manager may not delegate those aspects which require309.29professional judgment including assessments, reassessments, and309.30care plan development.309.31 Sec. 28. Minnesota Statutes 2002, section 256B.0913, 309.32 subdivision 8, is amended to read: 309.33 Subd. 8. [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 309.34 case manager shall implement the plan of care for each 309.35 alternative care client and ensure that a client's service needs 309.36 and eligibility are reassessed at least every 12 months. The 310.1 plan shall include any services prescribed by the individual's 310.2 attending physician as necessary to allow the individual to 310.3 remain in a community setting. In developing the individual's 310.4 care plan, the case manager should include the use of volunteers 310.5 from families and neighbors, religious organizations, social 310.6 clubs, and civic and service organizations to support the formal 310.7 home care services. The county shall be held harmless for 310.8 damages or injuries sustained through the use of volunteers 310.9 under this subdivision including workers' compensation 310.10 liability. The lead agency shall provide documentation in each 310.11 individual's plan of care and, if requested, to the commissioner 310.12 that the most cost-effective alternatives available have been 310.13 offered to the individual and that the individual was free to 310.14 choose among available qualified providers, both public and 310.15 private, including qualified case management or service 310.16 coordination providers other than those employed by the lead 310.17 agency when the lead agency maintains responsibility for prior 310.18 authorizing services in accordance with statutory and 310.19 administrative requirements. The case manager must give the 310.20 individual a ten-day written notice of any denial, termination, 310.21 or reduction of alternative care services. 310.22 (b) If the county administering alternative care services 310.23 is different than the county of financial responsibility, the 310.24 care plan may be implemented without the approval of the county 310.25 of financial responsibility. 310.26 Sec. 29. Minnesota Statutes 2002, section 256B.0913, 310.27 subdivision 10, is amended to read: 310.28 Subd. 10. [ALLOCATION FORMULA.] (a) The alternative care 310.29 appropriation for fiscal years 1992 and beyond shall cover only 310.30 alternative care eligible clients. By July 1 of each year, the 310.31 commissioner shall allocate to county agencies the state funds 310.32 available for alternative care for persons eligible under 310.33 subdivision 2. 310.34 (b) The adjusted base for each county is the county's 310.35 current fiscal year base allocation plus any targeted funds 310.36 approved during the current fiscal year. Calculations for 311.1 paragraphs (c) and (d) are to be made as follows: for each 311.2 county, the determination of alternative care program 311.3 expenditures shall be based on payments for services rendered 311.4 from April 1 through March 31 in the base year, to the extent 311.5 that claims have been submitted and paid by June 1 of that year. 311.6 (c) If the alternative care program expenditures as defined 311.7 in paragraph (b) are 95 percent or more of the county's adjusted 311.8 base allocation, the allocation for the next fiscal year is 100 311.9 percent of the adjusted base, plus inflation to the extent that 311.10 inflation is included in the state budget. 311.11 (d) If the alternative care program expenditures as defined 311.12 in paragraph (b) are less than 95 percent of the county's 311.13 adjusted base allocation, the allocation for the next fiscal 311.14 year is the adjusted base allocation less the amount of unspent 311.15 funds below the 95 percent level. 311.16 (e) If the annual legislative appropriation for the 311.17 alternative care program is inadequate to fund the combined 311.18 county allocations for a biennium, the commissioner shall 311.19 distribute to each county the entire annual appropriation as 311.20 that county's percentage of the computed base as calculated in 311.21 paragraphs (c) and (d). 311.22 (f) On agreement between the commissioner and the lead 311.23 agency, the commissioner may have discretion to reallocate 311.24 alternative care base allocations distributed to lead agencies 311.25 in which the base amount exceeds program expenditures. 311.26 Sec. 30. Minnesota Statutes 2002, section 256B.0913, 311.27 subdivision 12, is amended to read: 311.28 Subd. 12. [CLIENT PREMIUMS.] (a) A premium is required for 311.29 all alternative care eligible clients to help pay for the cost 311.30 of participating in the program. The amount of the premium for 311.31 the alternative care client shall be determined as follows: 311.32 (1) when the alternative care client's income less 311.33 recurring and predictable medical expenses isgreater than the311.34recipient's maintenance needs allowance as defined in section311.35256B.0915, subdivision 1d, paragraph (a), butless than 150 311.36 percent of the federal poverty guideline effective on July 1 of 312.1 the state fiscal year in which the premium is being computed, 312.2 and total assets are less than $10,000, the fee iszeroten 312.3 percent of the cost of alternative care services; or 312.4 (2) when the alternative care client's income less 312.5 recurring and predictable medical expenses is greater than or 312.6 equal to 150 percent of the federal poverty guideline effective 312.7 on July 1 of the state fiscal year in which the premium is being 312.8 computed, and total assets are less than $10,000, the fee is 25312.9percent of the cost of alternative care services or the312.10difference between 150 percent of the federal poverty guideline312.11effective on July 1 of the state fiscal year in which the312.12premium is being computed and the client's income less recurring312.13and predictable medical expenses, whichever is less; and312.14(3) when the alternative care client'sor total assets are 312.15 greater than or equal to $10,000, the fee is 25 percent of the 312.16 cost of alternative care services. 312.17 For married persons, total assets are defined as the total 312.18 marital assets less the estimated community spouse asset 312.19 allowance, under section 256B.059, if applicable. For married 312.20 persons, total income is defined as the client's income less the 312.21 monthly spousal allotment, under section 256B.058. 312.22 All alternative care servicesexcept case managementshall 312.23 be included in the estimated costs for the purpose of 312.24 determining25 percent ofthecostspremium amount. 312.25 Premiums are due and payable each month alternative care 312.26 services are received unless the actual cost of the services is 312.27 less than the premium, in which case the fee is the lesser 312.28 amount. 312.29 (b) The fee shall be waived by the commissioner when: 312.30 (1) a person who is residing in a nursing facility is 312.31 receiving case management only; 312.32 (2)a person is applying for medical assistance;312.33(3)a married couple is requesting an asset assessment 312.34 under the spousal impoverishment provisions; 312.35(4)(3) a person is found eligible for alternative care, 312.36 but is not yet receiving alternative care services;or313.1(5)(4) a person's fee under paragraph (a) is less than 313.2 $25; or 313.3 (5) a person has chosen to participate in a 313.4 consumer-directed service plan for which the cost is no greater 313.5 than the total cost of the person's alternative care service 313.6 plan less the monthly premium amount that would otherwise be 313.7 assessed. 313.8 (c) The county agency must record in the state's receivable 313.9 system the client's assessed premium amount or the reason the 313.10 premium has been waived. The commissioner will bill and collect 313.11 the premium from the client. Money collected must be deposited 313.12 in the general fund and is appropriated to the commissioner for 313.13 the alternative care program. The client must supply the county 313.14 with the client's social security number at the time of 313.15 application. The county shall supply the commissioner with the 313.16 client's social security number and other information the 313.17 commissioner requires to collect the premium from the client. 313.18 The commissioner shall collect unpaid premiums using the Revenue 313.19 Recapture Act in chapter 270A and other methods available to the 313.20 commissioner. The commissioner may require counties to inform 313.21 clients of the collection procedures that may be used by the 313.22 state if a premium is not paid. This paragraph does not apply 313.23 to alternative care pilot projects authorized in Laws 1993, 313.24 First Special Session chapter 1, article 5, section 133, if a 313.25 county operating under the pilot project reports the following 313.26 dollar amounts to the commissioner quarterly: 313.27 (1) total premiums billed to clients; 313.28 (2) total collections of premiums billed; and 313.29 (3) balance of premiums owed by clients. 313.30 If a county does not adhere to these reporting requirements, the 313.31 commissioner may terminate the billing, collecting, and 313.32 remitting portions of the pilot project and require the county 313.33 involved to operate under the procedures set forth in this 313.34 paragraph. 313.35 Sec. 31. Minnesota Statutes 2002, section 256B.0915, 313.36 subdivision 3, is amended to read: 314.1 Subd. 3. [LIMITS OF CASES, RATES, PAYMENTS, AND314.2FORECASTING.](a)The number of medical assistance waiver 314.3 recipients that a county may serve must be allocated according 314.4 to the number of medical assistance waiver cases open on July 1 314.5 of each fiscal year. Additional recipients may be served with 314.6 the approval of the commissioner. 314.7(b)Subd. 3a. [ELDERLY WAIVER COST LIMITS.] (a) The 314.8 monthly limit for the cost of waivered services to an individual 314.9 elderly waiver client shall be the weighted average monthly 314.10 nursing facility rate of the case mix resident class to which 314.11 the elderly waiver client would be assigned under Minnesota 314.12 Rules, parts 9549.0050 to 9549.0059, less the recipient's 314.13 maintenance needs allowance as described in subdivision 1d, 314.14 paragraph (a), until the first day of the state fiscal year in 314.15 which the resident assessment system as described in section 314.16 256B.437 for nursing home rate determination is implemented. 314.17 Effective on the first day of the state fiscal year in which the 314.18 resident assessment system as described in section 256B.437 for 314.19 nursing home rate determination is implemented and the first day 314.20 of each subsequent state fiscal year, the monthly limit for the 314.21 cost of waivered services to an individual elderly waiver client 314.22 shall be the rate of the case mix resident class to which the 314.23 waiver client would be assigned under Minnesota Rules, parts 314.24 9549.0050 to 9549.0059, in effect on the last day of the 314.25 previous state fiscal year, adjusted by the greater of any 314.26 legislatively adopted home and community-based services 314.27 cost-of-living percentage increase or any legislatively adopted 314.28 statewide percent rate increase for nursing facilities. 314.29(c)(b) If extended medical supplies and equipment or 314.30 environmental modifications are or will be purchased for an 314.31 elderly waiver client, the costs may be prorated for up to 12 314.32 consecutive months beginning with the month of purchase. If the 314.33 monthly cost of a recipient's waivered services exceeds the 314.34 monthly limit established in paragraph(b)(a), the annual cost 314.35 of all waivered services shall be determined. In this event, 314.36 the annual cost of all waivered services shall not exceed 12 315.1 times the monthly limit of waivered services as described in 315.2 paragraph(b)(a). 315.3(d)Subd. 3b. [COST LIMITS FOR ELDERLY WAIVER APPLICANTS 315.4 WHO RESIDE IN A NURSING FACILITY.] (a) For a person who is a 315.5 nursing facility resident at the time of requesting a 315.6 determination of eligibility for elderly waivered services, a 315.7 monthly conversion limit for the cost of elderly waivered 315.8 services may be requested. The monthly conversion limit for the 315.9 cost of elderly waiver services shall be the resident class 315.10 assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 315.11 for that resident in the nursing facility where the resident 315.12 currently resides until July 1 of the state fiscal year in which 315.13 the resident assessment system as described in section 256B.437 315.14 for nursing home rate determination is implemented. Effective 315.15 on July 1 of the state fiscal year in which the resident 315.16 assessment system as described in section 256B.437 for nursing 315.17 home rate determination is implemented, the monthly conversion 315.18 limit for the cost of elderly waiver services shall be the per 315.19 diem nursing facility rate as determined by the resident 315.20 assessment system as described in section 256B.437 for that 315.21 resident in the nursing facility where the resident currently 315.22 resides multiplied by 365 and divided by 12, less the 315.23 recipient's maintenance needs allowance as described in 315.24 subdivision 1d. The initially approved conversion rate may be 315.25 adjusted by the greater of any subsequent legislatively adopted 315.26 home and community-based services cost-of-living percentage 315.27 increase or any subsequent legislatively adopted statewide 315.28 percentage rate increase for nursing facilities. The limit 315.29 under thisclausesubdivision only applies to persons discharged 315.30 from a nursing facility after a minimum 30-day stay and found 315.31 eligible for waivered services on or after July 1, 1997. 315.32 (b) The following costs must be included in determining the 315.33 total monthly costs for the waiver client: 315.34 (1) cost of all waivered services, including extended 315.35 medical supplies and equipment and environmental modifications; 315.36 and 316.1 (2) cost of skilled nursing, home health aide, and personal 316.2 care services reimbursable by medical assistance. 316.3(e)Subd. 3c. [SERVICE APPROVAL AND CONTRACTING 316.4 PROVISIONS.] (a) Medical assistance funding for skilled nursing 316.5 services, private duty nursing, home health aide, and personal 316.6 care services for waiver recipients must be approved by the case 316.7 manager and included in the individual care plan. 316.8(f)(b) A county is not required to contract with a 316.9 provider of supplies and equipment if the monthly cost of the 316.10 supplies and equipment is less than $250. 316.11(g)Subd. 3d. [ADULT FOSTER CARE RATE.] The adult foster 316.12 care rate shall be considered a difficulty of care payment and 316.13 shall not include room and board. The adult foster care service 316.14 rate shall be negotiated between the county agency and the 316.15 foster care provider. The elderly waiver payment for the foster 316.16 care service in combination with the payment for all other 316.17 elderly waiver services, including case management, must not 316.18 exceed the limit specified in subdivision 3a, paragraph(b)(a). 316.19(h)Subd. 3e. [ASSISTED LIVING SERVICE RATE.] (a) Payment 316.20 for assisted living service shall be a monthly rate negotiated 316.21 and authorized by the county agency based on an individualized 316.22 service plan for each resident and may not cover direct rent or 316.23 food costs. 316.24(1)(b) The individualized monthly negotiated payment for 316.25 assisted living services as described in section 256B.0913, 316.26subdivision 5, paragraph (g) or (h)subdivisions 5d to 5f, and 316.27 residential care services as described in section 256B.0913, 316.28 subdivision5, paragraph (f)5c, shall not exceed the nonfederal 316.29 share, in effect on July 1 of the state fiscal year for which 316.30 the rate limit is being calculated, of the greater of either the 316.31 statewide or any of the geographic groups' weighted average 316.32 monthly nursing facility rate of the case mix resident class to 316.33 which the elderly waiver eligible client would be assigned under 316.34 Minnesota Rules, parts 9549.0050 to 9549.0059, less the 316.35 maintenance needs allowance as described in subdivision 1d, 316.36 paragraph (a), until the July 1 of the state fiscal year in 317.1 which the resident assessment system as described in section 317.2 256B.437 for nursing home rate determination is implemented. 317.3 Effective on July 1 of the state fiscal year in which the 317.4 resident assessment system as described in section 256B.437 for 317.5 nursing home rate determination is implemented and July 1 of 317.6 each subsequent state fiscal year, the individualized monthly 317.7 negotiated payment for the services described in this clause 317.8 shall not exceed the limit described in this clause which was in 317.9 effect on June 30 of the previous state fiscal year and which 317.10 has been adjusted by the greater of any legislatively adopted 317.11 home and community-based services cost-of-living percentage 317.12 increase or any legislatively adopted statewide percent rate 317.13 increase for nursing facilities. 317.14(2)(c) The individualized monthly negotiated payment for 317.15 assisted living services described in section 144A.4605 and 317.16 delivered by a provider licensed by the department of health as 317.17 a class A home care provider or an assisted living home care 317.18 provider and provided in a building that is registered as a 317.19 housing with services establishment under chapter 144D and that 317.20 provides 24-hour supervision in combination with the payment for 317.21 other elderly waiver services, including case management, must 317.22 not exceed the limit specified inparagraph (b)subdivision 3a. 317.23(i)Subd. 3f. [INDIVIDUAL SERVICE RATES; EXPENDITURE 317.24 FORECASTS.] (a) The county shall negotiate individual service 317.25 rates with vendors and may authorize payment for actual costs up 317.26 to the county's current approved rate. Persons or agencies must 317.27 be employed by or under a contract with the county agency or the 317.28 public health nursing agency of the local board of health in 317.29 order to receive funding under the elderly waiver program, 317.30 except as a provider of supplies and equipment when the monthly 317.31 cost of the supplies and equipment is less than $250. 317.32(j)(b) Reimbursement for the medical assistance recipients 317.33 under the approved waiver shall be made from the medical 317.34 assistance account through the invoice processing procedures of 317.35 the department's Medicaid Management Information System (MMIS), 317.36 only with the approval of the client's case manager. The budget 318.1 for the state share of the Medicaid expenditures shall be 318.2 forecasted with the medical assistance budget, and shall be 318.3 consistent with the approved waiver. 318.4(k)Subd. 3g. [SERVICE RATE LIMITS; STATE ASSUMPTION OF 318.5 COSTS.] (a) To improve access to community services and 318.6 eliminate payment disparities between the alternative care 318.7 program and the elderly waiver, the commissioner shall establish 318.8 statewide maximum service rate limits and eliminate 318.9 county-specific service rate limits. 318.10(1)(b) Effective July 1, 2001, for service rate limits, 318.11 except those described or defined inparagraphs (g) and318.12(h)subdivisions 3d and 3e, the rate limit for each service 318.13 shall be the greater of the alternative care statewide maximum 318.14 rate or the elderly waiver statewide maximum rate. 318.15(2)(c) Counties may negotiate individual service rates 318.16 with vendors for actual costs up to the statewide maximum 318.17 service rate limit. 318.18 Sec. 32. Minnesota Statutes 2002, section 256B.15, 318.19 subdivision 1, is amended to read: 318.20 Subdivision 1. [DEFINITION.] For purposes of this section, 318.21 "medical assistance" includes the medical assistance program 318.22 under this chapter and the general assistance medical care 318.23 program under chapter 256D, but does not include the alternative318.24care program for nonmedical assistance recipients under section318.25256B.0913, subdivision 4and alternative care for nonmedical 318.26 assistance recipients under section 256B.0913. 318.27 [EFFECTIVE DATE.] This section is effective July 1, 2003, 318.28 for decedents dying on or after that date. 318.29 Sec. 33. Minnesota Statutes 2002, section 256B.15, 318.30 subdivision 1a, is amended to read: 318.31 Subd. 1a. [ESTATES SUBJECT TO CLAIMS.] If a person 318.32 receives any medical assistance hereunder, on the person's 318.33 death, if single, or on the death of the survivor of a married 318.34 couple, either or both of whom received medical assistance, the 318.35 total amount paid for medical assistance rendered for the person 318.36 and spouse shall be filed as a claim against the estate of the 319.1 person or the estate of the surviving spouse in the court having 319.2 jurisdiction to probate the estate or to issue a decree of 319.3 descent according to sections 525.31 to 525.313. 319.4 A claim shall be filed if medical assistance was rendered 319.5 for either or both persons under one of the following 319.6 circumstances: 319.7 (a) the person was over 55 years of age, and received 319.8 services under this chapter, excluding alternative care; 319.9 (b) the person resided in a medical institution for six 319.10 months or longer, received services under this chapterexcluding319.11alternative care,and, at the time of institutionalization or 319.12 application for medical assistance, whichever is later, the 319.13 person could not have reasonably been expected to be discharged 319.14 and returned home, as certified in writing by the person's 319.15 treating physician. For purposes of this section only, a 319.16 "medical institution" means a skilled nursing facility, 319.17 intermediate care facility, intermediate care facility for 319.18 persons with mental retardation, nursing facility, or inpatient 319.19 hospital; or 319.20 (c) the person received general assistance medical care 319.21 services under chapter 256D. 319.22 The claim shall be considered an expense of the last 319.23 illness of the decedent for the purpose of section 524.3-805. 319.24 Any statute of limitations that purports to limit any county 319.25 agency or the state agency, or both, to recover for medical 319.26 assistance granted hereunder shall not apply to any claim made 319.27 hereunder for reimbursement for any medical assistance granted 319.28 hereunder. Notice of the claim shall be given to all heirs and 319.29 devisees of the decedent whose identity can be ascertained with 319.30 reasonable diligence. The notice must include procedures and 319.31 instructions for making an application for a hardship waiver 319.32 under subdivision 5; time frames for submitting an application 319.33 and determination; and information regarding appeal rights and 319.34 procedures. Counties are entitled to one-half of the nonfederal 319.35 share of medical assistance collections from estates that are 319.36 directly attributable to county effort. Counties are entitled 320.1 to ten percent of the collections for alternative care directly 320.2 attributable to county effort. 320.3 [EFFECTIVE DATE.] This section is effective July 1, 2003, 320.4 for decedents dying on or after that date. 320.5 Sec. 34. Minnesota Statutes 2002, section 256B.15, 320.6 subdivision 2, is amended to read: 320.7 Subd. 2. [LIMITATIONS ON CLAIMS.] The claim shall include 320.8 only the total amount of medical assistance rendered after age 320.9 55 or during a period of institutionalization described in 320.10 subdivision 1a, clause (b), and the total amount of general 320.11 assistance medical care rendered, and shall not include 320.12 interest. Claims that have been allowed but not paid shall bear 320.13 interest according to section 524.3-806, paragraph (d). A claim 320.14 against the estate of a surviving spouse who did not receive 320.15 medical assistance, for medical assistance rendered for the 320.16 predeceased spouse, is limited to the value of the assets of the 320.17 estate that were marital property or jointly owned property at 320.18 any time during the marriage. Claims for alternative care shall 320.19 be net of all premiums paid under section 256B.0913, subdivision 320.20 12, on or after July 1, 2003, and shall be limited to services 320.21 provided on or after July 1, 2003. 320.22 [EFFECTIVE DATE.] This section is effective July 1, 2003, 320.23 for decedents dying on or after that date. 320.24 Sec. 35. Minnesota Statutes 2002, section 256B.431, 320.25 subdivision 2r, is amended to read: 320.26 Subd. 2r. [PAYMENT RESTRICTIONS ON LEAVE DAYS.] Effective 320.27 July 1, 1993, the commissioner shall limit payment for leave 320.28 days in a nursing facility to 79 percent of that nursing 320.29 facility's total payment rate for the involved resident. For 320.30 services rendered on or after July 1, 2003, for facilities 320.31 reimbursed under this section or section 256B.434, the 320.32 commissioner shall limit payment for leave days in a nursing 320.33 facility to 60 percent of that nursing facility's total payment 320.34 rate for the involved resident. 320.35 Sec. 36. Minnesota Statutes 2002, section 256B.431, is 320.36 amended by adding a subdivision to read: 321.1 Subd. 2t. [PAYMENT LIMITATION.] For services rendered on 321.2 or after July 1, 2003, for facilities reimbursed under this 321.3 section or section 256B.434, the amount that shall be paid by or 321.4 on behalf of the Medicaid program shall only include a 321.5 co-payment during a Medicare-covered skilled nursing facility 321.6 stay if the Medicare rate less the resident's co-payment 321.7 responsibility is less than the Medicaid RUG-III case-mix 321.8 payment rate. The amount that shall be paid by or on behalf of 321.9 the Medicaid program is equal to the amount by which the 321.10 Medicaid RUG-III case-mix payment rate exceeds the Medicare rate 321.11 less the co-payment responsibility. 321.12 Sec. 37. Minnesota Statutes 2002, section 256B.431, 321.13 subdivision 32, is amended to read: 321.14 Subd. 32. [PAYMENT DURING FIRST 90 DAYS.] (a) For rate 321.15 years beginning on or after July 1, 2001, the total payment rate 321.16 for a facility reimbursed under this section, section 256B.434, 321.17 or any other section for the first 90 paid days after admission 321.18 shall be: 321.19 (1) for the first 30 paid days, the rate shall be 120 321.20 percent of the facility's medical assistance rate for each case 321.21 mix class;and321.22 (2) for the next 60 paid days after the first 30 paid days, 321.23 the rate shall be 110 percent of the facility's medical 321.24 assistance rate for each case mix class.; 321.25(b)(3) beginning with the 91st paid day after admission, 321.26 the payment rate shall be the rate otherwise determined under 321.27 this section, section 256B.434, or any other section.; and 321.28(c)(4) payments under thissubdivision appliesparagraph 321.29 apply to admissions occurring on or after July 1, 2001, and 321.30 resident days from that date through June 30, 2003. 321.31 (b) For rate years beginning on or after July 1, 2003, the 321.32 total payment rate for a facility reimbursed under this section, 321.33 section 256B.434, or any other section shall be: 321.34 (1) for the first 30 calendar days after admission, the 321.35 rate shall be 120 percent of the facility's medical assistance 321.36 rate for each RUG class; 322.1 (2) beginning with the 31st calendar day after admission, 322.2 the payment rate shall be the rate otherwise determined under 322.3 this section, section 256B.434, or any other section; and 322.4 (3) payments under this paragraph apply to admissions 322.5 occurring on or after July 1, 2003. 322.6 (c) Effective January 1, 2004, the enhanced rates under 322.7 this subdivision shall not be allowed if a resident has resided 322.8 in any nursing facility during the previous 30 calendar days. 322.9 Sec. 38. Minnesota Statutes 2002, section 256B.431, 322.10 subdivision 36, is amended to read: 322.11 Subd. 36. [EMPLOYEE SCHOLARSHIP COSTS AND TRAINING IN 322.12 ENGLISH AS A SECOND LANGUAGE.] (a) For the period between July 322.13 1, 2001, and June 30, 2003, the commissioner shall provide to 322.14 each nursing facility reimbursed under this section, section 322.15 256B.434, or any other section, a scholarship per diem of 25 322.16 cents to the total operating payment rate to be used: 322.17 (1) for employee scholarships that satisfy the following 322.18 requirements: 322.19 (i) scholarships are available to all employees who work an 322.20 average of at least 20 hours per week at the facility except the 322.21 administrator, department supervisors, and registered nurses; 322.22 and 322.23 (ii) the course of study is expected to lead to career 322.24 advancement with the facility or in long-term care, including 322.25 medical care interpreter services and social work; and 322.26 (2) to provide job-related training in English as a second 322.27 language. 322.28 (b) A facility receiving a rate adjustment under this 322.29 subdivision may submit to the commissioner on a schedule 322.30 determined by the commissioner and on a form supplied by the 322.31 commissioner a calculation of the scholarship per diem, 322.32 including: the amount received from this rate adjustment; the 322.33 amount used for training in English as a second language; the 322.34 number of persons receiving the training; the name of the person 322.35 or entity providing the training; and for each scholarship 322.36 recipient, the name of the recipient, the amount awarded, the 323.1 educational institution attended, the nature of the educational 323.2 program, the program completion date, and a determination of the 323.3 per diem amount of these costs based on actual resident days. 323.4 (c) On July 1, 2003, the commissioner shall remove the 25 323.5 cent scholarship per diem from the total operating payment rate 323.6 of each facility. 323.7(d) For rate years beginning after June 30, 2003, the323.8commissioner shall provide to each facility the scholarship per323.9diem determined in paragraph (b).323.10 Sec. 39. Minnesota Statutes 2002, section 256B.431, is 323.11 amended by adding a subdivision to read: 323.12 Subd. 38. [NURSING HOME RATE INCREASES EFFECTIVE IN FISCAL 323.13 YEAR 2003.] Effective June 1, 2003, the commissioner shall 323.14 provide to each nursing home reimbursed under this section or 323.15 section 256B.434, an increase in each case mix payment rate 323.16 equal to the increase in the per-bed surcharge paid under 323.17 section 256.9657, subdivision 1, paragraph (d), divided by 365 323.18 and further divided by .90. The increase shall not be subject 323.19 to any annual percentage increase. The 30-day advance notice 323.20 requirement in section 256B.47, subdivision 2, shall not apply 323.21 to rate increases resulting from this section. The commissioner 323.22 shall not adjust the rate increase under this subdivision unless 323.23 an adjustment under section 256.9657, subdivision 1, paragraph 323.24 (e), is greater than 1.5 percent of the surcharge amount. 323.25 [EFFECTIVE DATE.] This section is effective May 31, 2003. 323.26 Sec. 40. Minnesota Statutes 2002, section 256B.431, is 323.27 amended by adding a subdivision to read: 323.28 Subd. 39. [FACILITY RATES BEGINNING ON OR AFTER JULY 1, 323.29 2003.] For rate years beginning on or after July 1, 2003, 323.30 nursing facilities reimbursed under this section shall have 323.31 their July 1 operating payment rate be equal to their operating 323.32 payment rate in effect on the prior June 30th. 323.33 Sec. 41. Minnesota Statutes 2002, section 256B.434, 323.34 subdivision 4, is amended to read: 323.35 Subd. 4. [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 323.36 nursing facilities which have their payment rates determined 324.1 under this section rather than section 256B.431, the 324.2 commissioner shall establish a rate under this subdivision. The 324.3 nursing facility must enter into a written contract with the 324.4 commissioner. 324.5 (b) A nursing facility's case mix payment rate for the 324.6 first rate year of a facility's contract under this section is 324.7 the payment rate the facility would have received under section 324.8 256B.431. 324.9 (c) A nursing facility's case mix payment rates for the 324.10 second and subsequent years of a facility's contract under this 324.11 section are the previous rate year's contract payment rates plus 324.12 an inflation adjustment and, for facilities reimbursed under 324.13 this section or section 256B.431, an adjustment to include the 324.14 cost of any increase in health department licensing fees for the 324.15 facility taking effect on or after July 1, 2001. The index for 324.16 the inflation adjustment must be based on the change in the 324.17 Consumer Price Index-All Items (United States City average) 324.18 (CPI-U) forecasted byData Resources, Inc.the commissioner of 324.19 finance's national economic consultant, as forecasted in the 324.20 fourth quarter of the calendar year preceding the rate year. 324.21 The inflation adjustment must be based on the 12-month period 324.22 from the midpoint of the previous rate year to the midpoint of 324.23 the rate year for which the rate is being determined. For the 324.24 rate years beginning on July 1, 1999, July 1, 2000, July 1, 324.25 2001,andJuly 1, 2002, July 1, 2003, and July 1, 2004, this 324.26 paragraph shall apply only to the property-related payment rate, 324.27 except that adjustments to include the cost of any increase in 324.28 health department licensing fees taking effect on or after July 324.29 1, 2001, shall be provided. In determining the amount of the 324.30 property-related payment rate adjustment under this paragraph, 324.31 the commissioner shall determine the proportion of the 324.32 facility's rates that are property-related based on the 324.33 facility's most recent cost report. 324.34 (d) The commissioner shall develop additional 324.35 incentive-based payments of up to five percent above the 324.36 standard contract rate for achieving outcomes specified in each 325.1 contract. The specified facility-specific outcomes must be 325.2 measurable and approved by the commissioner. The commissioner 325.3 may establish, for each contract, various levels of achievement 325.4 within an outcome. After the outcomes have been specified the 325.5 commissioner shall assign various levels of payment associated 325.6 with achieving the outcome. Any incentive-based payment cancels 325.7 if there is a termination of the contract. In establishing the 325.8 specified outcomes and related criteria the commissioner shall 325.9 consider the following state policy objectives: 325.10 (1) improved cost effectiveness and quality of life as 325.11 measured by improved clinical outcomes; 325.12 (2) successful diversion or discharge to community 325.13 alternatives; 325.14 (3) decreased acute care costs; 325.15 (4) improved consumer satisfaction; 325.16 (5) the achievement of quality; or 325.17 (6) any additional outcomes proposed by a nursing facility 325.18 that the commissioner finds desirable. 325.19 Sec. 42. Minnesota Statutes 2002, section 256B.434, 325.20 subdivision 10, is amended to read: 325.21 Subd. 10. [EXEMPTIONS.] (a) To the extent permitted by 325.22 federal law, (1) a facility that has entered into a contract 325.23 under this section is not required to file a cost report, as 325.24 defined in Minnesota Rules, part 9549.0020, subpart 13, for any 325.25 year after the base year that is the basis for the calculation 325.26 of the contract payment rate for the first rate year of the 325.27 alternative payment demonstration project contract; and (2) a 325.28 facility under contract is not subject to audits of historical 325.29 costs or revenues, or paybacks or retroactive adjustments based 325.30 on these costs or revenues, except audits, paybacks, or 325.31 adjustments relating to the cost report that is the basis for 325.32 calculation of the first rate year under the contract. 325.33 (b) A facility that is under contract with the commissioner 325.34 under this section is not subject to the moratorium on licensure 325.35 or certification of new nursing home beds in section 144A.071, 325.36 unless the project results in a net increase in bed capacity or 326.1 involves relocation of beds from one site to another. Contract 326.2 payment rates must not be adjusted to reflect any additional 326.3 costs that a nursing facility incurs as a result of a 326.4 construction project undertaken under this paragraph. In 326.5 addition, as a condition of entering into a contract under this 326.6 section, a nursing facility must agree that any future medical 326.7 assistance payments for nursing facility services will not 326.8 reflect any additional costs attributable to the sale of a 326.9 nursing facility under this section and to construction 326.10 undertaken under this paragraph that otherwise would not be 326.11 authorized under the moratorium in section 144A.073. Nothing in 326.12 this section prevents a nursing facility participating in the 326.13 alternative payment demonstration project under this section 326.14 from seeking approval of an exception to the moratorium through 326.15 the process established in section 144A.073, and if approved the 326.16 facility's rates shall be adjusted to reflect the cost of the 326.17 project. Nothing in this section prevents a nursing facility 326.18 participating in the alternative payment demonstration project 326.19 from seeking legislative approval of an exception to the 326.20 moratorium under section 144A.071, and, if enacted, the 326.21 facility's rates shall be adjusted to reflect the cost of the 326.22 project. 326.23 (c) Notwithstanding section 256B.48, subdivision 6, 326.24 paragraphs (c), (d), and (e), and pursuant to any terms and 326.25 conditions contained in the facility's contract, a nursing 326.26 facility that is under contract with the commissioner under this 326.27 section is in compliance with section 256B.48, subdivision 6, 326.28 paragraph (b), if the facility is Medicare certified. 326.29 (d) Notwithstanding paragraph (a), if by April 1, 1996, the 326.30 health care financing administration has not approved a required 326.31 waiver, or the Centers for Medicare and Medicaid Services 326.32 otherwise requires cost reports to be filed prior to the 326.33 waiver's approval, the commissioner shall require a cost report 326.34 for the rate year. 326.35 (e) A facility that is under contract with the commissioner 326.36 under this section shall be allowed to change therapy 327.1 arrangements from an unrelated vendor to a related vendor during 327.2 the term of the contract. The commissioner may develop 327.3 reasonable requirements designed to prevent an increase in 327.4 therapy utilization for residents enrolled in the medical 327.5 assistance program. 327.6 (f) Nursing facilities participating in the alternative 327.7 payment system demonstration project must either participate in 327.8 the alternative payment system quality improvement program 327.9 established by the commissioner or submit information on their 327.10 own quality improvement process to the commissioner for 327.11 approval. Nursing facilities that have had their own quality 327.12 improvement process approved by the commissioner must report 327.13 results for at least one key area of quality improvement 327.14 annually to the commissioner. 327.15 [EFFECTIVE DATE.] This section is effective July 1, 2003. 327.16 Sec. 43. Minnesota Statutes 2002, section 256B.48, 327.17 subdivision 1, is amended to read: 327.18 Subdivision 1. [PROHIBITED PRACTICES.] A nursing facility 327.19 is not eligible to receive medical assistance payments unless it 327.20 refrains from all of the following: 327.21 (a) Charging private paying residents rates for similar 327.22 services which exceed those which are approved by the state 327.23 agency for medical assistance recipients as determined by the 327.24 prospective desk audit rate, except under the following 327.25 circumstances: (1) the nursing facility may(1)(i) charge 327.26 private paying residents a higher rate for a private room,and 327.27(2)(ii) charge for special services which are not included in 327.28 the daily rate if medical assistance residents are charged 327.29 separately at the same rate for the same services in addition to 327.30 the daily rate paid by the commissioner.; (2) effective July 1, 327.31 2003, nursing facilities may charge private paying residents 327.32 rates up to two percent higher than the allowable payment rate 327.33 in effect on June 30, 2003, plus an adjustment equal to any 327.34 other rate increase provided in law, for the RUGs group 327.35 currently assigned to the resident; (3) effective July 1, 2004, 327.36 nursing facilities may charge private paying residents rates up 328.1 to four percent higher than the allowable payment rate in effect 328.2 on June 30, 2003, plus an adjustment equal to any other rate 328.3 increase provided in law, for the RUGs group currently assigned 328.4 to the resident; (4) effective July 1, 2005, nursing facilities 328.5 may charge private paying residents rates up to six percent 328.6 higher than the allowable payment rate in effect on June 30, 328.7 2003, plus an adjustment equal to any other rate increase 328.8 provided in law, for the RUGs group currently assigned to the 328.9 resident; and (5) effective July 1, 2006, nursing facilities may 328.10 charge private paying residents rates up to eight percent higher 328.11 than the allowable payment rate in effect on June 30, 2003, plus 328.12 an adjustment equal to any other rate increase provided in law, 328.13 for the RUGs group currently assigned to the resident. For 328.14 purposes of this subdivision, the allowable payment rate is the 328.15 total payment rate under section 256B.431 or 256B.434 including 328.16 adjustments for enhanced rates during the first 30 days under 328.17 section 256B.431, subdivision 32, and private room differentials 328.18 under clause (1), item (i), and Minnesota Rules, part 9549.0060, 328.19 subpart 11, item C. Nothing in this section precludes a nursing 328.20 facility from charging a rate allowable under the facility's 328.21 single room election option under Minnesota Rules, part 328.22 9549.0060, subpart 11. Services covered by the payment rate 328.23 must be the same regardless of payment source. Special 328.24 services, if offered, must be available to all residents in all 328.25 areas of the nursing facility and charged separately at the same 328.26 rate. Residents are free to select or decline special services. 328.27 Special services must not include services which must be 328.28 provided by the nursing facility in order to comply with 328.29 licensure or certification standards and that if not provided 328.30 would result in a deficiency or violation by the nursing 328.31 facility. Services beyond those required to comply with 328.32 licensure or certification standards must not be charged 328.33 separately as a special service if they were included in the 328.34 payment rate for the previous reporting year. A nursing 328.35 facility that charges a private paying resident a rate in 328.36 violation of this clause is subject to an action by the state of 329.1 Minnesota or any of its subdivisions or agencies for civil 329.2 damages. A private paying resident or the resident's legal 329.3 representative has a cause of action for civil damages against a 329.4 nursing facility that charges the resident rates in violation of 329.5 this clause. The damages awarded shall include three times the 329.6 payments that result from the violation, together with costs and 329.7 disbursements, including reasonable attorneys' fees or their 329.8 equivalent. A private paying resident or the resident's legal 329.9 representative, the state, subdivision or agency, or a nursing 329.10 facility may request a hearing to determine the allowed rate or 329.11 rates at issue in the cause of action. Within 15 calendar days 329.12 after receiving a request for such a hearing, the commissioner 329.13 shall request assignment of an administrative law judge under 329.14 sections 14.48 to 14.56 to conduct the hearing as soon as 329.15 possible or according to agreement by the parties. The 329.16 administrative law judge shall issue a report within 15 calendar 329.17 days following the close of the hearing. The prohibition set 329.18 forth in this clause shall not apply to facilities licensed as 329.19 boarding care facilities which are not certified as skilled or 329.20 intermediate care facilities level I or II for reimbursement 329.21 through medical assistance. 329.22 (b) Effective July 1, 2007, paragraph (a) no longer 329.23 applies, except that special services, if offered, must be 329.24 available to all residents of the nursing facility and charged 329.25 separately at the same rate. Residents are free to select or 329.26 decline special services. Special services must not include 329.27 services which must be provided by the nursing facility in order 329.28 to comply with licensure or certification standards and that if 329.29 not provided would result in a deficiency or violation by the 329.30 nursing facility. 329.31(b)(c)(1) Charging, soliciting, accepting, or receiving 329.32 from an applicant for admission to the facility, or from anyone 329.33 acting in behalf of the applicant, as a condition of admission, 329.34 expediting the admission, or as a requirement for the 329.35 individual's continued stay, any fee, deposit, gift, money, 329.36 donation, or other consideration not otherwise required as 330.1 payment under the state plan. For residents on medical 330.2 assistance, medical assistance payment according to the state 330.3 plan must be accepted as payment in full for continued stay, 330.4 except where otherwise provided for under statute; 330.5 (2) requiring an individual, or anyone acting in behalf of 330.6 the individual, to loan any money to the nursing facility; 330.7 (3) requiring an individual, or anyone acting in behalf of 330.8 the individual, to promise to leave all or part of the 330.9 individual's estate to the facility; or 330.10 (4) requiring a third-party guarantee of payment to the 330.11 facility as a condition of admission, expedited admission, or 330.12 continued stay in the facility. 330.13 Nothing in this paragraph would prohibit discharge for 330.14 nonpayment of services in accordance with state and federal 330.15 regulations. 330.16(c)(d) Requiring any resident of the nursing facility to 330.17 utilize a vendor of health care services chosen by the nursing 330.18 facility. A nursing facility may require a resident to use 330.19 pharmacies that utilize unit dose packing systems approved by 330.20 the Minnesota board of pharmacy, and may require a resident to 330.21 use pharmacies that are able to meet the federal regulations for 330.22 safe and timely administration of medications such as systems 330.23 with specific number of doses, prompt delivery of medications, 330.24 or access to medications on a 24-hour basis. Notwithstanding 330.25 the provisions of this paragraph, nursing facilities shall not 330.26 restrict a resident's choice of pharmacy because the pharmacy 330.27 utilizes a specific system of unit dose drug packing. 330.28(d)(e) Providing differential treatment on the basis of 330.29 status with regard to public assistance. 330.30(e)(f) Discriminating in admissions, services offered, or 330.31 room assignment on the basis of status with regard to public 330.32 assistanceor refusal to purchase special330.33services. Discrimination in admissionsdiscrimination, services 330.34 offered, or room assignment shall include, but is not limited to:330.35(1)basing admissions decisions uponassurance by the330.36applicant to the nursing facility, or the applicant's guardian331.1or conservator, that the applicant is neither eligible for nor331.2will seekinformation or assurances regarding current or future 331.3 eligibility for public assistance for payment of nursing 331.4 facility carecosts; and. 331.5(2) engaging in preferential selection from waiting lists331.6based on an applicant's ability to pay privately or an331.7applicant's refusal to pay for a special service.331.8 The collection and use by a nursing facility of financial 331.9 information of any applicant pursuant to a preadmission 331.10 screening program established by law shall not raise an 331.11 inference that the nursing facility is utilizing that 331.12 information for any purpose prohibited by this paragraph. 331.13(f)(g) Requiring any vendor of medical care as defined by 331.14 section 256B.02, subdivision 7, who is reimbursed by medical 331.15 assistance under a separate fee schedule, to pay any amount 331.16 based on utilization or service levels or any portion of the 331.17 vendor's fee to the nursing facility except as payment for 331.18 renting or leasing space or equipment or purchasing support 331.19 services from the nursing facility as limited by section 331.20 256B.433. All agreements must be disclosed to the commissioner 331.21 upon request of the commissioner. Nursing facilities and 331.22 vendors of ancillary services that are found to be in violation 331.23 of this provision shall each be subject to an action by the 331.24 state of Minnesota or any of its subdivisions or agencies for 331.25 treble civil damages on the portion of the fee in excess of that 331.26 allowed by this provision and section 256B.433. Damages awarded 331.27 must include three times the excess payments together with costs 331.28 and disbursements including reasonable attorney's fees or their 331.29 equivalent. 331.30(g)(h) Refusing, for more than 24 hours, to accept a 331.31 resident returning to the same bed or a bed certified for the 331.32 same level of care, in accordance with a physician's order 331.33 authorizing transfer, after receiving inpatient hospital 331.34 services. 331.35 (i) For a period not to exceed 180 days, the commissioner 331.36 may continue to make medical assistance payments to a nursing 332.1 facility or boarding care home which is in violation of this 332.2 section if extreme hardship to the residents would result. In 332.3 these cases the commissioner shall issue an order requiring the 332.4 nursing facility to correct the violation. The nursing facility 332.5 shall have 20 days from its receipt of the order to correct the 332.6 violation. If the violation is not corrected within the 20-day 332.7 period the commissioner may reduce the payment rate to the 332.8 nursing facility by up to 20 percent. The amount of the payment 332.9 rate reduction shall be related to the severity of the violation 332.10 and shall remain in effect until the violation is corrected. 332.11 The nursing facility or boarding care home may appeal the 332.12 commissioner's action pursuant to the provisions of chapter 14 332.13 pertaining to contested cases. An appeal shall be considered 332.14 timely if written notice of appeal is received by the 332.15 commissioner within 20 days of notice of the commissioner's 332.16 proposed action. 332.17 In the event that the commissioner determines that a 332.18 nursing facility is not eligible for reimbursement for a 332.19 resident who is eligible for medical assistance, the 332.20 commissioner may authorize the nursing facility to receive 332.21 reimbursement on a temporary basis until the resident can be 332.22 relocated to a participating nursing facility. 332.23 Certified beds in facilities which do not allow medical 332.24 assistance intake on July 1, 1984, or after shall be deemed to 332.25 be decertified for purposes of section 144A.071 only. 332.26 Sec. 44. Minnesota Statutes 2002, section 256B.5012, is 332.27 amended by adding a subdivision to read: 332.28 Subd. 5. [RATE INCREASE EFFECTIVE JUNE 1, 2003.] For rate 332.29 periods beginning on or after June 1, 2003, the commissioner 332.30 shall increase the total operating payment rate for each 332.31 facility reimbursed under this section by $3 per day. The 332.32 increase shall not be subject to any annual percentage increase. 332.33 [EFFECTIVE DATE.] This section is effective June 1, 2003. 332.34 Sec. 45. Minnesota Statutes 2002, section 256B.76, is 332.35 amended to read: 332.36 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 333.1 (a) Effective for services rendered on or after October 1, 333.2 1992, the commissioner shall make payments for physician 333.3 services as follows: 333.4 (1) payment for level one Centers for Medicare and Medicaid 333.5 Services' common procedural coding system codes titled "office 333.6 and other outpatient services," "preventive medicine new and 333.7 established patient," "delivery, antepartum, and postpartum 333.8 care," "critical care," cesarean delivery and pharmacologic 333.9 management provided to psychiatric patients, and level three 333.10 codes for enhanced services for prenatal high risk, shall be 333.11 paid at the lower of (i) submitted charges, or (ii) 25 percent 333.12 above the rate in effect on June 30, 1992. If the rate on any 333.13 procedure code within these categories is different than the 333.14 rate that would have been paid under the methodology in section 333.15 256B.74, subdivision 2, then the larger rate shall be paid; 333.16 (2) payments for all other services shall be paid at the 333.17 lower of (i) submitted charges, or (ii) 15.4 percent above the 333.18 rate in effect on June 30, 1992; 333.19 (3) all physician rates shall be converted from the 50th 333.20 percentile of 1982 to the 50th percentile of 1989, less the 333.21 percent in aggregate necessary to equal the above increases 333.22 except that payment rates for home health agency services shall 333.23 be the rates in effect on September 30, 1992; 333.24 (4) effective for services rendered on or after January 1, 333.25 2000, payment rates for physician and professional services 333.26 shall be increased by three percent over the rates in effect on 333.27 December 31, 1999, except for home health agency and family 333.28 planning agency services; and 333.29 (5) the increases in clause (4) shall be implemented 333.30 January 1, 2000, for managed care. 333.31 (b) Effective for services rendered on or after October 1, 333.32 1992, the commissioner shall make payments for dental services 333.33 as follows: 333.34 (1) dental services shall be paid at the lower of (i) 333.35 submitted charges, or (ii) 25 percent above the rate in effect 333.36 on June 30, 1992; 334.1 (2) dental rates shall be converted from the 50th 334.2 percentile of 1982 to the 50th percentile of 1989, less the 334.3 percent in aggregate necessary to equal the above increases; 334.4 (3) effective for services rendered on or after January 1, 334.5 2000, payment rates for dental services shall be increased by 334.6 three percent over the rates in effect on December 31, 1999; 334.7 (4) the commissioner shall award grants to community 334.8 clinics or other nonprofit community organizations, political 334.9 subdivisions, professional associations, or other organizations 334.10 that demonstrate the ability to provide dental services 334.11 effectively to public program recipients. Grants may be used to 334.12 fund the costs related to coordinating access for recipients, 334.13 developing and implementing patient care criteria, upgrading or 334.14 establishing new facilities, acquiring furnishings or equipment, 334.15 recruiting new providers, or other development costs that will 334.16 improve access to dental care in a region. In awarding grants, 334.17 the commissioner shall give priority to applicants that plan to 334.18 serve areas of the state in which the number of dental providers 334.19 is not currently sufficient to meet the needs of recipients of 334.20 public programs or uninsured individuals. The commissioner 334.21 shall consider the following in awarding the grants: 334.22 (i) potential to successfully increase access to an 334.23 underserved population; 334.24 (ii) the ability to raise matching funds; 334.25 (iii) the long-term viability of the project to improve 334.26 access beyond the period of initial funding; 334.27 (iv) the efficiency in the use of the funding; and 334.28 (v) the experience of the proposers in providing services 334.29 to the target population. 334.30 The commissioner shall monitor the grants and may terminate 334.31 a grant if the grantee does not increase dental access for 334.32 public program recipients. The commissioner shall consider 334.33 grants for the following: 334.34 (i) implementation of new programs or continued expansion 334.35 of current access programs that have demonstrated success in 334.36 providing dental services in underserved areas; 335.1 (ii) a pilot program for utilizing hygienists outside of a 335.2 traditional dental office to provide dental hygiene services; 335.3 and 335.4 (iii) a program that organizes a network of volunteer 335.5 dentists, establishes a system to refer eligible individuals to 335.6 volunteer dentists, and through that network provides donated 335.7 dental care services to public program recipients or uninsured 335.8 individuals; 335.9 (5) beginning October 1, 1999, the payment for tooth 335.10 sealants and fluoride treatments shall be the lower of (i) 335.11 submitted charge, or (ii) 80 percent of median 1997 charges; 335.12 (6) the increases listed in clauses (3) and (5) shall be 335.13 implemented January 1, 2000, for managed care; and 335.14 (7) effective for services provided on or after January 1, 335.15 2002, payment for diagnostic examinations and dental x-rays 335.16 provided to children under age 21 shall be the lower of (i) the 335.17 submitted charge, or (ii) 85 percent of median 1999 charges. 335.18 (c) Effective for dental services rendered on or after 335.19 January 1, 2002, the commissioner may, within the limits of 335.20 available appropriation, increase reimbursements to dentists and 335.21 dental clinics deemed by the commissioner to be critical access 335.22 dental providers. Reimbursement to a critical access dental 335.23 provider may be increased by not more than 50 percent above the 335.24 reimbursement rate that would otherwise be paid to the 335.25 provider. Payments to health plan companies shall be adjusted 335.26 to reflect increased reimbursements to critical access dental 335.27 providers as approved by the commissioner. In determining which 335.28 dentists and dental clinics shall be deemed critical access 335.29 dental providers, the commissioner shall review: 335.30 (1) the utilization rate in the service area in which the 335.31 dentist or dental clinic operates for dental services to 335.32 patients covered by medical assistance, general assistance 335.33 medical care, or MinnesotaCare as their primary source of 335.34 coverage; 335.35 (2) the level of services provided by the dentist or dental 335.36 clinic to patients covered by medical assistance, general 336.1 assistance medical care, or MinnesotaCare as their primary 336.2 source of coverage; and 336.3 (3) whether the level of services provided by the dentist 336.4 or dental clinic is critical to maintaining adequate levels of 336.5 patient access within the service area. 336.6 In the absence of a critical access dental provider in a service 336.7 area, the commissioner may designate a dentist or dental clinic 336.8 as a critical access dental provider if the dentist or dental 336.9 clinic is willing to provide care to patients covered by medical 336.10 assistance, general assistance medical care, or MinnesotaCare at 336.11 a level which significantly increases access to dental care in 336.12 the service area. 336.13 (d)Effective July 1, 2001, the medical assistance rates336.14for outpatient mental health services provided by an entity that336.15operates:336.16(1) a Medicare-certified comprehensive outpatient336.17rehabilitation facility; and336.18(2) a facility that was certified prior to January 1, 1993,336.19with at least 33 percent of the clients receiving rehabilitation336.20services in the most recent calendar year who are medical336.21assistance recipients, will be increased by 38 percent, when336.22those services are provided within the comprehensive outpatient336.23rehabilitation facility and provided to residents of nursing336.24facilities owned by the entity.336.25(e)An entity that operates both a Medicare certified 336.26 comprehensive outpatient rehabilitation facility and a facility 336.27 which was certified prior to January 1, 1993, that is licensed 336.28 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 336.29 whom at least 33 percent of the clients receiving rehabilitation 336.30 services in the most recent calendar year are medical assistance 336.31 recipients, shall be reimbursed by the commissioner for 336.32 rehabilitation services at rates that are 38 percent greater 336.33 than the maximum reimbursement rate allowed under paragraph (a), 336.34 clause (2), when those services are (1) provided within the 336.35 comprehensive outpatient rehabilitation facility and (2) 336.36 provided to residents of nursing facilities owned by the entity. 337.1 Sec. 46. Minnesota Statutes 2002, section 256B.761, is 337.2 amended to read: 337.3 256B.761 [REIMBURSEMENT FOR MENTAL HEALTH SERVICES.] 337.4 (a) Effective for services rendered on or after July 1, 337.5 2001, payment for medication management provided to psychiatric 337.6 patients, outpatient mental health services, day treatment 337.7 services, home-based mental health services, and family 337.8 community support services shall be paid at the lower of (1) 337.9 submitted charges, or (2) 75.6 percent of the 50th percentile of 337.10 1999 charges. 337.11 (b) Effective July 1, 2001, the medical assistance rates 337.12 for outpatient mental health services provided by an entity that 337.13 operates: (1) a Medicare-certified comprehensive outpatient 337.14 rehabilitation facility; and (2) a facility that was certified 337.15 prior to January 1, 1993, with at least 33 percent of the 337.16 clients receiving rehabilitation services in the most recent 337.17 calendar year who are medical assistance recipients, will be 337.18 increased by 38 percent, when those services are provided within 337.19 the comprehensive outpatient rehabilitation facility and 337.20 provided to residents of nursing facilities owned by the entity. 337.21 Sec. 47. Minnesota Statutes 2002, section 256D.03, 337.22 subdivision 3a, is amended to read: 337.23 Subd. 3a. [CLAIMS; ASSIGNMENT OF BENEFITS.] Claims must be 337.24 filed pursuant to section 256D.16. General assistance medical 337.25 care applicants and recipients must apply or agree to apply 337.26 third party health and accident benefits to the costs of medical 337.27 care. They must cooperate with the state in establishing 337.28 paternity and obtaining third party payments. Bysigning an337.29application foraccepting general assistance, a person assigns 337.30 to the department of human services all rights to medical 337.31 support or payments for medical expenses from another person or 337.32 entity on their own or their dependent's behalf and agrees to 337.33 cooperate with the state in establishing paternity and obtaining 337.34 third party payments. The application shall contain a statement 337.35 explaining the assignment. Any rights or amounts assigned shall 337.36 be applied against the cost of medical care paid for under this 338.1 chapter. An assignment is effective on the date general 338.2 assistance medical care eligibility takes effect.The338.3assignment shall not affect benefits paid or provided under338.4automobile accident coverage and private health care coverage338.5until the person or organization providing the benefits has338.6received notice of the assignment.338.7 Sec. 48. Minnesota Statutes 2002, section 256I.02, is 338.8 amended to read: 338.9 256I.02 [PURPOSE.] 338.10 The Group Residential Housing Act establishes a 338.11 comprehensive system of rates and payments for persons who 338.12 reside ina group residencethe community and who meet the 338.13 eligibility criteria under section 256I.04, subdivision 1. 338.14 Sec. 49. Minnesota Statutes 2002, section 256I.04, 338.15 subdivision 3, is amended to read: 338.16 Subd. 3. [MORATORIUM ON THE DEVELOPMENT OF GROUP 338.17 RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter 338.18 into agreements for new group residential housing beds with 338.19 total rates in excess of the MSA equivalent rate except: (1) 338.20for group residential housing establishments meeting the338.21requirements of subdivision 2a, clause (2) with department338.22approval; (2)for group residential housing establishments 338.23 licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 338.24 provided the facility is needed to meet the census reduction 338.25 targets for persons with mental retardation or related 338.26 conditions at regional treatment centers;(3)(2) to ensure 338.27 compliance with the federal Omnibus Budget Reconciliation Act 338.28 alternative disposition plan requirements for inappropriately 338.29 placed persons with mental retardation or related conditions or 338.30 mental illness;(4)(3) up to 80 beds in a single, specialized 338.31 facility located in Hennepin county that will provide housing 338.32 for chronic inebriates who are repetitive users of 338.33 detoxification centers and are refused placement in emergency 338.34 shelters because of their state of intoxication, and planning 338.35 for the specialized facility must have been initiated before 338.36 July 1, 1991, in anticipation of receiving a grant from the 339.1 housing finance agency under section 462A.05, subdivision 20a, 339.2 paragraph (b);(5)(4) notwithstanding the provisions of 339.3 subdivision 2a, for up to 190 supportive housing units in Anoka, 339.4 Dakota, Hennepin, or Ramsey county for homeless adults with a 339.5 mental illness, a history of substance abuse, or human 339.6 immunodeficiency virus or acquired immunodeficiency syndrome. 339.7 For purposes of this section, "homeless adult" means a person 339.8 who is living on the street or in a shelter or discharged from a 339.9 regional treatment center, community hospital, or residential 339.10 treatment program and has no appropriate housing available and 339.11 lacks the resources and support necessary to access appropriate 339.12 housing. At least 70 percent of the supportive housing units 339.13 must serve homeless adults with mental illness, substance abuse 339.14 problems, or human immunodeficiency virus or acquired 339.15 immunodeficiency syndrome who are about to be or, within the 339.16 previous six months, has been discharged from a regional 339.17 treatment center, or a state-contracted psychiatric bed in a 339.18 community hospital, or a residential mental health or chemical 339.19 dependency treatment program. If a person meets the 339.20 requirements of subdivision 1, paragraph (a), and receives a 339.21 federal or state housing subsidy, the group residential housing 339.22 rate for that person is limited to the supplementary rate under 339.23 section 256I.05, subdivision 1a, and is determined by 339.24 subtracting the amount of the person's countable income that 339.25 exceeds the MSA equivalent rate from the group residential 339.26 housing supplementary rate. A resident in a demonstration 339.27 project site who no longer participates in the demonstration 339.28 program shall retain eligibility for a group residential housing 339.29 payment in an amount determined under section 256I.06, 339.30 subdivision 8, using the MSA equivalent rate. Service funding 339.31 under section 256I.05, subdivision 1a, will end June 30, 1997, 339.32 if federal matching funds are available and the services can be 339.33 provided through a managed care entity. If federal matching 339.34 funds are not available, then service funding will continue 339.35 under section 256I.05, subdivision 1a; or (6) for group 339.36 residential housing beds in settings meeting the requirements of 340.1 subdivision 2a, clauses (1) and (3), which are used exclusively 340.2 for recipients receiving home and community-based waiver 340.3 services under sections 256B.0915, 256B.092, subdivision 5, 340.4 256B.093, and 256B.49, and who resided in a nursing facility for 340.5 the six months immediately prior to the month of entry into the 340.6 group residential housing setting. The group residential 340.7 housing rate for these beds must be set so that the monthly 340.8 group residential housing payment for an individual occupying 340.9 the bed when combined with the nonfederal share of services 340.10 delivered under the waiver for that person does not exceed the 340.11 nonfederal share of the monthly medical assistance payment made 340.12 for the person to the nursing facility in which the person 340.13 resided prior to entry into the group residential housing 340.14 establishment. The rate may not exceed the MSA equivalent rate 340.15 plus $426.37 for any case. 340.16 (b) A county agency may enter into a group residential 340.17 housing agreement for beds with rates in excess of the MSA 340.18 equivalent rate in addition to those currently covered under a 340.19 group residential housing agreement if the additional beds are 340.20 only a replacement of beds with rates in excess of the MSA 340.21 equivalent rate which have been made available due to closure of 340.22 a setting, a change of licensure or certification which removes 340.23 the beds from group residential housing payment, or as a result 340.24 of the downsizing of a group residential housing setting. The 340.25 transfer of available beds from one county to another can only 340.26 occur by the agreement of both counties. 340.27 Sec. 50. Minnesota Statutes 2002, section 256I.05, 340.28 subdivision 1, is amended to read: 340.29 Subdivision 1. [MAXIMUM RATES.](a)Monthly room and board 340.30 rates negotiated by a county agency for a recipient living in 340.31 group residential housing must not exceed the MSA equivalent 340.32 rate specified under section 256I.03, subdivision 5,.with the340.33exception that a county agency may negotiate a supplementary340.34room and board rate that exceeds the MSA equivalent rate for340.35recipients of waiver services under title XIX of the Social340.36Security Act. This exception is subject to the following341.1conditions:341.2(1) the setting is licensed by the commissioner of human341.3services under Minnesota Rules, parts 9555.5050 to 9555.6265;341.4(2) the setting is not the primary residence of the license341.5holder and in which the license holder is not the primary341.6caregiver; and341.7(3) the average supplementary room and board rate in a341.8county for a calendar year may not exceed the average341.9supplementary room and board rate for that county in effect on341.10January 1, 2000. For calendar years beginning on or after341.11January 1, 2002, within the limits of appropriations341.12specifically for this purpose, the commissioner shall increase341.13each county's supplemental room and board rate average on an341.14annual basis by a factor consisting of the percentage change in341.15the Consumer Price Index-All items, United States city average341.16(CPI-U) for that calendar year compared to the preceding341.17calendar year as forecasted by Data Resources, Inc., in the341.18third quarter of the preceding calendar year. If a county has341.19not negotiated supplementary room and board rates for any341.20facilities located in the county as of January 1, 2000, or has341.21an average supplemental room and board rate under $100 per341.22person as of January 1, 2000, it may submit a supplementary room341.23and board rate request with budget information for a facility to341.24the commissioner for approval.341.25The county agency may at any time negotiate a higher or lower341.26room and board rate than the average supplementary room and341.27board rate.341.28(b) Notwithstanding paragraph (a), clause (3), county341.29agencies may negotiate a supplementary room and board rate that341.30exceeds the MSA equivalent rate by up to $426.37 for up to five341.31facilities, serving not more than 20 individuals in total, that341.32were established to replace an intermediate care facility for341.33persons with mental retardation and related conditions located341.34in the city of Roseau that became uninhabitable due to flood341.35damage in June 2002.341.36 [EFFECTIVE DATE.] This section is effective July 1, 2004, 342.1 or upon receipt of federal approval of waiver amendment, 342.2 whichever is later. 342.3 Sec. 51. Minnesota Statutes 2002, section 256I.05, 342.4 subdivision 1a, is amended to read: 342.5 Subd. 1a. [SUPPLEMENTARY SERVICE RATES.] (a) Subject to 342.6 the provisions of section 256I.04, subdivision 3,in addition to342.7the room and board rate specified in subdivision 1,the county 342.8 agency may negotiate a payment not to exceed $426.37 for other 342.9 services necessary to provide room and board provided by the 342.10 group residence if the residence is licensed by or registered by 342.11 the department of health, or licensed by the department of human 342.12 services to provide services in addition to room and board, and 342.13 if the provider of services is not also concurrently receiving 342.14 funding for services for a recipient under a home and 342.15 community-based waiver under title XIX of the Social Security 342.16 Act; or funding from the medical assistance program under 342.17 section 256B.0627, subdivision 4, for personal care services for 342.18 residents in the setting; or residing in a setting which 342.19 receives funding under Minnesota Rules, parts 9535.2000 to 342.20 9535.3000. If funding is available for other necessary services 342.21 through a home and community-based waiver, or personal care 342.22 services under section 256B.0627, subdivision 4, then the GRH 342.23 rate is limited to the rate set in subdivision 1. Unless 342.24 otherwise provided in law, in no case may the supplementary 342.25 service rateplus the supplementary room and board rateexceed 342.26 $426.37. The registration and licensure requirement does not 342.27 apply to establishments which are exempt from state licensure 342.28 because they are located on Indian reservations and for which 342.29 the tribe has prescribed health and safety requirements. 342.30 Service payments under this section may be prohibited under 342.31 rules to prevent the supplanting of federal funds with state 342.32 funds. The commissioner shall pursue the feasibility of 342.33 obtaining the approval of the Secretary of Health and Human 342.34 Services to provide home and community-based waiver services 342.35 under title XIX of the Social Security Act for residents who are 342.36 not eligible for an existing home and community-based waiver due 343.1 to a primary diagnosis of mental illness or chemical dependency 343.2 and shall apply for a waiver if it is determined to be 343.3 cost-effective. 343.4 (b) The commissioner is authorized to make cost-neutral 343.5 transfers from the GRH fund for beds under this section to other 343.6 funding programs administered by the department after 343.7 consultation with the county or counties in which the affected 343.8 beds are located. The commissioner may also make cost-neutral 343.9 transfers from the GRH fund to county human service agencies for 343.10 beds permanently removed from the GRH census under a plan 343.11 submitted by the county agency and approved by the 343.12 commissioner. The commissioner shall report the amount of any 343.13 transfers under this provision annually to the legislature. 343.14 (c) The provisions of paragraph (b) do not apply to a 343.15 facility that has its reimbursement rate established under 343.16 section 256B.431, subdivision 4, paragraph (c). 343.17 Sec. 52. Minnesota Statutes 2002, section 256I.05, 343.18 subdivision 7c, is amended to read: 343.19 Subd. 7c. [DEMONSTRATION PROJECT.] The commissioner is 343.20 authorized to pursue a demonstration project under federal food 343.21 stamp regulation for the purpose of gaining federal 343.22 reimbursement of food and nutritional costs currently paid by 343.23 the state group residential housing program. The commissioner 343.24 shall seek approval no later than January 1, 2004. Any 343.25 reimbursement received is nondedicated revenue to the general 343.26 fund. 343.27 Sec. 53. [514.991] [ALTERNATIVE CARE LIENS; DEFINITIONS.] 343.28 Subdivision 1. [APPLICABILITY.] The definitions in this 343.29 section apply to sections 514.991 to 514.995. 343.30 Subd. 2. [ALTERNATIVE CARE AGENCY, AGENCY, OR 343.31 DEPARTMENT.] "Alternative care agency," "agency," or "department" 343.32 means the department of human services when it pays for or 343.33 provides alternative care benefits for a nonmedical assistance 343.34 recipient directly or through a county social services agency 343.35 under chapter 256B according to section 256B.0913. 343.36 Subd. 3. [ALTERNATIVE CARE BENEFIT OR 344.1 BENEFITS.] "Alternative care benefit" or "benefits" means a 344.2 benefit provided to a nonmedical assistance recipient under 344.3 chapter 256B according to section 256B.0913. 344.4 Subd. 4. [ALTERNATIVE CARE RECIPIENT OR 344.5 RECIPIENT.] "Alternative care recipient" or "recipient" means a 344.6 person who receives alternative care grant benefits. 344.7 Subd. 5. [ALTERNATIVE CARE LIEN OR LIEN.] "Alternative 344.8 care lien" or "lien" means a lien filed under sections 514.992 344.9 to 514.995. 344.10 [EFFECTIVE DATE.] This section is effective July 1, 2003, 344.11 for services for persons first enrolling in the alternative care 344.12 program on or after that date and on the first day of the first 344.13 eligibility renewal period for persons enrolled in the 344.14 alternative care program prior to July 1, 2003. 344.15 Sec. 54. [514.992] [ALTERNATIVE CARE LIEN.] 344.16 Subdivision 1. [PROPERTY SUBJECT TO LIEN; LIEN AMOUNT.] (a) 344.17 Subject to sections 514.991 to 514.995, payments made by an 344.18 alternative care agency to provide benefits to a recipient or to 344.19 the recipient's spouse who owns property in this state 344.20 constitute a lien in favor of the agency on all real property 344.21 the recipient owns at and after the time the benefits are first 344.22 paid. 344.23 (b) The amount of the lien is limited to benefits paid for 344.24 services provided to recipients over 55 years of age and 344.25 provided on and after July 1, 2003. 344.26 Subd. 2. [ATTACHMENT.] (a) A lien attaches to and becomes 344.27 enforceable against specific real property as of the date when 344.28 all of the following conditions are met: 344.29 (1) the agency has paid benefits for a recipient; 344.30 (2) the recipient has been given notice and an opportunity 344.31 for a hearing under paragraph (b); 344.32 (3) the lien has been filed as provided for in section 344.33 514.993 or memorialized on the certificate of title for the 344.34 property it describes; and 344.35 (4) all restrictions against enforcement have ceased to 344.36 apply. 345.1 (b) An agency may not file a lien until it has sent the 345.2 recipient, their authorized representative, or their legal 345.3 representative written notice of its lien rights by certified 345.4 mail, return receipt requested, or registered mail and there has 345.5 been an opportunity for a hearing under section 256.045. No 345.6 person other than the recipient shall have a right to a hearing 345.7 under section 256.045 prior to the time the lien is filed. The 345.8 hearing shall be limited to whether the agency has met all of 345.9 the prerequisites for filing the lien and whether any of the 345.10 exceptions in this section apply. 345.11 (c) An agency may not file a lien against the recipient's 345.12 homestead when any of the following exceptions apply: 345.13 (1) while the recipient's spouse is also physically present 345.14 and lawfully and continuously residing in the homestead; 345.15 (2) a child of the recipient who is under age 21 or who is 345.16 blind or totally and permanently disabled according to 345.17 supplemental security income criteria is also physically present 345.18 on the property and lawfully and continuously residing on the 345.19 property from and after the date the recipient first receives 345.20 benefits; 345.21 (3) a child of the recipient who has also lawfully and 345.22 continuously resided on the property for a period beginning at 345.23 least two years before the first day of the month in which the 345.24 recipient began receiving alternative care, and who provided 345.25 uncompensated care to the recipient which enabled the recipient 345.26 to live without alternative care services for the two-year 345.27 period; 345.28 (4) a sibling of the recipient who has an ownership 345.29 interest in the property of record in the office of the county 345.30 recorder or registrar of titles for the county in which the real 345.31 property is located and who has also continuously occupied the 345.32 homestead for a period of at least one year immediately prior to 345.33 the first day of the first month in which the recipient received 345.34 benefits and continuously since that date. 345.35 (d) A lien only applies to the real property it describes. 345.36 Subd. 3. [CONTINUATION OF LIEN.] A lien remains effective 346.1 from the time it is filed until it is paid, satisfied, 346.2 discharged, or becomes unenforceable under sections 514.991 to 346.3 514.995. 346.4 Subd. 4. [PRIORITY OF LIEN.] (a) A lien which attaches to 346.5 the real property it describes is subject to the rights of 346.6 anyone else whose interest in the real property is perfected of 346.7 record before the lien has been recorded or filed under section 346.8 514.993, including: 346.9 (1) an owner, other than the recipient or the recipient's 346.10 spouse; 346.11 (2) a good faith purchaser for value without notice of the 346.12 lien; 346.13 (3) a holder of a mortgage or security interest; or 346.14 (4) a judgment lien creditor whose judgment lien has 346.15 attached to the recipient's interest in the real property. 346.16 (b) The rights of the other person have the same 346.17 protections against an alternative care lien as are afforded 346.18 against a judgment lien that arises out of an unsecured 346.19 obligation and arises as of the time of the filing of an 346.20 alternative care grant lien under section 514.993. The lien 346.21 shall be inferior to a lien for property taxes and special 346.22 assessments and shall be superior to all other matters first 346.23 appearing of record after the time and date the lien is filed or 346.24 recorded. 346.25 Subd. 5. [SETTLEMENT, SUBORDINATION, AND RELEASE.] (a) An 346.26 agency may, with absolute discretion, settle or subordinate the 346.27 lien to any other lien or encumbrance of record upon the terms 346.28 and conditions it deems appropriate. 346.29 (b) The agency filing the lien shall release and discharge 346.30 the lien: 346.31 (1) if it has been paid, discharged, or satisfied; 346.32 (2) if it has received reimbursement for the amounts 346.33 secured by the lien, has entered into a binding and legally 346.34 enforceable agreement under which it is reimbursed for the 346.35 amount of the lien, or receives other collateral sufficient to 346.36 secure payment of the lien; 347.1 (3) against some, but not all, of the property it describes 347.2 upon the terms, conditions, and circumstances the agency deems 347.3 appropriate; 347.4 (4) to the extent it cannot be lawfully enforced against 347.5 the property it describes because of an error, omission, or 347.6 other material defect in the legal description contained in the 347.7 lien or a necessary prerequisite to enforcement of the lien; and 347.8 (5) if, in its discretion, it determines the filing or 347.9 enforcement of the lien is contrary to the public interest. 347.10 (c) The agency executing the lien shall execute and file 347.11 the release as provided for in section 514.993, subdivision 2. 347.12 Subd. 6. [LENGTH OF LIEN.] (a) A lien shall be a lien on 347.13 the real property it describes for a period of ten years from 347.14 the date it attaches according to subdivision 2, paragraph (a), 347.15 except as otherwise provided for in sections 514.992 to 347.16 514.995. The agency filing the lien may renew the lien for one 347.17 additional ten-year period from the date it would otherwise 347.18 expire by recording or filing a certificate of renewal before 347.19 the lien expires. The certificate of renewal shall be recorded 347.20 or filed in the office of the county recorder or registrar of 347.21 titles for the county in which the lien is recorded or filed. 347.22 The certificate must refer to the recording or filing data for 347.23 the lien it renews. The certificate need not be attested, 347.24 certified, or acknowledged as a condition for recording or 347.25 filing. The recorder or registrar of titles shall record, file, 347.26 index, and return the certificate of renewal in the same manner 347.27 provided for liens in section 514.993, subdivision 2. 347.28 (b) An alternative care lien is not enforceable against the 347.29 real property of an estate to the extent there is a 347.30 determination by a court of competent jurisdiction, or by an 347.31 officer of the court designated for that purpose, that there are 347.32 insufficient assets in the estate to satisfy the lien in whole 347.33 or in part because of the homestead exemption under section 347.34 256B.15, subdivision 4, the rights of a surviving spouse or a 347.35 minor child under section 524.2-403, paragraphs (a) and (b), or 347.36 claims with a priority under section 524.3-805, paragraph (a), 348.1 clauses (1) to (4). For purposes of this section, the rights of 348.2 the decedent's adult children to exempt property under section 348.3 524.2-403, paragraph (b), shall not be considered costs of 348.4 administration under section 524.3-805, paragraph (a), clause 348.5 (1). 348.6 [EFFECTIVE DATE.] This section is effective July 1, 2003, 348.7 for services for persons first enrolling in the alternative care 348.8 program on or after that date and on the first day of the first 348.9 eligibility renewal period for persons enrolled in the 348.10 alternative care program prior to July 1, 2003. 348.11 Sec. 55. [514.993] [LIEN; CONTENTS AND FILING.] 348.12 Subdivision 1. [CONTENTS.] A lien shall be dated and must 348.13 contain: 348.14 (1) the recipient's full name, last known address, and 348.15 social security number; 348.16 (2) a statement that benefits have been paid to or for the 348.17 recipient's benefit; 348.18 (3) a statement that all of the recipient's interests in 348.19 the in the real property described in the lien may be subject to 348.20 or affected by the agency's right to reimbursement for benefits; 348.21 (4) a legal description of the real property subject to the 348.22 lien and whether it is registered or abstract property; 348.23 (5) such other contents, if any, as the agency deems 348.24 appropriate. 348.25 Subd. 2. [FILING.] Any lien, release, or other document 348.26 required or permitted to be filed under sections 514.991 to 348.27 514.995 must be recorded or filed in the office of the county 348.28 recorder or registrar of titles, as appropriate, in the county 348.29 where the real property is located. Notwithstanding section 348.30 386.77, the agency shall pay the applicable filing fee for any 348.31 documents filed under sections 514.991 to 514.995. An 348.32 attestation, certification, or acknowledgment is not required as 348.33 a condition of filing. If the property described in the lien is 348.34 registered property, the registrar of titles shall record it on 348.35 the certificate of title for each parcel of property described 348.36 in the lien. If the property described in the lien is abstract 349.1 property, the recorder shall file the lien in the county's 349.2 grantor-grantee indexes and any tract indexes the county 349.3 maintains for each parcel of property described in the lien. 349.4 The recorder or registrar shall return the recorded or filed 349.5 lien to the agency at no cost. If the agency provides a 349.6 duplicate copy of the lien, the recorder or registrar of titles 349.7 shall show the recording or filing data on the copy and return 349.8 it to the agency at no cost. The agency is responsible for 349.9 filing any lien, release, or other documents under sections 349.10 514.991 to 514.995. 349.11 [EFFECTIVE DATE.] This section is effective July 1, 2003, 349.12 for services for persons first enrolling in the alternative care 349.13 program on or after that date and on the first day of the first 349.14 eligibility renewal period for persons enrolled in the 349.15 alternative care program prior to July 1, 2003. 349.16 Sec. 56. [514.994] [ENFORCEMENT; OTHER REMEDIES.] 349.17 Subdivision 1. [FORECLOSURE OR ENFORCEMENT OF LIEN.] The 349.18 agency may enforce or foreclose a lien filed under sections 349.19 514.991 to 514.995 in the manner provided for by law for 349.20 enforcement of judgment liens against real estate or by a 349.21 foreclosure by action under chapter 581. The lien shall remain 349.22 enforceable as provided for in sections 514.991 to 514.995 349.23 notwithstanding any laws limiting the enforceability of 349.24 judgments. 349.25 Subd. 2. [HOMESTEAD EXEMPTION.] The lien may not be 349.26 enforced against the homestead property of the recipient or the 349.27 spouse while they physically occupy it as their lawful residence. 349.28 Subd. 3. [AGENCY CLAIM OR REMEDY.] Sections 514.992 to 349.29 514.995 do not limit the agency's right to file a claim against 349.30 the recipient's estate or the estate of the recipient's spouse, 349.31 do not limit any other claims for reimbursement the agency may 349.32 have, and do not limit the availability of any other remedy to 349.33 the agency. 349.34 [EFFECTIVE DATE.] This section is effective July 1, 2003, 349.35 for services for persons first enrolling in the alternative care 349.36 program on or after that date and on the first day of the first 350.1 eligibility renewal period for persons enrolled in the 350.2 alternative care program prior to July 1, 2003. 350.3 Sec. 57. [514.995] [AMOUNTS RECEIVED TO SATISFY LIEN.] 350.4 Amounts the agency receives to satisfy the lien must be 350.5 deposited in the state treasury and credited to the fund from 350.6 which the benefits were paid. 350.7 [EFFECTIVE DATE.] This section is effective July 1, 2003, 350.8 for services for persons first enrolling in the alternative care 350.9 program on or after that date and on the first day of the first 350.10 eligibility renewal period for persons enrolled in the 350.11 alternative care program prior to July 1, 2003. 350.12 Sec. 58. Minnesota Statutes 2002, section 524.3-805, is 350.13 amended to read: 350.14 524.3-805 [CLASSIFICATION OF CLAIMS.] 350.15 (a) If the applicable assets of the estate are insufficient 350.16 to pay all claims in full, the personal representative shall 350.17 make payment in the following order: 350.18 (1) costs and expenses of administration; 350.19 (2) reasonable funeral expenses; 350.20 (3) debts and taxes with preference under federal law; 350.21 (4) reasonable and necessary medical, hospital, or nursing 350.22 home expenses of the last illness of the decedent, including 350.23 compensation of persons attending the decedent, a claim filed 350.24 under section 256B.15 for recovery of expenditures for 350.25 alternative care for nonmedical assistance recipients under 350.26 section 256B.0913, and including a claim filed pursuant to 350.27 section 256B.15; 350.28 (5) reasonable and necessary medical, hospital, and nursing 350.29 home expenses for the care of the decedent during the year 350.30 immediately preceding death; 350.31 (6) debts with preference under other laws of this state, 350.32 and state taxes; 350.33 (7) all other claims. 350.34 (b) No preference shall be given in the payment of any 350.35 claim over any other claim of the same class, and a claim due 350.36 and payable shall not be entitled to a preference over claims 351.1 not due, except that if claims for expenses of the last illness 351.2 involve only claims filed under section 256B.15 for recovery of 351.3 expenditures for alternative care for nonmedical assistance 351.4 recipients under section 256B.0913, section 246.53 for costs of 351.5 state hospital care and claims filed under section 256B.15, 351.6 claims filed to recover expenditures for alternative care for 351.7 nonmedical assistance recipients under section 256B.0913 shall 351.8 have preference over claims filed under both sections 246.53 and 351.9 other claims filed under section 256B.15, and claims filed under 351.10 section 246.53 have preference over claims filed under section 351.11 256B.15 for recovery of amounts other than those for 351.12 expenditures for alternative care for nonmedical assistance 351.13 recipients under section 256B.0913. 351.14 [EFFECTIVE DATE.] This section is effective July 1, 2003, 351.15 for decedents dying on or after that date. 351.16 Sec. 59. [IMPOSITION OF FEDERAL CERTIFICATION REMEDIES.] 351.17 The commissioner of health shall seek changes in the 351.18 federal policy that mandates the imposition of federal sanctions 351.19 without providing an opportunity for a nursing facility to 351.20 correct deficiencies, solely as the result of previous 351.21 deficiencies issued to the nursing facility. 351.22 [EFFECTIVE DATE.] This section is effective July 1, 2003. 351.23 Sec. 60. [REPORT ON LONG-TERM CARE.] 351.24 The report on long-term care services required under 351.25 Minnesota Statutes, section 144A.351, that is presented to the 351.26 legislature by January 15, 2004, must also address the 351.27 feasibility of offering government or private sector loans or 351.28 lines of credit to individuals age 65 and over, for the purchase 351.29 of long-term care services. 351.30 Sec. 61. [REPORTS; POTENTIAL SAVINGS TO STATE FROM CERTAIN 351.31 LONG-TERM CARE INSURANCE PURCHASE INCENTIVES.] 351.32 Subdivision 1. [LONG-TERM CARE INSURANCE 351.33 PARTNERSHIPS.] The commissioner of human services, in 351.34 consultation with the commissioner of commerce, shall report to 351.35 the legislature on the feasibility of Minnesota adopting a 351.36 long-term care insurance partnership program similar to those 352.1 adopted in other states. In such a program, the state would 352.2 encourage purchase of private long-term care insurance by 352.3 permitting the insured to retain assets in excess of those 352.4 otherwise permitted for medical assistance eligibility, if the 352.5 insured later exhausts the private long-term care insurance 352.6 benefits. The report must include the feasibility of obtaining 352.7 any necessary federal waiver. The report must comply with 352.8 Minnesota Statutes, sections 3.195 and 3.197. 352.9 Subd. 2. [USE OF MEDICAL ASSISTANCE FUNDS TO SUBSIDIZE 352.10 PURCHASE OF LONG-TERM CARE INSURANCE.] The commissioner of human 352.11 services shall report to the legislature on the feasibility of 352.12 using state medical assistance funds to subsidize the purchase 352.13 of private long-term care insurance by individuals who would be 352.14 unlikely to purchase it without a subsidy, in order to generate 352.15 long-term savings of medical assistance expenditures. The 352.16 report must comply with Minnesota Statutes, sections 3.195 and 352.17 3.197. 352.18 Subd. 3. [NURSING FACILITY BENEFITS IN MEDICARE SUPPLEMENT 352.19 COVERAGE.] The commissioner of human services must study and 352.20 quantify the cost or savings to the state if a nursing facility 352.21 benefit were added to Medicare-related coverage, as defined in 352.22 Minnesota Statutes, section 62Q.01, subdivision 6. 352.23 [EFFECTIVE DATE.] This section is effective July 1, 2003. 352.24 Sec. 62. [REVISOR'S INSTRUCTION.] 352.25 For sections in Minnesota Statutes and Minnesota Rules 352.26 affected by the repealed sections in this article, the revisor 352.27 shall delete internal cross-references where appropriate and 352.28 make changes necessary to correct the punctuation, grammar, or 352.29 structure of the remaining text and preserve its meaning. 352.30 Sec. 63. [REPEALER.] 352.31 (a) Minnesota Statutes 2002, sections 256.973; 256.9772; 352.32 256B.0928; and 256B.437, subdivision 2, are repealed effective 352.33 July 1, 2003. 352.34 (b) Minnesota Statutes 2002, sections 62J.66; 62J.68; 352.35 144A.071, subdivision 5; and 144A.35, are repealed. 352.36 (c) Laws 1998, chapter 407, article 4, section 63, is 353.1 repealed. 353.2 (d) Minnesota Rules, parts 9505.3045; 9505.3050; 9505.3055; 353.3 9505.3060; 9505.3068; 9505.3070; 9505.3075; 9505.3080; 353.4 9505.3090; 9505.3095; 9505.3100; 9505.3105; 9505.3107; 353.5 9505.3110; 9505.3115; 9505.3120; 9505.3125; 9505.3130; 353.6 9505.3138; 9505.3139; 9505.3140; 9505.3680; 9505.3690; and 353.7 9505.3700, are repealed effective July 1, 2003. 353.8 ARTICLE 4 353.9 CONTINUING CARE FOR PERSONS WITH DISABILITIES 353.10 Section 1. Minnesota Statutes 2002, section 174.30, 353.11 subdivision 1, is amended to read: 353.12 Subdivision 1. [APPLICABILITY.] (a) The operating 353.13 standards for special transportation service adopted under this 353.14 section do not apply to special transportation provided by: 353.15 (1) a common carrier operating on fixed routes and 353.16 schedules; 353.17 (2) a volunteer driver using a private automobile; 353.18 (3) a school bus as defined in section 169.01, subdivision 353.19 6; or 353.20 (4) an emergency ambulance regulated under chapter 144. 353.21 (b) The operating standards adopted under this section only 353.22 apply to providers of special transportation service who receive 353.23 grants or other financial assistance from either the state or 353.24 the federal government, or both, to provide or assist in 353.25 providing that service; except that the operating standards 353.26 adopted under this section do not apply to any nursing home 353.27 licensed under section 144A.02, to any board and care facility 353.28 licensed under section 144.50, or to any day training and 353.29 habilitation services, day care, or group home facility licensed 353.30 under sections 245A.01 to 245A.19 unless the facility or program 353.31 provides transportation to nonresidents on a regular basis and 353.32 the facility receives reimbursement, other than per diem 353.33 payments, for that service under rules promulgated by the 353.34 commissioner of human services. 353.35 (c) Notwithstanding paragraph (b), the operating standards 353.36 adopted under this section do not apply to any vendor of 354.1 services licensed under chapter 245B that provides 354.2 transportation services to consumers or residents of other 354.3 vendors licensed under chapter 245B. 354.4 Sec. 2. Minnesota Statutes 2002, section 245B.06, 354.5 subdivision 8, is amended to read: 354.6 Subd. 8. [LEAVING THE RESIDENCE.] As specified in each 354.7 consumer's individual service plan, each consumer requiring a 354.8 24-hour plan of caremustmay leave the residence to participate 354.9 in regular education, employment, or community activities. 354.10 License holders, providing services to consumers living in a 354.11 licensed site, shall ensure that they are prepared to care for 354.12 consumers whenever they are at the residence during the day 354.13 because of illness, work schedules, or other reasons. 354.14 Sec. 3. Minnesota Statutes 2002, section 245B.07, 354.15 subdivision 11, is amended to read: 354.16 Subd. 11. [TRAVEL TIME TO AND FROM A DAY TRAINING AND 354.17 HABILITATION SITE.] Except in unusual circumstances, the license 354.18 holder must not transport a consumer receiving services for 354.19 longer thanone hour90 minutes per one-way trip. Nothing in 354.20 this subdivision relieves the provider of the obligation to 354.21 provide the number of program hours as identified in the 354.22 individualized service plan. 354.23 Sec. 4. Minnesota Statutes 2002, section 246.54, is 354.24 amended to read: 354.25 246.54 [LIABILITY OF COUNTY; REIMBURSEMENT.] 354.26 Subdivision 1. [COUNTY PORTION FOR COST OF CARE.] Except 354.27 for chemical dependency services provided under sections 254B.01 354.28 to 254B.09, the client's county shall pay to the state of 354.29 Minnesota a portion of the cost of care provided in a regional 354.30 treatment center or a state nursing facility to a client legally 354.31 settled in that county. A county's payment shall be made from 354.32 the county's own sources of revenue and payments shall be paid 354.33 as follows: payments to the state from the county shall 354.34 equalten20 percent of the cost of care, as determined by the 354.35 commissioner, for each day, or the portion thereof, that the 354.36 client spends at a regional treatment center or a state nursing 355.1 facility. If payments received by the state under sections 355.2 246.50 to 246.53 exceed9080 percent of the cost of care, the 355.3 county shall be responsible for paying the state only the 355.4 remaining amount. The county shall not be entitled to 355.5 reimbursement from the client, the client's estate, or from the 355.6 client's relatives, except as provided in section 246.53. No 355.7 such payments shall be made for any client who was last 355.8 committed prior to July 1, 1947. 355.9 Subd. 2. [EXCEPTIONS.] Subdivision 1 does not apply to 355.10 services provided at the Minnesota security hospital, the 355.11 Minnesota sex offender program, or the Minnesota extended 355.12 treatment options program. For services at these facilities, a 355.13 county's payment shall be made from the county's own sources of 355.14 revenue and payments shall be paid as follows: payments to the 355.15 state from the county shall equal ten percent of the cost of 355.16 care, as determined by the commissioner, for each day, or the 355.17 portion thereof, that the client spends at the facility. If 355.18 payments received by the state under sections 246.50 to 246.53 355.19 exceed 90 percent of the cost of care, the county shall be 355.20 responsible for paying the state only the remaining amount. The 355.21 county shall not be entitled to reimbursement from the client, 355.22 the client's estate, or from the client's relatives, except as 355.23 provided in section 246.53. 355.24 [EFFECTIVE DATE.] This section is effective January 1, 2004. 355.25 Sec. 5. Minnesota Statutes 2002, section 252.32, 355.26 subdivision 1, is amended to read: 355.27 Subdivision 1. [PROGRAM ESTABLISHED.] In accordance with 355.28 state policy established in section 256F.01 that all children 355.29 are entitled to live in families that offer safe, nurturing, 355.30 permanent relationships, and that public services be directed 355.31 toward preventing the unnecessary separation of children from 355.32 their families, and because many families who have children with 355.33mental retardation or related conditionsdisabilities have 355.34 special needs and expenses that other families do not have, the 355.35 commissioner of human services shall establish a program to 355.36 assist families who havedependentsdependent children with 356.1mental retardation or related conditionsdisabilities living in 356.2 their home. The program shall make support grants available to 356.3 the families. 356.4 Sec. 6. Minnesota Statutes 2002, section 252.32, 356.5 subdivision 1a, is amended to read: 356.6 Subd. 1a. [SUPPORT GRANTS.] (a) Provision of support 356.7 grants must be limited to families who require support and whose 356.8 dependents are under the age of2221and who have mental356.9retardation or who have a related conditionand who have been 356.10determined by a screening team establishedcertified disabled 356.11 under section256B.092 to be at risk of356.12institutionalization256B.055, subdivision 12, paragraphs (a), 356.13 (b), (c), (d), and (e). Families who are receiving home and 356.14 community-based waivered services for persons with mental 356.15 retardation or related conditions are not eligible for support 356.16 grants. 356.17Families receiving grants who will be receiving home and356.18community-based waiver services for persons with mental356.19retardation or a related condition for their family member356.20within the grant year, and who have ongoing payments for356.21environmental or vehicle modifications which have been approved356.22by the county as a grant expense and would have qualified for356.23payment under this waiver may receive a onetime grant payment356.24from the commissioner to reduce or eliminate the principal of356.25the remaining debt for the modifications, not to exceed the356.26maximum amount allowable for the remaining years of eligibility356.27for a family support grant. The commissioner is authorized to356.28use up to $20,000 annually from the grant appropriation for this356.29purpose. Any amount unexpended at the end of the grant year356.30shall be allocated by the commissioner in accordance with356.31subdivision 3a, paragraph (b), clause (2).Families whose 356.32 annual adjusted gross income is $60,000 or more are not eligible 356.33 for support grants except in cases where extreme hardship is 356.34 demonstrated. Beginning in state fiscal year 1994, the 356.35 commissioner shall adjust the income ceiling annually to reflect 356.36 the projected change in the average value in the United States 357.1 Department of Labor Bureau of Labor Statistics consumer price 357.2 index (all urban) for that year. 357.3 (b) Support grants may be made available as monthly subsidy 357.4 grants and lump sum grants. 357.5 (c) Support grants may be issued in the form of cash, 357.6 voucher, and direct county payment to a vendor. 357.7 (d) Applications for the support grant shall be made by the 357.8 legal guardian to the county social service agency. The 357.9 application shall specify the needs of the families, the form of 357.10 the grant requested by the families, andthatthefamilies have357.11agreed to use the support grant foritems and serviceswithin357.12the designated reimbursable expense categories and357.13recommendations of the countyto be reimbursed. 357.14(e) Families who were receiving subsidies on the date of357.15implementation of the $60,000 income limit in paragraph (a)357.16continue to be eligible for a family support grant until357.17December 31, 1991, if all other eligibility criteria are met.357.18After December 31, 1991, these families are eligible for a grant357.19in the amount of one-half the grant they would otherwise357.20receive, for as long as they remain eligible under other357.21eligibility criteria.357.22 Sec. 7. Minnesota Statutes 2002, section 252.32, 357.23 subdivision 3, is amended to read: 357.24 Subd. 3. [AMOUNT OF SUPPORT GRANT; USE.] Support grant 357.25 amounts shall be determined by the county social service 357.26 agency.Each serviceServices anditemitems purchased with a 357.27 support grant must: 357.28 (1) be over and above the normal costs of caring for the 357.29 dependent if the dependent did not have a disability; 357.30 (2) be directly attributable to the dependent's disabling 357.31 condition; and 357.32 (3) enable the family to delay or prevent the out-of-home 357.33 placement of the dependent. 357.34 The design and delivery of services and items purchased 357.35 under this section must suit the dependent's chronological age 357.36 and be provided in the least restrictive environment possible, 358.1 consistent with the needs identified in the individual service 358.2 plan. 358.3 Items and services purchased with support grants must be 358.4 those for which there are no other public or private funds 358.5 available to the family. Fees assessed to parents for health or 358.6 human services that are funded by federal, state, or county 358.7 dollars are not reimbursable through this program. 358.8 In approving or denying applications, the county shall 358.9 consider the following factors: 358.10 (1) the extent and areas of the functional limitations of 358.11 the disabled child; 358.12 (2) the degree of need in the home environment for 358.13 additional support; and 358.14 (3) the potential effectiveness of the grant to maintain 358.15 and support the person in the family environment. 358.16 The maximum monthly grant amount shall be $250 per eligible 358.17 dependent, or $3,000 per eligible dependent per state fiscal 358.18 year, within the limits of available funds. The county social 358.19 service agency may consider the dependent's supplemental 358.20 security income in determining the amount of the support grant. 358.21The county social service agency may exceed $3,000 per state358.22fiscal year per eligible dependent for emergency circumstances358.23in cases where exceptional resources of the family are required358.24to meet the health, welfare-safety needs of the child.358.25County social service agencies shall continue to provide358.26funds to families receiving state grants on June 30, 1997, if358.27eligibility criteria continue to be met.Any adjustments to 358.28 their monthly grant amount must be based on the needs of the 358.29 family and funding availability. 358.30 Sec. 8. Minnesota Statutes 2002, section 252.32, 358.31 subdivision 3c, is amended to read: 358.32 Subd. 3c. [COUNTY BOARD RESPONSIBILITIES.] County boards 358.33 receiving funds under this section shall: 358.34 (1)determine the needs of families for services in358.35accordance with section 256B.092 or 256E.08 and any rules358.36adopted under those sections;submit a plan to the department 359.1 for the management of the family support grant program. The 359.2 plan must include the projected number of families the county 359.3 will serve and policies and procedures for: 359.4 (i) identifying potential families for the program; 359.5 (ii) grant distribution; 359.6 (iii) waiting list procedures; and 359.7 (iv) prioritization of families to receive grants; 359.8 (2) determine the eligibility of all persons proposed for 359.9 program participation; 359.10 (3) approve a plan for items and services to be reimbursed 359.11 and inform families of the county's approval decision; 359.12 (4) issue support grants directly to, or on behalf of, 359.13 eligible families; 359.14 (5) inform recipients of their right to appeal under 359.15 subdivision 3e; 359.16 (6) submit quarterly financial reports under subdivision 3b 359.17 and indicateon the screening documentsthe annual grant level 359.18 for each family, the families denied grants, and the families 359.19 eligible but waiting for funding; and 359.20 (7) coordinate services with other programs offered by the 359.21 county. 359.22 Sec. 9. Minnesota Statutes 2002, section 252.41, 359.23 subdivision 3, is amended to read: 359.24 Subd. 3. [DAY TRAINING AND HABILITATION SERVICES FOR 359.25 ADULTS WITH MENTAL RETARDATION, RELATED CONDITIONS.] "Day 359.26 training and habilitation services for adults with mental 359.27 retardation and related conditions" means services that: 359.28 (1) include supervision, training, assistance, and 359.29 supported employment, work-related activities, or other 359.30 community-integrated activities designed and implemented in 359.31 accordance with the individual service and individual 359.32 habilitation plans required under Minnesota Rules, parts 359.33 9525.0015 to 9525.0165, to help an adult reach and maintain the 359.34 highest possible level of independence, productivity, and 359.35 integration into the community; and 359.36 (2) are provided under contract with the county where the 360.1 services are delivered by a vendor licensed under sections 360.2 245A.01 to 245A.16 and 252.28, subdivision 2, to provide day 360.3 training and habilitation services; and360.4(3) are regularly provided to one or more adults with360.5mental retardation or related conditions in a place other than360.6the adult's own home or residence unless medically360.7contraindicated. 360.8 Day training and habilitation services reimbursable under 360.9 this section do not include special education and related 360.10 services as defined in the Education of the Handicapped Act, 360.11 United States Code, title 20, chapter 33, section 1401, clauses 360.12 (6) and (17), or vocational services funded under section 110 of 360.13 the Rehabilitation Act of 1973, United States Code, title 29, 360.14 section 720, as amended. 360.15 Sec. 10. Minnesota Statutes 2002, section 252.46, 360.16 subdivision 1, is amended to read: 360.17 Subdivision 1. [RATES.] (a) Payment rates to vendors, 360.18 except regional centers, for county-funded day training and 360.19 habilitation services and transportation provided to persons 360.20 receiving day training and habilitation services established by 360.21 a county board are governed by subdivisions 2 to 19. The 360.22 commissioner shall approve the following three payment rates for 360.23 services provided by a vendor: 360.24 (1) a full-day service rate for persons who receive at 360.25 least six service hours a day, including the time it takes to 360.26 transport the person to and from the service site; 360.27 (2) a partial-day service rate that must not exceed 75 360.28 percent of the full-day service rate for persons who receive 360.29 less than a full day of service; and 360.30 (3) a transportation rate for providing, or arranging and 360.31 paying for, transportation of a person to and from the person's 360.32 residence to the service site. 360.33(b) The commissioner may also approve an hourly job-coach,360.34follow-along rate for services provided by one employee at or en360.35route to or from community locations to supervise, support, and360.36assist one person receiving the vendor's services to learn361.1job-related skills necessary to obtain or retain employment when361.2and where no other persons receiving services are present and361.3when all the following criteria are met:361.4(1) the vendor requests and the county recommends the361.5optional rate;361.6(2) the service is prior authorized by the county on the361.7Medicaid Management Information System for no more than 414361.8hours in a 12-month period and the daily per person charge to361.9medical assistance does not exceed the vendor's approved full361.10day plus transportation rates;361.11(3) separate full day, partial day, and transportation361.12rates are not billed for the same person on the same day;361.13(4) the approved hourly rate does not exceed the sum of the361.14vendor's current average hourly direct service wage, including361.15fringe benefits and taxes, plus a component equal to the361.16vendor's average hourly nondirect service wage expenses; and361.17(5) the actual revenue received for provision of hourly361.18job-coach, follow-along services is subtracted from the vendor's361.19total expenses for the same time period and those adjusted361.20expenses are used for determining recommended full day and361.21transportation payment rates under subdivision 5 in accordance361.22with the limitations in subdivision 3.361.23 (b) Notwithstanding any law or rule to the contrary, the 361.24 commissioner may authorize county participation in a voluntary 361.25 individualized payment rate structure for day training and 361.26 habilitation services to allow a county the flexibility to 361.27 change, after consulting with providers, from a site-based 361.28 payment rate structure to an individual payment rate structure 361.29 for the providers of day training and habilitation services in 361.30 the county. The commissioner shall seek input from providers 361.31 and consumers in establishing procedures for determining the 361.32 structure of voluntary individualized payment rates to ensure 361.33 that there is no additional cost to the state or counties and 361.34 that the rate structure is cost-neutral to providers of day 361.35 training and habilitation services, on July 1, 2004, or on day 361.36 one of the individual rate structure, whichever is later. 362.1 (c) Medical assistance rates for home and community-based 362.2 service provided under section 256B.501, subdivision 4, by 362.3 licensed vendors of day training and habilitation services must 362.4 not be greater than the rates for the same services established 362.5 by counties under sections 252.40 to 252.46. For very dependent 362.6 persons with special needs the commissioner may approve an 362.7 exception to the approved payment rate under section 256B.501, 362.8 subdivision 4 or 8. 362.9 Sec. 11. Minnesota Statutes 2002, section 256.476, 362.10 subdivision 3, is amended to read: 362.11 Subd. 3. [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person 362.12 is eligible to apply for a consumer support grant if the person 362.13 meets all of the following criteria: 362.14 (1) the person is eligible for and has been approved to 362.15 receive services under medical assistance as determined under 362.16 sections 256B.055 and 256B.056 or the person has been approved 362.17 to receive a grant under the developmental disability family 362.18 support program under section 252.32; 362.19 (2) the person is able to direct and purchase the person's 362.20 own care and supports, or the person has a family member, legal 362.21 representative, or other authorized representative who can 362.22 purchase and arrange supports on the person's behalf; 362.23 (3) the person has functional limitations, requires ongoing 362.24 supports to live in the community, and is at risk of or would 362.25 continue institutionalization without such supports; and 362.26 (4) the person will live in a home. For the purpose of 362.27 this section, "home" means the person's own home or home of a 362.28 person's family member. These homes are natural home settings 362.29 and are not licensed by the department of health or human 362.30 services. 362.31 (b) Persons may not concurrently receive a consumer support 362.32 grant if they are: 362.33 (1) receivinghome and community-based services under362.34United States Code, title 42, section 1396h(c);personal care 362.35 attendant and home health aide services, or private duty nursing 362.36 under section 256B.0625; a developmental disability family 363.1 support grant; or alternative care services under section 363.2 256B.0913; or 363.3 (2) residing in an institutional or congregate care setting. 363.4 (c) A person or person's family receiving a consumer 363.5 support grant shall not be charged a fee or premium by a local 363.6 agency for participating in the program. 363.7 (d)The commissioner may limit the participation of363.8recipients of services from federal waiver programs in the363.9consumer support grant program if the participation of these363.10individuals will result in an increase in the cost to the363.11state.Individuals receiving home and community-based waivers 363.12 under United States Code, title 42, section 1396h(c), are not 363.13 eligible for the consumer support grant. 363.14 (e) The commissioner shall establish a budgeted 363.15 appropriation each fiscal year for the consumer support grant 363.16 program. The number of individuals participating in the program 363.17 will be adjusted so the total amount allocated to counties does 363.18 not exceed the amount of the budgeted appropriation. The 363.19 budgeted appropriation will be adjusted annually to accommodate 363.20 changes in demand for the consumer support grants. 363.21 Sec. 12. Minnesota Statutes 2002, section 256.476, 363.22 subdivision 4, is amended to read: 363.23 Subd. 4. [SUPPORT GRANTS; CRITERIA AND LIMITATIONS.] (a) A 363.24 county board may choose to participate in the consumer support 363.25 grant program. If a county has not chosen to participate by 363.26 July 1, 2002, the commissioner shall contract with another 363.27 county or other entity to provide access to residents of the 363.28 nonparticipating county who choose the consumer support grant 363.29 option. The commissioner shall notify the county board in a 363.30 county that has declined to participate of the commissioner's 363.31 intent to enter into a contract with another county or other 363.32 entity at least 30 days in advance of entering into the 363.33 contract. The local agency shall establish written procedures 363.34 and criteria to determine the amount and use of support grants. 363.35 These procedures must include, at least, the availability of 363.36 respite care, assistance with daily living, and adaptive aids. 364.1 The local agency may establish monthly or annual maximum amounts 364.2 for grants and procedures where exceptional resources may be 364.3 required to meet the health and safety needs of the person on a 364.4 time-limited basis, however, the total amount awarded to each 364.5 individual may not exceed the limits established in subdivision 364.6 11. 364.7 (b) Support grants to a person or a person's family will be 364.8 provided through a monthly subsidy payment and be in the form of 364.9 cash, voucher, or direct county payment to vendor. Support 364.10 grant amounts must be determined by the local agency. Each 364.11 service and item purchased with a support grant must meet all of 364.12 the following criteria: 364.13 (1) it must be over and above the normal cost of caring for 364.14 the person if the person did not have functional limitations; 364.15 (2) it must be directly attributable to the person's 364.16 functional limitations; 364.17 (3) it must enable the person or the person's family to 364.18 delay or prevent out-of-home placement of the person; and 364.19 (4) it must be consistent with the needs identified in the 364.20 serviceplanagreement, when applicable. 364.21 (c) Items and services purchased with support grants must 364.22 be those for which there are no other public or private funds 364.23 available to the person or the person's family. Fees assessed 364.24 to the person or the person's family for health and human 364.25 services are not reimbursable through the grant. 364.26 (d) In approving or denying applications, the local agency 364.27 shall consider the following factors: 364.28 (1) the extent and areas of the person's functional 364.29 limitations; 364.30 (2) the degree of need in the home environment for 364.31 additional support; and 364.32 (3) the potential effectiveness of the grant to maintain 364.33 and support the person in the family environment or the person's 364.34 own home. 364.35 (e) At the time of application to the program or screening 364.36 for other services, the person or the person's family shall be 365.1 provided sufficient information to ensure an informed choice of 365.2 alternatives by the person, the person's legal representative, 365.3 if any, or the person's family. The application shall be made 365.4 to the local agency and shall specify the needs of the person 365.5 and family, the form and amount of grant requested, the items 365.6 and services to be reimbursed, and evidence of eligibility for 365.7 medical assistance. 365.8 (f) Upon approval of an application by the local agency and 365.9 agreement on a support plan for the person or person's family, 365.10 the local agency shall make grants to the person or the person's 365.11 family. The grant shall be in an amount for the direct costs of 365.12 the services or supports outlined in the service agreement. 365.13 (g) Reimbursable costs shall not include costs for 365.14 resources already available, such as special education classes, 365.15 day training and habilitation, case management, other services 365.16 to which the person is entitled, medical costs covered by 365.17 insurance or other health programs, or other resources usually 365.18 available at no cost to the person or the person's family. 365.19 (h) The state of Minnesota, the county boards participating 365.20 in the consumer support grant program, or the agencies acting on 365.21 behalf of the county boards in the implementation and 365.22 administration of the consumer support grant program shall not 365.23 be liable for damages, injuries, or liabilities sustained 365.24 through the purchase of support by the individual, the 365.25 individual's family, or the authorized representative under this 365.26 section with funds received through the consumer support grant 365.27 program. Liabilities include but are not limited to: workers' 365.28 compensation liability, the Federal Insurance Contributions Act 365.29 (FICA), or the Federal Unemployment Tax Act (FUTA). For 365.30 purposes of this section, participating county boards and 365.31 agencies acting on behalf of county boards are exempt from the 365.32 provisions of section 268.04. 365.33 Sec. 13. Minnesota Statutes 2002, section 256.476, 365.34 subdivision 5, is amended to read: 365.35 Subd. 5. [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a) 365.36 For the purpose of transferring persons to the consumer support 366.1 grant program fromspecific programs or services, such asthe 366.2 developmental disability family support program and personal 366.3 care assistant services, home health aide services, or private 366.4 duty nursing services, the amount of funds transferred by the 366.5 commissioner between the developmental disability family support 366.6 program account, the medical assistance account, or the consumer 366.7 support grant account shall be based on each county's 366.8 participation in transferring persons to the consumer support 366.9 grant program from those programs and services. 366.10 (b) At the beginning of each fiscal year, county 366.11 allocations for consumer support grants shall be based on: 366.12 (1) the number of persons to whom the county board expects 366.13 to provide consumer supports grants; 366.14 (2) their eligibility for current program and services; 366.15 (3) the amount of nonfederal dollars allowed under 366.16 subdivision 11; and 366.17 (4) projected dates when persons will start receiving 366.18 grants. County allocations shall be adjusted periodically by 366.19 the commissioner based on the actual transfer of persons or 366.20 service openings, and the nonfederal dollars associated with 366.21 those persons or service openings, to the consumer support grant 366.22 program. 366.23 (c) The amount of funds transferred by the commissioner 366.24 from the medical assistance account for an individual may be 366.25 changed if it is determined by the county or its agent that the 366.26 individual's need for support has changed. 366.27 (d) The authority to utilize funds transferred to the 366.28 consumer support grant account for the purposes of implementing 366.29 and administering the consumer support grant program will not be 366.30 limited or constrained by the spending authority provided to the 366.31 program of origination. 366.32 (e) The commissioner may use up to five percent of each 366.33 county's allocation, as adjusted, for payments for 366.34 administrative expenses, to be paid as a proportionate addition 366.35 to reported direct service expenditures. 366.36 (f) The county allocation for each individual or 367.1 individual's family cannot exceed the amount allowed under 367.2 subdivision 11. 367.3 (g) The commissioner may recover, suspend, or withhold 367.4 payments if the county board, local agency, or grantee does not 367.5 comply with the requirements of this section. 367.6 (h) Grant funds unexpended by consumers shall return to the 367.7 state once a year. The annual return of unexpended grant funds 367.8 shall occur in the quarter following the end of the state fiscal 367.9 year. 367.10 Sec. 14. Minnesota Statutes 2002, section 256.482, 367.11 subdivision 8, is amended to read: 367.12 Subd. 8. [SUNSET.] Notwithstanding section 15.059, 367.13 subdivision 5, the council on disability shall not sunset until 367.14 June 30,20032007. 367.15 [EFFECTIVE DATE.] This section is effective May 30, 2003. 367.16 Sec. 15. Minnesota Statutes 2002, section 256B.0621, 367.17 subdivision 4, is amended to read: 367.18 Subd. 4. [RELOCATION TARGETED CASE MANAGEMENT PROVIDER 367.19 QUALIFICATIONS.]The following qualifications and certification367.20standards must be met by providers of relocation targeted case367.21management:367.22(a) The commissioner must certify each provider of367.23relocation targeted case management before enrollment. The367.24certification process shall examine the provider's ability to367.25meet the requirements in this subdivision and other federal and367.26state requirements of this service. A certified relocation367.27targeted case management provider may subcontract with another367.28provider to deliver relocation targeted case management367.29services. Subcontracted providers must demonstrate the ability367.30to provide the services outlined in subdivision 6.367.31(b)(a) A relocation targeted case management provider is 367.32 an enrolled medical assistance provider who is determined by the 367.33 commissioner to have all of the following characteristics: 367.34 (1) the legal authority to provide public welfare under 367.35 sections 393.01, subdivision 7; and 393.07; or a federally 367.36 recognized Indian tribe; 368.1 (2) the demonstrated capacity and experience to provide the 368.2 components of case management to coordinate and link community 368.3 resources needed by the eligible population; 368.4 (3) the administrative capacity and experience to serve the 368.5 target population for whom it will provide services and ensure 368.6 quality of services under state and federal requirements; 368.7 (4) the legal authority to provide complete investigative 368.8 and protective services under section 626.556, subdivision 10; 368.9 and child welfare and foster care services under section 393.07, 368.10 subdivisions 1 and 2; or a federally recognized Indian tribe; 368.11 (5) a financial management system that provides accurate 368.12 documentation of services and costs under state and federal 368.13 requirements; and 368.14 (6) the capacity to document and maintain individual case 368.15 records under state and federal requirements. 368.16 (b) A provider of targeted case management under section 368.17 256B.0625, subdivision 20, may be deemed a certified provider of 368.18 relocation targeted case management. 368.19 (c) A relocation targeted case management provider may 368.20 subcontract with another provider to deliver relocation targeted 368.21 case management services. Subcontracted providers must 368.22 demonstrate the ability to provide the services outlined in 368.23 subdivision 6, and have a procedure in place that notifies the 368.24 recipient and the recipient's legal representative of any 368.25 conflict of interest if the contracted targeted case management 368.26 provider also provides, or will provide, the recipient's 368.27 services and supports. Contracted providers must provide 368.28 information on all conflicts of interest and obtain the 368.29 recipient's informed consent or provide the recipient with 368.30 alternatives. 368.31 Sec. 16. [256B.0622] [INTENSIVE REHABILITATIVE MENTAL 368.32 HEALTH SERVICES.] 368.33 Subdivision 1. [SCOPE.] Subject to federal approval, 368.34 medical assistance covers medically necessary, intensive 368.35 nonresidential and residential rehabilitative mental health 368.36 services as defined in subdivision 2, for recipients as defined 369.1 in subdivision 3, when the services are provided by an entity 369.2 meeting the standards in this section. 369.3 Subd. 2. [DEFINITIONS.] For purposes of this section, the 369.4 following terms have the meanings given them. 369.5 (a) "Intensive nonresidential rehabilitative mental health 369.6 services" means adult rehabilitative mental health services as 369.7 defined in section 256B.0623, subdivision 2, paragraph (a), 369.8 except that these services are provided by a multidisciplinary 369.9 staff using a total team approach consistent with assertive 369.10 community treatment and other evidence-based practices, and 369.11 directed to recipients with a serious mental illness who require 369.12 intensive services. 369.13 (b) "Intensive residential rehabilitative mental health 369.14 services" means short-term, time-limited services provided in a 369.15 residential setting to recipients who are in need of more 369.16 restrictive settings and are at risk of significant functional 369.17 deterioration if they do not receive these services. Services 369.18 are designed to develop and enhance psychiatric stability, 369.19 personal and emotional adjustment, self-sufficiency, and skills 369.20 to live in a more independent setting. Services must be 369.21 directed toward a targeted discharge date with specified client 369.22 outcomes and must be consistent with evidence-based practices. 369.23 (c) "Evidence-based practices" are nationally recognized 369.24 mental health services that are proven by substantial research 369.25 to be effective in helping individuals with serious mental 369.26 illness obtain specific treatment goals. 369.27 (d) "Overnight staff" means a member of the intensive 369.28 residential rehabilitative mental health treatment team who is 369.29 responsible during hours when recipients are typically asleep. 369.30 (e) "Treatment team" means all staff who provide services 369.31 under this section to recipients. At a minimum, this includes 369.32 the clinical supervisor, mental health professionals, mental 369.33 health practitioners, and mental health rehabilitation workers. 369.34 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 369.35 individual who: 369.36 (1) is age 18 or older; 370.1 (2) is eligible for medical assistance; 370.2 (3) is diagnosed with a mental illness; 370.3 (4) because of a mental illness, has substantial disability 370.4 and functional impairment in three or more of the areas listed 370.5 in section 245.462, subdivision 11a, so that self-sufficiency is 370.6 markedly reduced; 370.7 (5) has one or more of the following: a history of two or 370.8 more inpatient hospitalizations in the past year, significant 370.9 independent living instability, homelessness, or very frequent 370.10 use of mental health and related services yielding poor 370.11 outcomes; and 370.12 (6) in the written opinion of a licensed mental health 370.13 professional, has the need for mental health services that 370.14 cannot be met with other available community-based services, or 370.15 is likely to experience a mental health crisis or require a more 370.16 restrictive setting if intensive rehabilitative mental health 370.17 services are not provided. 370.18 Subd. 4. [PROVIDER CERTIFICATION AND CONTRACT 370.19 REQUIREMENTS.] (a) The intensive nonresidential rehabilitative 370.20 mental health services provider must: 370.21 (1) have a contract with the host county to provide 370.22 intensive adult rehabilitative mental health services; and 370.23 (2) be certified by the commissioner as being in compliance 370.24 with this section and section 256B.0623. 370.25 (b) The intensive residential rehabilitative mental health 370.26 services provider must: 370.27 (1) be licensed under Minnesota Rules, parts 9520.0500 to 370.28 9520.0670; 370.29 (2) not exceed 16 beds per site; 370.30 (3) comply with the additional standards in this section; 370.31 and 370.32 (4) have a contract with the host county to provide these 370.33 services. 370.34 (c) The commissioner shall develop procedures for counties 370.35 and providers to submit contracts and other documentation as 370.36 needed to allow the commissioner to determine whether the 371.1 standards in this section are met. 371.2 Subd. 5. [STANDARDS APPLICABLE TO BOTH NONRESIDENTIAL AND 371.3 RESIDENTIAL PROVIDERS.] (a) Services must be provided by 371.4 qualified staff as defined in section 256B.0623, subdivision 5, 371.5 who are trained and supervised according to section 256B.0623, 371.6 subdivision 6, except that mental health rehabilitation workers 371.7 acting as overnight staff are not required to comply with 371.8 section 256B.0623, subdivision 5, clause (3)(iv). 371.9 (b) The clinical supervisor must be an active member of the 371.10 treatment team. The treatment team must meet with the clinical 371.11 supervisor at least weekly to discuss recipients' progress and 371.12 make rapid adjustments to meet recipients' needs. The team 371.13 meeting shall include recipient-specific case reviews and 371.14 general treatment discussions among team members. 371.15 Recipient-specific case reviews and planning must be documented 371.16 in the individual recipient's treatment record. 371.17 (c) Treatment staff must have prompt access in person or by 371.18 telephone to a mental health practitioner or mental health 371.19 professional. The provider must have the capacity to promptly 371.20 and appropriately respond to emergent needs and make any 371.21 necessary staffing adjustments to assure the health and safety 371.22 of recipients. 371.23 (d) The initial functional assessment must be completed 371.24 within ten days of intake and updated at least every three 371.25 months or prior to discharge from the service, whichever comes 371.26 first. 371.27 (e) The initial individual treatment plan must be completed 371.28 within ten days of intake and reviewed and updated at least 371.29 monthly with the recipient. 371.30 Subd. 6. [ADDITIONAL STANDARDS APPLICABLE ONLY TO 371.31 INTENSIVE RESIDENTIAL REHABILITATIVE MENTAL HEALTH 371.32 SERVICES.] (a) The provider of intensive residential services 371.33 must have sufficient staff to provide 24 hour per day coverage 371.34 to deliver the rehabilitative services described in the 371.35 treatment plan and to safely supervise and direct the activities 371.36 of recipients given the recipient's level of behavioral and 372.1 psychiatric stability, cultural needs, and vulnerability. The 372.2 provider must have the capacity within the facility to provide 372.3 integrated services for chemical dependency, illness management 372.4 services, and family education when appropriate. 372.5 (b) At a minimum: 372.6 (1) staff must be available and provide direction and 372.7 supervision whenever recipients are present in the facility; 372.8 (2) staff must remain awake during all work hours; 372.9 (3) there must be a staffing ratio of at least one to nine 372.10 recipients for each day and evening shift. If more than nine 372.11 recipients are present at the residential site, there must be a 372.12 minimum of two staff during day and evening shifts, one of whom 372.13 must be a mental health practitioner or mental health 372.14 professional; 372.15 (4) if services are provided to recipients who need the 372.16 services of a medical professional, the provider shall assure 372.17 that these services are provided either by the provider's own 372.18 medical staff or through referral to a medical professional; and 372.19 (5) the provider must employ or contract with a licensed 372.20 registered nurse to ensure the effectiveness and safety of 372.21 medication administration in the facility. 372.22 Subd. 7. [ADDITIONAL STANDARDS FOR NONRESIDENTIAL 372.23 SERVICES.] The standards in this subdivision apply to intensive 372.24 nonresidential rehabilitative mental health services. 372.25 (1) The treatment team must use team treatment, not an 372.26 individual treatment model. 372.27 (2) The clinical supervisor must function as a practicing 372.28 clinician at least on a part-time basis. 372.29 (3) The staffing ratio must not exceed ten recipients to 372.30 one full-time equivalent treatment team position. 372.31 (4) Services must be available at times that meet client 372.32 needs. 372.33 (5) The treatment team must actively and assertively engage 372.34 and reach out to the recipient's family members and significant 372.35 others, after obtaining the recipient's permission. 372.36 (6) The treatment team must establish ongoing communication 373.1 and collaboration between the team, family, and significant 373.2 others and educate the family and significant others about 373.3 mental illness, symptom management, and the family's role in 373.4 treatment. 373.5 (7) The treatment team must provide interventions to 373.6 promote positive interpersonal relationships. 373.7 Subd. 8. [MEDICAL ASSISTANCE PAYMENT FOR INTENSIVE 373.8 REHABILITATIVE MENTAL HEALTH SERVICES.] (a) Payment for 373.9 residential and nonresidential services in this section shall be 373.10 based on one daily rate per provider inclusive of the following 373.11 services received by an eligible recipient in a given calendar 373.12 day: all rehabilitative services under this section and crisis 373.13 stabilization services under section 256B.0624. 373.14 (b) Except as indicated in paragraph (c), payment will not 373.15 be made to more than one entity for each recipient for services 373.16 provided under this section on a given day. If services under 373.17 this section are provided by a team that includes staff from 373.18 more than one entity, the team must determine how to distribute 373.19 the payment among the members. 373.20 (c) The host county shall recommend to the commissioner one 373.21 rate for each entity that will bill medical assistance for 373.22 residential services under this section and two rates for each 373.23 nonresidential provider. The first nonresidential rate is for 373.24 recipients who are not receiving residential services. The 373.25 second nonresidential rate is for recipients who are temporarily 373.26 receiving residential services and need continued contact with 373.27 the nonresidential team to assure timely discharge from 373.28 residential services. In developing these rates, the host 373.29 county shall consider and document: 373.30 (1) the cost for similar services in the local trade area; 373.31 (2) actual costs incurred by entities providing the 373.32 services; 373.33 (3) the intensity and frequency of services to be provided 373.34 to each recipient; 373.35 (4) the degree to which recipients will receive services 373.36 other than services under this section; 374.1 (5) the costs of other services, such as case management, 374.2 that will be separately reimbursed; and 374.3 (6) input from the local planning process authorized by the 374.4 adult mental health initiative under section 245.4661, regarding 374.5 recipients' service needs. 374.6 (d) The rate for intensive rehabilitative mental health 374.7 services must exclude room and board, as defined in section 374.8 256I.03, subdivision 6, and services not covered under this 374.9 section, such as case management, partial hospitalization, home 374.10 care, and inpatient services. Physician services that are not 374.11 separately billed may be included in the rate to the extent that 374.12 a psychiatrist is a member of the treatment team. The county's 374.13 recommendation shall specify the period for which the rate will 374.14 be applicable, not to exceed two years. 374.15 (e) When services under this section are provided by an 374.16 assertive community team, case management functions must be an 374.17 integral part of the team. The county must allocate costs which 374.18 are reimbursable under this section versus costs which are 374.19 reimbursable through case management or other reimbursement, so 374.20 that payment is not duplicated. 374.21 (f) The rate for a provider must not exceed the rate 374.22 charged by that provider for the same service to other payors. 374.23 (g) The commissioner shall approve or reject the county's 374.24 rate recommendation, based on the commissioner's own analysis of 374.25 the criteria in paragraph (c). 374.26 Subd. 9. [PROVIDER ENROLLMENT; RATE SETTING FOR 374.27 COUNTY-OPERATED ENTITIES.] Counties that employ their own staff 374.28 to provide services under this section shall apply directly to 374.29 the commissioner for enrollment and rate setting. In this case, 374.30 a county contract is not required and the commissioner shall 374.31 perform the program review and rate setting duties which would 374.32 otherwise be required of counties under this section. 374.33 Subd. 10. [PROVIDER ENROLLMENT; RATE SETTING FOR 374.34 SPECIALIZED PROGRAM.] A provider proposing to serve a 374.35 subpopulation of eligible recipients may bypass the county 374.36 approval procedures in this section and receive approval for 375.1 provider enrollment and rate setting directly from the 375.2 commissioner under the following circumstances: 375.3 (1) the provider demonstrates that the subpopulation to be 375.4 served requires a specialized program which is not available 375.5 from county-approved entities; and 375.6 (2) the subpopulation to be served is of such a low 375.7 incidence that it is not feasible to develop a program serving a 375.8 single county or regional group of counties. 375.9 For providers meeting the criteria in clauses (1) and (2), 375.10 the commissioner shall perform the program review and rate 375.11 setting duties which would otherwise be required of counties 375.12 under this section. 375.13 Sec. 17. Minnesota Statutes 2002, section 256B.0623, 375.14 subdivision 2, is amended to read: 375.15 Subd. 2. [DEFINITIONS.] For purposes of this section, the 375.16 following terms have the meanings given them. 375.17 (a) "Adult rehabilitative mental health services" means 375.18 mental health services which are rehabilitative and enable the 375.19 recipient to develop and enhance psychiatric stability, social 375.20 competencies, personal and emotional adjustment, and independent 375.21 living and community skills, when these abilities are impaired 375.22 by the symptoms of mental illness. Adult rehabilitative mental 375.23 health services are also appropriate when provided to enable a 375.24 recipient to retain stability and functioning, if the recipient 375.25 would be at risk of significant functional decompensation or 375.26 more restrictive service settings without these services. 375.27 (1) Adult rehabilitative mental health services instruct, 375.28 assist, and support the recipient in areas such as: 375.29 interpersonal communication skills, community resource 375.30 utilization and integration skills, crisis assistance, relapse 375.31 prevention skills, health care directives, budgeting and 375.32 shopping skills, healthy lifestyle skills and practices, cooking 375.33 and nutrition skills, transportation skills, medication 375.34 education and monitoring, mental illness symptom management 375.35 skills, household management skills, employment-related skills, 375.36 and transition to community living services. 376.1 (2) These services shall be provided to the recipient on a 376.2 one-to-one basis in the recipient's home or another community 376.3 setting or in groups. 376.4 (b) "Medication education services" means services provided 376.5 individually or in groups which focus on educating the recipient 376.6 about mental illness and symptoms; the role and effects of 376.7 medications in treating symptoms of mental illness; and the side 376.8 effects of medications. Medication education is coordinated 376.9 with medication management services and does not duplicate it. 376.10 Medication education services are provided by physicians, 376.11 pharmacists, physician's assistants, or registered nurses. 376.12 (c) "Transition to community living services" means 376.13 services which maintain continuity of contact between the 376.14 rehabilitation services provider and the recipient and which 376.15 facilitate discharge from a hospital, residential treatment 376.16 program under Minnesota Rules, chapter 9505, board and lodging 376.17 facility, or nursing home. Transition to community living 376.18 services are not intended to provide other areas of adult 376.19 rehabilitative mental health services. 376.20 Sec. 18. Minnesota Statutes 2002, section 256B.0623, 376.21 subdivision 4, is amended to read: 376.22 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) The provider 376.23 entity must be:376.24(1) a county operated entity certified by the state; or376.25(2) a noncounty entity certified by the entity's host376.26countycertified by the state following the certification 376.27 process and procedures developed by the commissioner. 376.28 (b) The certification process is a determination as to 376.29 whether the entity meets the standards in this subdivision. The 376.30 certification must specify which adult rehabilitative mental 376.31 health services the entity is qualified to provide. 376.32 (c)If an entity seeks to provide services outside its host376.33county, itA noncounty provider entity must obtain additional 376.34 certification from each county in which it will provide 376.35 services. The additional certification must be based on the 376.36 adequacy of the entity's knowledge of that county's local health 377.1 and human service system, and the ability of the entity to 377.2 coordinate its services with the other services available in 377.3 that county. A county-operated entity must obtain this 377.4 additional certification from any other county in which it will 377.5 provide services. 377.6 (d) Recertification must occur at least everytwothree 377.7 years. 377.8 (e) The commissioner may intervene at any time and 377.9 decertify providers with cause. The decertification is subject 377.10 to appeal to the state. A county board may recommend that the 377.11 state decertify a provider for cause. 377.12 (f) The adult rehabilitative mental health services 377.13 provider entity must meet the following standards: 377.14 (1) have capacity to recruit, hire, manage, and train 377.15 mental health professionals, mental health practitioners, and 377.16 mental health rehabilitation workers; 377.17 (2) have adequate administrative ability to ensure 377.18 availability of services; 377.19 (3) ensure adequate preservice and inservice and ongoing 377.20 training for staff; 377.21 (4) ensure that mental health professionals, mental health 377.22 practitioners, and mental health rehabilitation workers are 377.23 skilled in the delivery of the specific adult rehabilitative 377.24 mental health services provided to the individual eligible 377.25 recipient; 377.26 (5) ensure that staff is capable of implementing culturally 377.27 specific services that are culturally competent and appropriate 377.28 as determined by the recipient's culture, beliefs, values, and 377.29 language as identified in the individual treatment plan; 377.30 (6) ensure enough flexibility in service delivery to 377.31 respond to the changing and intermittent care needs of a 377.32 recipient as identified by the recipient and the individual 377.33 treatment plan; 377.34 (7) ensure that the mental health professional or mental 377.35 health practitioner, who is under the clinical supervision of a 377.36 mental health professional, involved in a recipient's services 378.1 participates in the development of the individual treatment 378.2 plan; 378.3 (8) assist the recipient in arranging needed crisis 378.4 assessment, intervention, and stabilization services; 378.5 (9) ensure that services are coordinated with other 378.6 recipient mental health services providers and the county mental 378.7 health authority and the federally recognized American Indian 378.8 authority and necessary others after obtaining the consent of 378.9 the recipient. Services must also be coordinated with the 378.10 recipient's case manager or care coordinator if the recipient is 378.11 receiving case management or care coordination services; 378.12 (10) develop and maintain recipient files, individual 378.13 treatment plans, and contact charting; 378.14 (11) develop and maintain staff training and personnel 378.15 files; 378.16 (12) submit information as required by the state; 378.17 (13) establish and maintain a quality assurance plan to 378.18 evaluate the outcome of services provided; 378.19 (14) keep all necessary records required by law; 378.20 (15) deliver services as required by section 245.461; 378.21 (16) comply with all applicable laws; 378.22 (17) be an enrolled Medicaid provider; 378.23 (18) maintain a quality assurance plan to determine 378.24 specific service outcomes and the recipient's satisfaction with 378.25 services; and 378.26 (19) develop and maintain written policies and procedures 378.27 regarding service provision and administration of the provider 378.28 entity. 378.29(g) The commissioner shall develop statewide procedures for378.30provider certification, including timelines for counties to378.31certify qualified providers.378.32 Sec. 19. Minnesota Statutes 2002, section 256B.0623, 378.33 subdivision 5, is amended to read: 378.34 Subd. 5. [QUALIFICATIONS OF PROVIDER STAFF.] Adult 378.35 rehabilitative mental health services must be provided by 378.36 qualified individual provider staff of a certified provider 379.1 entity. Individual provider staff must be qualified under one 379.2 of the following criteria: 379.3 (1) a mental health professional as defined in section 379.4 245.462, subdivision 18, clauses (1) to (5); 379.5 (2) a mental health practitioner as defined in section 379.6 245.462, subdivision 17. The mental health practitioner must 379.7 work under the clinical supervision of a mental health 379.8 professional; or 379.9 (3) a mental health rehabilitation worker. A mental health 379.10 rehabilitation worker means a staff person working under the 379.11 direction of a mental health practitioner or mental health 379.12 professional and under the clinical supervision of a mental 379.13 health professional in the implementation of rehabilitative 379.14 mental health services as identified in the recipient's 379.15 individual treatment plan who: 379.16 (i) is at least 21 years of age; 379.17 (ii) has a high school diploma or equivalent; 379.18 (iii) has successfully completed 30 hours of training 379.19 during the past two years in all of the following areas: 379.20 recipient rights, recipient-centered individual treatment 379.21 planning, behavioral terminology, mental illness, co-occurring 379.22 mental illness and substance abuse, psychotropic medications and 379.23 side effects, functional assessment, local community resources, 379.24 adult vulnerability, recipient confidentiality; and 379.25 (iv) meets the qualifications in subitem (A) or (B): 379.26 (A) has an associate of arts degree in one of the 379.27 behavioral sciences or human services, or is a registered nurse 379.28 without a bachelor's degree, or who within the previous ten 379.29 years has: 379.30 (1) three years of personal life experience with serious 379.31 and persistent mental illness; 379.32 (2) three years of life experience as a primary caregiver 379.33 to an adult with a serious mental illness or traumatic brain 379.34 injury; or 379.35 (3) 4,000 hours of supervised paid work experience in the 379.36 delivery of mental health services to adults with a serious 380.1 mental illness or traumatic brain injury; or 380.2 (B)(1) is fluent in the non-English language or competent 380.3 in the culture of the ethnic group to which at least5020 380.4 percent of the mental health rehabilitation worker's clients 380.5 belong; 380.6 (2) receives during the first 2,000 hours of work, monthly 380.7 documented individual clinical supervision by a mental health 380.8 professional; 380.9 (3) has 18 hours of documented field supervision by a 380.10 mental health professional or practitioner during the first 160 380.11 hours of contact work with recipients, and at least six hours of 380.12 field supervision quarterly during the following year; 380.13 (4) has review and cosignature of charting of recipient 380.14 contacts during field supervision by a mental health 380.15 professional or practitioner; and 380.16 (5) has 40 hours of additional continuing education on 380.17 mental health topics during the first year of employment. 380.18 Sec. 20. Minnesota Statutes 2002, section 256B.0623, 380.19 subdivision 6, is amended to read: 380.20 Subd. 6. [REQUIRED TRAINING AND SUPERVISION.] (a) Mental 380.21 health rehabilitation workers must receive ongoing continuing 380.22 education training of at least 30 hours every two years in areas 380.23 of mental illness and mental health services and other areas 380.24 specific to the population being served. Mental health 380.25 rehabilitation workers must also be subject to the ongoing 380.26 direction and clinical supervision standards in paragraphs (c) 380.27 and (d). 380.28 (b) Mental health practitioners must receive ongoing 380.29 continuing education training as required by their professional 380.30 license; or if the practitioner is not licensed, the 380.31 practitioner must receive ongoing continuing education training 380.32 of at least 30 hours every two years in areas of mental illness 380.33 and mental health services. Mental health practitioners must 380.34 meet the ongoing clinical supervision standards in paragraph (c). 380.35 (c) Clinical supervision may be provided by a full or 380.36 part-time qualified professional employed by or under contract 381.1 with the provider entity. Clinical supervision may be provided 381.2 by interactive videoconferencing according to procedures 381.3 developed by the commissioner. A mental health professional 381.4 providing clinical supervision of staff delivering adult 381.5 rehabilitative mental health services must provide the following 381.6 guidance: 381.7 (1) review the information in the recipient's file; 381.8 (2) review and approve initial and updates of individual 381.9 treatment plans; 381.10 (3) meet with mental health rehabilitation workers and 381.11 practitioners, individually or in small groups, at least monthly 381.12 to discuss treatment topics of interest to the workers and 381.13 practitioners; 381.14 (4) meet with mental health rehabilitation workers and 381.15 practitioners, individually or in small groups, at least monthly 381.16 to discuss treatment plans of recipients, and approve by 381.17 signature and document in the recipient's file any resulting 381.18 plan updates; 381.19 (5) meet at leasttwice a monthmonthly with the directing 381.20 mental health practitioner, if there is one, to review needs of 381.21 the adult rehabilitative mental health services program, review 381.22 staff on-site observations and evaluate mental health 381.23 rehabilitation workers, plan staff training, review program 381.24 evaluation and development, and consult with the directing 381.25 practitioner; and 381.26 (6) be available for urgent consultation as the individual 381.27 recipient needs or the situation necessitates; and381.28(7) provide clinical supervision by full- or part-time381.29mental health professionals employed by or under contract with381.30the provider entity. 381.31 (d) An adult rehabilitative mental health services provider 381.32 entity must have a treatment director who is a mental health 381.33 practitioner or mental health professional. The treatment 381.34 director must ensure the following: 381.35 (1) while delivering direct services to recipients, a newly 381.36 hired mental health rehabilitation worker must be directly 382.1 observed delivering services to recipients bythea mental 382.2 health practitioner or mental health professional for at least 382.3 six hours per 40 hours worked during the first 160 hours that 382.4 the mental health rehabilitation worker works; 382.5 (2) the mental health rehabilitation worker must receive 382.6 ongoing on-site direct service observation by a mental health 382.7 professional or mental health practitioner for at least six 382.8 hours for every six months of employment; 382.9 (3) progress notes are reviewed from on-site service 382.10 observation prepared by the mental health rehabilitation worker 382.11 and mental health practitioner for accuracy and consistency with 382.12 actual recipient contact and the individual treatment plan and 382.13 goals; 382.14 (4) immediate availability by phone or in person for 382.15 consultation by a mental health professional or a mental health 382.16 practitioner to the mental health rehabilitation services worker 382.17 during service provision; 382.18 (5) oversee the identification of changes in individual 382.19 recipient treatment strategies, revise the plan, and communicate 382.20 treatment instructions and methodologies as appropriate to 382.21 ensure that treatment is implemented correctly; 382.22 (6) model service practices which: respect the recipient, 382.23 include the recipient in planning and implementation of the 382.24 individual treatment plan, recognize the recipient's strengths, 382.25 collaborate and coordinate with other involved parties and 382.26 providers; 382.27 (7) ensure that mental health practitioners and mental 382.28 health rehabilitation workers are able to effectively 382.29 communicate with the recipients, significant others, and 382.30 providers; and 382.31 (8) oversee the record of the results of on-site 382.32 observation and charting evaluation and corrective actions taken 382.33 to modify the work of the mental health practitioners and mental 382.34 health rehabilitation workers. 382.35 (e) A mental health practitioner who is providing treatment 382.36 direction for a provider entity must receive supervision at 383.1 least monthly from a mental health professional to: 383.2 (1) identify and plan for general needs of the recipient 383.3 population served; 383.4 (2) identify and plan to address provider entity program 383.5 needs and effectiveness; 383.6 (3) identify and plan provider entity staff training and 383.7 personnel needs and issues; and 383.8 (4) plan, implement, and evaluate provider entity quality 383.9 improvement programs. 383.10 Sec. 21. Minnesota Statutes 2002, section 256B.0623, 383.11 subdivision 8, is amended to read: 383.12 Subd. 8. [DIAGNOSTIC ASSESSMENT.] Providers of adult 383.13 rehabilitative mental health services must complete a diagnostic 383.14 assessment as defined in section 245.462, subdivision 9, within 383.15 five days after the recipient's second visit or within 30 days 383.16 after intake, whichever occurs first. In cases where a 383.17 diagnostic assessment is available that reflects the recipient's 383.18 current status, and has been completed within 180 days preceding 383.19 admission, an update must be completed. An update shall include 383.20 a written summary by a mental health professional of the 383.21 recipient's current mental health status and service needs. If 383.22 the recipient's mental health status has changed significantly 383.23 since the adult's most recent diagnostic assessment, a new 383.24 diagnostic assessment is required. For initial implementation 383.25 of adult rehabilitative mental health services, until June 30, 383.26 2005, a diagnostic assessment that reflects the recipient's 383.27 current status and has been completed within the past three 383.28 years preceding admission is acceptable. 383.29 Sec. 22. Minnesota Statutes 2002, section 256B.0625, 383.30 subdivision 19c, is amended to read: 383.31 Subd. 19c. [PERSONAL CARE.] Medical assistance covers 383.32 personal care assistant services provided by an individual who 383.33 is qualified to provide the services according to subdivision 383.34 19a and section 256B.0627, where the services are prescribed by 383.35 a physician in accordance with a plan of treatment and are 383.36 supervised by the recipient or a qualified professional. 384.1 "Qualified professional" means a mental health professional as 384.2 defined in section 245.462, subdivision 18, or 245.4871, 384.3 subdivision 27; or a registered nurse as defined in sections 384.4 148.171 to 148.285, or a licensed social worker as defined in 384.5 section 148B.21. As part of the assessment, the county public 384.6 health nurse will assist the recipient or responsible party to 384.7 identify the most appropriate person to provide supervision of 384.8 the personal care assistant. The qualified professional shall 384.9 perform the duties described in Minnesota Rules, part 9505.0335, 384.10 subpart 4. 384.11 Sec. 23. Minnesota Statutes 2002, section 256B.0627, 384.12 subdivision 1, is amended to read: 384.13 Subdivision 1. [DEFINITION.] (a) "Activities of daily 384.14 living" includes eating, toileting, grooming, dressing, bathing, 384.15 transferring, mobility, and positioning. 384.16 (b) "Assessment" means a review and evaluation of a 384.17 recipient's need for home care services conducted in person. 384.18 Assessments for private duty nursing shall be conducted by a 384.19 registered private duty nurse. Assessments for home health 384.20 agency services shall be conducted by a home health agency 384.21 nurse. Assessments for personal care assistant services shall 384.22 be conducted by the county public health nurse or a certified 384.23 public health nurse under contract with the county. A 384.24 face-to-face assessment must include: documentation of health 384.25 status, determination of need, evaluation of service 384.26 effectiveness, identification of appropriate services, service 384.27 plan development or modification, coordination of services, 384.28 referrals and follow-up to appropriate payers and community 384.29 resources, completion of required reports, recommendation of 384.30 service authorization, and consumer education. Once the need 384.31 for personal care assistant services is determined under this 384.32 section, the county public health nurse or certified public 384.33 health nurse under contract with the county is responsible for 384.34 communicating this recommendation to the commissioner and the 384.35 recipient. A face-to-face assessment for personal care 384.36 assistant services is conducted on those recipients who have 385.1 never had a county public health nurse assessment. A 385.2 face-to-face assessment must occur at least annually or when 385.3 there is a significant change in the recipient's condition or 385.4 when there is a change in the need for personal care assistant 385.5 services. A service update may substitute for the annual 385.6 face-to-face assessment when there is not a significant change 385.7 in recipient condition or a change in the need for personal care 385.8 assistant service. A service update or review for temporary 385.9 increase includes a review of initial baseline data, evaluation 385.10 of service effectiveness, redetermination of service need, 385.11 modification of service plan and appropriate referrals, update 385.12 of initial forms, obtaining service authorization, and on going 385.13 consumer education. Assessments for medical assistance home 385.14 care services for mental retardation or related conditions and 385.15 alternative care services for developmentally disabled home and 385.16 community-based waivered recipients may be conducted by the 385.17 county public health nurse to ensure coordination and avoid 385.18 duplication. Assessments must be completed on forms provided by 385.19 the commissioner within 30 days of a request for home care 385.20 services by a recipient or responsible party. 385.21 (c) "Care plan" means a written description of personal 385.22 care assistant services developed by the qualified professional 385.23 or the recipient's physician with the recipient or responsible 385.24 party to be used by the personal care assistant with a copy 385.25 provided to the recipient or responsible party. 385.26 (d) "Complex and regular private duty nursing care" means: 385.27 (1) complex care is private duty nursing provided to 385.28 recipients who are ventilator dependent or for whom a physician 385.29 has certified that were it not for private duty nursing the 385.30 recipient would meet the criteria for inpatient hospital 385.31 intensive care unit (ICU) level of care; and 385.32 (2) regular care is private duty nursing provided to all 385.33 other recipients. 385.34 (e) "Health-related functions" means functions that can be 385.35 delegated or assigned by a licensed health care professional 385.36 under state law to be performed by a personal care attendant. 386.1 (f) "Home care services" means a health service, determined 386.2 by the commissioner as medically necessary, that is ordered by a 386.3 physician and documented in a service plan that is reviewed by 386.4 the physician at least once every 60 days for the provision of 386.5 home health services, or private duty nursing, or at least once 386.6 every 365 days for personal care. Home care services are 386.7 provided to the recipient at the recipient's residence that is a 386.8 place other than a hospital or long-term care facility or as 386.9 specified in section 256B.0625. 386.10 (g) "Instrumental activities of daily living" includes meal 386.11 planning and preparation, managing finances, shopping for food, 386.12 clothing, and other essential items, performing essential 386.13 household chores, communication by telephone and other media, 386.14 and getting around and participating in the community. 386.15 (h) "Medically necessary" has the meaning given in 386.16 Minnesota Rules, parts 9505.0170 to 9505.0475. 386.17 (i) "Personal care assistant" means a person who: 386.18 (1) is at least 18 years old, except for persons 16 to 18 386.19 years of age who participated in a related school-based job 386.20 training program or have completed a certified home health aide 386.21 competency evaluation; 386.22 (2) is able to effectively communicate with the recipient 386.23 and personal care provider organization; 386.24 (3) effective July 1, 1996, has completed one of the 386.25 training requirements as specified in Minnesota Rules, part 386.26 9505.0335, subpart 3, items A to D; 386.27 (4) has the ability to, and provides covered personal care 386.28 assistant services according to the recipient's care plan, 386.29 responds appropriately to recipient needs, and reports changes 386.30 in the recipient's condition to the supervising qualified 386.31 professional or physician; 386.32 (5) is not a consumer of personal care assistant services; 386.33 and 386.34 (6) is subject to criminal background checks and procedures 386.35 specified in section 245A.04. 386.36 (j) "Personal care provider organization" means an 387.1 organization enrolled to provide personal care assistant 387.2 services under the medical assistance program that complies with 387.3 the following: (1) owners who have a five percent interest or 387.4 more, and managerial officials are subject to a background study 387.5 as provided in section 245A.04. This applies to currently 387.6 enrolled personal care provider organizations and those agencies 387.7 seeking enrollment as a personal care provider organization. An 387.8 organization will be barred from enrollment if an owner or 387.9 managerial official of the organization has been convicted of a 387.10 crime specified in section 245A.04, or a comparable crime in 387.11 another jurisdiction, unless the owner or managerial official 387.12 meets the reconsideration criteria specified in section 245A.04; 387.13 (2) the organization must maintain a surety bond and liability 387.14 insurance throughout the duration of enrollment and provides 387.15 proof thereof. The insurer must notify the department of human 387.16 services of the cancellation or lapse of policy; and (3) the 387.17 organization must maintain documentation of services as 387.18 specified in Minnesota Rules, part 9505.2175, subpart 7, as well 387.19 as evidence of compliance with personal care assistant training 387.20 requirements. 387.21 (k) "Responsible party" means an individualresiding with a387.22recipient of personal care assistant serviceswho is capable of 387.23 providing thesupportive caresupport necessary to assist the 387.24 recipient to live in the community, is at least 18 years 387.25 old, actively participates in planning and directing of personal 387.26 care assistant services, and is notathe personal care 387.27 assistant. The responsible party must be accessible to the 387.28 recipient and the personal care assistant when personal care 387.29 services are being provided and monitor the services at least 387.30 weekly according to the plan of care. The responsible party 387.31 must be identified at the time of assessment and listed on the 387.32 recipient's service agreement and care plan. Responsible 387.33 partieswho are parents of minors or guardians of minors or387.34incapacitated personsmay delegate the responsibility to another 387.35 adultduring a temporary absence of at least 24 hours but not387.36more than six months. The person delegated as a responsible388.1party must be able to meet the definition of responsible party,388.2except that the delegated responsible party is required to388.3reside with the recipient only while serving as the responsible388.4partywho is not the personal care assistant. The responsible 388.5 party must assure that the delegate performs the functions of 388.6 the responsible party, is identified at the time of the 388.7 assessment, and is listed on the service agreement and the care 388.8 plan. Foster care license holders may be designated the 388.9 responsible party for residents of the foster care home if case 388.10 management is provided as required in section 256B.0625, 388.11 subdivision 19a. For persons who, as of April 1, 1992, are 388.12 sharing personal care assistant services in order to obtain the 388.13 availability of 24-hour coverage, an employee of the personal 388.14 care provider organization may be designated as the responsible 388.15 party if case management is provided as required in section 388.16 256B.0625, subdivision 19a. 388.17 (l) "Service plan" means a written description of the 388.18 services needed based on the assessment developed by the nurse 388.19 who conducts the assessment together with the recipient or 388.20 responsible party. The service plan shall include a description 388.21 of the covered home care services, frequency and duration of 388.22 services, and expected outcomes and goals. The recipient and 388.23 the provider chosen by the recipient or responsible party must 388.24 be given a copy of the completed service plan within 30 calendar 388.25 days of the request for home care services by the recipient or 388.26 responsible party. 388.27 (m) "Skilled nurse visits" are provided in a recipient's 388.28 residence under a plan of care or service plan that specifies a 388.29 level of care which the nurse is qualified to provide. These 388.30 services are: 388.31 (1) nursing services according to the written plan of care 388.32 or service plan and accepted standards of medical and nursing 388.33 practice in accordance with chapter 148; 388.34 (2) services which due to the recipient's medical condition 388.35 may only be safely and effectively provided by a registered 388.36 nurse or a licensed practical nurse; 389.1 (3) assessments performed only by a registered nurse; and 389.2 (4) teaching and training the recipient, the recipient's 389.3 family, or other caregivers requiring the skills of a registered 389.4 nurse or licensed practical nurse. 389.5 (n) "Telehomecare" means the use of telecommunications 389.6 technology by a home health care professional to deliver home 389.7 health care services, within the professional's scope of 389.8 practice, to a patient located at a site other than the site 389.9 where the practitioner is located. 389.10 Sec. 24. Minnesota Statutes 2002, section 256B.0627, 389.11 subdivision 4, is amended to read: 389.12 Subd. 4. [PERSONAL CARE ASSISTANT SERVICES.] (a) The 389.13 personal care assistant services that are eligible for payment 389.14 are services and supports furnished to an individual, as needed, 389.15 to assist in accomplishing activities of daily living; 389.16 instrumental activities of daily living; health-related 389.17 functions through hands-on assistance, supervision, and cuing; 389.18 and redirection and intervention for behavior including 389.19 observation and monitoring. 389.20 (b) Payment for services will be made within the limits 389.21 approved using the prior authorized process established in 389.22 subdivision 5. 389.23 (c) The amount and type of services authorized shall be 389.24 based on an assessment of the recipient's needs in these areas: 389.25 (1) bowel and bladder care; 389.26 (2) skin care to maintain the health of the skin; 389.27 (3) repetitive maintenance range of motion, muscle 389.28 strengthening exercises, and other tasks specific to maintaining 389.29 a recipient's optimal level of function; 389.30 (4) respiratory assistance; 389.31 (5) transfers and ambulation; 389.32 (6) bathing, grooming, and hairwashing necessary for 389.33 personal hygiene; 389.34 (7) turning and positioning; 389.35 (8) assistance with furnishing medication that is 389.36 self-administered; 390.1 (9) application and maintenance of prosthetics and 390.2 orthotics; 390.3 (10) cleaning medical equipment; 390.4 (11) dressing or undressing; 390.5 (12) assistance with eating and meal preparation and 390.6 necessary grocery shopping; 390.7 (13) accompanying a recipient to obtain medical diagnosis 390.8 or treatment; 390.9 (14) assisting, monitoring, or prompting the recipient to 390.10 complete the services in clauses (1) to (13); 390.11 (15) redirection, monitoring, and observation that are 390.12 medically necessary and an integral part of completing the 390.13 personal care assistant services described in clauses (1) to 390.14 (14); 390.15 (16) redirection and intervention for behavior, including 390.16 observation and monitoring; 390.17 (17) interventions for seizure disorders, including 390.18 monitoring and observation if the recipient has had a seizure 390.19 that requires intervention within the past three months; 390.20 (18) tracheostomy suctioning using a clean procedure if the 390.21 procedure is properly delegated by a registered nurse. Before 390.22 this procedure can be delegated to a personal care assistant, a 390.23 registered nurse must determine that the tracheostomy suctioning 390.24 can be accomplished utilizing a clean rather than a sterile 390.25 procedure and must ensure that the personal care assistant has 390.26 been taught the proper procedure; and 390.27 (19) incidental household services that are an integral 390.28 part of a personal care service described in clauses (1) to (18). 390.29 For purposes of this subdivision, monitoring and observation 390.30 means watching for outward visible signs that are likely to 390.31 occur and for which there is a covered personal care service or 390.32 an appropriate personal care intervention. For purposes of this 390.33 subdivision, a clean procedure refers to a procedure that 390.34 reduces the numbers of microorganisms or prevents or reduces the 390.35 transmission of microorganisms from one person or place to 390.36 another. A clean procedure may be used beginning 14 days after 391.1 insertion. 391.2 (d) The personal care assistant services that are not 391.3 eligible for payment are the following: 391.4 (1) services not ordered by the physician; 391.5 (2) assessments by personal care assistant provider 391.6 organizations or by independently enrolled registered nurses; 391.7 (3) services that are not in the service plan; 391.8 (4) services provided by the recipient's spouse, legal 391.9 guardian for an adult or child recipient, or parent of a 391.10 recipient under age 18; 391.11 (5) services provided by a foster care provider of a 391.12 recipient who cannot direct the recipient's own care, unless 391.13 monitored by a county or state case manager under section 391.14 256B.0625, subdivision 19a; 391.15 (6) services provided by the residential or program license 391.16 holder in a residence for more than four persons; 391.17 (7) services that are the responsibility of a residential 391.18 or program license holder under the terms of a service agreement 391.19 and administrative rules; 391.20 (8) sterile procedures; 391.21 (9) injections of fluids into veins, muscles, or skin; 391.22 (10)services provided by parents of adult recipients,391.23adult children, or siblings of the recipient, unless these391.24relatives meet one of the following hardship criteria and the391.25commissioner waives this requirement:391.26(i) the relative resigns from a part-time or full-time job391.27to provide personal care for the recipient;391.28(ii) the relative goes from a full-time to a part-time job391.29with less compensation to provide personal care for the391.30recipient;391.31(iii) the relative takes a leave of absence without pay to391.32provide personal care for the recipient;391.33(iv) the relative incurs substantial expenses by providing391.34personal care for the recipient; or391.35(v) because of labor conditions, special language needs, or391.36intermittent hours of care needed, the relative is needed in392.1order to provide an adequate number of qualified personal care392.2assistants to meet the medical needs of the recipient;392.3(11)homemaker services that are not an integral part of a 392.4 personal care assistant services; 392.5(12)(11) home maintenance, or chore services; 392.6(13)(12) services not specified under paragraph (a); and 392.7(14)(13) services not authorized by the commissioner or 392.8 the commissioner's designee. 392.9 (e) The recipient or responsible party may choose to 392.10 supervise the personal care assistant or to have a qualified 392.11 professional, as defined in section 256B.0625, subdivision 19c, 392.12 provide the supervision. As required under section 256B.0625, 392.13 subdivision 19c, the county public health nurse, as a part of 392.14 the assessment, will assist the recipient or responsible party 392.15 to identify the most appropriate person to provide supervision 392.16 of the personal care assistant. Health-related delegated tasks 392.17 performed by the personal care assistant will be under the 392.18 supervision of a qualified professional or the direction of the 392.19 recipient's physician. If the recipient has a qualified 392.20 professional, Minnesota Rules, part 9505.0335, subpart 4, 392.21 applies. 392.22 Sec. 25. Minnesota Statutes 2002, section 256B.0627, 392.23 subdivision 9, is amended to read: 392.24 Subd. 9. [FLEXIBLE USE OF PERSONAL CARE ASSISTANT HOURS.] 392.25 (a)The commissioner may allow for the flexible use of personal392.26care assistant hours."Flexible use" means the scheduled use of 392.27 authorized hours of personal care assistant services, which vary 392.28 within the length of the service authorization in order to more 392.29 effectively meet the needs and schedule of the recipient. 392.30 Recipients may use their approved hours flexibly within the 392.31 service authorization period for medically necessary covered 392.32 services specified in the assessment required in subdivision 1. 392.33 The flexible use of authorized hours does not increase the total 392.34 amount of authorized hours available to a recipient as 392.35 determined under subdivision 5. The commissioner shall not 392.36 authorize additional personal care assistant services to 393.1 supplement a service authorization that is exhausted before the 393.2 end date under a flexible service use plan, unless the county 393.3 public health nurse determines a change in condition and a need 393.4 for increased services is established. 393.5 (b)The recipient or responsible party, together with the393.6county public health nurse, shall determine whether flexible use393.7is an appropriate option based on the needs and preferences of393.8the recipient or responsible party, and, if appropriate, must393.9ensure that the allocation of hours covers the ongoing needs of393.10the recipient over the entire service authorization period. As393.11part of the assessment and service planning process, the393.12recipient or responsible party must work with the county public393.13health nurse to develop a written month-to-month plan of the393.14projected use of personal care assistant services that is part393.15of the service plan and ensures that the:393.16(1) health and safety needs of the recipient will be met;393.17(2) total annual authorization will not exceed before the393.18end date; and393.19(3) how actual use of hours will be monitored.393.20(c) If the actual use of personal care assistant service393.21varies significantly from the use projected in the plan, the393.22written plan must be promptly updated by the recipient or393.23responsible party and the county public health nurse.393.24(d)The recipient or responsible party, together with the 393.25 provider, must work to monitor and document the use of 393.26 authorized hours and ensure that a recipient is able to manage 393.27 services effectively throughout the authorized period.The393.28provider must ensure that the month-to-month plan is393.29incorporated into the care plan.Upon request of the recipient 393.30 or responsible party, the provider must furnish regular updates 393.31 to the recipient or responsible party on the amount of personal 393.32 care assistant services used. 393.33(e) The recipient or responsible party may revoke the393.34authorization for flexible use of hours by notifying the393.35provider and county public health nurse in writing.393.36(f) If the requirements in paragraphs (a) to (e) have not394.1substantially been met, the commissioner shall deny, revoke, or394.2suspend the authorization to use authorized hours flexibly. The394.3recipient or responsible party may appeal the commissioner's394.4action according to section 256.045. The denial, revocation, or394.5suspension to use the flexible hours option shall not affect the394.6recipient's authorized level of personal care assistant services394.7as determined under subdivision 5.394.8 Sec. 26. Minnesota Statutes 2002, section 256B.0911, 394.9 subdivision 4d, is amended to read: 394.10 Subd. 4d. [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 394.11 YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 394.12 ensure that individuals with disabilities or chronic illness are 394.13 served in the most integrated setting appropriate to their needs 394.14 and have the necessary information to make informed choices 394.15 about home and community-based service options. 394.16 (b) Individuals under 65 years of age who are admitted to a 394.17 nursing facility from a hospital must be screened prior to 394.18 admission as outlined in subdivisions 4a through 4c. 394.19 (c) Individuals under 65 years of age who are admitted to 394.20 nursing facilities with only a telephone screening must receive 394.21 a face-to-face assessment from the long-term care consultation 394.22 team member of the county in which the facility is located or 394.23 from the recipient's county case manager within20 working40 394.24 calendar days of admission. 394.25 (d) Individuals under 65 years of age who are admitted to a 394.26 nursing facility without preadmission screening according to the 394.27 exemption described in subdivision 4b, paragraph (a), clause 394.28 (3), and who remain in the facility longer than 30 days must 394.29 receive a face-to-face assessment within 40 days of admission. 394.30 (e) At the face-to-face assessment, the long-term care 394.31 consultation team member or county case manager must perform the 394.32 activities required under subdivision 3b. 394.33 (f) For individuals under 21 years of age, a screening 394.34 interview which recommends nursing facility admission must be 394.35 face-to-face and approved by the commissioner before the 394.36 individual is admitted to the nursing facility. 395.1 (g) In the event that an individual under 65 years of age 395.2 is admitted to a nursing facility on an emergency basis, the 395.3 county must be notified of the admission on the next working 395.4 day, and a face-to-face assessment as described in paragraph (c) 395.5 must be conducted within20 working days40 calendar days of 395.6 admission. 395.7 (h) At the face-to-face assessment, the long-term care 395.8 consultation team member or the case manager must present 395.9 information about home and community-based options so the 395.10 individual can make informed choices. If the individual chooses 395.11 home and community-based services, the long-term care 395.12 consultation team member or case manager must complete a written 395.13 relocation plan within 20 working days of the visit. The plan 395.14 shall describe the services needed to move out of the facility 395.15 and a time line for the move which is designed to ensure a 395.16 smooth transition to the individual's home and community. 395.17 (i) An individual under 65 years of age residing in a 395.18 nursing facility shall receive a face-to-face assessment at 395.19 least every 12 months to review the person's service choices and 395.20 available alternatives unless the individual indicates, in 395.21 writing, that annual visits are not desired. In this case, the 395.22 individual must receive a face-to-face assessment at least once 395.23 every 36 months for the same purposes. 395.24 (j) Notwithstanding the provisions of subdivision 6, the 395.25 commissioner may pay county agencies directly for face-to-face 395.26 assessments for individuals under 65 years of age who are being 395.27 considered for placement or residing in a nursing facility. 395.28 Sec. 27. Minnesota Statutes 2002, section 256B.0915, is 395.29 amended by adding a subdivision to read: 395.30 Subd. 9. [TRIBAL MANAGEMENT OF ELDERLY WAIVER.] 395.31 Notwithstanding contrary provisions of this section, or those in 395.32 other state laws or rules, the commissioner and White Earth 395.33 reservation may develop a model for tribal management of the 395.34 elderly waiver program and implement this model through a 395.35 contract between the state and White Earth reservation. The 395.36 model shall include the provision of tribal waiver case 396.1 management, assessment for personal care assistance, and 396.2 administrative requirements otherwise carried out by counties 396.3 but shall not include tribal financial eligibility determination 396.4 for medical assistance. 396.5 Sec. 28. Minnesota Statutes 2002, section 256B.092, 396.6 subdivision 1a, is amended to read: 396.7 Subd. 1a. [CASE MANAGEMENT ADMINISTRATION AND SERVICES.] 396.8 (a) The administrative functions of case management provided to 396.9 or arranged for a person include: 396.10 (1)intakereview of eligibility for services; 396.11 (2)diagnosisscreening; 396.12 (3)screeningintake; 396.13 (4)service authorizationdiagnosis; 396.14 (5)review of eligibility for servicesthe completion and 396.15 authorization of services based upon an individualized service 396.16 plan; and 396.17 (6) responding to requests for conciliation conferences and 396.18 appeals according to section 256.045 made by the person, the 396.19 person's legal guardian or conservator, or the parent if the 396.20 person is a minor. 396.21 (b) Case management service activities provided to or 396.22 arranged for a person include: 396.23 (1) development of the individual service plan;396.24 (2) informing the individual or the individual's legal 396.25 guardian or conservator, or parent if the person is a minor, of 396.26 service options; 396.27 (3) consulting with relevant medical experts or service 396.28 providers; 396.29(3)(4) assisting the person in the identification of 396.30 potential providers; 396.31(4)(5) assisting the person to access services; 396.32(5)(6) coordination of services, if coordination is not 396.33 provided by another service provider; 396.34(6)(7) evaluation and monitoring of the services 396.35 identified in the plan; and 396.36(7)(8) annual reviews of service plans and services 397.1 provided. 397.2 (c) Case management administration and service activities 397.3 that are provided to the person with mental retardation or a 397.4 related condition shall be provided directly by county agencies 397.5 or under contract. 397.6 (d) Case managers are responsible for the administrative 397.7 duties and service provisions listed in paragraphs (a) and (b). 397.8 Case managers shall collaborate with consumers, families, legal 397.9 representatives, and relevant medical experts and service 397.10 providers in the development and annual review of the 397.11 individualized service and habilitation plans. 397.12 (e) The department of human services shall offer ongoing 397.13 education in case management to case managers. Case managers 397.14 shall receive no less than ten hours of case management 397.15 education and disability-related training each year. 397.16 Sec. 29. Minnesota Statutes 2002, section 256B.092, 397.17 subdivision 5, is amended to read: 397.18 Subd. 5. [FEDERAL WAIVERS.] (a) The commissioner shall 397.19 apply for any federal waivers necessary to secure, to the extent 397.20 allowed by law, federal financial participation under United 397.21 States Code, title 42, sections 1396 et seq., as amended, for 397.22 the provision of services to persons who, in the absence of the 397.23 services, would need the level of care provided in a regional 397.24 treatment center or a community intermediate care facility for 397.25 persons with mental retardation or related conditions. The 397.26 commissioner may seek amendments to the waivers or apply for 397.27 additional waivers under United States Code, title 42, sections 397.28 1396 et seq., as amended, to contain costs. The commissioner 397.29 shall ensure that payment for the cost of providing home and 397.30 community-based alternative services under the federal waiver 397.31 plan shall not exceed the cost of intermediate care services 397.32 including day training and habilitation services that would have 397.33 been provided without the waivered services. 397.34 (b) The commissioner, in administering home and 397.35 community-based waivers for persons with mental retardation and 397.36 related conditions, shall ensure that day services for eligible 398.1 persons are not provided by the person's residential service 398.2 provider, unless the person or the person's legal representative 398.3 is offered a choice of providers and agrees in writing to 398.4 provision of day services by the residential service provider. 398.5 The individual service plan for individuals who choose to have 398.6 their residential service provider provide their day services 398.7 must describe how health, safety,andprotection, and 398.8 habilitation needs will be metby, including how frequent and 398.9 regular contact with persons other than the residential service 398.10 provider will occur. The individualized service plan must 398.11 address the provision of services during the day outside the 398.12 residence on weekdays. 398.13 Sec. 30. Minnesota Statutes 2002, section 256B.095, is 398.14 amended to read: 398.15 256B.095 [QUALITY ASSURANCEPROJECTSYSTEM ESTABLISHED.] 398.16 (a) Effective July 1, 1998,an alternativea quality 398.17 assurancelicensingsystemprojectfor persons with 398.18 developmental disabilities, which includes an alternative 398.19 quality assurance licensing system for programsfor persons with398.20developmental disabilities, is established in Dodge, Fillmore, 398.21 Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele, 398.22 Wabasha, and Winona counties for the purpose of improving the 398.23 quality of services provided to persons with developmental 398.24 disabilities. A county, at its option, may choose to have all 398.25 programs for persons with developmental disabilities located 398.26 within the county licensed under chapter 245A using standards 398.27 determined under the alternative quality assurance licensing 398.28 systemprojector may continue regulation of these programs 398.29 under the licensing system operated by the commissioner. The 398.30 project expires on June 30,20052007. 398.31 (b) Effective July 1, 2003, a county not listed in 398.32 paragraph (a) may apply to participate in the quality assurance 398.33 system established under paragraph (a). The commission 398.34 established under section 256B.0951 may, at its option, allow 398.35 additional counties to participate in the system. 398.36 (c) Effective July 1, 2003, any county or group of counties 399.1 not listed in paragraph (a) may establish a quality assurance 399.2 system under this section. A new system established under this 399.3 section shall have the same rights and duties as the system 399.4 established under paragraph (a). A new system shall be governed 399.5 by a commission under section 256B.0951. The commissioner shall 399.6 appoint the initial commission members based on recommendations 399.7 from advocates, families, service providers, and counties in the 399.8 geographic area included in the new system. Counties that 399.9 choose to participate in a new system shall have the duties 399.10 assigned under section 256B.0952. The new system shall 399.11 establish a quality assurance process under section 256B.0953. 399.12 The provisions of section 256B.0954 shall apply to a new system 399.13 established under this paragraph. The commissioner shall 399.14 delegate authority to a new system established under this 399.15 paragraph according to section 256B.0955. 399.16 [EFFECTIVE DATE.] This section is effective July 1, 2003. 399.17 Sec. 31. Minnesota Statutes 2002, section 256B.0951, 399.18 subdivision 1, is amended to read: 399.19 Subdivision 1. [MEMBERSHIP.] Theregion 10quality 399.20 assurance commission is established. The commission consists of 399.21 at least 14 but not more than 21 members as follows: at least 399.22 three but not more than five members representing advocacy 399.23 organizations; at least three but not more than five members 399.24 representing consumers, families, and their legal 399.25 representatives; at least three but not more than five members 399.26 representing service providers; at least three but not more than 399.27 five members representing counties; and the commissioner of 399.28 human services or the commissioner's designee.Initial399.29membership of the commission shall be recruited and approved by399.30the region 10 stakeholders group. Prior to approving the399.31commission's membership, the stakeholders group shall provide to399.32the commissioner a list of the membership in the stakeholders399.33group, as of February 1, 1997, a brief summary of meetings held399.34by the group since July 1, 1996, and copies of any materials399.35prepared by the group for public distribution.The first 399.36 commission shall establish membership guidelines for the 400.1 transition and recruitment of membership for the commission's 400.2 ongoing existence. Members of the commission who do not receive 400.3 a salary or wages from an employer for time spent on commission 400.4 duties may receive a per diem payment when performing commission 400.5 duties and functions. All members may be reimbursed for 400.6 expenses related to commission activities. Notwithstanding the 400.7 provisions of section 15.059, subdivision 5, the commission 400.8 expires on June 30,20052007. 400.9 [EFFECTIVE DATE.] This section is effective July 1, 2003. 400.10 Sec. 32. Minnesota Statutes 2002, section 256B.0951, 400.11 subdivision 2, is amended to read: 400.12 Subd. 2. [AUTHORITY TO HIRE STAFF; CHARGE FEES; PROVIDE 400.13 TECHNICAL ASSISTANCE.] (a) The commission may hire staff to 400.14 perform the duties assigned in this section. 400.15 (b) The commission may charge fees for its services. 400.16 (c) The commission may provide technical assistance to 400.17 other counties, families, providers, and advocates interested in 400.18 participating in a quality assurance system under section 400.19 256B.095, paragraph (b) or (c). 400.20 [EFFECTIVE DATE.] This section is effective July 1, 2003. 400.21 Sec. 33. Minnesota Statutes 2002, section 256B.0951, 400.22 subdivision 3, is amended to read: 400.23 Subd. 3. [COMMISSION DUTIES.] (a) By October 1, 1997, the 400.24 commission, in cooperation with the commissioners of human 400.25 services and health, shall do the following: (1) approve an 400.26 alternative quality assurance licensing system based on the 400.27 evaluation of outcomes; (2) approve measurable outcomes in the 400.28 areas of health and safety, consumer evaluation, education and 400.29 training, providers, and systems that shall be evaluated during 400.30 the alternative licensing process; and (3) establish variable 400.31 licensure periods not to exceed three years based on outcomes 400.32 achieved. For purposes of this subdivision, "outcome" means the 400.33 behavior, action, or status of a person that can be observed or 400.34 measured and can be reliably and validly determined. 400.35 (b) By January 15, 1998, the commission shall approve, in 400.36 cooperation with the commissioner of human services, a training 401.1 program for members of the quality assurance teams established 401.2 under section 256B.0952, subdivision 4. 401.3 (c) The commission and the commissioner shall establish an 401.4 ongoing review process for the alternative quality assurance 401.5 licensing system. The review shall take into account the 401.6 comprehensive nature of the alternative system, which is 401.7 designed to evaluate the broad spectrum of licensed and 401.8 unlicensed entities that provide services to clients, as401.9compared to the current licensing system. 401.10 (d)The commission shall contract with an independent401.11entity to conduct a financial review of the alternative quality401.12assurance project. The review shall take into account the401.13comprehensive nature of the alternative system, which is401.14designed to evaluate the broad spectrum of licensed and401.15unlicensed entities that provide services to clients, as401.16compared to the current licensing system. The review shall401.17include an evaluation of possible budgetary savings within the401.18department of human services as a result of implementation of401.19the alternative quality assurance project. If a federal waiver401.20is approved under subdivision 7, the financial review shall also401.21evaluate possible savings within the department of health. This401.22review must be completed by December 15, 2000.401.23(e) The commission shall submit a report to the legislature401.24by January 15, 2001, on the results of the review process for401.25the alternative quality assurance project, a summary of the401.26results of the independent financial review, and a401.27recommendation on whether the project should be extended beyond401.28June 30, 2001.401.29(f)Thecommissionercommission, in consultation with 401.30 thecommissioncommissioner, shallexamine the feasibility of401.31expandingwork cooperatively with other populations to expand 401.32 theprojectsystem tootherthose populationsor geographic401.33areasand identify barriers to expansion. The commissioner 401.34 shall report findings and recommendations to the legislature by 401.35 December 15, 2004. 401.36 [EFFECTIVE DATE.] This section is effective July 1, 2003. 402.1 Sec. 34. Minnesota Statutes 2002, section 256B.0951, 402.2 subdivision 5, is amended to read: 402.3 Subd. 5. [VARIANCE OF CERTAIN STANDARDS PROHIBITED.] The 402.4 safety standards, rights, or procedural protections under 402.5 sections 245.825; 245.91 to 245.97; 245A.04, subdivisions 3, 3a, 402.6 3b, and 3c; 245A.09, subdivision 2, paragraph (c), clauses (2) 402.7 and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, 402.8 subdivisions 1b, clause (7), and 10; 626.556; 626.557, and 402.9 procedures for the monitoring of psychotropic medications shall 402.10 not be varied under the alternativelicensingquality assurance 402.11 licensing systemproject. The commission may make 402.12 recommendations to the commissioners of human services and 402.13 health or to the legislature regarding alternatives to or 402.14 modifications of the rules and procedures referenced in this 402.15 subdivision. 402.16 [EFFECTIVE DATE.] This section is effective July 1, 2003. 402.17 Sec. 35. Minnesota Statutes 2002, section 256B.0951, 402.18 subdivision 7, is amended to read: 402.19 Subd. 7. [WAIVER OF RULES.] If a federal waiver is 402.20 approved under subdivision 8, the commissioner of health may 402.21 exempt residents of intermediate care facilities for persons 402.22 with mental retardation (ICFs/MR) who participate in the 402.23 alternative quality assuranceprojectsystem established in 402.24 section 256B.095 from the requirements of Minnesota Rules, 402.25 chapter 4665. 402.26 [EFFECTIVE DATE.] This section is effective July 1, 2003. 402.27 Sec. 36. Minnesota Statutes 2002, section 256B.0951, 402.28 subdivision 9, is amended to read: 402.29 Subd. 9. [EVALUATION.] The commission, in consultation 402.30 with the commissioner of human services, shall conduct an 402.31 evaluation of thealternativequality assurance system, and 402.32 present a report to the commissioner by June 30, 2004. 402.33 [EFFECTIVE DATE.] This section is effective July 1, 2003. 402.34 Sec. 37. Minnesota Statutes 2002, section 256B.0952, 402.35 subdivision 1, is amended to read: 402.36 Subdivision 1. [NOTIFICATION.]For each year of the403.1project, region 10Counties shall give notice to the commission 403.2 and commissioners of human services and healthby March 15of 403.3 intent to join thequality assurancealternative quality 403.4 assurance licensing system, effective July 1 of that year. A 403.5 county choosing to participate in the alternative quality 403.6 assurance licensing system commits to participateuntil June 30,403.72005. Counties participating in the quality assurance403.8alternative licensing system as of January 1, 2001, shall notify403.9the commission and the commissioners of human services and403.10health by March 15, 2001, of intent to continue participation.403.11Counties that elect to continue participation must participate403.12in the alternative licensing system until June 30, 2005for 403.13 three years. 403.14 [EFFECTIVE DATE.] This section is effective July 1, 2003. 403.15 Sec. 38. Minnesota Statutes 2002, section 256B.0953, 403.16 subdivision 2, is amended to read: 403.17 Subd. 2. [LICENSURE PERIODS.] (a) In order to be licensed 403.18 under the alternative quality assuranceprocesslicensing 403.19 system, a facility, program, or service must satisfy the health 403.20 and safety outcomes approved for thepilot projectalternative 403.21 quality assurance licensing system. 403.22 (b) Licensure shall be approved for periods of one to three 403.23 years for a facility, program, or service that satisfies the 403.24 requirements of paragraph (a) and achieves the outcome 403.25 measurements in the categories of consumer evaluation, education 403.26 and training, providers, and systems. 403.27 [EFFECTIVE DATE.] This section is effective July 1, 2003. 403.28 Sec. 39. Minnesota Statutes 2002, section 256B.0955, is 403.29 amended to read: 403.30 256B.0955 [DUTIES OF THE COMMISSIONER OF HUMAN SERVICES.] 403.31 (a) Effective July 1, 1998, the commissioner of human 403.32 services shall delegate authority to perform licensing functions 403.33 and activities, in accordance with section 245A.16, to counties 403.34 participating in the alternative quality assurance licensing 403.35 system. The commissioner shall not license or reimburse a 403.36 facility, program, or service for persons with developmental 404.1 disabilities in a county that participates in the 404.2 alternative quality assurance licensing system if the 404.3 commissioner has received from the appropriate county 404.4 notification that the facility, program, or service has been 404.5 reviewed by a quality assurance team and has failed to qualify 404.6 for licensure. 404.7 (b) The commissioner may conduct random licensing 404.8 inspections based on outcomes adopted under section 256B.0951 at 404.9 facilities, programs, and services governed by the alternative 404.10 quality assurance licensing system. The role of such random 404.11 inspections shall be to verify that the alternative quality 404.12 assurance licensing system protects the safety and well-being of 404.13 consumers and maintains the availability of high-quality 404.14 services for persons with developmental disabilities. 404.15(c) The commissioner shall provide technical assistance and404.16support or training to the alternative licensing system pilot404.17project.404.18 [EFFECTIVE DATE.] This section is effective July 1, 2003. 404.19 Sec. 40. Minnesota Statutes 2002, section 256B.19, 404.20 subdivision 1, is amended to read: 404.21 Subdivision 1. [DIVISION OF COST.] The state and county 404.22 share of medical assistance costs not paid by federal funds 404.23 shall be as follows: 404.24 (1) beginning January 1, 1992, 50 percent state funds and 404.25 50 percent county funds for the cost of placement of severely 404.26 emotionally disturbed children in regional treatment centers; 404.27and404.28 (2) beginning January 1, 2003, 80 percent state funds and 404.29 20 percent county funds for the costs of nursing facility 404.30 placements of persons with disabilities under the age of 65 that 404.31 have exceeded 90 days. This clause shall be subject to chapter 404.32 256G and shall not apply to placements in facilities not 404.33 certified to participate in medical assistance.; 404.34 (3) beginning January 1, 2004, 90 percent state funds and 404.35 10 percent county funds for the costs of placements that have 404.36 exceeded 90 days in intermediate care facilities for persons 405.1 with mental retardation or a related condition that have seven 405.2 or more beds. This provision includes pass-through payments 405.3 made under section 256B.5015; and 405.4 (4) beginning January 1, 2004, when state funds are used to 405.5 pay for a nursing facility placement due to the facility's 405.6 status as an institution for mental diseases (IMD), the county 405.7 shall pay 20 percent of the nonfederal share of costs that have 405.8 exceeded 90 days. This clause is subject to chapter 256G. 405.9 For counties that participate in a Medicaid demonstration 405.10 project under sections 256B.69 and 256B.71, the division of the 405.11 nonfederal share of medical assistance expenses for payments 405.12 made to prepaid health plans or for payments made to health 405.13 maintenance organizations in the form of prepaid capitation 405.14 payments, this division of medical assistance expenses shall be 405.15 95 percent by the state and five percent by the county of 405.16 financial responsibility. 405.17 In counties where prepaid health plans are under contract 405.18 to the commissioner to provide services to medical assistance 405.19 recipients, the cost of court ordered treatment ordered without 405.20 consulting the prepaid health plan that does not include 405.21 diagnostic evaluation, recommendation, and referral for 405.22 treatment by the prepaid health plan is the responsibility of 405.23 the county of financial responsibility. 405.24 Sec. 41. Minnesota Statutes 2002, section 256B.47, 405.25 subdivision 2, is amended to read: 405.26 Subd. 2. [NOTICE TO RESIDENTS.] (a) No increase in nursing 405.27 facility rates for private paying residents shall be effective 405.28 unless the nursing facility notifies the resident or person 405.29 responsible for payment of the increase in writing 30 days 405.30 before the increase takes effect. 405.31 A nursing facility may adjust its rates without giving the 405.32 notice required by this subdivision when the purpose of the rate 405.33 adjustment is to reflect anecessarychange in thelevel of care405.34provided to acase-mix classification of the resident. If the 405.35 state fails to set rates as required by section 405.36 256B.431, subdivision 1, the time required for giving notice is 406.1 decreased by the number of days by which the state was late in 406.2 setting the rates. 406.3 (b) If the state does not set rates by the date required in 406.4 section 256B.431, subdivision 1, nursing facilities shall meet 406.5 the requirement for advance notice by informing the resident or 406.6 person responsible for payments, on or before the effective date 406.7 of the increase, that a rate increase will be effective on that 406.8 date. If the exact amount has not yet been determined, the 406.9 nursing facility may raise the rates by the amount anticipated 406.10 to be allowed. Any amounts collected from private pay residents 406.11 in excess of the allowable rate must be repaid to private pay 406.12 residents with interest at the rate used by the commissioner of 406.13 revenue for the late payment of taxes and in effect on the date 406.14 the rate increase is effective. 406.15 Sec. 42. [256B.492] [REGIONAL MANAGEMENT OF HOME AND 406.16 COMMUNITY-BASED WAIVER SERVICES.] 406.17 Subdivision 1. [REGION.] For the purposes of this section, 406.18 "region" means a county or a group of counties, with a 406.19 population of 100,000 or more, that have formed a joint powers 406.20 agreement to manage the home and community-based waiver services. 406.21 Subd. 2. [PURPOSE.] Counties may form joint powers 406.22 agreements for the purpose of regionally managing the home and 406.23 community-based waiver services under sections 256B.0916 and 406.24 256B.49. Counties with a population of less than 100,000 are 406.25 encouraged to form joint powers agreements with other counties 406.26 to regionally manage the home and community-based waiver 406.27 services under sections 256B.0916 and 256B.49. 406.28 Subd. 3. [REGIONAL WAIVER AUTHORITY.] One of the parties 406.29 to the joint powers agreement or a new regional waiver authority 406.30 entity shall be designated the regional waiver authority and 406.31 shall monitor regional authorizations and expenditures. The 406.32 joint powers agreement shall specify how decisions are made on 406.33 authorizations and expenditures from the home and 406.34 community-based waiver allocation. 406.35 Subd. 4. [FISCAL MANAGEMENT.] A region may reserve up to 406.36 two percent of its home and community-based allocation in a 407.1 given fiscal year to meet unanticipated needs. 407.2 Subd. 5. [ALTERNATIVE METHOD.] When waiver resources are 407.3 to be distributed to a group of counties that do not meet the 407.4 criteria for a region or otherwise elect not to form a region, 407.5 the commissioner may (1) require a joint powers agreement; (2) 407.6 contract with a public or private agency; or (3) require both to 407.7 administer the waiver program for that geographic area. The 407.8 commissioner is responsible for assuring that funds are used 407.9 properly within the amount allocated. 407.10 Sec. 43. [256B.493] [COST MANAGEMENT OF HOME AND 407.11 COMMUNITY-BASED WAIVERED SERVICES.] 407.12 (a) The commissioner of human services shall efficiently 407.13 allocate and manage limited home and community-based waiver 407.14 services program resources to achieve the following outcomes: 407.15 (1) the establishment of feasible and viable alternatives 407.16 for persons in institutional or hospital settings to relocate to 407.17 home and community-based settings; 407.18 (2) the availability of timely assistance to persons at 407.19 imminent risk of institutional or hospital placement or whose 407.20 health and safety is at immediate risk; and 407.21 (3) the maximum provision of essential community supports 407.22 to eligible persons in need of and waiting for home and 407.23 community-based service alternatives. 407.24 (b) The commissioner shall monitor the costs of home and 407.25 community-based services, and may adjust home and 407.26 community-based service allocations, as necessary, to assure 407.27 that program costs are managed within available funding. When 407.28 making this determination, the commissioner shall give 407.29 consideration to offsets that may occur in other programs as a 407.30 result of the availability and use of home and community-based 407.31 services. 407.32 (c) The commissioner shall allocate home and 407.33 community-based resources to local/regional entities in a manner 407.34 that considers: 407.35 (1) the historical costs of serving individuals in a county 407.36 or region; 408.1 (2) the individualized service plans for current recipients 408.2 and eligible individuals expected to enter the waiver during the 408.3 fiscal year; and 408.4 (3) the need for crisis services or other short-term 408.5 services required because of unforeseen circumstances. 408.6 (d) The commissioner may reallocate resources from one 408.7 county or region to another if available funding in that county 408.8 or region is not likely to be spent and the reallocation is 408.9 necessary to achieve the outcomes specified in paragraph (a). 408.10 Sec. 44. Minnesota Statutes 2002, section 256B.501, 408.11 subdivision 1, is amended to read: 408.12 Subdivision 1. [DEFINITIONS.] For the purposes of this 408.13 section, the following terms have the meaning given them. 408.14 (a) "Commissioner" means the commissioner of human services. 408.15 (b) "Facility" means a facility licensed as a mental 408.16 retardation residential facility under section 252.28, licensed 408.17 as a supervised living facility under chapter 144, and certified 408.18 as an intermediate care facility for persons with mental 408.19 retardation or related conditions. The term does not include a 408.20 state regional treatment center. 408.21 (c) "Habilitation services" means health and social 408.22 services directed toward increasing and maintaining the 408.23 physical, intellectual, emotional, and social functioning of 408.24 persons with mental retardation or related conditions. 408.25 Habilitation services include therapeutic activities, 408.26 assistance, training, supervision, and monitoring in the areas 408.27 of self-care, sensory and motor development, interpersonal 408.28 skills, communication, socialization, reduction or elimination 408.29 of maladaptive behavior, community living and mobility, health 408.30 care, leisure and recreation, money management, and household 408.31 chores. 408.32 (d) "Services during the day" means services or supports 408.33 provided to a person that enables the person to be fully 408.34 integrated into the community. Services during the day must 408.35 include habilitation services, and may include a variety of 408.36 supports to enable the person to exercise choices for community 409.1 integration and inclusion activities. Services during the day 409.2 may include, but are not limited to: supported work, support 409.3 during community activities, community volunteer opportunities, 409.4 adult day care, recreational activities, and other 409.5 individualized integrated supports. 409.6 (e) "Waivered service" means home or community-based 409.7 service authorized under United States Code, title 42, section 409.8 1396n(c), as amended through December 31, 1987, and defined in 409.9 the Minnesota state plan for the provision of medical assistance 409.10 services. Waivered services include, at a minimum, case 409.11 management, family training and support, developmental training 409.12 homes, supervised living arrangements, semi-independent living 409.13 services, respite care, and training and habilitation services. 409.14 Sec. 45. Minnesota Statutes 2002, section 256B.501, is 409.15 amended by adding a subdivision to read: 409.16 Subd. 3m. [SERVICES DURING THE DAY.] When establishing a 409.17 rate for services during the day, the commissioner shall ensure 409.18 that these services comply with active treatment requirements 409.19 for persons residing in an ICF/MR as defined under federal 409.20 regulations and shall ensure that day services for eligible 409.21 persons are not provided by the person's residential service 409.22 provider, unless the person or the person's legal representative 409.23 is offered a choice of providers and agrees in writing to 409.24 provision of day services by the residential service provider, 409.25 consistent with the individual service plan. The individual 409.26 service plan for individuals who choose to have their 409.27 residential service provider provide their day services must 409.28 describe how health, safety, protection, and habilitation needs 409.29 will be met, including how frequent and regular contact with 409.30 persons other than the residential service provider will occur. 409.31 The individualized service plan must address the provision of 409.32 services during the day outside the residence. 409.33 Sec. 46. Minnesota Statutes 2002, section 256B.5013, 409.34 subdivision 4, is amended to read: 409.35 Subd. 4. [TEMPORARYRATE ADJUSTMENTSTO ADDRESS OCCUPANCY409.36AND ACCESSFOR SHORT-TERM ADMISSIONS FOR CRISIS OR SPECIALIZED 410.1 MEDICAL CARE.] Beginning July 1,20022003, the 410.2 commissionershall adjust the total payment rate for up to 75410.3days for the remaining recipients for facilities in which the410.4monthly occupancy rate of licensed beds is 75 percent or410.5greater. This mechanism shall not be used to pay for hospital410.6or therapeutic leave days beyond the maximums allowedmay 410.7 designate up to 25 beds in ICF/MR facilities statewide for the 410.8 purpose of providing short-term admissions due to crisis care 410.9 needs or care for medically fragile individuals. The 410.10 commissioner shall adjust the total payment rate for up to 75 410.11 days for the remaining recipients of the facility when the 410.12 monthly rate of the crisis or respite bed is 50 percent or 410.13 greater. 410.14 Sec. 47. Minnesota Statutes 2002, section 256B.5015, is 410.15 amended to read: 410.16 256B.5015 [PASS-THROUGH OFTRAINING AND HABILITATIONOTHER 410.17 SERVICES COSTS.] 410.18 Subdivision 1. [DAY TRAINING AND HABILITATION SERVICES.] 410.19 Day training and habilitation services costs shall be paid as a 410.20 pass-through payment at the lowest rate paid for the comparable 410.21 services at that site under sections 252.40 to 252.46. The 410.22 pass-through payments for training and habilitation services 410.23 shall be paid separately by the commissioner and shall not be 410.24 included in the computation of the ICF/MR facility total payment 410.25 rate. 410.26 Subd. 2. [SERVICES DURING THE DAY.] Services during the 410.27 day, as defined in section 256B.501, but excluding day training 410.28 and habilitation services, shall be paid as a pass-through 410.29 payment no later than January 1, 2004. The commissioner shall 410.30 establish rates for these services, other than day training and 410.31 habilitation services, at levels that do not exceed 75 percent 410.32 of a recipient's day training and habilitation service costs 410.33 prior to the service change. 410.34 When establishing a rate for these services, the 410.35 commissioner shall also consider an individual recipient's needs 410.36 as identified in the individualized service plan and the 411.1 person's need for active treatment as defined under federal 411.2 regulations. The pass-through payments for services during the 411.3 day shall be paid separately by the commissioner and may not be 411.4 included in the computation of the ICF/MR facility total payment 411.5 rate. 411.6 Sec. 48. Minnesota Statutes 2002, section 256B.82, is 411.7 amended to read: 411.8 256B.82 [PREPAID PLANS AND MENTAL HEALTH REHABILITATIVE 411.9 SERVICES.] 411.10 Medical assistance and MinnesotaCare prepaid health plans 411.11 may include coverage for adult mental health rehabilitative 411.12 services under section 256B.0623, intensive rehabilitative 411.13 services under section 256B.0622, and adult mental health crisis 411.14 response services under section 256B.0624, beginning January 1, 411.1520042005. 411.16 By January 15,20032004, the commissioner shall report to 411.17 the legislature how these services should be included in prepaid 411.18 plans. The commissioner shall consult with mental health 411.19 advocates, health plans, and counties in developing this 411.20 report. The report recommendations must include a plan to 411.21 ensure coordination of these services between health plans and 411.22 counties, assure recipient access to essential community 411.23 providers, and monitor the health plans' delivery of services 411.24 through utilization review and quality standards. 411.25 Sec. 49. [256I.08] [COUNTY SHARE FOR CERTAIN NURSING 411.26 FACILITY STAYS.] 411.27 Beginning January 1, 2004, if group residential housing is 411.28 used to pay for a nursing facility placement due to the 411.29 facility's status as an Institution for Mental Diseases, the 411.30 county is liable for 20 percent of the nonfederal share of costs 411.31 for persons under the age of 65 that have exceeded 90 days. 411.32 Sec. 50. [HOME AND COMMUNITY-BASED WAIVERED SERVICE 411.33 PRIORITIES.] 411.34 For the 2004-2005 biennium, the commissioner shall monitor 411.35 all available home and community-based waiver resources to 411.36 support the following priorities for service for eligible 412.1 individuals: 412.2 (1) children or adults who cannot be maintained safely in 412.3 their current living situation without waiver services; 412.4 (2) children or adults in unstable living situations due to 412.5 significant needs, age, or incapacity of the primary caregiver; 412.6 and 412.7 (3) other persons who have been screened and are eligible, 412.8 including those living in an institution. 412.9 Sec. 51. [HOME AND COMMUNITY-BASED WAIVER FOR PERSONS WITH 412.10 MENTAL RETARDATION OR A RELATED CONDITION; RESOURCE MANAGEMENT 412.11 STATEWIDE.] 412.12 The commissioner shall manage MR/RC waiver resources during 412.13 the 2004-2005 biennium to assure that all available funds are 412.14 allocated to meet the service priority needs and maintain a 412.15 reserve statewide of no more than three percent of available 412.16 funds. In order to effectively manage available resources to 412.17 meet service priorities, the commissioner shall enable counties 412.18 to manage resources on a regional basis. 412.19 Sec. 52. [DENIAL, REDUCTION, OR TERMINATION OF WAIVER 412.20 SERVICES.] 412.21 For the 2004-2005 biennium, when a county is evaluating 412.22 individual denials, reductions, or terminations of home and 412.23 community-based services under sections 256B.0916 and 256B.49 412.24 for an individual, the case manager shall offer to meet with the 412.25 individual or the individual's guardian and prioritize service 412.26 needs based on the individualized service plan. The reduction 412.27 in the authorized services for an individual due to changes in 412.28 funding for waivered services may not exceed the amount needed 412.29 to assure medically necessary services to meet the individual's 412.30 health, safety, and welfare. 412.31 Sec. 53. [DIRECTION TO THE COMMISSIONER; HOME AND 412.32 COMMUNITY-BASED SERVICES RESOURCE ALLOCATION METHOD 412.33 DEVELOPMENT.] 412.34 The commissioner shall consult with representatives of 412.35 persons with disabilities, their families and guardians, 412.36 counties, service providers, and advocacy organizations to 413.1 develop recommendations for a statewide method of allocating 413.2 resources sufficient to meet the identified needs of persons 413.3 eligible for home and community-based waiver services under 413.4 Minnesota Statutes, sections 256B.0916 and 256B.49. The 413.5 recommendations shall include provisions that address the 413.6 feasibility of (1) offering incentives to persons with less 413.7 urgent service needs who are receiving services or on the 413.8 waiting list to postpone their access to home and 413.9 community-based service options, (2) providing case management 413.10 services to individuals on the MR/RC waiting list, (3) analyzing 413.11 the impact of allocating resources on rates, payments, and 413.12 changes in services to people, (4) analyzing individual 413.13 capitation, and (5) evaluating whether the parental fee 413.14 structure should be modified to reflect service utilization 413.15 differences. The recommendations shall be provided to the 413.16 legislative committees with jurisdiction over health and human 413.17 services issues by January 15, 2005. A status report shall be 413.18 provided to the committee by January 15, 2004. 413.19 Sec. 54. [HOME AND COMMUNITY-BASED SERVICES FUNDING 413.20 METHODOLOGY.] 413.21 Beginning July 1, 2003, before making significant 413.22 administrative changes in the funding methodology for the home 413.23 and community-based waiver for persons with mental retardation 413.24 or a related condition, the commissioner shall consult with 413.25 representatives of counties, service providers, and persons with 413.26 disabilities and their families to provide specific information 413.27 about the funding formula and funding changes and the 413.28 opportunity to comment at least 90 days before the changes 413.29 become effective. 413.30 Sec. 55. [CASE MANAGEMENT ACCESS FOR PERSONS SEEKING 413.31 COMMUNITY-BASED SERVICES.] 413.32 For the 2004-2005 biennium, when a person requests case 413.33 management services under Minnesota Statutes, section 256B.0621, 413.34 256B.092, or 256B.49, subdivision 13, the county must determine 413.35 whether the person qualifies, begin the screening process, begin 413.36 individualized service plan development, and provide mandated 414.1 case management services or relocation service coordination to 414.2 those eligible within a reasonable time. If a county is unable 414.3 to provide case management services within the required time 414.4 period under sections 256B.0621, subdivision 7; 256B.49, 414.5 subdivision 13; and Minnesota Rules, parts 9525.0004 to 414.6 9525.0036, the county shall contract for case management 414.7 services to meet the obligation. 414.8 Sec. 56. [CASE MANAGEMENT SERVICES REDESIGN.] 414.9 In consultation with representatives for consumers, 414.10 consumer advocates, counties, and service providers, the 414.11 commissioner shall develop proposed legislation for case 414.12 management changes that will (1) streamline administration, (2) 414.13 improve consumer access to case management services, (3) assess 414.14 the feasibility of a comprehensive universal assessment protocol 414.15 for persons seeking community supports, (4) provide 414.16 recommendations to case managers on reasonable means to meet 414.17 consumer needs given resource allocation methods, (5) establish 414.18 accountability for funds and performance measures, (6) provide 414.19 for consumer choice of the case management service vendor, and 414.20 (7) evaluate whether case management services to individuals 414.21 with mental retardation or a related condition under Minnesota 414.22 Statutes, section 256B.092, not reimbursed as a waivered service 414.23 should be paid by the state. The proposed legislation shall be 414.24 provided to the legislative committees with jurisdiction over 414.25 health and human services issues by January 15, 2005. 414.26 Sec. 57. [SEMI-INDEPENDENT LIVING SERVICES AND FAMILY 414.27 SUPPORT GRANTS.] 414.28 The commissioner shall require a county contribution equal 414.29 to 20 percent of the cost of the semi-independent living 414.30 services and family support grant programs, by January 1, 2004. 414.31 Sec. 58. [VACANCY LISTINGS.] 414.32 The commissioner of human services shall work with 414.33 interested stakeholders on how provider and industry specific 414.34 Web sites can provide useful information to consumers on bed 414.35 vacancies for group residential housing providers and 414.36 intermediate care facilities for persons with mental retardation 415.1 and related conditions. Providers and industry trade 415.2 organizations are responsible for all costs related to 415.3 maintaining Web sites listing bed vacancies. 415.4 Sec. 59. [HOMELESS SERVICES; STATE CONTRACTS.] 415.5 The commissioner of human services may contract directly 415.6 with nonprofit organizations providing homeless services in two 415.7 or more counties. No more than two percent of the Children's 415.8 and Community Social Services Act funds may be set aside to 415.9 provide for contracts under this section. 415.10 Sec. 60. [GOVERNOR'S COUNCIL ON DEVELOPMENTAL DISABILITY, 415.11 OMBUDSMAN FOR MENTAL HEALTH AND MENTAL RETARDATION, AND COUNCIL 415.12 ON DISABILITIES.] 415.13 The governor's council on developmental disability under 415.14 Minnesota Statutes, section 16B.053, the ombudsman for mental 415.15 health and mental retardation under Minnesota Statutes, section 415.16 245.92, the centers for independent living, and the council on 415.17 disability under Minnesota Statutes, section 256.482, must study 415.18 the feasibility of (1) space coordination, (2) shared use of 415.19 technology, (3) coordination of resource priorities, and (4) 415.20 consolidation and make recommendations to the house and senate 415.21 committees with jurisdiction over these entities by January 15, 415.22 2004. 415.23 Sec. 61. [GOVERNOR'S COUNCIL ON DEVELOPMENTAL DISABILITY.] 415.24 The governor's council on developmental disability under 415.25 Minnesota Statutes, section 16B.053, shall provide an annual 415.26 report of its activities to the house and senate committees with 415.27 jurisdiction over human services by February 1 of each year. 415.28 Sec. 62. [REVISOR'S INSTRUCTION.] 415.29 For sections in Minnesota Statutes and Minnesota Rules 415.30 affected by the repealed sections in this article, the revisor 415.31 shall delete internal cross-references where appropriate and 415.32 make changes necessary to correct the punctuation, grammar, or 415.33 structure of the remaining text and preserve its meaning. 415.34 Sec. 63. [REPEALER.] 415.35 (a) Minnesota Statutes 2002, sections 252.32, subdivision 415.36 2; 256B.095; 256B.0951; 256B.0952; 256B.0953; 256B.0954; and 416.1 256B.0955, are repealed July 1, 2003. 416.2 (b) Minnesota Statutes 2002, section 245.4712, subdivision 416.3 2, is repealed July 1, 2005. 416.4 (c) Laws 2001, First Special Session chapter 9, article 13, 416.5 section 24, is repealed July 1, 2003. 416.6 ARTICLE 5 416.7 CHILDREN'S SERVICES 416.8 Section 1. Minnesota Statutes 2002, section 256B.0625, 416.9 subdivision 20, is amended to read: 416.10 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 416.11 extent authorized by rule of the state agency, medical 416.12 assistance covers case management services to persons with 416.13 serious and persistent mental illness and children with severe 416.14 emotional disturbance. Services provided under this section 416.15 must meet the relevant standards in sections 245.461 to 416.16 245.4888, the Comprehensive Adult and Children's Mental Health 416.17 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 416.18 9505.0322, excluding subpart 10. 416.19 (b) Entities meeting program standards set out in rules 416.20 governing family community support services as defined in 416.21 section 245.4871, subdivision 17, are eligible for medical 416.22 assistance reimbursement for case management services for 416.23 children with severe emotional disturbance when these services 416.24 meet the program standards in Minnesota Rules, parts 9520.0900 416.25 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 416.26 (c) Medical assistance and MinnesotaCare payment for mental 416.27 health case management shall be made on a monthly basis. In 416.28 order to receive payment for an eligible child, the provider 416.29 must document at least a face-to-face contact with the child, 416.30 the child's parents, or the child's legal representative. To 416.31 receive payment for an eligible adult, the provider must 416.32 document: 416.33 (1) at least a face-to-face contact with the adult or the 416.34 adult's legal representative; or 416.35 (2) at least a telephone contact with the adult or the 416.36 adult's legal representative and document a face-to-face contact 417.1 with the adult or the adult's legal representative within the 417.2 preceding two months. 417.3 (d) Payment for mental health case management provided by 417.4 county or state staff shall be based on the monthly rate 417.5 methodology under section 256B.094, subdivision 6, paragraph 417.6 (b), with separate rates calculated for child welfare and mental 417.7 health, and within mental health, separate rates for children 417.8 and adults. 417.9 (e) Payment for mental health case management provided by 417.10 Indian health services or by agencies operated by Indian tribes 417.11 may be made according to this section or other relevant 417.12 federally approved rate setting methodology. 417.13 (f) Payment for mental health case management provided by 417.14 vendors who contract with a county or Indian tribe shall be 417.15 based on a monthly rate negotiated by the host county or tribe. 417.16 The negotiated rate must not exceed the rate charged by the 417.17 vendor for the same service to other payers. If the service is 417.18 provided by a team of contracted vendors, the county or tribe 417.19 may negotiate a team rate with a vendor who is a member of the 417.20 team. The team shall determine how to distribute the rate among 417.21 its members. No reimbursement received by contracted vendors 417.22 shall be returned to the county or tribe, except to reimburse 417.23 the county or tribe for advance funding provided by the county 417.24 or tribe to the vendor. 417.25 (g) If the service is provided by a team which includes 417.26 contracted vendors, tribal staff, and county or state staff, the 417.27 costs for county or state staff participation in the team shall 417.28 be included in the rate for county-provided services. In this 417.29 case, the contracted vendor, the tribal agency, and the county 417.30 may each receive separate payment for services provided by each 417.31 entity in the same month. In order to prevent duplication of 417.32 services, each entity must document, in the recipient's file, 417.33 the need for team case management and a description of the roles 417.34 of the team members. 417.35 (h) The commissioner shall calculate the nonfederal share 417.36 of actual medical assistance and general assistance medical care 418.1 payments for each county, based on the higher of calendar year 418.2 1995 or 1996, by service date, project that amount forward to 418.3 1999, and transfer one-half of the result from medical 418.4 assistance and general assistance medical care to each county's 418.5 mental health grants under sections 245.4886 and 256E.12 for 418.6 calendar year 1999. The annualized minimum amount added to each 418.7 county's mental health grant shall be $3,000 per year for 418.8 children and $5,000 per year for adults. The commissioner may 418.9 reduce the statewide growth factor in order to fund these 418.10 minimums. The annualized total amount transferred shall become 418.11 part of the base for future mental health grants for each county. 418.12 (i)Any net increase in revenue to the county or tribe as a418.13result of the change in this section must be used to provide418.14expanded mental health services as defined in sections 245.461418.15to 245.4888, the Comprehensive Adult and Children's Mental418.16Health Acts, excluding inpatient and residential treatment. For418.17adults, increased revenue may also be used for services and418.18consumer supports which are part of adult mental health projects418.19approved under Laws 1997, chapter 203, article 7, section 25.418.20For children, increased revenue may also be used for respite418.21care and nonresidential individualized rehabilitation services418.22as defined in section 245.492, subdivisions 17 and 23.418.23"Increased revenue" has the meaning given in Minnesota Rules,418.24part 9520.0903, subpart 3.418.25(j)Notwithstanding section 256B.19, subdivision 1, the 418.26 nonfederal share of costs for mental health case management 418.27 shall be provided by the recipient's county of responsibility, 418.28 as defined in sections 256G.01 to 256G.12, from sources other 418.29 than federal funds or funds used to match other federal funds. 418.30 If the service is provided by a tribal agency, the nonfederal 418.31 share, if any, shall be provided by the recipient's tribe. 418.32(k)(j) The commissioner may suspend, reduce, or terminate 418.33 the reimbursement to a provider that does not meet the reporting 418.34 or other requirements of this section. The county of 418.35 responsibility, as defined in sections 256G.01 to 256G.12, or, 418.36 if applicable, the tribal agency, is responsible for any federal 419.1 disallowances. The county or tribe may share this 419.2 responsibility with its contracted vendors. 419.3(l)(k) The commissioner shall set aside a portion of the 419.4 federal funds earned under this section to repay the special 419.5 revenue maximization account under section 256.01, subdivision 419.6 2, clause (15). The repayment is limited to: 419.7 (1) the costs of developing and implementing this section; 419.8 and 419.9 (2) programming the information systems. 419.10(m)(l) Payments to counties and tribal agencies for case 419.11 management expenditures under this section shall only be made 419.12 from federal earnings from services provided under this 419.13 section. Payments to county-contracted vendors shall include 419.14 both the federal earnings and the county share. 419.15(n)(m) Notwithstanding section 256B.041, county payments 419.16 for the cost of mental health case management services provided 419.17 by county or state staff shall not be made to the state 419.18 treasurer. For the purposes of mental health case management 419.19 services provided by county or state staff under this section, 419.20 the centralized disbursement of payments to counties under 419.21 section 256B.041 consists only of federal earnings from services 419.22 provided under this section. 419.23(o)(n) Case management services under this subdivision do 419.24 not include therapy, treatment, legal, or outreach services. 419.25(p)(o) If the recipient is a resident of a nursing 419.26 facility, intermediate care facility, or hospital, and the 419.27 recipient's institutional care is paid by medical assistance, 419.28 payment for case management services under this subdivision is 419.29 limited to the last 180 days of the recipient's residency in 419.30 that facility and may not exceed more than six months in a 419.31 calendar year. 419.32(q)(p) Payment for case management services under this 419.33 subdivision shall not duplicate payments made under other 419.34 program authorities for the same purpose. 419.35(r)(q) By July 1, 2000, the commissioner shall evaluate 419.36 the effectiveness of the changes required by this section, 420.1 including changes in number of persons receiving mental health 420.2 case management, changes in hours of service per person, and 420.3 changes in caseload size. 420.4(s)(r) For each calendar year beginning with the calendar 420.5 year 2001, the annualized amount of state funds for each county 420.6 determined under paragraph (h) shall be adjusted by the county's 420.7 percentage change in the average number of clients per month who 420.8 received case management under this section during the fiscal 420.9 year that ended six months prior to the calendar year in 420.10 question, in comparison to the prior fiscal year. 420.11(t)(s) For counties receiving the minimum allocation of 420.12 $3,000 or $5,000 described in paragraph (h), the adjustment in 420.13 paragraph(s)(r) shall be determined so that the county 420.14 receives the higher of the following amounts: 420.15 (1) a continuation of the minimum allocation in paragraph 420.16 (h); or 420.17 (2) an amount based on that county's average number of 420.18 clients per month who received case management under this 420.19 section during the fiscal year that ended six months prior to 420.20 the calendar year in question, times the average statewide grant 420.21 per person per month for counties not receiving the minimum 420.22 allocation. 420.23(u)(t) The adjustments in paragraphs(s)(r) and 420.24(t)(s) shall be calculated separately for children and adults. 420.25 Sec. 2. Minnesota Statutes 2002, section 256B.0625, 420.26 subdivision 23, is amended to read: 420.27 Subd. 23. [DAY TREATMENT SERVICES.] Medical assistance 420.28 covers day treatment services for adults as specified in 420.29sectionssection 245.462, subdivision 8,and 245.4871,420.30subdivision 10,that are provided under contract with the county 420.31 board. Notwithstanding Minnesota Rules, part 9505.0323, subpart 420.32 15, the commissioner may set authorization thresholds for day 420.33 treatment according to section 256B.0625, subdivision 25. 420.34 Medical assistance covers day treatment services for children as 420.35 specified under section 256B.0943. Medical assistance coverage 420.36 for day treatment for adults ends on June 30, 2005. 421.1 [EFFECTIVE DATE.] This section is effective July 1, 2004. 421.2 Sec. 3. Minnesota Statutes 2002, section 256B.0625, is 421.3 amended by adding a subdivision to read: 421.4 Subd. 35a. [CHILDREN'S MENTAL HEALTH CRISIS RESPONSE 421.5 SERVICES.] Medical assistance covers children's mental health 421.6 crisis response services according to section 256B.0944. 421.7 [EFFECTIVE DATE.] This section is effective July 1, 2004. 421.8 Sec. 4. Minnesota Statutes 2002, section 256B.0625, is 421.9 amended by adding a subdivision to read: 421.10 Subd. 35b. [CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.] 421.11 Medical assistance covers children's therapeutic services and 421.12 supports according to section 256B.0943. 421.13 [EFFECTIVE DATE.] This section is effective July 1, 2004. 421.14 Sec. 5. Minnesota Statutes 2002, section 256B.0625, is 421.15 amended by adding a subdivision to read: 421.16 Subd. 45. [SUBACUTE PSYCHIATRIC CARE FOR PERSONS UNDER 21 421.17 YEARS OF AGE.] Medical assistance covers subacute psychiatric 421.18 care for person under 21 years of age when: 421.19 (1) the services meet the requirements of Code of Federal 421.20 Regulations, title 42, section 440.160; 421.21 (2) the facility is accredited as a psychiatric treatment 421.22 facility by the joint commission on accreditation of healthcare 421.23 organizations, the commission on accreditation of rehabilitation 421.24 facilities, or the council on accreditation; and 421.25 (3) the facility is licensed by the commissioner of health 421.26 under section 144.50. 421.27 [EFFECTIVE DATE.] This section is effective July 1, 2003. 421.28 Sec. 6. [256B.0943] [CHILDREN'S THERAPEUTIC SERVICES AND 421.29 SUPPORTS.] 421.30 Subdivision 1. [DEFINITIONS.] For purposes of this 421.31 section, the following terms have the meanings given them. 421.32 (a) "Children's therapeutic services and supports" means 421.33 the flexible package of mental health services for children who 421.34 require varying therapeutic and rehabilitative levels of 421.35 intervention. The services are time-limited interventions that 421.36 are delivered using various treatment modalities and 422.1 combinations of services designed to reach treatment outcomes 422.2 identified in the individual treatment plan. 422.3 (b) "Clinical supervision" means the overall responsibility 422.4 of the mental health professional for the control and direction 422.5 of individualized treatment planning, service delivery, and 422.6 treatment review for each client. A mental health professional 422.7 who is an enrolled Minnesota health care program provider 422.8 accepts full professional responsibility for a supervisee's 422.9 actions and decisions, instructs the supervisee in the 422.10 supervisee's work, and oversees or directs the supervisee's work. 422.11 (c) "County board" means the county board of commissioners 422.12 or board established under sections 402.01 to 402.10 or 471.59. 422.13 (d) "Crisis assistance" has the meaning given in section 422.14 245.4871, subdivision 9a. 422.15 (e) "Culturally competent provider" means a provider who 422.16 understands and can utilize to a client's benefit the client's 422.17 culture when providing services to the client. A provider may 422.18 be culturally competent because the provider is of the same 422.19 cultural or ethnic group as the client or the provider has 422.20 developed the knowledge and skills through training and 422.21 experience to provide services to culturally diverse clients. 422.22 (f) "Day treatment program" for children means a site-based 422.23 structured program consisting of group psychotherapy for more 422.24 than three individuals and other intensive therapeutic services 422.25 provided by a multidisciplinary team, under the clinical 422.26 supervision of a mental health professional. 422.27 (g) "Diagnostic assessment" has the meaning given in 422.28 section 245.4871, subdivision 11. 422.29 (h) "Direct service time" means the time that a mental 422.30 health professional, mental health practitioner, or mental 422.31 health behavioral aide spends face-to-face with a client and the 422.32 client's family. Direct service time includes time in which the 422.33 provider obtains a client's history or provides service 422.34 components of children's therapeutic services and supports. 422.35 Direct service time does not include time doing work before and 422.36 after providing direct services, including scheduling, 423.1 maintaining clinical records, consulting with others about the 423.2 client's mental health status, preparing reports, receiving 423.3 clinical supervision directly related to the client's 423.4 psychotherapy session, and revising the client's individual 423.5 treatment plan. 423.6 (i) "Direction of mental health behavioral aide" means the 423.7 activities of a mental health professional or mental health 423.8 practitioner in guiding the mental health behavioral aide in 423.9 providing services to a client. The direction of a mental 423.10 health behavioral aide must be based on the client's 423.11 individualized treatment plan and meet the requirements in 423.12 subdivision 6, paragraph (b), clause (5). 423.13 (j) "Emotional disturbance" has the meaning given in 423.14 section 245.4871, subdivision 15. For persons at least age 18 423.15 but under age 21, mental illness has the meaning given in 423.16 section 245.462, subdivision 20, paragraph (a). 423.17 (k) "Individual behavioral plan" means a plan of 423.18 intervention, treatment, and services for a child written by a 423.19 mental health professional or mental health practitioner, under 423.20 the clinical supervision of a mental health professional, to 423.21 guide the work of the mental health behavioral aide. 423.22 (l) "Individual treatment plan" has the meaning given in 423.23 section 245.4871, subdivision 21. 423.24 (m) "Mental health professional" means an individual as 423.25 defined in section 245.4871, subdivision 27, clauses (1) to (5), 423.26 or tribal vendor as defined in section 256B.02, subdivision 7, 423.27 paragraph (b). 423.28 (n) "Preschool program" means a day program licensed under 423.29 Minnesota Rules, parts 9503.0005 to 9503.0175, and enrolled as a 423.30 children's therapeutic services and supports provider to provide 423.31 a structured treatment program to a child who is at least 33 423.32 months old but who has not yet attended the first day of 423.33 kindergarten. 423.34 (o) "Skills training" means individual, family, or group 423.35 training designed to improve the basic functioning of the child 423.36 with emotional disturbance and the child's family in the 424.1 activities of daily living and community living, and to improve 424.2 the social functioning of the child and the child's family in 424.3 areas important to the child's maintaining or reestablishing 424.4 residency in the community. Individual, family, and group 424.5 skills training must: 424.6 (1) consist of activities designed to promote skill 424.7 development of the child and the child's family in the use of 424.8 age-appropriate daily living skills, interpersonal and family 424.9 relationships, and leisure and recreational services; 424.10 (2) consist of activities that will assist the family's 424.11 understanding of normal child development and to use parenting 424.12 skills that will help the child with emotional disturbance 424.13 achieve the goals outlined in the child's individual treatment 424.14 plan; and 424.15 (3) promote family preservation and unification, promote 424.16 the family's integration with the community, and reduce the use 424.17 of unnecessary out-of-home placement or institutionalization of 424.18 children with emotional disturbance. 424.19 Subd. 2. [COVERED SERVICE COMPONENTS OF CHILDREN'S 424.20 THERAPEUTIC SERVICES AND SUPPORTS.] (a) Subject to federal 424.21 approval, medical assistance covers medically necessary 424.22 children's therapeutic services and supports as defined in this 424.23 section that an eligible provider entity under subdivisions 4 424.24 and 5 provides to a client eligible under subdivision 3. 424.25 (b) The service components of children's therapeutic 424.26 services and supports are: 424.27 (1) individual, family, and group psychotherapy; 424.28 (2) individual, family, or group skills training provide by 424.29 a mental health professional or mental health practitioner; 424.30 (3) crisis assistance; 424.31 (4) mental health behavioral aide services; and 424.32 (5) direction of a mental health behavioral aide. 424.33 (c) Service components may be combined to constitute 424.34 therapeutic programs, including day treatment programs and 424.35 preschool programs. Although day treatment and preschool 424.36 programs have specific client and provider eligibility 425.1 requirements, medical assistance only pays for the service 425.2 components listed in paragraph (b). 425.3 Subd. 3. [DETERMINATION OF CLIENT ELIGIBILITY.] A client's 425.4 eligibility to receive children's therapeutic services and 425.5 supports under this section shall be determined based on a 425.6 diagnostic assessment by a mental health professional that is 425.7 performed within 180 days of the initial start of service. The 425.8 diagnostic assessment must: 425.9 (1) include current diagnoses on all five axes of the 425.10 client's current mental health status; 425.11 (2) determine whether a child under age 18 has a diagnosis 425.12 of emotional disturbance or, if the person is between the ages 425.13 of 18 and 21, whether the person has a mental illness; 425.14 (3) document children's therapeutic services and supports 425.15 as medically necessary to address an identified disability, 425.16 functional impairment, and the individual client's needs and 425.17 goals; 425.18 (4) be used in the development of the individualized 425.19 treatment plan; and 425.20 (5) be completed annually until age 18. For individuals 425.21 between age 18 and 21, unless a client's mental health condition 425.22 has changed markedly since the client's most recent diagnostic 425.23 assessment, annual updating is necessary. For the purpose of 425.24 this section, "updating" means a written summary, including 425.25 current diagnoses on all five axes, by a mental health 425.26 professional of the client's current mental health status and 425.27 service needs. 425.28 Subd. 4. [PROVIDER ENTITY CERTIFICATION.] (a) Effective 425.29 July 1, 2003, the commissioner shall establish an initial 425.30 provider entity application and certification process and 425.31 recertification process to determine whether a provider entity 425.32 has an administrative and clinical infrastructure that meets the 425.33 requirements in subdivisions 5 and 6. The commissioner shall 425.34 recertify a provider entity at least every three years. The 425.35 commissioner shall establish a process for decertification of a 425.36 provider entity that no longer meets the requirements in this 426.1 section. The county, tribe, and the commissioner shall be 426.2 mutually responsible and accountable for the county's, tribe's, 426.3 and state's part of the certification, recertification, and 426.4 decertification processes. 426.5 (b) For purposes of this section, a provider entity must be: 426.6 (1) an Indian health services facility or a facility owned 426.7 and operated by a tribe or tribal organization operating as a 426.8 638 facility under Public Law 93-368 certified by the state; 426.9 (2) a county-operated entity certified by the state; or 426.10 (3) a noncounty entity recommended for certification by the 426.11 provider's host county and certified by the state. 426.12 Subd. 5. [PROVIDER ENTITY ADMINISTRATIVE INFRASTRUCTURE 426.13 REQUIREMENTS.] (a) To be an eligible provider entity under this 426.14 section, a provider entity must have an administrative 426.15 infrastructure that establishes authority and accountability for 426.16 decision making and oversight of functions, including finance, 426.17 personnel, system management, clinical practice, and performance 426.18 measurement. The provider must have written policies and 426.19 procedures that it reviews and updates every three years and 426.20 distributes to staff initially and upon each subsequent update. 426.21 (b) The administrative infrastructure written policies and 426.22 procedures must include: 426.23 (1) personnel procedures, including a process for: (i) 426.24 recruiting, hiring, training, and retention of culturally and 426.25 linguistically competent providers; (ii) conducting a criminal 426.26 background check on all direct service providers and volunteers; 426.27 (iii) investigating, reporting, and acting on violations of 426.28 ethical conduct standards; (iv) investigating, reporting, and 426.29 acting on violations of data privacy policies that are compliant 426.30 with federal and state laws; (v) utilizing volunteers, including 426.31 screening applicants, training and supervising volunteers, and 426.32 providing liability coverage for volunteers; and (vi) 426.33 documenting that a mental health professional, mental health 426.34 practitioner, or mental health behavioral aide meets the 426.35 applicable provider qualification criteria, training criteria 426.36 under subdivision 8, and clinical supervision or direction of a 427.1 mental health behavioral aide requirements under subdivision 6; 427.2 (2) fiscal procedures, including internal fiscal control 427.3 practices and a process for collecting revenue that is compliant 427.4 with federal and state laws; 427.5 (3) if a client is receiving services from a case manager 427.6 or other provider entity, a service coordination process that 427.7 ensures services are provided in the most appropriate manner to 427.8 achieve maximum benefit to the client. The provider entity must 427.9 ensure coordination and nonduplication of services consistent 427.10 with county board coordination procedures established under 427.11 section 245.4881, subdivision 5; 427.12 (4) a performance measurement system, including monitoring 427.13 to determine cultural appropriateness of services identified in 427.14 the individual treatment plan, as determined by the client's 427.15 culture, beliefs, values, and language, and family-driven 427.16 services; and 427.17 (5) a process to establish and maintain individual client 427.18 records. The client's records must include: (i) the client's 427.19 personal information; (ii) forms applicable to data privacy; 427.20 (iii) the client's diagnostic assessment, updates, tests, 427.21 individual treatment plan, and individual behavior plan, if 427.22 necessary; (iv) documentation of service delivery as specified 427.23 under subdivision 6; (v) telephone contacts; (vi) discharge 427.24 plan; and (vii) if applicable, insurance information. 427.25 Subd. 6. [PROVIDER ENTITY CLINICAL INFRASTRUCTURE 427.26 REQUIREMENTS.] (a) To be an eligible provider entity under this 427.27 section, a provider entity must have a clinical infrastructure 427.28 that utilizes diagnostic assessment, an individualized treatment 427.29 plan, service delivery, and individual treatment plan review 427.30 that are culturally competent, child-centered, and family-driven 427.31 to achieve maximum benefit for the client. The provider entity 427.32 must review and update the clinical policies and procedures 427.33 every three years and must distribute the policies and 427.34 procedures to staff initially and upon each subsequent update. 427.35 (b) The clinical infrastructure written policies and 427.36 procedures must include policies and procedures for: 428.1 (1) providing or obtaining a client's diagnostic assessment 428.2 that identifies acute and chronic clinical disorders, 428.3 co-occurring medical conditions, sources of psychological and 428.4 environmental problems, and a functional assessment. The 428.5 functional assessment must clearly summarize the client's 428.6 individual strengths and needs; 428.7 (2) developing an individual treatment plan that is: (i) 428.8 based on the information in the client's diagnostic assessment; 428.9 (ii) developed no later than the end of the first psychotherapy 428.10 session after the completion of the client's diagnostic 428.11 assessment by the mental health professional who provides the 428.12 client's psychotherapy; (iii) developed through a 428.13 child-centered, family-driven planning process that identifies 428.14 service needs and individualized, planned, and 428.15 culturally-appropriate interventions that contain specific 428.16 treatment goals and objectives for the client and the client's 428.17 family or foster family; (iv) reviewed at least once every 90 428.18 days and revised, if necessary; and (v) signed by the client or, 428.19 if appropriate, by the client's parent or other person 428.20 authorized by statute to consent to mental health services for 428.21 the client; 428.22 (3) developing an individual behavior plan that documents 428.23 services to be provided by the mental health behavioral aide. 428.24 The individual behavior plan must include: (i) detailed 428.25 instructions on the service to be provided; (ii) time allocated 428.26 to each service; (iii) methods of documenting the child's 428.27 behavior; (iv) methods of monitoring the child's progress in 428.28 reaching objectives; and (v) goals to increase or decrease 428.29 targeted behavior as identified in the individual treatment 428.30 plan; 428.31 (4) clinical supervision of the mental health practitioner 428.32 and mental health behavioral aide. A mental health professional 428.33 must document the clinical supervision the professional provides 428.34 by cosigning individual treatment plans and making entries in 428.35 the client's record on supervisory activities. Clinical 428.36 supervision does not include the authority to make or terminate 429.1 court-ordered placements of the child. A clinical supervisor 429.2 must be available for urgent consultation as required by the 429.3 individual client's needs or the situation. Clinical 429.4 supervision may occur individually or in a small group to 429.5 discuss treatment and review progress toward goals. The focus 429.6 of clinical supervision must be the client's treatment needs and 429.7 progress and the mental health practitioner's or behavioral 429.8 aide's ability to provide services; 429.9 (5) providing direction to a mental health behavioral 429.10 aide. For entities that employ mental health behavioral aides, 429.11 the clinical supervisor must be employed by the provider entity 429.12 to ensure necessary and appropriate oversight for the client's 429.13 treatment and continuity of care. The mental health 429.14 professional or mental health practitioner giving direction must 429.15 begin with the goals on the individualized treatment plan, and 429.16 instruct the mental health behavioral aide on how to construct 429.17 therapeutic activities and interventions that will lead to goal 429.18 attainment. The professional or practitioner giving direction 429.19 must also instruct the mental health behavioral aide about the 429.20 client's diagnosis, functional status, and other characteristics 429.21 that are likely to affect service delivery. Direction must also 429.22 include determining that the mental health behavioral aide has 429.23 the skills to interact with the client and the client's family 429.24 in ways that convey personal and cultural respect and that the 429.25 aide actively solicits information relevant to treatment from 429.26 the family. The aide must be able to clearly explain the 429.27 activities the aide is doing with the client and the activities' 429.28 relationship to treatment goals. Direction is more didactic 429.29 than is supervision and requires the professional or 429.30 practitioner providing it to continuously evaluate the mental 429.31 health behavioral aide's ability to carry out the activities of 429.32 the individualized treatment plan and the individualized 429.33 behavior plan. When providing direction, the professional or 429.34 practitioner must: (i) review progress notes prepared by the 429.35 mental health behavioral aide for accuracy and consistency with 429.36 diagnostic assessment, treatment plan, and behavior goals and 430.1 the professional or practitioner must approve and sign the 430.2 progress notes; (ii) identify changes in treatment strategies, 430.3 revise the individual behavior plan, and communicate treatment 430.4 instructions and methodologies as appropriate to ensure that 430.5 treatment is implemented correctly; (iii) demonstrate 430.6 family-friendly behaviors that support healthy collaboration 430.7 among the child, the child's family, and providers as treatment 430.8 is planned and implemented; (iv) ensure that the mental health 430.9 behavioral aide is able to effectively communicate with the 430.10 child, the child's family, and the provider; and (v) record the 430.11 results of any evaluation and corrective actions taken to modify 430.12 the work of the mental health behavioral aide; 430.13 (6) providing service delivery that implements the 430.14 individual treatment plan and meets the requirements under 430.15 subdivision 9; and 430.16 (7) individual treatment plan review. The review must 430.17 determine the extent to which the services have met the goals 430.18 and objectives in the previous treatment plan. The review must 430.19 assess the client's progress and ensure that services and 430.20 treatment goals continue to be necessary and appropriate to the 430.21 client and the client's family or foster family. Revision of 430.22 the individual treatment plan does not require a new diagnostic 430.23 assessment unless the client's mental health status has changed 430.24 markedly. The updated treatment plan must be signed by the 430.25 client, if appropriate, and by the client's parent or other 430.26 person authorized by statute to give consent to the mental 430.27 health services for the child. 430.28 Subd. 7. [QUALIFICATIONS OF INDIVIDUAL AND TEAM 430.29 PROVIDERS.] (a) An individual or team provider working within 430.30 the scope of the provider's practice or qualifications may 430.31 provide service components of children's therapeutic services 430.32 and supports that are identified as medically necessary in a 430.33 client's individual treatment plan. 430.34 (b) An individual provider and multidisciplinary team 430.35 include: 430.36 (1) a mental health professional as defined in subdivision 431.1 1, paragraph (m); 431.2 (2) a mental health practitioner as defined in section 431.3 245.4871, subdivision 26. The mental health practitioner must 431.4 work under the clinical supervision of a mental health 431.5 professional; 431.6 (3) a mental health behavioral aide working under the 431.7 direction of a mental health professional to implement the 431.8 rehabilitative mental health services identified in the client's 431.9 individual treatment plan. A level I mental health behavioral 431.10 aide must: (i) be at least 18 years old; (ii) have a high 431.11 school diploma or general equivalency diploma (GED) or two years 431.12 of experience as a primary caregiver to a child with severe 431.13 emotional disturbance within the previous ten years; and (iii) 431.14 meet preservices and continuing education requirements under 431.15 subdivision 8. A level II mental health behavioral aide must: 431.16 (i) be at least 18 years old; (ii) have an associate or 431.17 bachelor's degree or 4,000 hours of experience in delivering 431.18 clinical services in the treatment of mental illness concerning 431.19 children or adolescents; and (iii) meet preservice and 431.20 continuing education requirements in subdivision 8; 431.21 (4) a preschool program multidisciplinary team that 431.22 includes at least one mental health professional and one or more 431.23 of the following individuals under the clinical supervision of a 431.24 mental health professional: (i) a mental health practitioner; 431.25 or (ii) a program person, including a teacher, assistant 431.26 teacher, or aide, who meets the qualifications and training 431.27 standards of a level I mental health behavioral aide; or 431.28 (5) a day treatment multidisciplinary team that includes at 431.29 least one mental health professional and one mental health 431.30 practitioner. 431.31 Subd. 8. [REQUIRED PRESERVICE AND CONTINUING 431.32 EDUCATION.] (a) A provider entity shall establish a plan to 431.33 provide preservice and continuing education for staff. The plan 431.34 must clearly describe the type of training necessary to maintain 431.35 current skills and obtain new skills, and that relates to the 431.36 provider entity's goals and objectives for services offered. 432.1 (b) A provider that employs a mental health behavioral aide 432.2 under this section must require the mental health behavioral 432.3 aide to complete 30 hours of preservice training. The 432.4 preservice training must include topics specified in Minnesota 432.5 Rules, part 9535.4068, subparts 1 and 2, and parent team 432.6 training. The preservice training must include 15 hours of 432.7 in-person training of a mental health behavioral aide in mental 432.8 health services delivery and eight hours of parent team 432.9 training. Components of parent team training include: 432.10 (1) partnering with parents; 432.11 (2) fundamentals of family support; 432.12 (3) fundamentals of policy and decision making; 432.13 (4) defining equal partnership; 432.14 (5) complexities of the parent and service provider 432.15 partnership in multiple service delivery systems due to system 432.16 strengths and weaknesses; 432.17 (6) sibling impacts; 432.18 (7) support networks; and 432.19 (8) community resources. 432.20 (c) A provider entity that employs a mental health 432.21 practitioner and a mental health behavioral aide to provide 432.22 children's therapeutic services and supports under this section 432.23 must require the mental health practitioner and mental health 432.24 behavioral aide to complete 20 hours of continuing education 432.25 every two calendar years. The continuing education must be 432.26 related to serving the needs of a child with emotional 432.27 disturbance in the child's home environment and the child's 432.28 family. The topics covered in orientation and training must 432.29 conform to Minnesota Rules, part 9535.4068. 432.30 (d) The provider entity must document the mental health 432.31 practitioner's or mental health behavioral aide's annual 432.32 completion of the required continuing education. The 432.33 documentation must include the date, subject, and number of 432.34 hours of the continuing education, and attendance records, as 432.35 verified by the staff member's signature, job title, and the 432.36 instructor's name. The provider entity must keep documentation 433.1 for each employee, including records of attendance at 433.2 professional workshops and conferences, at a central location 433.3 and in the employee's personnel file. 433.4 Subd. 9. [SERVICE DELIVERY CRITERIA.] (a) In delivering 433.5 services under this section, a certified provider entity must 433.6 ensure that: 433.7 (1) each individual provider's caseload size permits the 433.8 provider to deliver services to both clients with severe, 433.9 complex needs and clients with less intensive needs. The 433.10 provider's caseload size should reasonably enable the provider 433.11 to play an active role in service planning, monitoring, and 433.12 delivering services to meet the client's and client's family's 433.13 needs, as specified in each client's individual treatment plan; 433.14 (2) site-based programs, including day treatment and 433.15 preschool programs, provide staffing and facilities to ensure 433.16 the client's health, safety, and protection of rights, and that 433.17 the programs are able to implement each client's individual 433.18 treatment plan; 433.19 (3) a day treatment program is provided to a group of 433.20 clients by a multidisciplinary staff under the clinical 433.21 supervision of a mental health professional. The day treatment 433.22 program must be provided in and by: (i) an outpatient hospital 433.23 accredited by the joint commission on accreditation of health 433.24 organizations and licensed under sections 144.50 to 144.55; (ii) 433.25 a community mental health center under section 245.62; and (iii) 433.26 an entity that is under contract with the county board to 433.27 operate a program that meets the requirements of sections 433.28 245.4712, subdivision 2, and 245.4884, subdivision 2, and 433.29 Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment 433.30 program must stabilize the client's mental health status while 433.31 developing and improving the client's independent living and 433.32 socialization skills. The goal of the day treatment program 433.33 must be to reduce or relieve the effects of mental illness and 433.34 provide training to enable the client to live in the community. 433.35 The program must be available at least one day a week for a 433.36 minimum three-hour time block. The three-hour time block must 434.1 include at least one hour, but no more than two hours, of 434.2 individual or group psychotherapy. The remainder of the 434.3 three-hour time block may include recreation therapy, 434.4 socialization therapy, or independent living skills therapy, but 434.5 only if the therapies are included in the client's individual 434.6 treatment plan. Day treatment programs are not part of 434.7 inpatient or residential treatment services; and 434.8 (4) a preschool program is a structured treatment program 434.9 offered to a child who is at least 33 months old, but who has 434.10 not yet reached the first day of kindergarten, by a preschool 434.11 multidisciplinary team in a day program licensed under Minnesota 434.12 Rules, parts 9503.0005 to 9503.0175. The program must be 434.13 available at least one day a week for a minimum two-hour time 434.14 block. The structured treatment program may include individual 434.15 or group psychotherapy and recreation therapy, socialization 434.16 therapy, or independent living skills therapy, if included in 434.17 the client's individual treatment plan. 434.18 (b) A provider entity must delivery the service components 434.19 of children's therapeutic services and supports in compliance 434.20 with the following requirements: 434.21 (1) individual, family, and group psychotherapy must be 434.22 delivered as specified in Minnesota Rules, parts 9505.0523; 434.23 (2) individual, family, or group skills training must be 434.24 provided by a mental health professional or a mental health 434.25 practitioner who has a consulting relationship with a mental 434.26 health professional who accepts full professional responsibility 434.27 for the training; 434.28 (3) crisis assistance must be an intense, time-limited, and 434.29 designed to resolve or stabilize crisis through arrangements for 434.30 direct intervention and support services to the child and the 434.31 child's family. Crisis assistance must utilize resources 434.32 designed to address abrupt or substantial changes in the 434.33 functioning of the child or the child's family as evidenced by a 434.34 sudden change in behavior with negative consequences for well 434.35 being, a loss of usual coping mechanisms, or the presentation of 434.36 danger to self or others; 435.1 (4) medically necessary services that are provided by a 435.2 mental health behavioral aide must be designed to improve the 435.3 functioning of the child and support the family in activities of 435.4 daily and community living. A mental health behavioral aide 435.5 must document the delivery of services in written progress 435.6 notes. The mental health behavioral aide must implement goals 435.7 in the treatment plan for the child's emotional disturbance that 435.8 allow the child to acquire developmentally and therapeutically 435.9 appropriate daily living skills, social skills, and leisure and 435.10 recreational skills through targeted activities. These 435.11 activities may include: 435.12 (i) assisting a child as needed with skills development in 435.13 dressing, eating, and toileting; 435.14 (ii) assisting, monitoring, and guiding the child to 435.15 complete tasks, including facilitating the child's participation 435.16 in medical appointments; 435.17 (iii) observing the child and intervening to redirect the 435.18 child's inappropriate behavior; 435.19 (iv) assisting the child in using age-appropriate 435.20 self-management skills as related to the child's emotional 435.21 disorder or mental illness, including problem solving, decision 435.22 making, communication, conflict resolution, anger management, 435.23 social skills, and recreational skills; 435.24 (v) implementing deescalation techniques as recommended by 435.25 the mental health professional; 435.26 (vi) implementing any other mental health service that the 435.27 mental health professional has approved as being within the 435.28 scope of the behavioral aide's duties; or 435.29 (vii) assisting the parents to develop and use parenting 435.30 skills that help the child achieve the goals outlined in the 435.31 child's individual treatment plan or individual behavioral 435.32 plan. Parenting skills must be directed exclusively to the 435.33 child's treatment; and 435.34 (5) direction of a mental health behavioral aide must 435.35 include the following: 435.36 (i) a total of one hour of on-site observation by a mental 436.1 health professional during the first 12 hours of service 436.2 provided to a child; 436.3 (ii) ongoing on-site observation by a mental health 436.4 professional or mental health practitioner for at least a total 436.5 of one hour during every 40 hours of service provided to a 436.6 child; and 436.7 (iii) immediate accessibility of the mental health 436.8 professional or mental health practitioner to the mental health 436.9 behavioral aide during service provision. 436.10 Subd. 10. [SERVICE AUTHORIZATION.] The commissioner shall 436.11 publish in the State Register a list of health services that 436.12 require prior authorization, as well as the criteria and 436.13 standards used to select health services on the list. The list 436.14 and the criteria and standards used to formulate the list are 436.15 not subject to the requirements of sections 14.001 to 14.69. 436.16 The commissioner's decision on whether prior authorization is 436.17 required for a health service is not subject to administrative 436.18 appeal. 436.19 Subd. 11. [DOCUMENTATION AND BILLING.] (a) A provider 436.20 entity must document the services it provides under this 436.21 section. The provider entity must ensure that the entity's 436.22 documentation standards meet the requirements of federal and 436.23 state laws. Services billed under this section that are not 436.24 documented according to this subdivision shall be subject to 436.25 monetary recovery by the commissioner. 436.26 (b) An individual mental health provider must promptly 436.27 document the following in a client's record after providing 436.28 services to the client: 436.29 (1) each occurrence of the client's mental health service, 436.30 including the date, type, length, and scope of the service; 436.31 (2) the name of the person who gave the service; 436.32 (3) contact made with other persons interested in the 436.33 client, including representatives of the courts, corrections 436.34 systems, or schools. The provider must document the name and 436.35 date of each contact; 436.36 (4) any contact made with the client's other mental health 437.1 providers, case manager, family members, primary caregiver, 437.2 legal representative, or the reason the provider did not contact 437.3 the client's family members, primary caregiver, or legal 437.4 representative, if applicable; and 437.5 (5) required clinical supervision, as appropriate. 437.6 Subd. 12. [EXCLUDED SERVICES.] The following services are 437.7 not eligible for medical assistance payment as children's 437.8 therapeutic services and supports: 437.9 (1) service components of children's therapeutic services 437.10 and supports simultaneously provided by more than one provider 437.11 entity unless prior authorization is obtained; 437.12 (2) children's therapeutic services and supports provided 437.13 in violation of medical assistance policy in Minnesota Rules, 437.14 part 9505.0220; 437.15 (3) mental health behavioral aide services provided by a 437.16 personal care assistant who is not qualified as a mental health 437.17 behavioral aide and employed by a certified children's 437.18 therapeutic services and supports provider entity; 437.19 (4) services that are the responsibility of a residential 437.20 or program license holder, including foster care providers under 437.21 the terms of a service agreement or administrative rules 437.22 governing licensure; 437.23 (5) up to 15 hours of children's therapeutic services and 437.24 supports provided within a six-month period to a child with 437.25 severe emotional disturbance who is residing in a hospital, a 437.26 group home as defined in Minnesota Rules, part 9560.0520, 437.27 subpart 4, a residential treatment facility licensed under 437.28 Minnesota Rules, parts 9545.0900 to 9545.1090, a regional 437.29 treatment center, or other institutional group setting or who is 437.30 participating in a program of partial hospitalization are 437.31 eligible for medical assistance payment if part of the discharge 437.32 plan; and 437.33 (6) adjunctive activities that may be offered by a provider 437.34 entity but are not otherwise covered by medical assistance, 437.35 including: 437.36 (i) a service that is primarily recreation oriented or that 438.1 is provided in a setting that is not medically supervised. This 438.2 includes sports activities, exercise groups, activities such as 438.3 craft hours, leisure time, social hours, meal or snack time, 438.4 trips to community activities, and tours; 438.5 (ii) a social or educational service that does not have or 438.6 cannot reasonably be expected to have a therapeutic outcome 438.7 related to the client's emotional disturbance; 438.8 (iii) consultation with other providers or service agency 438.9 staff about the care or progress of a client; 438.10 (iv) prevention or education programs provided to the 438.11 community; and 438.12 (v) treatment for clients with primary diagnoses of alcohol 438.13 or other drug abuse. 438.14 [EFFECTIVE DATE.] Unless otherwise specified, this section 438.15 is effective July 1, 2004. 438.16 Sec. 7. [256B.0944] [COVERED SERVICES; CHILDREN'S MENTAL 438.17 HEALTH CRISIS RESPONSE SERVICES.] 438.18 Subdivision 1. [DEFINITIONS.] For purposes of this 438.19 section, the following terms have the meanings given them. 438.20 (a) "Mental health crisis" means a child's behavioral, 438.21 emotional, or psychiatric situation that, but for the provision 438.22 of crisis response services to the child, would likely result in 438.23 significantly reduced levels of functioning in primary 438.24 activities of daily living, an emergency situation, or the 438.25 child's placement in a more restrictive setting, including, but 438.26 not limited to, inpatient hospitalization. 438.27 (b) "Mental health emergency" means a child's behavioral, 438.28 emotional, or psychiatric situation that causes an immediate 438.29 need for mental health services and is consistent with section 438.30 62Q.55. A physician, mental health professional, or crisis 438.31 mental health practitioner determines a mental health crisis or 438.32 emergency for medical assistance reimbursement with input from 438.33 the client and the client's family, if possible. 438.34 (c) "Mental health crisis assessment" means an immediate 438.35 face-to-face assessment by a physician, mental health 438.36 professional, or mental health practitioner under the clinical 439.1 supervision of a mental health professional, following a 439.2 screening that suggests the child may be experiencing a mental 439.3 health crisis or mental health emergency situation. 439.4 (d) "Mental health mobile crisis intervention services" 439.5 means face-to-face, short-term intensive mental health services 439.6 initiated during a mental health crisis or mental health 439.7 emergency. Mental health mobile crisis services must help the 439.8 recipient cope with immediate stressors, identify and utilize 439.9 available resources and strengths, and begin to return to the 439.10 recipient's baseline level of functioning. Mental health mobile 439.11 services must be provided on-site by a mobile crisis 439.12 intervention team outside of an emergency room, urgent care, or 439.13 an inpatient hospital setting. 439.14 (e) "Mental health crisis stabilization services" means 439.15 individualized mental health services provided to a recipient 439.16 following crisis intervention services that are designed to 439.17 restore the recipient to the recipient's prior functional 439.18 level. The individual treatment plan recommending mental health 439.19 crisis stabilization must be completed by the intervention team 439.20 or by staff after an inpatient or urgent care visit. Mental 439.21 health crisis stabilization services may be provided in the 439.22 recipient's home, the home of a family member or friend of the 439.23 recipient, another community setting, or a short-term 439.24 supervised, licensed residential program if the service is not 439.25 included in the facility's cost pool or per diem. Mental health 439.26 crisis stabilization is not reimbursable when provided as part 439.27 of a partial hospitalization or day treatment program. 439.28 Subd. 2. [MEDICAL ASSISTANCE COVERAGE.] Medical assistance 439.29 covers medically necessary children's mental health crisis 439.30 response services, subject to federal approval, if provided to 439.31 an eligible recipient under subdivision 3, by a qualified 439.32 provider entity under subdivision 4 or a qualified individual 439.33 provider working within the provider's scope of practice, and 439.34 identified in the recipient's individual crisis treatment plan 439.35 under subdivision 8. 439.36 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 440.1 individual who: 440.2 (1) is eligible for medical assistance; 440.3 (2) is under age 18 or between the ages of 18 and 21; 440.4 (3) is screened as possibly experiencing a mental health 440.5 crisis or mental health emergency where a mental health crisis 440.6 assessment is needed; 440.7 (4) is assessed as experiencing a mental health crisis or 440.8 mental health emergency, and mental health mobile crisis 440.9 intervention or mental health crisis stabilization services are 440.10 determined to be medically necessary; and 440.11 (5) meets the criteria for emotional disturbance or mental 440.12 illness. 440.13 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) A crisis 440.14 intervention and crisis stabilization provider entity must meet 440.15 the administrative and clinical standards specified in section 440.16 256B.0943, subdivisions 5 and 6, meet the standards listed in 440.17 paragraph (b), and be: 440.18 (1) an Indian health service facility or facility owned and 440.19 operated by a tribe or a tribal organization operating under 440.20 Public Law 93-638 as a 638 facility; 440.21 (2) a county-board operated entity; or 440.22 (3) a provider entity that is under contract with the 440.23 county board in the county where the potential crisis or 440.24 emergency is occurring. 440.25 (b) The children's mental health crisis response services 440.26 provider entity must: 440.27 (1) ensure that mental health crisis assessment and mobile 440.28 crisis intervention services are available 24 hours a day, seven 440.29 days a week; 440.30 (2) directly provide the services or, if services are 440.31 subcontracted, the provider entity must maintain clinical 440.32 responsibility for services and billing; 440.33 (3) ensure that crisis intervention services are provided 440.34 in a manner consistent with sections 245.487 to 245.4888; and 440.35 (4) develop and maintain written policies and procedures 440.36 regarding service provision that include safety of staff and 441.1 recipients in high-risk situations. 441.2 Subd. 5. [MOBILE CRISIS INTERVENTION STAFF 441.3 QUALIFICATIONS.] (a) To provide children's mental health mobile 441.4 crisis intervention services, a mobile crisis intervention team 441.5 must include: 441.6 (1) at least two mental health professionals as defined in 441.7 section 256B.0943, subdivision 1, paragraph (m); or 441.8 (2) a combination of at least one mental health 441.9 professional and one mental health practitioner as defined in 441.10 section 245.4871, subdivision 26, with the required mental 441.11 health crisis training and under the clinical supervision of a 441.12 mental health professional on the team. 441.13 (b) The team must have at least two people with at least 441.14 one member providing on-site crisis intervention services when 441.15 needed. Team members must be experienced in mental health 441.16 assessment, crisis intervention techniques, and clinical 441.17 decision making under emergency conditions and have knowledge of 441.18 local services and resources. The team must recommend and 441.19 coordinate the team's services with appropriate local resources, 441.20 including as the county social services agency, mental health 441.21 service providers, and local law enforcement, if necessary. 441.22 Subd. 6. [INITIAL SCREENING, CRISIS ASSESSMENT, AND MOBILE 441.23 INTERVENTION TREATMENT PLANNING.] (a) Before initiating mobile 441.24 crisis intervention services, a screening of the potential 441.25 crisis situation must be conducted. The screening may use the 441.26 resources of crisis assistance and emergency services as defined 441.27 in sections 245.4871, subdivision 14, and 245.4879, subdivisions 441.28 1 and 2. The screening must gather information, determine 441.29 whether a crisis situation exists, identify the parties 441.30 involved, and determine an appropriate response. 441.31 (b) If a crisis exists, a crisis assessment must be 441.32 completed. A crisis assessment must evaluate any immediate 441.33 needs for which emergency services are needed and, as time 441.34 permits, the recipient's current life situation, sources of 441.35 stress, mental health problems and symptoms, strengths, cultural 441.36 considerations, support network, vulnerabilities, and current 442.1 functioning. 442.2 (c) If the crisis assessment determines mobile crisis 442.3 intervention services are needed, the intervention services must 442.4 be provided promptly. As the opportunity presents itself during 442.5 the intervention, at least two members of the mobile crisis 442.6 intervention team must confer directly or by telephone about the 442.7 assessment, treatment plan, and actions taken and needed. At 442.8 least one of the team members must be on site providing crisis 442.9 intervention services. If providing on-site crisis intervention 442.10 services, a mental health practitioner must seek clinical 442.11 supervision as required under subdivision 9. 442.12 (d) The mobile crisis intervention team must develop an 442.13 initial, brief crisis treatment plan as soon as appropriate but 442.14 no later than 24 hours after the initial face-to-face 442.15 intervention. The plan must address the needs and problems 442.16 noted in the crisis assessment and include measurable short-term 442.17 goals, cultural considerations, and frequency and type of 442.18 services to be provided to achieve the goals and reduce or 442.19 eliminate the crisis. The crisis treatment plan must be updated 442.20 as needed to reflect current goals and services. The team must 442.21 involve the client and the client's family in developing and 442.22 implementing the plan. 442.23 (e) The team must document in progress notes which 442.24 short-term goals have been met and when no further crisis 442.25 intervention services are required. 442.26 (f) If the client's crisis is stabilized, but the client 442.27 needs a referral for mental health crisis stabilization services 442.28 or to other services, the team must provide a referral to these 442.29 services. If the recipient has a case manager, planning for 442.30 other services must be coordinated with the case manager. 442.31 Subd. 7. [CRISIS STABILIZATION SERVICES.] (a) Crisis 442.32 stabilization services must be provided by a mental health 442.33 professional or a mental health practitioner who works under the 442.34 clinical supervision of a mental health professional and for a 442.35 crisis stabilization services provider entity, and must meet the 442.36 following standards: 443.1 (1) a crisis stabilization treatment plan must be developed 443.2 which meets the criteria in subdivision 8; 443.3 (2) services must be delivered according to the treatment 443.4 plan and include face-to-face contact with the recipient by 443.5 qualified staff for further assessment, help with referrals, 443.6 updating the crisis stabilization treatment plan, supportive 443.7 counseling, skills training, and collaboration with other 443.8 service providers in the community; and 443.9 (3) mental health practitioners must have completed at 443.10 least 30 hours of training in crisis intervention and 443.11 stabilization during the past two years. 443.12 Subd. 8. [TREATMENT PLAN.] (a)The individual crisis 443.13 stabilization treatment plan must include, at a minimum: 443.14 (1) a list of problems identified in the assessment; 443.15 (2) a list of the recipient's strengths and resources; 443.16 (3) concrete, measurable short-term goals and tasks to be 443.17 achieved, including time frames for achievement of the goals; 443.18 (4) specific objectives directed toward the achievement of 443.19 each goal; 443.20 (5) documentation of the participants involved in the 443.21 service planning; 443.22 (6) planned frequency and type of services initiated; 443.23 (7) a crisis response action plan if a crisis should occur; 443.24 and 443.25 (8) clear progress notes on the outcome of goals. 443.26 (b) The client, if clinically appropriate, must be a 443.27 participant in the development of the crisis stabilization 443.28 treatment plan. The client or the client's legal guardian must 443.29 sign the service plan or documentation must be provided why this 443.30 was not possible. A copy of the plan must be given to the 443.31 client and the client's legal guardian. The plan should include 443.32 services arranged, including specific providers where applicable. 443.33 (c) A treatment plan must be developed by a mental health 443.34 professional or mental health practitioner under the clinical 443.35 supervision of a mental health professional. A written plan 443.36 must be completed within 24 hours of beginning services with the 444.1 client. 444.2 Subd. 9. [SUPERVISION.] (a) A mental health practitioner 444.3 may provide crisis assessment and mobile crisis intervention 444.4 services if the following clinical supervision requirements are 444.5 met: 444.6 (1) the mental health provider entity must accept full 444.7 responsibility for the services provided; 444.8 (2) the mental health professional of the provider entity, 444.9 who is an employee or under contract with the provider entity, 444.10 must be immediately available by telephone or in person for 444.11 clinical supervision; 444.12 (3) the mental health professional is consulted, in person 444.13 or by telephone, during the first three hours when a mental 444.14 health practitioner provides on-site service; and 444.15 (4) the mental health professional must review and approve 444.16 the tentative crisis assessment and crisis treatment plan, 444.17 document the consultation, and sign the crisis assessment and 444.18 treatment plan within the next business day. 444.19 (b) If the mobile crisis intervention services continue 444.20 into a second calendar day, a mental health professional must 444.21 contact the client face-to-face on the second day to provide 444.22 services and update the crisis treatment plan. The on-site 444.23 observation must be documented in the client's record and signed 444.24 by the mental health professional. 444.25 Subd. 10. [CLIENT RECORD.] The provider must maintain a 444.26 file for each client that complies with the requirements under 444.27 section 256B.0943, subdivision 11, and contains the following 444.28 information: 444.29 (1) individual crisis treatment plans signed by the 444.30 recipient, mental health professional, and mental health 444.31 practitioner who developed the crisis treatment plan, or if the 444.32 recipient refused to sign the plan, the date and reason stated 444.33 by the recipient for not signing the plan; 444.34 (2) signed release of information forms; 444.35 (3) recipient health information and current medications; 444.36 (4) emergency contacts for the recipient; 445.1 (5) case records that document the date of service, place 445.2 of service delivery, signature of the person providing the 445.3 service, and the nature, extent, and units of service. Direct 445.4 or telephone contact with the recipient's family or others 445.5 should be documented; 445.6 (6) required clinical supervision by mental health 445.7 professionals; 445.8 (7) summary of the recipient's case reviews by staff; and 445.9 (8) any written information by the recipient that the 445.10 recipient wants in the file. 445.11 Subd. 11. [EXCLUDED SERVICES.] The following services are 445.12 excluded from reimbursement under this section: 445.13 (1) room and board services; 445.14 (2) services delivered to a recipient while admitted to an 445.15 inpatient hospital; 445.16 (3) transportation services under children's mental health 445.17 crisis response service; 445.18 (4) services provided and billed by a provider who is not 445.19 enrolled under medical assistance to provide children's mental 445.20 health crisis response services; 445.21 (5) crisis response services provided by a residential 445.22 treatment center to clients in their facility; 445.23 (6) services performed by volunteers; 445.24 (7) direct billing of time spent "on call" when not 445.25 delivering services to a recipient; 445.26 (8) provider service time included in case management 445.27 reimbursement; 445.28 (9) outreach services to potential recipients; and 445.29 (10) a mental health service that is not medically 445.30 necessary. 445.31 [EFFECTIVE DATE.] This section is effective July 1, 2004. 445.32 Sec. 8. Minnesota Statutes 2002, section 256B.0945, 445.33 subdivision 2, is amended to read: 445.34 Subd. 2. [COVERED SERVICES.] All services must be included 445.35 in a child's individualized treatment or multiagency plan of 445.36 care as defined in chapter 245. 446.1(a) For facilities that are institutions for mental446.2diseases according to statute and regulation or are not446.3institutions for mental diseases but are approved by the446.4commissioner to provide services under this paragraph, medical446.5assistance covers the full contract rate, including room and446.6board if the services meet the requirements of Code of Federal446.7Regulations, title 42, section 440.160.446.8(b)For facilities that are not institutions for mental 446.9 diseases according to federal statute and regulationand are not446.10providing services under paragraph (a), medical assistance 446.11 covers mental health related services that are required to be 446.12 provided by a residential facility under section 245.4882 and 446.13 administrative rules promulgated thereunder, except for room and 446.14 board. 446.15 Sec. 9. Minnesota Statutes 2002, section 256B.0945, 446.16 subdivision 4, is amended to read: 446.17 Subd. 4. [PAYMENT RATES.] (a) Notwithstanding sections 446.18 256B.19 and 256B.041, payments to counties for residential 446.19 services provided by a residential facility shall only be made 446.20 of federal earnings for services provided under this section, 446.21 and the nonfederal share of costs for services provided under 446.22 this section shall be paid by the county from sources other than 446.23 federal funds or funds used to match other federal funds. 446.24Payment to counties for services provided according to446.25subdivision 2, paragraph (a), shall be the federal share of the446.26contract rate.Payment to counties for services provided 446.27 according tosubdivision 2, paragraph (b),this section shall be 446.28 a proportion of the per day contract rate that relates to 446.29 rehabilitative mental health services and shall not include 446.30 payment for costs or services that are billed to the IV-E 446.31 program as room and board. 446.32 (b) The commissioner shall set aside a portion not to 446.33 exceed five percent of the federal funds earned under this 446.34 section to cover the state costs of administering this section. 446.35 Any unexpended funds from the set-aside shall be distributed to 446.36 the counties in proportion to their earnings under this section. 447.1 Sec. 10. Minnesota Statutes 2002, section 256F.10, 447.2 subdivision 6, is amended to read: 447.3 Subd. 6. [DISTRIBUTION OF NEW FEDERAL REVENUE.] (a) Except 447.4 for portion set aside in paragraph (b), the federal funds earned 447.5 under this section and section 256B.094 by providers shall be 447.6 paid to each provider based on its earnings, and must be used by447.7each provider to expand preventive child welfare services. 447.8 If a county or tribal social services agency chooses to be a 447.9 provider of child welfare targeted case management and if that 447.10 county or tribal social services agency also joins a local 447.11 children's mental health collaborative as authorized by the 1993 447.12 legislature, then the federal reimbursement received by the 447.13 county or tribal social services agency for providing child 447.14 welfare targeted case management services to children served by 447.15 the local collaborative shall be transferred by the county or 447.16 tribal social services agency to the integrated fund. The 447.17 federal reimbursement transferred to the integrated fund by the 447.18 county or tribal social services agency must not be used for 447.19 residential care other than respite care described under 447.20 subdivision 7, paragraph (d). 447.21 (b) The commissioner shall set aside a portion of the 447.22 federal funds earned under this section to repay the special 447.23 revenue maximization account under section 256.01, subdivision 447.24 2, clause (15). The repayment is limited to: 447.25 (1) the costs of developing and implementing this section 447.26 and sections 256B.094 and 256J.48; 447.27 (2) programming the information systems; and 447.28 (3) the lost federal revenue for the central office claim 447.29 directly caused by the implementation of these sections. 447.30 Any unexpended funds from the set aside under this 447.31 paragraph shall be distributed to providers according to 447.32 paragraph (a). 447.33 Sec. 11. Minnesota Statutes 2002, section 257.05, is 447.34 amended to read: 447.35 257.05 [IMPORTATION.] 447.36 Subdivision 1. [NOTIFICATION AND DUTIES OF COMMISSIONER.] 448.1 No person, except as provided bysubdivisionsubdivisions 2 and 448.2 3, shall bring or send into the state any child for the purpose 448.3 of placing the child out or procuring the child's adoption 448.4 without first obtaining the consent of the commissioner of human 448.5 services, and such person shall conform to all rules of the 448.6 commissioner of human services and laws of the state of 448.7 Minnesota relating to protection of children in foster care. 448.8 Before any child shall be brought or sent into the state for the 448.9 purpose of being placed in foster care, the person bringing or 448.10 sending the child into the state shall first notify the 448.11 commissioner of human services of the person's intention, and 448.12 shall obtain from the commissioner of human services a 448.13 certificate stating that the home in which the child is to be 448.14 placed is, in the opinion of the commissioner of human services, 448.15 a suitable adoptive home for the child if legal adoption is 448.16 contemplated or that the home meets the commissioner's 448.17 requirements for licensing of foster homes if legal adoption is 448.18 not contemplated. The commissioner is responsible for 448.19 protecting the child's interests so long as the child remains 448.20 within the state and until the child reaches the age of 18 or is 448.21 legally adopted. Notice to the commissioner shall state the 448.22 name, age, and personal description of the child, and the name 448.23 and address of the person with whom the child is to be placed, 448.24 and such other information about the child and the foster home 448.25 as may be required by the commissioner. 448.26 Subd. 2. [EXEMPT RELATIVES.] A parent, stepparent, 448.27 grandparent, brother, sister and aunt or uncle in the first 448.28 degree of the minor child who bring a child into the state for 448.29 placement within their own home shall be exempt from the 448.30 provisions of subdivision 1. This relationship may be by blood 448.31 or marriage. 448.32 Subd. 3. [INTERNATIONAL ADOPTIONS.] Subject to state and 448.33 federal laws and rules, adoption agencies licensed under chapter 448.34 245A and Minnesota Rules, parts 9545.0755 to 9545.0845, and 448.35 county social services agencies are authorized to certify that 448.36 the prospective adoptive home of a child brought into the state 449.1 from another country for the purpose of adoption is a suitable 449.2 home, or that the home meets the commissioner's requirements for 449.3 licensing of foster homes if legal adoption is not contemplated. 449.4 Sec. 12. Minnesota Statutes 2002, section 259.67, 449.5 subdivision 4, is amended to read: 449.6 Subd. 4. [ELIGIBILITY CONDITIONS.] (a) The placing agency 449.7 shall use the AFDC requirements as specified in federal law as 449.8 of July 16, 1996, when determining the child's eligibility for 449.9 adoption assistance under title IV-E of the Social Security 449.10 Act. If the child does not qualify, the placing agency shall 449.11 certify a child as eligible for state funded adoption assistance 449.12 only if the following criteria are met: 449.13 (1) Due to the child's characteristics or circumstances it 449.14 would be difficult to provide the child an adoptive home without 449.15 adoption assistance. 449.16 (2)(i) A placement agency has made reasonable efforts to 449.17 place the child for adoption without adoption assistance, but 449.18 has been unsuccessful; or 449.19 (ii) the child's licensed foster parents desire to adopt 449.20 the child and it is determined by the placing agency that the 449.21 adoption is in the best interest of the child. 449.22 (3) The child has been a ward of the commissioneror, a 449.23 Minnesota-licensed child-placing agency, or a tribal social 449.24 service agency of Minnesota recognized by the Secretary of the 449.25 Interior. 449.26 (b) For purposes of this subdivision, the characteristics 449.27 or circumstances that may be considered in determining whether a 449.28 child is a child with special needs under United States Code, 449.29 title 42, chapter 7, subchapter IV, part E, or meets the 449.30 requirements of paragraph (a), clause (1), are the following: 449.31 (1) The child is a member of a sibling group to be placed 449.32 as one unit in which at least one sibling is older than 15 449.33 months of age or is described in clause (2) or (3). 449.34 (2) The child has documented physical, mental, emotional, 449.35 or behavioral disabilities. 449.36 (3) The child has a high risk of developing physical, 450.1 mental, emotional, or behavioral disabilities. 450.2 (4) The child is adopted according to tribal law without a 450.3 termination of parental rights or relinquishment, provided that 450.4 the tribe has documented the valid reason why the child cannot 450.5 or should not be returned to the home of the child's parent. 450.6 (c) When a child's eligibility for adoption assistance is 450.7 based upon the high risk of developing physical, mental, 450.8 emotional, or behavioral disabilities, payments shall not be 450.9 made under the adoption assistance agreement unless and until 450.10 the potential disability manifests itself as documented by an 450.11 appropriate health care professional. 450.12 Sec. 13. Minnesota Statutes 2002, section 260C.141, 450.13 subdivision 2, is amended to read: 450.14 Subd. 2. [REVIEW OF FOSTER CARE STATUS.] The social 450.15 services agency responsible for the placement of a child in a 450.16 residential facility, as defined in section 260C.212, 450.17 subdivision 1, pursuant to a voluntary release by the child's 450.18 parent or parents must proceed in juvenile court to review the 450.19 foster care status of the child in the manner provided in this 450.20 section. 450.21 (a) Except for a child in placement due solely to the 450.22 child's developmental disability or emotional disturbance, when 450.23 a child continues in voluntary placement according to section 450.24 260C.212, subdivision 8, a petition shall be filed alleging the 450.25 child to be in need of protection or services or seeking 450.26 termination of parental rights or other permanent placement of 450.27 the child away from the parent within 90 days of the date of the 450.28 voluntary placement agreement. The petition shall state the 450.29 reasons why the child is in placement, the progress on the 450.30 out-of-home placement plan required under section 260C.212, 450.31 subdivision 1, and the statutory basis for the petition under 450.32 section 260C.007, subdivision 6, 260C.201, subdivision 11, or 450.33 260C.301. 450.34 (1) In the case of a petition alleging the child to be in 450.35 need of protection or services filed under this paragraph, if 450.36 all parties agree and the court finds it is in the best 451.1 interests of the child, the court may find the petition states a 451.2 prima facie case that: 451.3 (i) the child's needs are being met; 451.4 (ii) the placement of the child in foster care is in the 451.5 best interests of the child; 451.6 (iii) reasonable efforts to reunify the child and the 451.7 parent or guardian are being made; and 451.8 (iv) the child will be returned home in the next three 451.9 months. 451.10 (2) If the court makes findings under paragraph (1), the 451.11 court shall approve the voluntary arrangement and continue the 451.12 matter for up to three more months to ensure the child returns 451.13 to the parents' home. The responsible social services agency 451.14 shall: 451.15 (i) report to the court when the child returns home and the 451.16 progress made by the parent on the out-of-home placement plan 451.17 required under section 260C.212, in which case the court shall 451.18 dismiss jurisdiction; 451.19 (ii) report to the court that the child has not returned 451.20 home, in which case the matter shall be returned to the court 451.21 for further proceedings under section 260C.163; or 451.22 (iii) if any party does not agree to continue the matter 451.23 under paragraph (1) and this paragraph, the matter shall proceed 451.24 under section 260C.163. 451.25 (b) In the case of a child in voluntary placement due 451.26 solely to the child's developmental disability or emotional 451.27 disturbance according to section 260C.212, subdivision 9, the 451.28 following procedures apply: 451.29 (1) [REPORT TO COURT.] (i) Unless the county attorney 451.30 determines that a petition under subdivision 1 is appropriate, 451.31 without filing a petition, a written report shall be forwarded 451.32 to the court within 165 days of the date of the voluntary 451.33 placement agreement. The written report shall contain necessary 451.34 identifying information for the court to proceed, a copy of the 451.35 out-of-home placement plan required under section 260C.212, 451.36 subdivision 1, a written summary of the proceedings of any 452.1 administrative review required under section 260C.212, 452.2 subdivision 7, and any other information the responsible social 452.3 services agency, parent or guardian, the child or the foster 452.4 parent or other residential facility wants the court to consider. 452.5 (ii) The responsible social services agency, where 452.6 appropriate, must advise the child, parent or guardian, the 452.7 foster parent, or representative of the residential facility of 452.8 the requirements of this section and of their right to submit 452.9 information to the court. If the child, parent or guardian, 452.10 foster parent, or representative of the residential facility 452.11 wants to send information to the court, the responsible social 452.12 services agency shall advise those persons of the reporting date 452.13 and the identifying information necessary for the court 452.14 administrator to accept the information and submit it to a judge 452.15 with the agency's report. The responsible social services 452.16 agency must also notify those persons that they have the right 452.17 to be heard in person by the court and how to exercise that 452.18 right. The responsible social services agency must also provide 452.19 notice that an in-court hearing will not be held unless 452.20 requested by a parent or guardian, foster parent, or the child. 452.21 (iii) After receiving the required report, the court has 452.22 jurisdiction to make the following determinations and must do so 452.23 within ten days of receiving the forwarded report: (A) whether 452.24 or not the placement of the child is in the child's best 452.25 interests; and (B) whether the parent and agency are 452.26 appropriately planning for the child. Unless requested by a 452.27 parent or guardian, foster parent, or child, no in-court hearing 452.28 need be held in order for the court to make findings and issue 452.29 an order under this paragraph. 452.30 (iv) If the court finds the placement is in the child's 452.31 best interests and that the agency and parent are appropriately 452.32 planning for the child, the court shall issue an order 452.33 containing explicit, individualized findings to support its 452.34 determination. The court shall send a copy of the order to the 452.35 county attorney, the responsible social services agency, the 452.36 parent or guardian, the child, and the foster parents. The 453.1 court shall also send the parent or guardian, the child, and the 453.2 foster parent notice of the required review under clause (2). 453.3 (v) If the court finds continuing the placement not to be 453.4 in the child's best interests or that the agency or the parent 453.5 or guardian is not appropriately planning for the child, the 453.6 court shall notify the county attorney, the responsible social 453.7 services agency, the parent or guardian, the foster parent, the 453.8 child, and the county attorney of the court's determinations and 453.9 the basis for the court's determinations. 453.10 (2) [PERMANENCY REVIEW BY PETITION.] If a child with a 453.11 developmental disability or an emotional disturbance continues 453.12 in out-of-home placement for 13 months from the date of a 453.13 voluntary placement, a petition alleging the child to be in need 453.14 of protection or services, for termination of parental rights, 453.15 or for permanent placement of the child away from the parent 453.16 under section 260C.201 shall be filed. The court shall conduct 453.17 a permanency hearing on the petition no later than 14 months 453.18 after the date of the voluntary placement. At the permanency 453.19 hearing, the court shall determine the need for an order 453.20 permanently placing the child away from the parent or determine 453.21 whether there are compelling reasons that continued voluntary 453.22 placement is in the child's best interests. A petition alleging 453.23 the child to be in need of protection or services shall state 453.24 the date of the voluntary placement agreement, the nature of the 453.25 child's developmental disability or emotional disturbance, the 453.26 plan for the ongoing care of the child, the parents' 453.27 participation in the plan, the responsible social services 453.28 agency's efforts to finalize a plan for the permanent placement 453.29 of the child, and the statutory basis for the petition. 453.30 (i) If a petition alleging the child to be in need of 453.31 protection or services is filed under this paragraph, the court 453.32 may find, based on the contents of the sworn petition, and the 453.33 agreement of all parties, including the child, where 453.34 appropriate, that there are compelling reasons that the 453.35 voluntary arrangement is in the best interests of the child and 453.36 that the responsible social services agency has made reasonable 454.1 efforts to finalize a plan for the permanent placement of the 454.2 child, approve the continued voluntary placement, and continue 454.3 the matter under the court's jurisdiction for the purpose of 454.4 reviewing the child's placement as a continued voluntary 454.5 arrangement every 12 months as long as the child continues in 454.6 out-of-home placement. The matter must be returned to the court 454.7 for further review every 12 months as long as the child remains 454.8 in placement. The court shall give notice to the parent or 454.9 guardian of the continued review requirements under this 454.10 section. Nothing in this paragraph shall be construed to mean 454.11 the court must order permanent placement for the child under 454.12 section 260C.201, subdivision 11, as long as the court finds 454.13 compelling reasons at the first review required under this 454.14 section. 454.15 (ii) If a petition for termination of parental rights, for 454.16 transfer of permanent legal and physical custody to a relative, 454.17 for long-term foster care, or for foster care for a specified 454.18 period of time is filed, the court must proceed under section 454.19 260C.201, subdivision 11. 454.20 (3) If any party, including the child, disagrees with the 454.21 voluntary arrangement, the court shall proceed under section 454.22 260C.163. 454.23 Sec. 14. Minnesota Statutes 2002, section 626.559, 454.24 subdivision 5, is amended to read: 454.25 Subd. 5. [REVENUE.] The commissioner of human services 454.26 shall add the following funds to the funds appropriated under 454.27 section 626.5591, subdivision 2, to develop and support training: 454.28 (a) The commissioner of human services shall submit claims 454.29 for federal reimbursement earned through the activities and 454.30 services supported through department of human services child 454.31 protection or child welfare training funds. Federal revenue 454.32 earned must be used to improve and expand training services by 454.33 the department. The department expenditures eligible for 454.34 federal reimbursement under this section must not be made from 454.35 federal funds or funds used to match other federal funds. 454.36 (b) Each year, the commissioner of human services shall 455.1 withhold from funds distributed to each county under Minnesota 455.2 Rules, parts 9550.0300 to 9550.0370, an amount equivalent to 1.5 455.3 percent of each county's annual title XX allocation under 455.4 section256E.07256M.50. The commissioner must use these funds 455.5 to ensure decentralization of training. 455.6 (c) The federal revenue under this subdivision is available 455.7 for these purposes until the funds are expended. 455.8 Sec. 15. [TRANSITION TO CHILDREN'S THERAPEUTIC SERVICES 455.9 AND SUPPORTS.] 455.10 Beginning July 1, 2003, the commissioner shall use the 455.11 provider entity certification process under section 7 instead of 455.12 the provider certification process required under Minnesota 455.13 Rules, parts 9505.0324; 9505.0326; and 9505.0327. 455.14 Sec. 16. [CONFLICTS.] 455.15 The amendments to Minnesota Statutes 2002, section 256F.10, 455.16 subdivision 6, in this article prevail over any conflicting law 455.17 that amends or repeals it regardless of the order or date of 455.18 enactment. 455.19 Sec. 17. [REVISOR'S INSTRUCTION.] 455.20 For sections in Minnesota Statutes and Minnesota Rules 455.21 affected by the repealed sections in this article, the revisor 455.22 shall delete internal cross-references where appropriate and 455.23 make changes necessary to correct the punctuation, grammar, or 455.24 structure of the remaining text and preserve its meaning. 455.25 Sec. 18. [REPEALER.] 455.26 (a) Minnesota Statutes 2002, sections 256B.0945, 455.27 subdivision 10; and 256F.10, subdivision 7, are repealed. 455.28 (b) Minnesota Statutes 2002, section 256B.0625, 455.29 subdivisions 35 and 36, are repealed effective July 1, 2004. 455.30 (c) Minnesota Rules, parts 9505.0324; 9505.0326; and 455.31 9505.0327, are repealed effective July 1, 2004. 455.32 ARTICLE 6 455.33 COMMUNITY SERVICES ACT 455.34 Section 1. [256M.01] [CITATION.] 455.35 Sections 256M.01 to 256M.80 may be cited as the "Children 455.36 and Community Services Act." This act establishes a fund to 456.1 address the needs of children, adolescents, and adults within 456.2 each county in accordance with a service plan entered into by 456.3 the board of county commissioners of each county in consultation 456.4 with stakeholders. The service plan shall specify the outcomes 456.5 to be achieved, the general strategies to be employed, and the 456.6 respective state and county roles. The service plan shall be 456.7 reviewed and updated every two years, or sooner if both the 456.8 state and the county deem it necessary. Nothing in this act is 456.9 intended to limit the ability of counties to provide services to 456.10 adults over age 25. 456.11 Sec. 2. [256M.10] [DEFINITIONS.] 456.12 Subdivision 1. [SCOPE.] For the purposes of sections 456.13 256M.01 to 256M.80, the terms defined in this section have the 456.14 meanings given them. 456.15 Subd. 2. [CHILDREN AND COMMUNITY SERVICES.] (a) "Children 456.16 and community services" means services provided or arranged for 456.17 by county boards for children, adolescents and other individuals 456.18 in transition from childhood to adulthood, and adults who 456.19 experience dependency, abuse, neglect, poverty, disability, 456.20 chronic health conditions, or other factors, including ethnicity 456.21 and race, that may result in poor outcomes or disparities, as 456.22 well as services for family members to support those individuals. 456.23 These services may be provided by professionals or 456.24 nonprofessionals, including the person's natural supports in the 456.25 community. 456.26 (b) Children and community services do not include services 456.27 under the public assistance programs known as the Minnesota 456.28 family investment program, Minnesota supplemental aid, medical 456.29 assistance, general assistance, general assistance medical care, 456.30 MinnesotaCare, or community health services. 456.31 Subd. 3. [COMMISSIONER.] "Commissioner" means the 456.32 commissioner of human services. 456.33 Subd. 4. [COUNTY BOARD.] "County board" means the board of 456.34 county commissioners in each county. 456.35 Subd. 5. [FORMER CHILDREN'S SERVICES AND COMMUNITY SERVICE 456.36 GRANTS.] "Former children's services and community service 457.1 grants" means allocations for the following grants: 457.2 (1) community social service grants under sections 252.24, 457.3 256E.06, and 256E.14; 457.4 (2) family preservation grants under section 256F.05, 457.5 subdivision 3; 457.6 (3) concurrent permanency planning grants under section 457.7 260C.213, subdivision 5; 457.8 (4) social service block grants (Title XX) under section 457.9 256E.07; and 457.10 (5) children's mental health grants under sections 245.4886 457.11 and 260.152. 457.12 Subd. 6. [HUMAN SERVICES BOARD.] "Human services board" 457.13 means a board established under section 402.02; Laws 1974, 457.14 chapter 293; or Laws 1976, chapter 340. 457.15 Sec. 3. [256M.20] [DUTIES OF COMMISSIONER OF HUMAN 457.16 SERVICES.] 457.17 Subdivision 1. [GENERAL SUPERVISION.] Each year the 457.18 commissioner shall allocate funds to each county according to 457.19 section 256M.40 and service plans under section 256M.30. The 457.20 funds shall be used to address the needs of children, 457.21 adolescents, and adults. The commissioner, in consultation with 457.22 counties, shall provide technical assistance and evaluate county 457.23 performance in achieving outcomes. 457.24 Subd. 2. [ADDITIONAL DUTIES.] The commissioner shall: 457.25 (1) provide necessary information and assistance to each 457.26 county for establishing baselines and desired improvements on 457.27 safety, permanency, and well-being for children, adolescents, 457.28 and adults; 457.29 (2) provide training, technical assistance, and other 457.30 supports to each county board to assist in needs assessment, 457.31 planning, implementation, and monitoring of outcomes and service 457.32 quality; 457.33 (3) specify requirements for reports, including fiscal 457.34 reports to account for funds distributed; 457.35 (4) request waivers from federal programs as necessary to 457.36 implement this act; and 458.1 (5) have authority under sections 14.055 and 14.056 to 458.2 grant a variance to existing state rules as needed to eliminate 458.3 barriers to achieving desired outcomes. 458.4 Subd. 3. [SANCTIONS.] The commissioner shall establish and 458.5 maintain a monitoring program designed to reduce the possibility 458.6 of noncompliance with federal laws and federal regulations that 458.7 may result in federal fiscal sanctions. If a county is not 458.8 complying with federal law or federal regulation and the 458.9 noncompliance may result in federal fiscal sanctions, the 458.10 commissioner may withhold a portion of the county's share of 458.11 state and federal funds for that program. The amount withheld 458.12 must be equal to the percentage difference between the level of 458.13 compliance maintained by the county and the level of compliance 458.14 required by the federal regulations, multiplied by the county's 458.15 share of state and federal funds for the program. The state and 458.16 federal funds may be withheld until the county is found to be in 458.17 compliance with all federal laws or federal regulations 458.18 applicable to the program. If a county remains out of 458.19 compliance for more than six consecutive months, the 458.20 commissioner may reallocate the withheld funds to counties that 458.21 are in compliance with the federal regulations. 458.22 Subd. 4. [CORRECTIVE ACTION PROCEDURE.] The commissioner 458.23 must comply with the following procedures when reducing county 458.24 funds under subdivision 3. 458.25 (a) The commissioner shall notify the county, by certified 458.26 mail, of the statute, rule, federal law, or federal regulation 458.27 with which the county has not complied. 458.28 (b) The commissioner shall give the county 30 days to 458.29 demonstrate to the commissioner that the county is in compliance 458.30 with the statute, rule, federal law, or federal regulation cited 458.31 in the notice or to develop a corrective action plan to address 458.32 the problem. Upon request from the county, the commissioner 458.33 shall provide technical assistance to the county in developing a 458.34 corrective action plan. The county shall have 30 days from the 458.35 date the technical assistance is provided to develop the 458.36 corrective action plan. 459.1 (c) The commissioner shall take no further action if the 459.2 county demonstrates compliance with the statute, rule, federal 459.3 law, or federal regulation cited in the notice. 459.4 (d) The commissioner shall review and approve or disapprove 459.5 the corrective action plan within 30 days after the commissioner 459.6 receives the corrective action plan. 459.7 (e) If the commissioner approves the corrective action plan 459.8 submitted by the county, the county has 90 days after the date 459.9 of approval to implement the corrective action plan. 459.10 (f) If the county fails to demonstrate compliance or fails 459.11 to implement the corrective action plan approved by the 459.12 commissioner, the commissioner may reduce the county's share of 459.13 state or federal funds according to subdivision 3. 459.14 Sec. 4. [256M.30] [SERVICE PLAN.] 459.15 Subdivision 1. [SERVICE PLAN SUBMITTED TO COMMISSIONER.] 459.16 Effective January 1, 2004, and each two-year period thereafter, 459.17 each county must have a biennial service plan submitted to the 459.18 commissioner in order to receive funds. Counties may submit 459.19 multicounty or regional service plans. 459.20 Subd. 2. [CONTENTS.] The service plan shall be completed 459.21 in a form prescribed by the commissioner. The plan must include: 459.22 (1) a statement of the needs of the children, adolescents, 459.23 and adults who experience the conditions defined in section 459.24 256M.10, subdivision 2, paragraph (a), and strengths and 459.25 resources available in the community to address those needs; 459.26 (2) strategies the county will pursue to achieve the 459.27 performance targets. Strategies must include specification of 459.28 how funds under this section and other community resources will 459.29 be used to achieve desired performance targets; and 459.30 (3) description of the county's process to solicit public 459.31 input and a summary of that input. 459.32 Subd. 3. [INFORMATION.] The commissioner shall provide 459.33 each county with information and technical assistance needed to 459.34 complete the service plan, including: information on child 459.35 safety, permanency, and well-being in the county; comparisons 459.36 with other counties; baseline performance on outcome measures; 460.1 and promising program practices. 460.2 Subd. 4. [TIMELINES.] The preliminary service plan must be 460.3 submitted to the commissioner by October 15, 2003, and October 460.4 15 of every two years thereafter. 460.5 Subd. 5. [PUBLIC COMMENT.] The county board must determine 460.6 how citizens in the county will participate in the development 460.7 of the service plan and provide opportunities for such 460.8 participation. The county must allow a period of no less than 460.9 30 days prior to the submission of the plan to the commissioner 460.10 to solicit comments from the public on the contents of the plan. 460.11 Sec. 5. [256M.40] [STATE CHILDREN AND COMMUNITY SERVICES 460.12 GRANT ALLOCATION.] 460.13 Subdivision 1. [FORMULA.] The commissioner shall allocate 460.14 state funds appropriated for children and community services 460.15 grants to each county board on a calendar year basis in an 460.16 amount determined according to the formula in paragraphs (a) to 460.17 (c). 460.18 (a) For July 1, 2003, through December 31, 2003, the 460.19 commissioner shall allocate funds to each county equal to that 460.20 county's allocation for the grants under section 256M.10, 460.21 subdivision 5, for calendar year 2003 less payments made on or 460.22 before June 30, 2003. 460.23 (b) For calendar year 2004 and 2005, the commissioner shall 460.24 allocate available funds to each county in proportion to that 460.25 county's share of the calendar year 2003 allocations for the 460.26 grants under section 256M.10, subdivision 5. 460.27 (c) For calendar year 2006 and each calendar year 460.28 thereafter, the commissioner shall allocate available funds to 460.29 each county in proportion to that county's share in the 460.30 preceding calendar year. 460.31 Subd. 2. [PROJECT OF REGIONAL SIGNIFICANCE; STUDY.] The 460.32 commissioner shall study whether and how to dedicate a portion 460.33 of the allocated funds for projects of regional significance. 460.34 The study shall include an analysis of the amount of annual 460.35 funding to be dedicated for projects of regional significance 460.36 and what efforts these projects must support. The commissioner 461.1 shall submit a report to the chairs of the house and senate 461.2 committees with jurisdiction over children and community 461.3 services grants by January 15, 2005. The commissioner of 461.4 finance, in preparing the proposed biennial budget for fiscal 461.5 years 2006 and 2007, is instructed to include $25 million in 461.6 funding for projects of regional significance under this chapter. 461.7 Subd. 3. [PAYMENTS.] Calendar year allocations under 461.8 subdivision 1 shall be paid to counties on or before July 10 of 461.9 each year. 461.10 Sec. 6. [256M.50] [FEDERAL CHILDREN AND COMMUNITY SERVICES 461.11 GRANT ALLOCATION.] 461.12 In federal fiscal year 2004 and subsequent years, money for 461.13 social services received from the federal government to 461.14 reimburse counties for social service expenditures according to 461.15 Title XX of the Social Security Act shall be allocated to each 461.16 county according to section 256M.40, except for funds allocated 461.17 for administrative purposes and migrant day care. 461.18 Sec. 7. [256M.60] [DUTIES OF COUNTY BOARDS.] 461.19 Subdivision 1. [RESPONSIBILITIES.] The county board of 461.20 each county shall be responsible for administration and funding 461.21 of children and community services as defined in section 461.22 256M.10, subdivisions 1 and 2. Each county board shall singly 461.23 or in combination with other county boards use funds available 461.24 to the county under this act to carry out these responsibilities. 461.25 The county board shall coordinate and facilitate the effective 461.26 use of formal and informal helping systems to best support and 461.27 nurture children, adolescents, and adults within the county who 461.28 experience dependency, abuse, neglect, poverty, disability, 461.29 chronic health conditions, or other factors, including ethnicity 461.30 and race, that may result in poor outcomes or disparities, as 461.31 well as services for family members to support such 461.32 individuals. This includes assisting individuals to function at 461.33 the highest level of ability while maintaining family and 461.34 community relationships to the greatest extent possible. 461.35 Subd. 2. [DAY TRAINING AND HABILITATION SERVICES; 461.36 ALTERNATIVE HABILITATION SERVICES.] To the extent provided in 462.1 the county service plan under section 256M.30, the county board 462.2 of each county shall be responsible for providing day training 462.3 and habilitation services or alternative habilitation services 462.4 during the day for persons with developmental disabilities to 462.5 the extent this is required by the person's individualized 462.6 service plan. 462.7 Subd. 3. [REPORTS.] The county board shall provide 462.8 necessary reports and data as required by the commissioner. 462.9 Subd. 4. [CONTRACTS FOR SERVICES.] The county board may 462.10 contract with a human services board, a multicounty board 462.11 established by a joint powers agreement, other political 462.12 subdivisions, a children's mental health collaborative, a family 462.13 services collaborative, or private organizations in discharging 462.14 its duties. 462.15 Subd. 5. [EXEMPTION FROM LIABILITY.] The state of 462.16 Minnesota, the county boards, or the agencies acting on behalf 462.17 of the county boards in the implementation and administration of 462.18 children and community services shall not be liable for damages, 462.19 injuries, or liabilities sustained through the purchase of 462.20 services by the individual, the individual's family, or the 462.21 authorized representative under this section. 462.22 Subd. 6. [FEES FOR SERVICES.] The county board may 462.23 establish a schedule of fees based upon clients' ability to pay 462.24 to be charged to recipients of community social services. 462.25 Payment, in whole or in part, for services may be accepted from 462.26 any person except that no fee may be charged to persons or 462.27 families whose adjusted gross household income is below the 462.28 federal poverty level. When services are provided to any 462.29 person, including a recipient of aids administered by the 462.30 federal, state, or county government, payment of any charges due 462.31 may be billed to and accepted from a public assistance agency or 462.32 from any public or private corporation. 462.33 Sec. 8. [256M.70] [FISCAL LIMITATIONS.] 462.34 Subdivision 1. [DEMONSTRATION OF REASONABLE EFFORT.] The 462.35 county shall make reasonable efforts to comply with all children 462.36 and community services requirements. For the purposes of this 463.1 section, a county is making reasonable efforts if the county has 463.2 made efforts to comply with requirements within the limits of 463.3 available funding, including efforts to identify and apply for 463.4 commonly available state and federal funding for services. 463.5 Subd. 2. [IDENTIFICATION OF SERVICES TO BE PROVIDED.] If a 463.6 county has made reasonable efforts to provide services according 463.7 to the service plan under section 256M.30, but funds 463.8 appropriated for purposes of sections 256M.01 to 256M.80 are 463.9 insufficient, then the county may limit services according to 463.10 the following criteria: 463.11 (1) whether the services are needed to protect individuals 463.12 from maltreatment, abuse, and neglect; 463.13 (2) whether emergency and crisis services are needed to 463.14 protect clients from physical, emotional, or psychological harm; 463.15 (3) the need for assessment of persons applying for 463.16 services and referral to appropriate services when necessary; 463.17 (4) whether there is a need for public guardianship 463.18 services; 463.19 (5) the need for case management for persons with 463.20 developmental disabilities, children with serious emotional 463.21 disturbances, and adults with serious and persistent mental 463.22 illness; 463.23 (6) the need for day training and habilitation services or 463.24 alternative habilitative services during the day for adults with 463.25 developmental disabilities based on the individualized service 463.26 plan; 463.27 (7) whether there is a need to fulfill licensing 463.28 responsibilities delegated to the county by the commissioner 463.29 under section 245A.16; and 463.30 (8) whether subacute detoxification services are needed. 463.31 Subd. 3. [DENIAL, REDUCTION, OR TERMINATION OF SERVICES 463.32 DUE TO FISCAL LIMITATIONS.] Before a county denies, reduces, or 463.33 terminates services to an individual due to fiscal limitations, 463.34 the county must meet the requirements in this section. The 463.35 county must notify the individual and the individual's guardian 463.36 in writing of the reason for the denial, reduction, or 464.1 termination of services and must inform the individual and the 464.2 individual's guardian in writing that the county will, upon 464.3 request, meet to discuss alternatives before services are 464.4 terminated or reduced. No reduction in services for an 464.5 individual may be greater than twice the amount of the county 464.6 average reduction. 464.7 Subd. 4. [RIGHT TO PETITION FOR REVIEW.] Any individual 464.8 who applies for or receives children and community services 464.9 under this chapter, whose application is denied, or whose 464.10 services are reduced or terminated may petition the commissioner 464.11 to review the county's performance under the county service 464.12 plan. The petition must be in writing and must be specific as 464.13 to what action the individual believes is inconsistent with the 464.14 county service plan, and what action the individual believes 464.15 should be required. Upon receiving a petition, the commissioner 464.16 shall have 60 days in which to make a reply in writing as to its 464.17 determination and any corrective action required. 464.18 Notwithstanding any state law to the contrary, and subject to 464.19 provisions of federal law, during this time period, the denial 464.20 of eligibility or reduction or termination of services shall 464.21 take effect, unless it is determined this would endanger the 464.22 life or safety of the individual. 464.23 Sec. 9. [256M.80] [PROGRAM EVALUATION.] 464.24 Subdivision 1. [COUNTY EVALUATION.] Each county shall 464.25 submit to the commissioner data from the past calendar year on 464.26 the outcomes in the service plan. The commissioner shall 464.27 prescribe standard methods to be used by the counties in 464.28 providing the data. The data shall be submitted no later than 464.29 March 1 of each year, beginning with March 1, 2005. 464.30 Subd. 2. [STATEWIDE EVALUATION.] Six months after the end 464.31 of the first full calendar year and annually thereafter, the 464.32 commissioner shall prepare a report on the counties' progress in 464.33 improving the outcomes of children, adolescents, and adults 464.34 related to safety, permanency, and well-being. This report 464.35 shall be disseminated throughout the state. 464.36 Sec. 10. [256M.90] [GRANTS AND PURCHASE OF SERVICE 465.1 CONTRACTS.] 465.2 Subdivision 1. [AUTHORITY.] The local agency may purchase 465.3 community social services by grant or purchase of service 465.4 contract from agencies or individuals approved as vendors. 465.5 Subd. 2. [DUTIES OF LOCAL AGENCY.] The local agency must: 465.6 (1) use a written grant or purchase of service contract 465.7 when purchasing community social services. Every grant and 465.8 purchase of service contract must be completed, signed, and 465.9 approved by all parties to the agreement, including the county 465.10 board, unless the county board has designated the local agency 465.11 to sign on its behalf. No service shall be provided before the 465.12 effective date of the grant or purchase of service contract; 465.13 (2) determine a client's eligibility for purchased 465.14 services, or delegate the responsibility for making the 465.15 preliminary determination to the approved vendor under the terms 465.16 of the grant or purchase of service contract; 465.17 (3) ensure the development of an individual social service 465.18 plan based on the client's needs; 465.19 (4) monitor purchased services and evaluate grants and 465.20 contracts on the basis of client outcomes; and 465.21 (5) purchase only from approved vendors. 465.22 Subd. 3. [LOCAL AGENCY CRITERIA.] When the local agency 465.23 chooses to purchase community social services from a vendor that 465.24 is not subject to state licensing laws or department rules, the 465.25 local agency must establish written criteria for vendor approval 465.26 to ensure the health, safety, and well being of clients. 465.27 Subd. 4. [CASE RECORDS AND REPORTING REQUIREMENTS.] Case 465.28 records and data reporting requirements for grants and purchased 465.29 services are the same as case record and data reporting 465.30 requirements for direct services. 465.31 Subd. 5. [FILES.] The local agency must keep an 465.32 administrative file for each grant and contract. 465.33 Subd. 6. [CONTRACTING WITHIN AND ACROSS COUNTY LINES; LEAD 465.34 COUNTY CONTRACTS.] Paragraphs (a) to (e) govern contracting 465.35 within and across county lines and lead county contracts. 465.36 (a) Once a local agency and an approved vendor execute a 466.1 contract that meets the requirements of this subdivision, the 466.2 contract governs all other purchases of service from the vendor 466.3 by all other local agencies for the term of the contract. The 466.4 local agency that negotiated and entered into the contract 466.5 becomes the lead county for the contract. 466.6 (b) When the local agency in the county where a vendor is 466.7 located wants to purchase services from that vendor and the 466.8 vendor has no contract with the local agency or any other 466.9 county, the local agency must negotiate and execute a contract 466.10 with the vendor. 466.11 (c) When a local agency in one county wants to purchase 466.12 services from a vendor located in another county, it must notify 466.13 the local agency in the county where the vendor is located. 466.14 Within 30 days of being notified, the local agency in the 466.15 vendor's county must: 466.16 (1) if it has a contract with the vendor, send a copy to 466.17 the inquiring agency; 466.18 (2) if there is a contract with the vendor for which 466.19 another local agency is the lead county, identify the lead 466.20 county to the inquiring agency; or 466.21 (3) if no local agency has a contract with the vendor, 466.22 inform the inquiring agency whether it will negotiate a contract 466.23 and become the lead county. If the agency where the vendor is 466.24 located will not negotiate a contract with the vendor because of 466.25 concerns related to clients' health and safety, the agency must 466.26 share those concerns with the inquiring agency. 466.27 (d) If the local agency in the county where the vendor is 466.28 located declines to negotiate a contract with the vendor or 466.29 fails to respond within 30 days of receiving the notification 466.30 under paragraph (c), the inquiring agency is authorized to 466.31 negotiate a contract and must notify the local agency that 466.32 declined or failed to respond. 466.33 (e) When the inquiring county under paragraph (d) becomes 466.34 the lead county for a contract and the contract expires and 466.35 needs to be renegotiated, that county must again follow the 466.36 requirements under paragraph (c) and notify the local agency 467.1 where the vendor is located. The local agency where the vendor 467.2 is located has the option of becoming the lead county for the 467.3 new contract. If the local agency does not exercise the option, 467.4 paragraph (d) applies. 467.5 (f) This subdivision does not affect the requirement to 467.6 seek county concurrence under section 256B.092, subdivision 8a, 467.7 when the services are to be purchased for a person with mental 467.8 retardation or a related condition or under section 245.4711, 467.9 subdivision 3, when the services to be purchased are for an 467.10 adult with serious and persistent mental illness. 467.11 Subd. 7. [CONTRACTS WITH COMMUNITY MENTAL HEALTH 467.12 BOARDS.] A local agency within the geographic area served by a 467.13 community mental health board authorized by sections 245.61 to 467.14 245.69, may contract directly with the community mental health 467.15 board. However, if a local agency outside of the geographic 467.16 area served by a community mental health board wishes to 467.17 purchase services from the board, the local agency must follow 467.18 the requirements under subdivision 6. 467.19 Subd. 8. [PLACEMENT AGREEMENTS.] A placement agreement 467.20 must be used for residential services. Placement agreements are 467.21 valid when signed by authorized representatives of the facility 467.22 and the county of financial responsibility. If the county of 467.23 financial responsibility and the county where the approved 467.24 vendor is located are not the same, the county of financial 467.25 responsibility must, if requested, mail a copy of the placement 467.26 agreement to the county where the approved vendor is providing 467.27 the service and to the lead county within ten calendar days 467.28 after the date on which the placement agreement is signed. The 467.29 placement agreement must specify that the service will be 467.30 provided in accordance with the individual service plan as 467.31 required and must specify the unit cost, the date of placement, 467.32 and the date for the review of the placement. A placement 467.33 agreement may also be used for nonresidential services. 467.34 Sec. 11. [REVISOR'S INSTRUCTION.] 467.35 For sections in Minnesota Statutes and Minnesota Rules 467.36 affected by the repealed sections in this article, the revisor 468.1 shall delete internal cross-references where appropriate and 468.2 make changes necessary to correct the punctuation, grammar, or 468.3 structure of the remaining text and preserve its meaning. 468.4 Sec. 12. [REPEALER.] 468.5 (a) Minnesota Statutes 2002, sections 245.478; 245.4886; 468.6 245.4888; 245.496; 254A.17; 256B.0945, subdivisions 6, 7, 8, 9, 468.7 and 10; 256B.83; 256E.01; 256E.02; 256E.03; 256E.04; 256E.05; 468.8 256E.06; 256E.07; 256E.08; 256E.081; 256E.09; 256E.10; 256E.11; 468.9 256E.115; 256E.13; 256E.14; 256E.15; 256F.01; 256F.02; 256F.03; 468.10 256F.04; 256F.05; 256F.06; 256F.07; 256F.08; 256F.11; 256F.12; 468.11 256F.14; 257.075; 257.81; 260.152; and 626.562, are repealed. 468.12 (b) Minnesota Rules, parts 9550.0010; 9550.0020; 9550.0030; 468.13 9550.0040; 9550.0050; 9550.0060; 9550.0070; 9550.0080; 468.14 9550.0090; 9550.0091; 9550.0092; and 9550.0093, are repealed. 468.15 ARTICLE 7 468.16 HUMAN SERVICES LICENSING, COUNTY INITIATIVES, 468.17 AND MISCELLANEOUS 468.18 Section 1. Minnesota Statutes 2002, section 69.021, 468.19 subdivision 11, is amended to read: 468.20 Subd. 11. [EXCESS POLICE STATE-AID HOLDING ACCOUNT.] (a) 468.21 The excess police state-aid holding account is established in 468.22 the general fund. The excess police state-aid holding account 468.23 must be administered by the commissioner. 468.24 (b) Excess police state aid determined according to 468.25 subdivision 10, must be deposited in the excess police state-aid 468.26 holding account. 468.27 (c) From the balance in the excess police state-aid holding 468.28 account,$1,000,000$900,000 is appropriated to and must be 468.29 transferred annually to the ambulance service personnel 468.30 longevity award and incentive suspense account established by 468.31 section 144E.42, subdivision 2. 468.32 (d) If a police officer stress reduction program is created 468.33 by law and money is appropriated for that program, an amount 468.34 equal to that appropriation must be transferred from the balance 468.35 in the excess police state-aid holding account. 468.36 (e) On October 1, 1997, and annually on each subsequent 469.1 October 1, one-half of the balance of the excess police 469.2 state-aid holding account remaining after the deductions under 469.3 paragraphs (c) and (d) is appropriated for additional 469.4 amortization aid under section 423A.02, subdivision 1b. 469.5 (f) Annually, the remaining balance in the excess police 469.6 state-aid holding account, after the deductions under paragraphs 469.7 (c), (d), and (e), cancels to the general fund. 469.8 Sec. 2. Minnesota Statutes 2002, section 124D.23, 469.9 subdivision 2, is amended to read: 469.10 Subd. 2. [DUTIES.] (a) Each collaborative must: 469.11 (1) establish, with assistance from families and service 469.12 providers, clear goals for addressing the health, developmental, 469.13 educational, and family-related needs of children and youth and 469.14 use outcome-based indicators to measure progress toward 469.15 achieving those goals; 469.16 (2) establish a comprehensive planning process that 469.17 involves all sectors of the community, identifies local needs, 469.18 and surveys existing local programs; 469.19 (3) integrate service funding sources so that children and 469.20 their families obtain services from providers best able to 469.21 anticipate and meet their needs; 469.22 (4) coordinate families' services to avoid duplicative and 469.23 overlapping assessment and intake procedures; 469.24 (5) focus primarily on family-centered services; 469.25 (6) encourage parents and volunteers to actively 469.26 participate by using flexible scheduling and actively recruiting 469.27 volunteers; 469.28 (7) provide services in locations that are readily 469.29 accessible to children and families; 469.30 (8) usenew or reallocatedfunds toimprove or469.31enhanceprovide servicesprovidedto children and their 469.32 families; 469.33 (9) identify federal, state, and local institutional 469.34 barriers to coordinating services and suggest ways to remove 469.35 these barriers; and 469.36 (10) design and implement an integrated local service 470.1 delivery system for children and their families that coordinates 470.2 services across agencies and is client centered. The delivery 470.3 system shall provide a continuum of services for children birth 470.4 to age 18, or birth through age 21 for individuals with 470.5 disabilities. The collaborative shall describe the community 470.6 plan for serving pregnant women and children from birth to age 470.7 six. 470.8 (b) The outcome-based indicators developed in paragraph 470.9 (a), clause (1), may include the number of low birth weight 470.10 babies, the infant mortality rate, the number of children who 470.11 are adequately immunized and healthy, require out-of-home 470.12 placement or long-term special education services, and the 470.13 number of minor parents. 470.14 Sec. 3. Minnesota Statutes 2002, section 245.4932, 470.15 subdivision 1, is amended to read: 470.16 Subdivision 1. [COLLABORATIVE RESPONSIBILITIES.] The 470.17 children's mental health collaborative shall have the following 470.18 authority and responsibilities regarding federal revenue 470.19 enhancement: 470.20 (1) the collaborative must establish an integrated fund; 470.21 (2) the collaborative shall designate a lead county or 470.22 other qualified entity as the fiscal agency for reporting, 470.23 claiming, and receiving payments; 470.24 (3) the collaborative or lead county may enter into 470.25 subcontracts with other counties, school districts, special 470.26 education cooperatives, municipalities, and other public and 470.27 nonprofit entities for purposes of identifying and claiming 470.28 eligible expenditures to enhance federal reimbursement; 470.29 (4) the collaborative shall use any enhanced revenue 470.30 attributable to the activities of the collaborative, including 470.31 administrative and service revenue,solelyto provide mental 470.32 health services or to expand the operational target population.470.33The lead county or other qualified entity may not use enhanced470.34federal revenue for any other purpose; 470.35 (5)the members of the collaborative must continue the base470.36level of expenditures, as defined in section 245.492,471.1subdivision 2, for services for children with emotional or471.2behavioral disturbances and their families from any state,471.3county, federal, or other public or private funding source471.4which, in the absence of the new federal reimbursement earned471.5under sections 245.491 to 245.496, would have been available for471.6those services. The base year for purposes of this subdivision471.7shall be the accounting period closest to state fiscal year471.81993;471.9(6)the collaborative or lead county must develop and 471.10 maintain an accounting and financial management system adequate 471.11 to support all claims for federal reimbursement, including a 471.12 clear audit trail and any provisions specified in the contract 471.13 with the commissioner of human services; 471.14(7)(6) the collaborative or its members may elect to pay 471.15 the nonfederal share of the medical assistance costs for 471.16 services designated by the collaborative; and 471.17(8)(7) the lead county or other qualified entity may not 471.18 use federal funds or local funds designated as matching for 471.19 other federal funds to provide the nonfederal share of medical 471.20 assistance. 471.21 Sec. 4. Minnesota Statutes 2002, section 245A.035, 471.22 subdivision 3, is amended to read: 471.23 Subd. 3. [REQUIREMENTS FOR EMERGENCY LICENSE.] Before an 471.24 emergency license may be issued, the following requirements must 471.25 be met: 471.26 (1) the county agency must conduct an initial inspection of 471.27 the premises where the foster care is to be provided to ensure 471.28 the health and safety of any child placed in the home. The 471.29 county agency shall conduct the inspection using a form 471.30 developed by the commissioner; 471.31 (2) at the time of the inspection or placement, whichever 471.32 is earlier, the relative being considered for an emergency 471.33 license shall receive an application form for a child foster 471.34 care license; 471.35 (3) whenever possible, prior to placing the child in the 471.36 relative's home, the relative being considered for an emergency 472.1 license shall provide the information required by section 472.2 245A.04, subdivision 3, paragraph(b)(k); and 472.3 (4) if the county determines, prior to the issuance of an 472.4 emergency license, that anyone requiring a background study may 472.5 be disqualified under section 245A.04, and the disqualification 472.6 is one which the commissioner cannot set aside, an emergency 472.7 license shall not be issued. 472.8 Sec. 5. Minnesota Statutes 2002, section 245A.04, 472.9 subdivision 3, is amended to read: 472.10 Subd. 3. [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 472.11 (a) Individuals and organizations that are required in statute 472.12 to initiate background studies under this section shall comply 472.13 with the following requirements: 472.14 (1) Applicants for licensure, license holders, and other 472.15 entities as provided in this section must submit completed 472.16 background study forms to the commissioner before individuals 472.17 specified in paragraph (c), clauses (1) to (4), (6), and (7), 472.18 begin positions allowing direct contact in any licensed program. 472.19 (2) Applicants and license holders under the jurisdiction 472.20 of other state agencies who are required in other statutory 472.21 sections to initiate background studies under this section must 472.22 submit completed background study forms to the commissioner 472.23 prior to the background study subject beginning in a position 472.24 allowing direct contact in the licensed program, or where 472.25 applicable, prior to being employed. 472.26 (3) Organizations required to initiate background studies 472.27 under section 256B.0627 for individuals described in paragraph 472.28 (c), clause (5), must submit a completed background study form 472.29 to the commissioner before those individuals begin a position 472.30 allowing direct contact with persons served by the 472.31 organization. The commissioner shall recover the cost of these 472.32 background studies through a fee of no more than $12 per study 472.33 charged to the organization responsible for submitting the 472.34 background study form. The fees collected under this paragraph 472.35 are appropriated to the commissioner for the purpose of 472.36 conducting background studies. 473.1 Upon receipt of the background study forms from the 473.2 entities in clauses (1) to (3), the commissioner shall complete 473.3 the background study as specified under this section and provide 473.4 notices required in subdivision 3a. Unless otherwise specified, 473.5 the subject of a background study may have direct contact with 473.6 persons served by a program after the background study form is 473.7 mailed or submitted to the commissioner pending notification of 473.8 the study results under subdivision 3a. A county agency may 473.9 accept a background study completed by the commissioner under 473.10 this section in place of the background study required under 473.11 section 245A.16, subdivision 3, in programs with joint licensure 473.12 as home and community-based services and adult foster care for 473.13 people with developmental disabilities when the license holder 473.14 does not reside in the foster care residence and the subject of 473.15 the study has been continuously affiliated with the license 473.16 holder since the date of the commissioner's study. 473.17 (b) The definitions in this paragraph apply only to 473.18 subdivisions 3 to 3e. 473.19 (1) "Background study" means the review of records 473.20 conducted by the commissioner to determine whether a subject is 473.21 disqualified from direct contact with persons served by a 473.22 program, and where specifically provided in statutes, whether a 473.23 subject is disqualified from having access to persons served by 473.24 a program. 473.25 (2) "Continuous, direct supervision" means an individual is 473.26 within sight or hearing of the supervising person to the extent 473.27 that supervising person is capable at all times of intervening 473.28 to protect the health and safety of the persons served by the 473.29 program. 473.30 (3) "Contractor" means any person, regardless of employer, 473.31 who is providing program services for hire under the control of 473.32 the provider. 473.33 (4) "Direct contact" means providing face-to-face care, 473.34 training, supervision, counseling, consultation, or medication 473.35 assistance to persons served by the program. 473.36 (5) "Reasonable cause" means information or circumstances 474.1 exist which provide the commissioner with articulable suspicion 474.2 that further pertinent information may exist concerning a 474.3 subject. The commissioner has reasonable cause when, but not 474.4 limited to, the commissioner has received a report from the 474.5 subject, the license holder, or a third party indicating that 474.6 the subject has a history that would disqualify the person or 474.7 that may pose a risk to the health or safety of persons 474.8 receiving services. 474.9 (6) "Subject of a background study" means an individual on 474.10 whom a background study is required or completed. 474.11 (c) The applicant, license holder, registrant under section 474.12 144A.71, subdivision 1, bureau of criminal apprehension, 474.13 commissioner of health, and county agencies, after written 474.14 notice to the individual who is the subject of the study, shall 474.15 help with the study by giving the commissioner criminal 474.16 conviction data and reports about the maltreatment of adults 474.17 substantiated under section 626.557 and the maltreatment of 474.18 minors in licensed programs substantiated under section 474.19 626.556. If a background study is initiated by an applicant or 474.20 license holder and the applicant or license holder receives 474.21 information about the possible criminal or maltreatment history 474.22 of an individual who is the subject of the background study, the 474.23 applicant or license holder must immediately provide the 474.24 information to the commissioner. The individuals to be studied 474.25 shall include: 474.26 (1) the applicant; 474.27 (2) persons age 13 and over living in the household where 474.28 the licensed program will be provided; 474.29 (3) current employees or contractors of the applicant who 474.30 will have direct contact with persons served by the facility, 474.31 agency, or program; 474.32 (4) volunteers or student volunteers who have direct 474.33 contact with persons served by the program to provide program 474.34 services, if the contact is not under the continuous, direct 474.35 supervision by an individual listed in clause (1) or (3); 474.36 (5) any person required under section 256B.0627 to have a 475.1 background study completed under this section; 475.2 (6) persons ages 10 to 12 living in the household where the 475.3 licensed services will be provided when the commissioner has 475.4 reasonable cause; and 475.5 (7) persons who, without providing direct contact services 475.6 at a licensed program, may have unsupervised access to children 475.7 or vulnerable adults receiving services from the program 475.8 licensed to provide family child care for children, foster care 475.9 for children in the provider's own home, or foster care or day 475.10 care services for adults in the provider's own home when the 475.11 commissioner has reasonable cause. 475.12 (d) According to paragraph (c), clauses (2) and (6), the 475.13 commissioner shall review records from the juvenile courts. For 475.14 persons under paragraph (c), clauses (1), (3), (4), (5), and 475.15 (7), who are ages 13 to 17, the commissioner shall review 475.16 records from the juvenile courts when the commissioner has 475.17 reasonable cause. The juvenile courts shall help with the study 475.18 by giving the commissioner existing juvenile court records on 475.19 individuals described in paragraph (c), clauses (2), (6), and 475.20 (7), relating to delinquency proceedings held within either the 475.21 five years immediately preceding the background study or the 475.22 five years immediately preceding the individual's 18th birthday, 475.23 whichever time period is longer. The commissioner shall destroy 475.24 juvenile records obtained pursuant to this subdivision when the 475.25 subject of the records reaches age 23. 475.26 (e) Beginning August 1, 2001, the commissioner shall 475.27 conduct all background studies required under this chapter and 475.28 initiated by supplemental nursing services agencies registered 475.29 under section 144A.71, subdivision 1. Studies for the agencies 475.30 must be initiated annually by each agency. The commissioner 475.31 shall conduct the background studies according to this chapter. 475.32 The commissioner shall recover the cost of the background 475.33 studies through a fee of no more than $8 per study, charged to 475.34 the supplemental nursing services agency. The fees collected 475.35 under this paragraph are appropriated to the commissioner for 475.36 the purpose of conducting background studies. 476.1 (f) For purposes of this section, a finding that a 476.2 delinquency petition is proven in juvenile court shall be 476.3 considered a conviction in state district court. 476.4 (g) A study of an individual in paragraph (c), clauses (1) 476.5 to (7), shall be conducted at least upon application for initial 476.6 license for all license types or registration under section 476.7 144A.71, subdivision 1, and at reapplication for a license for 476.8 family child care, child foster care, and adult foster care. 476.9 The commissioner is not required to conduct a study of an 476.10 individual at the time of reapplication for a license or if the 476.11 individual has been continuously affiliated with a foster care 476.12 provider licensed by the commissioner of human services and 476.13 registered under chapter 144D, other than a family day care or 476.14 foster care license, if: (i) a study of the individual was 476.15 conducted either at the time of initial licensure or when the 476.16 individual became affiliated with the license holder; (ii) the 476.17 individual has been continuously affiliated with the license 476.18 holder since the last study was conducted; and (iii) the 476.19 procedure described in paragraph (j) has been implemented and 476.20 was in effect continuously since the last study was conducted. 476.21 For the purposes of this section, a physician licensed under 476.22 chapter 147 is considered to be continuously affiliated upon the 476.23 license holder's receipt from the commissioner of health or 476.24 human services of the physician's background study results. For 476.25 individuals who are required to have background studies under 476.26 paragraph (c) and who have been continuously affiliated with a 476.27 foster care provider that is licensed in more than one county, 476.28 criminal conviction data may be shared among those counties in 476.29 which the foster care programs are licensed. A county agency's 476.30 receipt of criminal conviction data from another county agency 476.31 shall meet the criminal data background study requirements of 476.32 this section. 476.33 (h) The commissioner may also conduct studies on 476.34 individuals specified in paragraph (c), clauses (3) and (4), 476.35 when the studies are initiated by: 476.36 (i) personnel pool agencies; 477.1 (ii) temporary personnel agencies; 477.2 (iii) educational programs that train persons by providing 477.3 direct contact services in licensed programs; and 477.4 (iv) professional services agencies that are not licensed 477.5 and which contract with licensed programs to provide direct 477.6 contact services or individuals who provide direct contact 477.7 services. 477.8 (i) Studies on individuals in paragraph (h), items (i) to 477.9 (iv), must be initiated annually by these agencies, programs, 477.10 and individuals. Except as provided in paragraph (a), clause 477.11 (3), no applicant, license holder, or individual who is the 477.12 subject of the study shall pay any fees required to conduct the 477.13 study. 477.14 (1) At the option of the licensed facility, rather than 477.15 initiating another background study on an individual required to 477.16 be studied who has indicated to the licensed facility that a 477.17 background study by the commissioner was previously completed, 477.18 the facility may make a request to the commissioner for 477.19 documentation of the individual's background study status, 477.20 provided that: 477.21 (i) the facility makes this request using a form provided 477.22 by the commissioner; 477.23 (ii) in making the request the facility informs the 477.24 commissioner that either: 477.25 (A) the individual has been continuously affiliated with a 477.26 licensed facility since the individual's previous background 477.27 study was completed, or since October 1, 1995, whichever is 477.28 shorter; or 477.29 (B) the individual is affiliated only with a personnel pool 477.30 agency, a temporary personnel agency, an educational program 477.31 that trains persons by providing direct contact services in 477.32 licensed programs, or a professional services agency that is not 477.33 licensed and which contracts with licensed programs to provide 477.34 direct contact services or individuals who provide direct 477.35 contact services; and 477.36 (iii) the facility provides notices to the individual as 478.1 required in paragraphs (a) to (j), and that the facility is 478.2 requesting written notification of the individual's background 478.3 study status from the commissioner. 478.4 (2) The commissioner shall respond to each request under 478.5 paragraph (1) with a written or electronic notice to the 478.6 facility and the study subject. If the commissioner determines 478.7 that a background study is necessary, the study shall be 478.8 completed without further request from a licensed agency or 478.9 notifications to the study subject. 478.10 (3) When a background study is being initiated by a 478.11 licensed facility or a foster care provider that is also 478.12 registered under chapter 144D, a study subject affiliated with 478.13 multiple licensed facilities may attach to the background study 478.14 form a cover letter indicating the additional facilities' names, 478.15 addresses, and background study identification numbers. When 478.16 the commissioner receives such notices, each facility identified 478.17 by the background study subject shall be notified of the study 478.18 results. The background study notice sent to the subsequent 478.19 agencies shall satisfy those facilities' responsibilities for 478.20 initiating a background study on that individual. 478.21 (j) If an individual who is affiliated with a program or 478.22 facility regulated by the department of human services or 478.23 department of health or who is affiliated with any type of home 478.24 care agency or provider of personal care assistance services, is 478.25 convicted of a crime constituting a disqualification under 478.26 subdivision 3d, the probation officer or corrections agent shall 478.27 notify the commissioner of the conviction. For the purpose of 478.28 this paragraph, "conviction" has the meaning given it in section 478.29 609.02, subdivision 5. The commissioner, in consultation with 478.30 the commissioner of corrections, shall develop forms and 478.31 information necessary to implement this paragraph and shall 478.32 provide the forms and information to the commissioner of 478.33 corrections for distribution to local probation officers and 478.34 corrections agents. The commissioner shall inform individuals 478.35 subject to a background study that criminal convictions for 478.36 disqualifying crimes will be reported to the commissioner by the 479.1 corrections system. A probation officer, corrections agent, or 479.2 corrections agency is not civilly or criminally liable for 479.3 disclosing or failing to disclose the information required by 479.4 this paragraph. Upon receipt of disqualifying information, the 479.5 commissioner shall provide the notifications required in 479.6 subdivision 3a, as appropriate to agencies on record as having 479.7 initiated a background study or making a request for 479.8 documentation of the background study status of the individual. 479.9 This paragraph does not apply to family day care and child 479.10 foster care programs. 479.11 (k) The individual who is the subject of the study must 479.12 provide the applicant or license holder with sufficient 479.13 information to ensure an accurate study including the 479.14 individual's first, middle, and last name and all other names by 479.15 which the individual has been known; home address, city, county, 479.16 and state of residence for the past five years; zip code; sex; 479.17 date of birth; and driver's license number or state 479.18 identification number. The applicant or license holder shall 479.19 provide this information about an individual in paragraph (c), 479.20 clauses (1) to (7), on forms prescribed by the commissioner. By 479.21 January 1, 2000, for background studies conducted by the 479.22 department of human services, the commissioner shall implement a 479.23 system for the electronic transmission of: (1) background study 479.24 information to the commissioner; and (2) background study 479.25 results to the license holder. The commissioner may request 479.26 additional information of the individual, which shall be 479.27 optional for the individual to provide, such as the individual's 479.28 social security number or race. 479.29 (l) For programs directly licensed by the commissioner, a 479.30 study must include information related to names of substantiated 479.31 perpetrators of maltreatment of vulnerable adults that has been 479.32 received by the commissioner as required under section 626.557, 479.33 subdivision 9c, paragraph (i), and the commissioner's records 479.34 relating to the maltreatment of minors in licensed programs, 479.35 information from juvenile courts as required in paragraph (c) 479.36 for persons listed in paragraph (c), clauses (2), (6), and (7), 480.1 and information from the bureau of criminal apprehension. For 480.2 child foster care, adult foster care, and family day care homes, 480.3 the study must include information from the county agency's 480.4 record of substantiated maltreatment of adults, and the 480.5 maltreatment of minors, information from juvenile courts as 480.6 required in paragraph (c) for persons listed in paragraph (c), 480.7 clauses (2), (6), and (7), and information from the bureau of 480.8 criminal apprehension. The commissioner may also review arrest 480.9 and investigative information from the bureau of criminal 480.10 apprehension, the commissioner of health, a county attorney, 480.11 county sheriff, county agency, local chief of police, other 480.12 states, the courts, or the Federal Bureau of Investigation if 480.13 the commissioner has reasonable cause to believe the information 480.14 is pertinent to the disqualification of an individual listed in 480.15 paragraph (c), clauses (1) to (7). The commissioner is not 480.16 required to conduct more than one review of a subject's records 480.17 from the Federal Bureau of Investigation if a review of the 480.18 subject's criminal history with the Federal Bureau of 480.19 Investigation has already been completed by the commissioner and 480.20 there has been no break in the subject's affiliation with the 480.21 license holder who initiated the background study. 480.22 (m) For any background study completed under this section, 480.23 when the commissioner has reasonable cause to believe that 480.24 further pertinent information may exist on the subject, the 480.25 subject shall provide a set of classifiable fingerprints 480.26 obtained from an authorized law enforcement agency. For 480.27 purposes of requiring fingerprints, the commissioner shall be 480.28 considered to have reasonable cause under, but not limited to, 480.29 the following circumstances: 480.30 (1) information from the bureau of criminal apprehension 480.31 indicates that the subject is a multistate offender; 480.32 (2) information from the bureau of criminal apprehension 480.33 indicates that multistate offender status is undetermined; or 480.34 (3) the commissioner has received a report from the subject 480.35 or a third party indicating that the subject has a criminal 480.36 history in a jurisdiction other than Minnesota. 481.1 (n) The failure or refusal of an applicant, license holder, 481.2 or registrant under section 144A.71, subdivision 1, to cooperate 481.3 with the commissioner is reasonable cause to disqualify a 481.4 subject, deny a license application or immediately suspend, 481.5 suspend, or revoke a license or registration. Failure or 481.6 refusal of an individual to cooperate with the study is just 481.7 cause for denying or terminating employment of the individual if 481.8 the individual's failure or refusal to cooperate could cause the 481.9 applicant's application to be denied or the license holder's 481.10 license to be immediately suspended, suspended, or revoked. 481.11 (o) The commissioner shall not consider an application to 481.12 be complete until all of the information required to be provided 481.13 under this subdivision has been received. 481.14 (p) No person in paragraph (c), clauses (1) to (7), who is 481.15 disqualified as a result of this section may be retained by the 481.16 agency in a position involving direct contact with persons 481.17 served by the program and no person in paragraph (c), clauses 481.18 (2), (6), and (7), or as provided elsewhere in statute who is 481.19 disqualified as a result of this section may be allowed access 481.20 to persons served by the program, unless the commissioner has 481.21 provided written notice to the agency stating that: 481.22 (1) the individual may remain in direct contact during the 481.23 period in which the individual may request reconsideration as 481.24 provided in subdivision 3a, paragraph (b), clause (2) or (3); 481.25 (2) the individual's disqualification has been set aside 481.26 for that agency as provided in subdivision 3b, paragraph (b); or 481.27 (3) the license holder has been granted a variance for the 481.28 disqualified individual under subdivision 3e. 481.29 (q) Termination of affiliation with persons in paragraph 481.30 (c), clauses (1) to (7), made in good faith reliance on a notice 481.31 of disqualification provided by the commissioner shall not 481.32 subject the applicant or license holder to civil liability. 481.33 (r) The commissioner may establish records to fulfill the 481.34 requirements of this section. 481.35 (s) The commissioner may not disqualify an individual 481.36 subject to a study under this section because that person has, 482.1 or has had, a mental illness as defined in section 245.462, 482.2 subdivision 20. 482.3 (t) An individual subject to disqualification under this 482.4 subdivision has the applicable rights in subdivision 3a, 3b, or 482.5 3c. 482.6 (u) For the purposes of background studies completed by 482.7 tribal organizations performing licensing activities otherwise 482.8 required of the commissioner under this chapter, after obtaining 482.9 consent from the background study subject, tribal licensing 482.10 agencies shall have access to criminal history data in the same 482.11 manner as county licensing agencies and private licensing 482.12 agencies under this chapter. 482.13 (v) County agencies shall have access to the criminal 482.14 history data in the same manner as county licensing agencies 482.15 under this chapter for purposes of background studies completed 482.16 by county agencies on legal nonlicensed child care providers to 482.17 determine eligibility for child care funds under chapter 119B. 482.18 Sec. 6. Minnesota Statutes 2002, section 245A.04, 482.19 subdivision 3b, is amended to read: 482.20 Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a) The 482.21 individual who is the subject of the disqualification may 482.22 request a reconsideration of the disqualification. 482.23 The individual must submit the request for reconsideration 482.24 to the commissioner in writing. A request for reconsideration 482.25 for an individual who has been sent a notice of disqualification 482.26 under subdivision 3a, paragraph (b), clause (1) or (2), must be 482.27 submitted within 30 calendar days of the disqualified 482.28 individual's receipt of the notice of disqualification. Upon 482.29 showing that the information in clause (1) or (2) cannot be 482.30 obtained within 30 days, the disqualified individual may request 482.31 additional time, not to exceed 30 days, to obtain that 482.32 information. A request for reconsideration for an individual 482.33 who has been sent a notice of disqualification under subdivision 482.34 3a, paragraph (b), clause (3), must be submitted within 15 482.35 calendar days of the disqualified individual's receipt of the 482.36 notice of disqualification. An individual who was determined to 483.1 have maltreated a child under section 626.556 or a vulnerable 483.2 adult under section 626.557, and who was disqualified under this 483.3 section on the basis of serious or recurring maltreatment, may 483.4 request reconsideration of both the maltreatment and the 483.5 disqualification determinations. The request for 483.6 reconsideration of the maltreatment determination and the 483.7 disqualification must be submitted within 30 calendar days of 483.8 the individual's receipt of the notice of disqualification. 483.9 Removal of a disqualified individual from direct contact shall 483.10 be ordered if the individual does not request reconsideration 483.11 within the prescribed time, and for an individual who submits a 483.12 timely request for reconsideration, if the disqualification is 483.13 not set aside. The individual must present information showing 483.14 that: 483.15 (1) the information the commissioner relied upon in 483.16 determining that the underlying conduct giving rise to the 483.17 disqualification occurred, and for maltreatment, that the 483.18 maltreatment was serious or recurring, is incorrect; or 483.19 (2) the subject of the study does not pose a risk of harm 483.20 to any person served by the applicant, license holder, or 483.21 registrant under section 144A.71, subdivision 1. 483.22 (b) The commissioner shall rescind the disqualification if 483.23 the commissioner finds that the information relied on to 483.24 disqualify the subject is incorrect. The commissioner may set 483.25 aside the disqualification under this section if the 483.26 commissioner finds that the individual does not pose a risk of 483.27 harm to any person served by the applicant, license holder, or 483.28 registrant under section 144A.71, subdivision 1. In determining 483.29 that an individual does not pose a risk of harm, the 483.30 commissioner shall consider the nature, severity, and 483.31 consequences of the event or events that lead to 483.32 disqualification, whether there is more than one disqualifying 483.33 event, the age and vulnerability of the victim at the time of 483.34 the event, the harm suffered by the victim, the similarity 483.35 between the victim and persons served by the program, the time 483.36 elapsed without a repeat of the same or similar event, 484.1 documentation of successful completion by the individual studied 484.2 of training or rehabilitation pertinent to the event, and any 484.3 other information relevant to reconsideration. In reviewing a 484.4 disqualification under this section, the commissioner shall give 484.5 preeminent weight to the safety of each person to be served by 484.6 the license holder, applicant, or registrant under section 484.7 144A.71, subdivision 1, over the interests of the license 484.8 holder, applicant, or registrant under section 144A.71, 484.9 subdivision 1. If the commissioner sets aside a 484.10 disqualification under this section, the disqualified individual 484.11 remains disqualified, but may hold a license and have direct 484.12 contact with or access to persons receiving services. The 484.13 commissioner's set aside of a disqualification is limited solely 484.14 to the licensed program, applicant, or agency specified in the 484.15 set aside notice, unless otherwise specified in the notice. The 484.16 commissioner may rescind a previous set aside of a 484.17 disqualification under this section based on new information 484.18 that indicates the individual may pose a risk of harm to persons 484.19 served by the applicant, license holder, or registrant. If the 484.20 commissioner rescinds a set aside of a disqualification under 484.21 this paragraph, the appeal rights under paragraphs (a) and (e) 484.22 shall apply. 484.23 (c) Unless the information the commissioner relied on in 484.24 disqualifying an individual is incorrect, the commissioner may 484.25 not set aside the disqualification of an individual in 484.26 connection with a license to provide family day care for 484.27 children, foster care for children in the provider's own home, 484.28 or foster care or day care services for adults in the provider's 484.29 own home if: 484.30 (1) less than ten years have passed since the discharge of 484.31 the sentence imposed for the offense; and the individual has 484.32 been convicted of a violation of any offense listed in sections 484.33 609.165 (felon ineligible to possess firearm), criminal 484.34 vehicular homicide under 609.21 (criminal vehicular homicide and 484.35 injury), 609.215 (aiding suicide or aiding attempted suicide), 484.36 felony violations under 609.223 or 609.2231 (assault in the 485.1 third or fourth degree), 609.713 (terroristic threats), 609.235 485.2 (use of drugs to injure or to facilitate crime), 609.24 (simple 485.3 robbery), 609.255 (false imprisonment), 609.562 (arson in the 485.4 second degree), 609.71 (riot), 609.498, subdivision 1 or1a1b 485.5 (aggravated first degree or first degree tampering with a 485.6 witness), burglary in the first or second degree under 609.582 485.7 (burglary), 609.66 (dangerous weapon), 609.665 (spring guns), 485.8 609.67 (machine guns and short-barreled shotguns), 609.749, 485.9 subdivision 2 (gross misdemeanor harassment; stalking), 152.021 485.10 or 152.022 (controlled substance crime in the first or second 485.11 degree), 152.023, subdivision 1, clause (3) or (4), or 485.12 subdivision 2, clause (4) (controlled substance crime in the 485.13 third degree), 152.024, subdivision 1, clause (2), (3), or (4) 485.14 (controlled substance crime in the fourth degree), 609.224, 485.15 subdivision 2, paragraph (c) (fifth-degree assault by a 485.16 caregiver against a vulnerable adult), 609.23 (mistreatment of 485.17 persons confined), 609.231 (mistreatment of residents or 485.18 patients), 609.2325 (criminal abuse of a vulnerable adult), 485.19 609.233 (criminal neglect of a vulnerable adult), 609.2335 485.20 (financial exploitation of a vulnerable adult), 609.234 (failure 485.21 to report), 609.265 (abduction), 609.2664 to 609.2665 485.22 (manslaughter of an unborn child in the first or second degree), 485.23 609.267 to 609.2672 (assault of an unborn child in the first, 485.24 second, or third degree), 609.268 (injury or death of an unborn 485.25 child in the commission of a crime), 617.293 (disseminating or 485.26 displaying harmful material to minors), a felony level 485.27 conviction involving alcohol or drug use, a gross misdemeanor 485.28 offense under 609.324, subdivision 1 (other prohibited acts), a 485.29 gross misdemeanor offense under 609.378 (neglect or endangerment 485.30 of a child), a gross misdemeanor offense under 609.377 485.31 (malicious punishment of a child), 609.72, subdivision 3 485.32 (disorderly conduct against a vulnerable adult); or an attempt 485.33 or conspiracy to commit any of these offenses, as each of these 485.34 offenses is defined in Minnesota Statutes; or an offense in any 485.35 other state, the elements of which are substantially similar to 485.36 the elements of any of the foregoing offenses; 486.1 (2) regardless of how much time has passed since the 486.2 involuntary termination of parental rights under section 486.3 260C.301 or the discharge of the sentence imposed for the 486.4 offense, the individual was convicted of a violation of any 486.5 offense listed in sections 609.185 to 609.195 (murder in the 486.6 first, second, or third degree), 609.20 (manslaughter in the 486.7 first degree), 609.205 (manslaughter in the second degree), 486.8 609.245 (aggravated robbery), 609.25 (kidnapping), 609.561 486.9 (arson in the first degree), 609.749, subdivision 3, 4, or 5 486.10 (felony-level harassment; stalking), 609.228 (great bodily harm 486.11 caused by distribution of drugs), 609.221 or 609.222 (assault in 486.12 the first or second degree), 609.66, subdivision 1e (drive-by 486.13 shooting), 609.855, subdivision 5 (shooting in or at a public 486.14 transit vehicle or facility), 609.2661 to 609.2663 (murder of an 486.15 unborn child in the first, second, or third degree), a felony 486.16 offense under 609.377 (malicious punishment of a child), a 486.17 felony offense under 609.324, subdivision 1 (other prohibited 486.18 acts), a felony offense under 609.378 (neglect or endangerment 486.19 of a child), 609.322 (solicitation, inducement, and promotion of 486.20 prostitution), 609.342 to 609.345 (criminal sexual conduct in 486.21 the first, second, third, or fourth degree), 609.352 486.22 (solicitation of children to engage in sexual conduct), 617.246 486.23 (use of minors in a sexual performance), 617.247 (possession of 486.24 pictorial representations of a minor), 609.365 (incest), a 486.25 felony offense under sections 609.2242 and 609.2243 (domestic 486.26 assault), a felony offense of spousal abuse, a felony offense of 486.27 child abuse or neglect, a felony offense of a crime against 486.28 children, or an attempt or conspiracy to commit any of these 486.29 offenses as defined in Minnesota Statutes, or an offense in any 486.30 other state, the elements of which are substantially similar to 486.31 any of the foregoing offenses; 486.32 (3) within the seven years preceding the study, the 486.33 individual committed an act that constitutes maltreatment of a 486.34 child under section 626.556, subdivision 10e, and that resulted 486.35 in substantial bodily harm as defined in section 609.02, 486.36 subdivision 7a, or substantial mental or emotional harm as 487.1 supported by competent psychological or psychiatric evidence; or 487.2 (4) within the seven years preceding the study, the 487.3 individual was determined under section 626.557 to be the 487.4 perpetrator of a substantiated incident of maltreatment of a 487.5 vulnerable adult that resulted in substantial bodily harm as 487.6 defined in section 609.02, subdivision 7a, or substantial mental 487.7 or emotional harm as supported by competent psychological or 487.8 psychiatric evidence. 487.9 In the case of any ground for disqualification under 487.10 clauses (1) to (4), if the act was committed by an individual 487.11 other than the applicant, license holder, or registrant under 487.12 section 144A.71, subdivision 1, residing in the applicant's or 487.13 license holder's home, or the home of a registrant under section 487.14 144A.71, subdivision 1, the applicant, license holder, or 487.15 registrant under section 144A.71, subdivision 1, may seek 487.16 reconsideration when the individual who committed the act no 487.17 longer resides in the home. 487.18 The disqualification periods provided under clauses (1), 487.19 (3), and (4) are the minimum applicable disqualification 487.20 periods. The commissioner may determine that an individual 487.21 should continue to be disqualified from licensure or 487.22 registration under section 144A.71, subdivision 1, because the 487.23 license holder, applicant, or registrant under section 144A.71, 487.24 subdivision 1, poses a risk of harm to a person served by that 487.25 individual after the minimum disqualification period has passed. 487.26 (d) The commissioner shall respond in writing or by 487.27 electronic transmission to all reconsideration requests for 487.28 which the basis for the request is that the information relied 487.29 upon by the commissioner to disqualify is incorrect or 487.30 inaccurate within 30 working days of receipt of a request and 487.31 all relevant information. If the basis for the request is that 487.32 the individual does not pose a risk of harm, the commissioner 487.33 shall respond to the request within 15 working days after 487.34 receiving the request for reconsideration and all relevant 487.35 information. If the request is based on both the correctness or 487.36 accuracy of the information relied on to disqualify the 488.1 individual and the risk of harm, the commissioner shall respond 488.2 to the request within 45 working days after receiving the 488.3 request for reconsideration and all relevant information. If 488.4 the disqualification is set aside, the commissioner shall notify 488.5 the applicant or license holder in writing or by electronic 488.6 transmission of the decision. 488.7 (e) Except as provided in subdivision 3c, if a 488.8 disqualification for which reconsideration was requested is not 488.9 set aside or is not rescinded, an individual who was 488.10 disqualified on the basis of a preponderance of evidence that 488.11 the individual committed an act or acts that meet the definition 488.12 of any of the crimes listed in subdivision 3d, paragraph (a), 488.13 clauses (1) to (4); for a determination under section 626.556 or 488.14 626.557 of substantiated maltreatment that was serious or 488.15 recurring under subdivision 3d, paragraph (a), clause (4); or 488.16 for failure to make required reports under section 626.556, 488.17 subdivision 3, or 626.557, subdivision 3, pursuant to 488.18 subdivision 3d, paragraph (a), clause (4), may request a fair 488.19 hearing under section 256.045. Except as provided under 488.20 subdivision 3c, the fair hearing is the only administrative 488.21 appeal of the final agency determination for purposes of appeal 488.22 by the disqualified individual, specifically, including a 488.23 challenge to the accuracy and completeness of data under section 488.24 13.04. If the individual was disqualified based on a conviction 488.25 or admission to any crimes listed in subdivision 3d, paragraph 488.26 (a), clauses (1) to (4), the reconsideration decision under this 488.27 subdivision is the final agency determination for purposes of 488.28 appeal by the disqualified individual and is not subject to a 488.29 hearing under section 256.045. 488.30 (f) Except as provided under subdivision 3c, if an 488.31 individual was disqualified on the basis of a determination of 488.32 maltreatment under section 626.556 or 626.557, which was serious 488.33 or recurring, and the individual has requested reconsideration 488.34 of the maltreatment determination under section 626.556, 488.35 subdivision 10i, or 626.557, subdivision 9d, and also requested 488.36 reconsideration of the disqualification under this subdivision, 489.1 reconsideration of the maltreatment determination and 489.2 reconsideration of the disqualification shall be consolidated 489.3 into a single reconsideration. For maltreatment and 489.4 disqualification determinations made by county agencies, the 489.5 consolidated reconsideration shall be conducted by the county 489.6 agency. If the county agency has disqualified an individual on 489.7 multiple bases, one of which is a county maltreatment 489.8 determination for which the individual has a right to request 489.9 reconsideration, the county shall conduct the reconsideration of 489.10 all disqualifications. Except as provided under subdivision 3c, 489.11 if an individual who was disqualified on the basis of serious or 489.12 recurring maltreatment requests a fair hearing on the 489.13 maltreatment determination under section 626.556, subdivision 489.14 10i, or 626.557, subdivision 9d, and requests a fair hearing on 489.15 the disqualification, which has not been set aside or rescinded 489.16 under this subdivision, the scope of the fair hearing under 489.17 section 256.045 shall include the maltreatment determination and 489.18 the disqualification. Except as provided under subdivision 3c, 489.19 a fair hearing is the only administrative appeal of the final 489.20 agency determination, specifically, including a challenge to the 489.21 accuracy and completeness of data under section 13.04. 489.22 (g) In the notice from the commissioner that a 489.23 disqualification has been set aside, the license holder must be 489.24 informed that information about the nature of the 489.25 disqualification and which factors under paragraph (b) were the 489.26 bases of the decision to set aside the disqualification is 489.27 available to the license holder upon request without consent of 489.28 the background study subject. With the written consent of a 489.29 background study subject, the commissioner may release to the 489.30 license holder copies of all information related to the 489.31 background study subject's disqualification and the 489.32 commissioner's decision to set aside the disqualification as 489.33 specified in the written consent. 489.34 Sec. 7. Minnesota Statutes 2002, section 245A.04, 489.35 subdivision 3d, is amended to read: 489.36 Subd. 3d. [DISQUALIFICATION.] (a) Upon receipt of 490.1 information showing, or when a background study completed under 490.2 subdivision 3 shows any of the following: a conviction of one 490.3 or more crimes listed in clauses (1) to (4); the individual has 490.4 admitted to or a preponderance of the evidence indicates the 490.5 individual has committed an act or acts that meet the definition 490.6 of any of the crimes listed in clauses (1) to (4); or an 490.7 investigation results in an administrative determination listed 490.8 under clause (4), the individual shall be disqualified from any 490.9 position allowing direct contact with persons receiving services 490.10 from the license holder, entity identified in subdivision 3, 490.11 paragraph (a), or registrant under section 144A.71, subdivision 490.12 1, and for individuals studied under section 245A.04, 490.13 subdivision 3, paragraph (c), clauses (2), (6), and (7), the 490.14 individual shall also be disqualified from access to a person 490.15 receiving services from the license holder: 490.16 (1) regardless of how much time has passed since the 490.17 involuntary termination of parental rights under section 490.18 260C.301 or the discharge of the sentence imposed for the 490.19 offense, and unless otherwise specified, regardless of the level 490.20 of the conviction, the individual was convicted of any of the 490.21 following offenses: sections 609.185 (murder in the first 490.22 degree); 609.19 (murder in the second degree); 609.195 (murder 490.23 in the third degree); 609.2661 (murder of an unborn child in the 490.24 first degree); 609.2662 (murder of an unborn child in the second 490.25 degree); 609.2663 (murder of an unborn child in the third 490.26 degree); 609.20 (manslaughter in the first degree); 609.205 490.27 (manslaughter in the second degree); 609.221 or 609.222 (assault 490.28 in the first or second degree); 609.228 (great bodily harm 490.29 caused by distribution of drugs); 609.245 (aggravated robbery); 490.30 609.25 (kidnapping); 609.561 (arson in the first degree); 490.31 609.749, subdivision 3, 4, or 5 (felony-level harassment; 490.32 stalking); 609.66, subdivision 1e (drive-by shooting); 609.855, 490.33 subdivision 5 (shooting at or in a public transit vehicle or 490.34 facility); 609.322 (solicitation, inducement, and promotion of 490.35 prostitution); 609.342 (criminal sexual conduct in the first 490.36 degree); 609.343 (criminal sexual conduct in the second degree); 491.1 609.344 (criminal sexual conduct in the third degree); 609.345 491.2 (criminal sexual conduct in the fourth degree); 609.352 491.3 (solicitation of children to engage in sexual conduct); 609.365 491.4 (incest); felony offense under 609.377 (malicious punishment of 491.5 a child); a felony offense under 609.378 (neglect or 491.6 endangerment of a child); a felony offense under 609.324, 491.7 subdivision 1 (other prohibited acts); 617.246 (use of minors in 491.8 sexual performance prohibited); 617.247 (possession of pictorial 491.9 representations of minors); a felony offense under sections 491.10 609.2242 and 609.2243 (domestic assault), a felony offense of 491.11 spousal abuse, a felony offense of child abuse or neglect, a 491.12 felony offense of a crime against children; or attempt or 491.13 conspiracy to commit any of these offenses as defined in 491.14 Minnesota Statutes, or an offense in any other state or country, 491.15 where the elements are substantially similar to any of the 491.16 offenses listed in this clause; 491.17 (2) if less than 15 years have passed since the discharge 491.18 of the sentence imposed for the offense; and the individual has 491.19 received a felony conviction for a violation of any of these 491.20 offenses: sections 609.21 (criminal vehicular homicide and 491.21 injury); 609.165 (felon ineligible to possess firearm); 609.215 491.22 (suicide); 609.223 or 609.2231 (assault in the third or fourth 491.23 degree); repeat offenses under 609.224 (assault in the fifth 491.24 degree); repeat offenses under 609.3451 (criminal sexual conduct 491.25 in the fifth degree); 609.498, subdivision 1 or1a491.26 1b (aggravated first degree or first degree tampering with a 491.27 witness); 609.713 (terroristic threats); 609.235 (use of drugs 491.28 to injure or facilitate crime); 609.24 (simple robbery); 609.255 491.29 (false imprisonment); 609.562 (arson in the second degree); 491.30 609.563 (arson in the third degree); repeat offenses under 491.31 617.23 (indecent exposure; penalties); repeat offenses under 491.32 617.241 (obscene materials and performances; distribution and 491.33 exhibition prohibited; penalty); 609.71 (riot); 609.66 491.34 (dangerous weapons); 609.67 (machine guns and short-barreled 491.35 shotguns); 609.2325 (criminal abuse of a vulnerable adult); 491.36 609.2664 (manslaughter of an unborn child in the first degree); 492.1 609.2665 (manslaughter of an unborn child in the second degree); 492.2 609.267 (assault of an unborn child in the first degree); 492.3 609.2671 (assault of an unborn child in the second degree); 492.4 609.268 (injury or death of an unborn child in the commission of 492.5 a crime); 609.52 (theft); 609.2335 (financial exploitation of a 492.6 vulnerable adult); 609.521 (possession of shoplifting gear); 492.7 609.582 (burglary); 609.625 (aggravated forgery); 609.63 492.8 (forgery); 609.631 (check forgery; offering a forged check); 492.9 609.635 (obtaining signature by false pretense); 609.27 492.10 (coercion); 609.275 (attempt to coerce); 609.687 (adulteration); 492.11 260C.301 (grounds for termination of parental rights); chapter 492.12 152 (drugs; controlled substance); and a felony level conviction 492.13 involving alcohol or drug use. An attempt or conspiracy to 492.14 commit any of these offenses, as each of these offenses is 492.15 defined in Minnesota Statutes; or an offense in any other state 492.16 or country, the elements of which are substantially similar to 492.17 the elements of the offenses in this clause. If the individual 492.18 studied is convicted of one of the felonies listed in this 492.19 clause, but the sentence is a gross misdemeanor or misdemeanor 492.20 disposition, the lookback period for the conviction is the 492.21 period applicable to the disposition, that is the period for 492.22 gross misdemeanors or misdemeanors; 492.23 (3) if less than ten years have passed since the discharge 492.24 of the sentence imposed for the offense; and the individual has 492.25 received a gross misdemeanor conviction for a violation of any 492.26 of the following offenses: sections 609.224 (assault in the 492.27 fifth degree); 609.2242 and 609.2243 (domestic assault); 492.28 violation of an order for protection under 518B.01, subdivision 492.29 14; 609.3451 (criminal sexual conduct in the fifth degree); 492.30 repeat offenses under 609.746 (interference with privacy); 492.31 repeat offenses under 617.23 (indecent exposure); 617.241 492.32 (obscene materials and performances); 617.243 (indecent 492.33 literature, distribution); 617.293 (harmful materials; 492.34 dissemination and display to minors prohibited); 609.71 (riot); 492.35 609.66 (dangerous weapons); 609.749, subdivision 2 (harassment; 492.36 stalking); 609.224, subdivision 2, paragraph (c) (assault in the 493.1 fifth degree by a caregiver against a vulnerable adult); 609.23 493.2 (mistreatment of persons confined); 609.231 (mistreatment of 493.3 residents or patients); 609.2325 (criminal abuse of a vulnerable 493.4 adult); 609.233 (criminal neglect of a vulnerable adult); 493.5 609.2335 (financial exploitation of a vulnerable adult); 609.234 493.6 (failure to report maltreatment of a vulnerable adult); 609.72, 493.7 subdivision 3 (disorderly conduct against a vulnerable adult); 493.8 609.265 (abduction); 609.378 (neglect or endangerment of a 493.9 child); 609.377 (malicious punishment of a child); 609.324, 493.10 subdivision 1a (other prohibited acts; minor engaged in 493.11 prostitution); 609.33 (disorderly house); 609.52 (theft); 493.12 609.582 (burglary); 609.631 (check forgery; offering a forged 493.13 check); 609.275 (attempt to coerce); or an attempt or conspiracy 493.14 to commit any of these offenses, as each of these offenses is 493.15 defined in Minnesota Statutes; or an offense in any other state 493.16 or country, the elements of which are substantially similar to 493.17 the elements of any of the offenses listed in this clause. If 493.18 the defendant is convicted of one of the gross misdemeanors 493.19 listed in this clause, but the sentence is a misdemeanor 493.20 disposition, the lookback period for the conviction is the 493.21 period applicable to misdemeanors; or 493.22 (4) if less than seven years have passed since the 493.23 discharge of the sentence imposed for the offense; and the 493.24 individual has received a misdemeanor conviction for a violation 493.25 of any of the following offenses: sections 609.224 (assault in 493.26 the fifth degree); 609.2242 (domestic assault); violation of an 493.27 order for protection under 518B.01 (Domestic Abuse Act); 493.28 violation of an order for protection under 609.3232 (protective 493.29 order authorized; procedures; penalties); 609.746 (interference 493.30 with privacy); 609.79 (obscene or harassing phone calls); 493.31 609.795 (letter, telegram, or package; opening; harassment); 493.32 617.23 (indecent exposure; penalties); 609.2672 (assault of an 493.33 unborn child in the third degree); 617.293 (harmful materials; 493.34 dissemination and display to minors prohibited); 609.66 493.35 (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 493.36 exploitation of a vulnerable adult); 609.234 (failure to report 494.1 maltreatment of a vulnerable adult); 609.52 (theft); 609.27 494.2 (coercion); or an attempt or conspiracy to commit any of these 494.3 offenses, as each of these offenses is defined in Minnesota 494.4 Statutes; or an offense in any other state or country, the 494.5 elements of which are substantially similar to the elements of 494.6 any of the offenses listed in this clause; a determination or 494.7 disposition of failure to make required reports under section 494.8 626.556, subdivision 3, or 626.557, subdivision 3, for incidents 494.9 in which: (i) the final disposition under section 626.556 or 494.10 626.557 was substantiated maltreatment, and (ii) the 494.11 maltreatment was recurring or serious; or a determination or 494.12 disposition of substantiated serious or recurring maltreatment 494.13 of a minor under section 626.556 or of a vulnerable adult under 494.14 section 626.557 for which there is a preponderance of evidence 494.15 that the maltreatment occurred, and that the subject was 494.16 responsible for the maltreatment. 494.17 For the purposes of this section, "serious maltreatment" 494.18 means sexual abuse; maltreatment resulting in death; or 494.19 maltreatment resulting in serious injury which reasonably 494.20 requires the care of a physician whether or not the care of a 494.21 physician was sought; or abuse resulting in serious injury. For 494.22 purposes of this section, "abuse resulting in serious injury" 494.23 means: bruises, bites, skin laceration or tissue damage; 494.24 fractures; dislocations; evidence of internal injuries; head 494.25 injuries with loss of consciousness; extensive second-degree or 494.26 third-degree burns and other burns for which complications are 494.27 present; extensive second-degree or third-degree frostbite, and 494.28 others for which complications are present; irreversible 494.29 mobility or avulsion of teeth; injuries to the eyeball; 494.30 ingestion of foreign substances and objects that are harmful; 494.31 near drowning; and heat exhaustion or sunstroke. For purposes 494.32 of this section, "care of a physician" is treatment received or 494.33 ordered by a physician, but does not include diagnostic testing, 494.34 assessment, or observation. For the purposes of this section, 494.35 "recurring maltreatment" means more than one incident of 494.36 maltreatment for which there is a preponderance of evidence that 495.1 the maltreatment occurred, and that the subject was responsible 495.2 for the maltreatment. For purposes of this section, "access" 495.3 means physical access to an individual receiving services or the 495.4 individual's personal property without continuous, direct 495.5 supervision as defined in section 245A.04, subdivision 3. 495.6 (b) Except for background studies related to child foster 495.7 care, adult foster care, or family child care licensure, when 495.8 the subject of a background study is regulated by a 495.9 health-related licensing board as defined in chapter 214, and 495.10 the regulated person has been determined to have been 495.11 responsible for substantiated maltreatment under section 626.556 495.12 or 626.557, instead of the commissioner making a decision 495.13 regarding disqualification, the board shall make a determination 495.14 whether to impose disciplinary or corrective action under 495.15 chapter 214. 495.16 (1) The commissioner shall notify the health-related 495.17 licensing board: 495.18 (i) upon completion of a background study that produces a 495.19 record showing that the individual was determined to have been 495.20 responsible for substantiated maltreatment; 495.21 (ii) upon the commissioner's completion of an investigation 495.22 that determined the individual was responsible for substantiated 495.23 maltreatment; or 495.24 (iii) upon receipt from another agency of a finding of 495.25 substantiated maltreatment for which the individual was 495.26 responsible. 495.27 (2) The commissioner's notice shall indicate whether the 495.28 individual would have been disqualified by the commissioner for 495.29 the substantiated maltreatment if the individual were not 495.30 regulated by the board. The commissioner shall concurrently 495.31 send this notice to the individual. 495.32 (3) Notwithstanding the exclusion from this subdivision for 495.33 individuals who provide child foster care, adult foster care, or 495.34 family child care, when the commissioner or a local agency has 495.35 reason to believe that the direct contact services provided by 495.36 the individual may fall within the jurisdiction of a 496.1 health-related licensing board, a referral shall be made to the 496.2 board as provided in this section. 496.3 (4) If, upon review of the information provided by the 496.4 commissioner, a health-related licensing board informs the 496.5 commissioner that the board does not have jurisdiction to take 496.6 disciplinary or corrective action, the commissioner shall make 496.7 the appropriate disqualification decision regarding the 496.8 individual as otherwise provided in this chapter. 496.9 (5) The commissioner has the authority to monitor the 496.10 facility's compliance with any requirements that the 496.11 health-related licensing board places on regulated persons 496.12 practicing in a facility either during the period pending a 496.13 final decision on a disciplinary or corrective action or as a 496.14 result of a disciplinary or corrective action. The commissioner 496.15 has the authority to order the immediate removal of a regulated 496.16 person from direct contact or access when a board issues an 496.17 order of temporary suspension based on a determination that the 496.18 regulated person poses an immediate risk of harm to persons 496.19 receiving services in a licensed facility. 496.20 (6) A facility that allows a regulated person to provide 496.21 direct contact services while not complying with the 496.22 requirements imposed by the health-related licensing board is 496.23 subject to action by the commissioner as specified under 496.24 sections 245A.06 and 245A.07. 496.25 (7) The commissioner shall notify a health-related 496.26 licensing board immediately upon receipt of knowledge of 496.27 noncompliance with requirements placed on a facility or upon a 496.28 person regulated by the board. 496.29 Sec. 8. Minnesota Statutes 2002, section 245A.09, 496.30 subdivision 7, is amended to read: 496.31 Subd. 7. [REGULATORY METHODS.] (a) Where appropriate and 496.32 feasible the commissioner shall identify and implement 496.33 alternative methods of regulation and enforcement to the extent 496.34 authorized in this subdivision. These methods shall include: 496.35 (1) expansion of the types and categories of licenses that 496.36 may be granted; 497.1 (2) when the standards of another state or federal 497.2 governmental agency or an independent accreditation body have 497.3 been shown topredict compliance with the rulesrequire the same 497.4 standards, methods, or alternative methods to achieve 497.5 substantially the same intended outcomes as the licensing 497.6 standards, the commissioner shall consider compliance with the 497.7 governmental or accreditation standards to be equivalent to 497.8 partial compliance with theruleslicensing standards; and 497.9 (3) use of an abbreviated inspection that employs key 497.10 standards that have been shown to predict full compliance with 497.11 the rules. 497.12 (b) If the commissioner accepts accreditation as 497.13 documentation of compliance with a licensing standard under 497.14 paragraph (a), the commissioner shall continue to investigate 497.15 complaints related to noncompliance with all licensing standards. 497.16 The commissioner may take a licensing action for noncompliance 497.17 under this chapter and shall recognize all existing appeal 497.18 rights regarding any licensing actions taken under this chapter. 497.19 (c) The commissioner shall work with the commissioners of 497.20 health, public safety, administration, and children, families, 497.21 and learning in consolidating duplicative licensing and 497.22 certification rules and standards if the commissioner determines 497.23 that consolidation is administratively feasible, would 497.24 significantly reduce the cost of licensing, and would not reduce 497.25 the protection given to persons receiving services in licensed 497.26 programs. Where administratively feasible and appropriate, the 497.27 commissioner shall work with the commissioners of health, public 497.28 safety, administration, and children, families, and learning in 497.29 conducting joint agency inspections of programs. 497.30(c)(d) The commissioner shall work with the commissioners 497.31 of health, public safety, administration, and children, 497.32 families, and learning in establishing a single point of 497.33 application for applicants who are required to obtain concurrent 497.34 licensure from more than one of the commissioners listed in this 497.35 clause. 497.36(d)(e) Unless otherwise specified in statute, the 498.1 commissioner mayspecify in rule periods of licensure up to two498.2yearsconduct routine inspections biennially. 498.3 Sec. 9. Minnesota Statutes 2002, section 245A.10, is 498.4 amended to read: 498.5 245A.10 [FEES.] 498.6 Subdivision 1. [APPLICATION OR LICENSE FEE REQUIRED, 498.7 PROGRAMS EXEMPT FROM FEE.] (a) Unless exempt under paragraph 498.8 (b), the commissioner shall charge a fee for evaluation of 498.9 applications and inspection of programs, other than family day498.10care and foster care,which are licensed under this chapter. 498.11The commissioner may charge a fee for the licensing of school498.12age child care programs, in an amount sufficient to cover the498.13cost to the state agency of processing the license.498.14 (b) Notwithstanding paragraph (a), no application or 498.15 license fee shall be charged for child foster care, adult foster 498.16 care, or state-operated programs, unless the state-operated 498.17 program is an intermediate care facility for persons with mental 498.18 retardation or related conditions (ICF/MR). 498.19 Subd. 2. [COUNTY FEES FOR BACKGROUND STUDIES AND LICENSING 498.20 INSPECTIONS IN FAMILY AND GROUP FAMILY CHILD CARE.] (a) For 498.21 purposes of family and group family child care licensing under 498.22 this chapter, a county agency may charge a fee to an applicant 498.23 or license holder to recover the actual cost of background 498.24 studies, but in any case not to exceed $100 annually. A county 498.25 agency may also charge a fee to an applicant or license holder 498.26 to recover the actual cost of licensing inspections, but in any 498.27 case not to exceed $150 annually. 498.28 (b) Pursuant to section 119B.125, a county agency may 498.29 charge a onetime fee to a legal nonlicensed child care provider 498.30 or applicant equal to the actual cost of conducting a criminal 498.31 background check, up to a maximum of $100. 498.32 (c) Counties may elect to reduce or waive the fees in 498.33 paragraph (a): 498.34 (1) in cases of financial hardship; and 498.35 (2) if the county has a shortage of providers in the 498.36 county's area. 499.1 (d) Counties may allow providers to pay the applicant fees 499.2 in paragraph (a) or (b) on an installment basis for up to one 499.3 year. If the provider is receiving child care assistance 499.4 payments from the state, the provider may have the fees under 499.5 paragraph (a) or (b) deducted from the child care assistance 499.6 payments for up to one year and the state shall reimburse the 499.7 county for the county fees collected in this manner. 499.8 Subd. 3. [APPLICATION FEE FOR INITIAL LICENSE OR 499.9 CERTIFICATION.] (a) For fees required under subdivision 1, an 499.10 applicant for an initial license or certification issued by the 499.11 commissioner shall submit a $500 application fee with each new 499.12 application required under this subdivision. The application 499.13 fee shall not be prorated, is nonrefundable, and is in lieu of 499.14 the annual license or certification fee that expires on December 499.15 31. The commissioner shall not process an application until the 499.16 application fee is paid. 499.17 (b) Except as provided in clauses (1) to (3), an applicant 499.18 shall apply for a license to provide services at a specific 499.19 location. 499.20 (1) For a license to provide waivered services to persons 499.21 with developmental disabilities or related conditions, an 499.22 applicant shall submit an application for each county in which 499.23 the waivered services will be provided. 499.24 (2) For a license to provide semi-independent living 499.25 services to persons with developmental disabilities or related 499.26 conditions, an applicant shall submit a single application to 499.27 provide services statewide. 499.28 (3) For a license to provide independent living assistance 499.29 for youth under section 245A.22, an applicant shall submit a 499.30 single application to provide services statewide. 499.31 Subd. 4. [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS 499.32 WITH LICENSED CAPACITY.] (a) Child care centers and programs 499.33 with a licensed capacity shall pay an annual nonrefundable 499.34 license or certification fee based on the following schedule: 499.35 Licensed Capacity Child Care Residential 499.36 Center Program 500.1 License Fee License Fee 500.2 1 to 24 persons $300 $400 500.3 25 to 49 persons $450 $600 500.4 50 to 74 persons $600 $800 500.5 75 to 99 persons $750 $1,000 500.6 100 to 124 persons $900 $1,200 500.7 125 to 149 persons $1,200 $1,400 500.8 150 to 174 persons $1,400 $1,600 500.9 175 to 199 persons $1,600 $1,800 500.10 200 to 224 persons $1,800 $2,000 500.11 225 or more persons $2,000 $2,500 500.12 (b) A day training and habilitation program serving persons 500.13 with developmental disabilities or related conditions shall be 500.14 assessed a license fee based on the schedule in paragraph (a) 500.15 unless the license holder serves more than 50 percent of the 500.16 same persons at two or more locations in the community. When a 500.17 day training and habilitation program serves more than 50 500.18 percent of the same persons in two or more locations in a 500.19 community, the day training and habilitation program shall pay a 500.20 license fee based on the licensed capacity of the largest 500.21 facility and the other facility or facilities shall be charged a 500.22 license fee based on a licensed capacity of a residential 500.23 program serving one to 24 persons. 500.24 Subd. 5. [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS 500.25 WITHOUT A LICENSED CAPACITY.] (a) Except as provided in 500.26 paragraph (b), a program without a stated licensed capacity 500.27 shall pay a license or certification fee of $400. 500.28 (b) A mental health center or mental health clinic 500.29 requesting certification for purposes of insurance and 500.30 subscriber contract reimbursement under Minnesota Rules, parts 500.31 9520.0750 to 9520.0870 shall pay a certification fee of $1,000 500.32 per year. If the mental health center or mental health clinic 500.33 provides services at a primary location with satellite 500.34 facilities, the satellite facilities shall be certified with the 500.35 primary location without an additional charge. 500.36 Subd. 6. [LICENSE NOT ISSUED UNTIL LICENSE OR 501.1 CERTIFICATION FEE IS PAID.] The commissioner shall not issue a 501.2 license or certification until the license or certification fee 501.3 is paid. The commissioner shall send a bill for the license or 501.4 certification fee to the billing address identified by the 501.5 license holder. If the license holder does not submit the 501.6 license or certification fee payment by the due date, the 501.7 commissioner shall send the license holder a past due notice. 501.8 If the license holder fails to pay the license or certification 501.9 fee by the due date on the past due notice, the commissioner 501.10 shall send a final notice to the license holder informing the 501.11 license holder that the program license will expire on December 501.12 31 unless the license fee is paid before December 31. If a 501.13 license expires, the program is no longer licensed and, unless 501.14 exempt from licensure under section 245A.03, subdivision 2, must 501.15 not operate after the expiration date. After a license expires, 501.16 if the former license holder wishes to provide licensed 501.17 services, the former license holder must submit a new license 501.18 application and application fee under subdivision 3. 501.19 Sec. 10. Minnesota Statutes 2002, section 245A.11, 501.20 subdivision 2a, is amended to read: 501.21 Subd. 2a. [ADULT FOSTER CARE LICENSE CAPACITY.] (a) An 501.22 adult foster care license holder may have a maximum license 501.23 capacity of five if all persons in care are age 55 or over and 501.24 do not have a serious and persistent mental illness or a 501.25 developmental disability. 501.26 (b) The commissioner may grant variances to paragraph (a) 501.27 to allow a foster care provider with a licensed capacity of five 501.28 persons to admit an individual under the age of 55 if the 501.29 variance complies with section 245A.04, subdivision 9, and 501.30 approval of the variance is recommended by the county in which 501.31 the licensed foster care provider is located. 501.32 (c) The commissioner may grant variances to paragraph (a) 501.33 to allow the use of a fifth bed for emergency crisis services 501.34 for a person with serious and persistent mental illness or a 501.35 developmental disability, regardless of age, if the variance 501.36 complies with section 245A.04, subdivision 9, and approval of 502.1 the variance is recommended by the county in which the licensed 502.2 foster care provider is located. 502.3 (d) Notwithstanding paragraph (a), the commissioner may 502.4 issue an adult foster care license with a capacity of five or 502.5 six adults when the capacity is recommended by the county 502.6 licensing agency of the county in which the facility is located 502.7 and if the recommendation verifies that: 502.8 (1) the facility meets the physical environment 502.9 requirements in the adult foster care licensing rule; 502.10 (2) the five- or six-bed living arrangement is specified 502.11 for each resident in the resident's (i) individualized plan of 502.12 care; (ii) individual service plan under section 256B.092, 502.13 subdivision 1b, if required; or (iii) individual resident 502.14 placement agreement under Minnesota Rules, part 9555.5105, 502.15 subpart 19, if required; 502.16 (3) the license holder obtains written and signed informed 502.17 consent from each resident or resident's legal representative 502.18 documenting the resident's informed choice to living in the home 502.19 and that the resident's refusal to consent would not have 502.20 resulted in service termination; and 502.21 (4) the facility was licensed for adult foster care before 502.22 March 1, 2003. 502.23 (e) The commissioner shall not issue a new adult foster 502.24 care license under paragraph (d) after June 30, 2005. The 502.25 commissioner shall allow a facility with an adult foster care 502.26 license issued under paragraph (d) before June 30, 2005, to 502.27 continue with a capacity of five or six adults if the license 502.28 holder continues to comply with the requirements in paragraph 502.29 (d). 502.30 Sec. 11. Minnesota Statutes 2002, section 245A.11, 502.31 subdivision 2b, is amended to read: 502.32 Subd. 2b. [ADULT FOSTER CARE; FAMILY ADULT DAY CARE.] An 502.33 adult foster care license holder licensed under the conditions 502.34 in subdivision 2a may also provide family adult day care for 502.35 adults age 55 or over if no persons in the adult foster or adult 502.36 family day care program have a serious and persistent mental 503.1 illness or a developmental disability. The maximum combined 503.2 capacity for adult foster care and family adult day care is five 503.3 adults, except that the commissioner may grant a variance for a 503.4 family adult day care provider to admit up to seven individuals 503.5 for day care services and one individual for respite care 503.6 services, if all of the following requirements are met: (1) the 503.7 variance complies with section 245A.04, subdivision 9; (2) a 503.8 second caregiver is present whenever six or more clients are 503.9 being served; and (3) the variance is recommended by the county 503.10 social service agency in the county where the provider is 503.11 located. A separate license is not required to provide family 503.12 adult day care under this subdivision. Adult foster care homes 503.13 providing services to five adults under this section shall not 503.14 be subject to licensure by the commissioner of health under the 503.15 provisions of chapter 144, 144A, 157, or any other law requiring 503.16 facility licensure by the commissioner of health. 503.17 Sec. 12. Minnesota Statutes 2002, section 245A.11, is 503.18 amended by adding a subdivision to read: 503.19 Subd. 7. [ADULT FOSTER CARE; VARIANCE FOR ALTERNATE 503.20 OVERNIGHT SUPERVISION.] (a) The commissioner may grant a 503.21 variance under section 245A.04, subdivision 9, to rule parts 503.22 requiring a caregiver to be present in an adult foster care home 503.23 during normal sleeping hours to allow for alternative methods of 503.24 overnight supervision. The commissioner may grant the variance 503.25 if the local county licensing agency recommends the variance and 503.26 the county recommendation includes documentation verifying that: 503.27 (1) the county has approved the license holder's plan for 503.28 alternative methods of providing overnight supervision and 503.29 determined the plan protects the residents' health, safety, and 503.30 rights; 503.31 (2) the license holder has obtained written and signed 503.32 informed consent from each resident or each resident's legal 503.33 representative documenting the resident's or legal 503.34 representative's agreement with the alternative method of 503.35 overnight supervision; and 503.36 (3) the alternative method of providing overnight 504.1 supervision is specified for each resident in the resident's: 504.2 (i) individualized plan of care; (ii) individual service plan 504.3 under section 256B.092, subdivision 1b, if required; or (iii) 504.4 individual resident placement agreement under Minnesota Rules, 504.5 part 9555.5105, subpart 19, if required. 504.6 (b) To be eligible for a variance under paragraph (a), the 504.7 adult foster care license holder must not have had a licensing 504.8 action under section 245A.06 or 245A.07 during the prior 24 504.9 months based on failure to provide adequate supervision, health 504.10 care services, or resident safety in the adult foster care home. 504.11 Sec. 13. Minnesota Statutes 2002, section 245B.03, 504.12 subdivision 2, is amended to read: 504.13 Subd. 2. [RELATIONSHIP TO OTHER STANDARDS GOVERNING 504.14 SERVICES FOR PERSONS WITH MENTAL RETARDATION OR RELATED 504.15 CONDITIONS.] (a) ICFs/MR are exempt from: 504.16 (1) section 245B.04; 504.17 (2) section 245B.06, subdivisions 4 and 6; and 504.18 (3) section 245B.07, subdivisions 4, paragraphs (b) and 504.19 (c); 7; and 8, paragraphs (1), clause (iv), and (2). 504.20 (b) License holders also licensed under chapter 144 as a 504.21 supervised living facility are exempt from section 245B.04. 504.22 (c) Residential service sites controlled by license holders 504.23 licensed under chapter 245B for home and community-based 504.24 waivered services for four or fewer adults are exempt from 504.25 compliance with Minnesota Rules, parts 9543.0040, subpart 2, 504.26 item C; 9555.5505; 9555.5515, items B and G; 9555.5605; 504.27 9555.5705; 9555.6125, subparts 3, item C, subitem (2), and 4 to 504.28 6; 9555.6185; 9555.6225, subpart 8; 9555.6245; 9555.6255; and 504.29 9555.6265; and as provided under section 245B.06, subdivision 2, 504.30 the license holder is exempt from the program abuse prevention 504.31 plans and individual abuse prevention plans otherwise required 504.32 under sections 245A.65, subdivision 2, and 626.557, subdivision 504.33 14. The commissioner may approve alternative methods of 504.34 providing overnight supervision using the process and criteria 504.35 for granting a variance in section 245A.04, subdivision 9. This 504.36 chapter does not apply to foster care homes that do not provide 505.1 residential habilitation services funded under the home and 505.2 community-based waiver programs defined in section 256B.092. 505.3 (d) Residential service sites controlled by license holders 505.4 licensed under this chapter for home and community-based 505.5 waivered services for four or fewer children are exempt from 505.6 compliance with Minnesota Rules, parts 9545.0130; 9545.0140; 505.7 9545.0150; 9545.0170; 9545.0220, subparts 1, items C, F, and I, 505.8 and 3; and 9545.0230. 505.9 (e) The commissioner may exempt license holders from 505.10 applicable standards of this chapter when the license holder 505.11 meets the standards under section 245A.09, subdivision 7. 505.12 License holders that are accredited by an independent 505.13 accreditation body shall continue to be licensed under this 505.14 chapter. 505.15(e)(f) License holders governed by sections 245B.02 to 505.16 245B.07 must also meet the licensure requirements in chapter 505.17 245A. 505.18(f)(g) Nothing in this chapter prohibits license holders 505.19 from concurrently serving consumers with and without mental 505.20 retardation or related conditions provided this chapter's 505.21 standards are met as well as other relevant standards. 505.22(g)(h) The documentation that sections 245B.02 to 245B.07 505.23 require of the license holder meets the individual program plan 505.24 required in section 256B.092 or successor provisions. 505.25 Sec. 14. Minnesota Statutes 2002, section 245B.03, is 505.26 amended by adding a subdivision to read: 505.27 Subd. 3. [CONTINUITY OF CARE.] (a) When a consumer changes 505.28 service to the same type of service provided under a different 505.29 license held by the same license holder and the policies and 505.30 procedures under section 245B.07, subdivision 8, are 505.31 substantially similar, the license holder is exempt from the 505.32 requirements in sections 245B.06, subdivisions 2, paragraphs (e) 505.33 and (f), and 4; and 245B.07, subdivision 9, clause (2). 505.34 (b) When a direct service staff person begins providing 505.35 direct service under one or more licenses other than the license 505.36 for which the staff person initially received the staff 506.1 orientation requirements under section 245B.07, subdivision 5, 506.2 the license holder is exempt from all staff orientation 506.3 requirements under section 245B.07, subdivision 5, except that: 506.4 (1) if the service provision location changes, the staff 506.5 person must receive orientation regarding any policies or 506.6 procedures under section 245B.07, subdivision 8, that are 506.7 specific to the service provision location; and 506.8 (2) if the staff person provides direct service to one or 506.9 more consumers for whom the staff person has not previously 506.10 provided direct service, the staff person must review each 506.11 consumer's: (i) service plans and risk management plan in 506.12 accordance with section 245B.07, subdivision 5, paragraph (b), 506.13 clause (1); and (ii) medication administration in accordance 506.14 with section 245B.07, subdivision 5, paragraph (b), clause (6). 506.15 Sec. 15. Minnesota Statutes 2002, section 245B.04, 506.16 subdivision 2, is amended to read: 506.17 Subd. 2. [SERVICE-RELATED RIGHTS.] A consumer's 506.18 service-related rights include the right to: 506.19 (1) refuse or terminate services and be informed of the 506.20 consequences of refusing or terminating services; 506.21 (2) know, in advance, limits to the services available from 506.22 the license holder; 506.23 (3) know conditions and terms governing the provision of 506.24 services, including those related to initiation and termination; 506.25 (4) know what the charges are for services, regardless of 506.26 who will be paying for the services, and be notified upon 506.27 request of changes in those charges; 506.28 (5) know, in advance, whether services are covered by 506.29 insurance, government funding, or other sources, and be told of 506.30 any charges the consumer or other private party may have to pay; 506.31 and 506.32 (6) receive licensed services from individuals who are 506.33 competent and trained, who have professional certification or 506.34 licensure, as required, and who meet additional qualifications 506.35 identified in the individual service plan. 506.36 Sec. 16. Minnesota Statutes 2002, section 245B.06, 507.1 subdivision 2, is amended to read: 507.2 Subd. 2. [RISK MANAGEMENT PLAN.] (a) The license holder 507.3 must developand, document in writing, and implement a risk 507.4 management plan thatincorporates the individual abuse507.5prevention plan as required in section 245A.65meets the 507.6 requirements of this subdivision. License holders licensed 507.7 under this chapter are exempt from sections 245A.65, subdivision 507.8 2, and 626.557, subdivision 14, if the requirements of this 507.9 subdivision are met. 507.10 (b) The risk management plan must identify areas in which 507.11 the consumer is vulnerable, based on an assessment, at a 507.12 minimum, of the following areas: 507.13 (1) an adult consumer's susceptibility to physical, 507.14 emotional, and sexual abuse as defined in section 626.5572, 507.15 subdivision 2, and financial exploitation as defined in section 507.16 626.5572, subdivision 9; a minor consumer's susceptibility to 507.17 sexual and physical abuse as defined in section 626.556, 507.18 subdivision 2; and a consumer's susceptibility to self-abuse, 507.19 regardless of age; 507.20 (2) the consumer's health needs, considering the consumer's 507.21 physical disabilities; allergies; sensory impairments; seizures; 507.22 diet; need for medications; and ability to obtain medical 507.23 treatment; 507.24 (3) the consumer's safety needs, considering the consumer's 507.25 ability to take reasonable safety precautions; community 507.26 survival skills; water survival skills; ability to seek 507.27 assistance or provide medical care; and access to toxic 507.28 substances or dangerous items; 507.29 (4) environmental issues, considering the program's 507.30 location in a particular neighborhood or community; the type of 507.31 grounds and terrain surrounding the building; and the consumer's 507.32 ability to respond to weather-related conditions, open locked 507.33 doors, and remain alone in any environment; and 507.34 (5) the consumer's behavior, including behaviors that may 507.35 increase the likelihood of physical aggression between consumers 507.36 or sexual activity between consumers involving force or 508.1 coercion, as defined under section 245B.02, subdivision 10, 508.2 clauses (6) and (7). 508.3 (c) When assessing a consumer's vulnerability, the license 508.4 holder must consider only the consumer's skills and abilities, 508.5 independent of staffing patterns, supervision plans, the 508.6 environment, or other situational elements. 508.7 (d) License holders jointly providing services to a 508.8 consumer shall coordinate and use the resulting assessment of 508.9 risk areas for the development ofthiseach license holder's 508.10 risk management or the shared risk management plan.Upon508.11initiation of services, the license holder will have in place an508.12initial risk management plan that identifies areas in which the508.13consumer is vulnerable, including health, safety, and508.14environmental issues and the supports the provider will have in508.15place to protect the consumer and to minimize these risks. The508.16plan must be changed based on the needs of the individual508.17consumer and reviewed at least annually.The license holder's 508.18 plan must include the specific actions a staff person will take 508.19 to protect the consumer and minimize risks for the identified 508.20 vulnerability areas. The specific actions must include the 508.21 proactive measures being taken, training being provided, or a 508.22 detailed description of actions a staff person will take when 508.23 intervention is needed. 508.24 (e) Prior to or upon initiating services, a license holder 508.25 must develop an initial risk management plan that is, at a 508.26 minimum, verbally approved by the consumer or consumer's legal 508.27 representative and case manager. The license holder must 508.28 document the date the license holder receives the consumer's or 508.29 consumer's legal representative's and case manager's verbal 508.30 approval of the initial plan. 508.31 (f) As part of the meeting held within 45 days of 508.32 initiating service, as required under section 245B.06, 508.33 subdivision 4, the license holder must review the initial risk 508.34 management plan for accuracy and revise the plan if necessary. 508.35 The license holder must give the consumer or consumer's legal 508.36 representative and case manager an opportunity to participate in 509.1 this plan review. If the license holder revises the plan, or if 509.2 the consumer or consumer's legal representative and case manager 509.3 have not previously signed and dated the plan, the license 509.4 holder must obtain dated signatures to document the plan's 509.5 approval. 509.6 (g) After plan approval, the license holder must review the 509.7 plan at least annually and update the plan based on the 509.8 individual consumer's needs and changes to the environment. The 509.9 license holder must give the consumer or consumer's legal 509.10 representative and case manager an opportunity to participate in 509.11 the ongoing plan development. The license holder shall obtain 509.12 dated signatures from the consumer or consumer's legal 509.13 representative and case manager to document completion of the 509.14 annual review and approval of plan changes. 509.15 Sec. 17. Minnesota Statutes 2002, section 245B.06, 509.16 subdivision 5, is amended to read: 509.17 Subd. 5. [PROGRESS REVIEWS.] The license holder must 509.18 participate in progress review meetings following stated time 509.19 lines established in the consumer's individual service plan or 509.20 as requested in writing by the consumer, the consumer's legal 509.21 representative, or the case manager, at a minimum of once a 509.22 year. The license holder must summarize the progress toward 509.23 achieving the desired outcomes and make recommendations in a 509.24 written report sent to the consumer or the consumer's legal 509.25 representative and case manager prior to the review meeting. 509.26For consumers under public guardianship, the license holder is509.27required to provide quarterly written progress review reports to509.28the consumer, designated family member, and case manager.509.29 Sec. 18. Minnesota Statutes 2002, section 245B.07, 509.30 subdivision 6, is amended to read: 509.31 Subd. 6. [STAFF TRAINING.] (a) The license holder shall 509.32 ensure that direct service staff annually complete hours of 509.33 training equal to two percent of the number of hours the staff 509.34 person worked or one percent for license holders providing 509.35 semi-independent living services. Direct service staff who have 509.36 worked for the license holder for an average of at least 30 510.1 hours per week for 24 or more months must annually complete 510.2 hours of training equal to one percent of the number of hours 510.3 the staff person worked. If direct service staff has received 510.4 training from a license holder licensed under a program rule 510.5 identified in this chapter or completed course work regarding 510.6 disability-related issues from a post-secondary educational 510.7 institute, that training may also count toward training 510.8 requirements for other services and for other license holders. 510.9 (b) The license holder must document the training completed 510.10 by each employee. 510.11 (c) Training shall address staff competencies necessary to 510.12 address the consumer needs as identified in the consumer's 510.13 individual service plan and ensure consumer health, safety, and 510.14 protection of rights. Training may also include other areas 510.15 identified by the license holder. 510.16 (d) For consumers requiring a 24-hour plan of care, the 510.17 license holder shall provide training in cardiopulmonary 510.18 resuscitation, from a qualified source determined by the 510.19 commissioner, if the consumer's health needs as determined by 510.20 the consumer's physician indicate trained staff would be 510.21 necessary to the consumer. 510.22 Sec. 19. Minnesota Statutes 2002, section 245B.07, 510.23 subdivision 9, is amended to read: 510.24 Subd. 9. [AVAILABILITY OF CURRENT WRITTEN POLICIES AND 510.25 PROCEDURES.] The license holder shall: 510.26 (1) review and update, as needed, the written policies and 510.27 procedures in this chapterand inform all consumers or the510.28consumer's legal representatives, case managers, and employees510.29of the revised policies and procedures when they affect the510.30service provision; 510.31 (2) inform consumers or the consumer's legal 510.32 representatives of the written policies and procedures in this 510.33 chapter upon service initiation. Copies must be available to 510.34 consumers or the consumer's legal representatives, case 510.35 managers, the county where services are located, and the 510.36 commissioner upon request;and511.1 (3) provide all consumers or the consumers' legal 511.2 representatives and case managers a copy and explanation of 511.3 revisions to policies and procedures that affect consumers' 511.4 service-related or protection-related rights under section 511.5 245B.04. Unless there is reasonable cause, the license holder 511.6 must provide this notice at least 30 days before implementing 511.7 the revised policy and procedure. The license holder must 511.8 document the reason for not providing the notice at least 30 511.9 days before implementing the revisions; 511.10 (4) annually notify all consumers or the consumers' legal 511.11 representatives and case managers of any revised policies and 511.12 procedures under this chapter, other than those in clause (3). 511.13 Upon request, the license holder must provide the consumer or 511.14 consumer's legal representative and case manager copies of the 511.15 revised policies and procedures; 511.16 (5) before implementing revisions to policies and 511.17 procedures under this chapter, inform all employees of the 511.18 revised policies and procedures; and 511.19 (6) document and maintain relevant information related to 511.20 the policies and procedures in this chapter. 511.21 Sec. 20. Minnesota Statutes 2002, section 245B.08, 511.22 subdivision 1, is amended to read: 511.23 Subdivision 1. [ALTERNATIVE METHODS OF DETERMINING 511.24 COMPLIANCE.] (a) In addition to methods specified in chapter 511.25 245A, the commissioner may use alternative methods and new 511.26 regulatory strategies to determine compliance with this 511.27 section. The commissioner may use sampling techniques to ensure 511.28 compliance with this section. Notwithstanding section 245A.09, 511.29 subdivision 7, paragraph(d)(e), the commissioner may also 511.30 extend periods of licensure, not to exceed five years, for 511.31 license holders who have demonstrated substantial and consistent 511.32 compliance with sections 245B.02 to 245B.07 and have 511.33 consistently maintained the health and safety of consumers and 511.34 have demonstrated by alternative methods in paragraph (b) that 511.35 they meet or exceed the requirements of this section. For 511.36 purposes of this section, "substantial and consistent 512.1 compliance" means that during the current licensing period: 512.2 (1) the license holder's license has not been made 512.3 conditional, suspended, or revoked; 512.4 (2) there have been no substantiated allegations of 512.5 maltreatment against the license holder; 512.6 (3) there have been no program deficiencies that have been 512.7 identified that would jeopardize the health or safety of 512.8 consumers being served; and 512.9 (4) the license holder is in substantial compliance with 512.10 the other requirements of chapter 245A and other applicable laws 512.11 and rules. 512.12 (b) To determine the length of a license, the commissioner 512.13 shall consider: 512.14 (1) information from affected consumers, and the license 512.15 holder's responsiveness to consumers' concerns and 512.16 recommendations; 512.17 (2) self assessments and peer reviews of the standards of 512.18 this section, corrective actions taken by the license holder, 512.19 and sharing the results of the inspections with consumers, the 512.20 consumers' families, and others, as requested; 512.21 (3) length of accreditation by an independent accreditation 512.22 body, if applicable; 512.23 (4) information from the county where the license holder is 512.24 located; and 512.25 (5) information from the license holder demonstrating 512.26 performance that meets or exceeds the minimum standards of this 512.27 chapter. 512.28 (c) The commissioner may reduce the length of the license 512.29 if the license holder fails to meet the criteria in paragraph 512.30 (a) and the conditions specified in paragraph (b). 512.31 Sec. 21. Minnesota Statutes 2002, section 252.27, 512.32 subdivision 2a, is amended to read: 512.33 Subd. 2a. [CONTRIBUTION AMOUNT.] (a) The natural or 512.34 adoptive parents of a minor child, including a child determined 512.35 eligible for medical assistance without consideration of 512.36 parental income, must contribute monthly to the cost of 513.1 services, unless the child is married or has been married, 513.2 parental rights have been terminated, or the child's adoption is 513.3 subsidized according to section 259.67 or through title IV-E of 513.4 the Social Security Act. 513.5 (b) For households with adjusted gross income equal to or 513.6 greater than 100 percent of federal poverty guidelines, the 513.7 parental contribution shall bethe greater of a minimum monthly513.8fee of $25 for households with adjusted gross income of $30,000513.9and over, or an amount to becomputed by applying the following 513.10 schedule of rates to the adjusted gross income of the natural or 513.11 adoptive parentsthat exceeds 150 percent of the federal poverty513.12guidelines for the applicable household size, the following513.13schedule of rates: 513.14 (1)on the amount of adjusted gross income over 150 percent513.15of poverty, but not over $50,000, ten percentif the adjusted 513.16 gross income is equal to or greater than 100 percent of federal 513.17 poverty guidelines and less than 175 percent of federal poverty 513.18 guidelines, the parental contribution is $4 per month; 513.19 (2)onif theamount ofadjusted gross incomeover 150513.20percent of poverty and over $50,000 but not over $60,000, 12513.21percentis equal to or greater than 175 percent of federal 513.22 poverty guidelines and less than or equal to 975 percent of 513.23 federal poverty guidelines, the parental contribution shall be 513.24 determined using a sliding fee scale established by the 513.25 commissioner of human services which begins at one percent of 513.26 adjusted gross income at 175 percent of federal poverty 513.27 guidelines and increases to 16 percent of adjusted gross income 513.28 for those with adjusted gross income up to 975 percent of 513.29 federal poverty guidelines; 513.30(3) on the amount of adjusted gross income over 150 percent513.31of poverty, and over $60,000 but not over $75,000, 14 percent;513.32and513.33(4) on all adjusted gross income amounts over 150 percent513.34of poverty, and over $75,000, 15 percent.513.35 (3) if the adjusted gross income is equal to or greater 513.36 than 975 percent of federal poverty guidelines, the parental 514.1 contribution shall be 16 percent of adjusted gross income. 514.2 If the child lives with the parent, theparental514.3contributionannual adjusted gross income is reduced by$200,514.4except that the parent must pay the minimum monthly $25 fee514.5under this paragraph$4,800 prior to calculating the parental 514.6 contribution. If the child resides in an institution specified 514.7 in section 256B.35, the parent is responsible for the personal 514.8 needs allowance specified under that section in addition to the 514.9 parental contribution determined under this section. The 514.10 parental contribution is reduced by any amount required to be 514.11 paid directly to the child pursuant to a court order, but only 514.12 if actually paid. 514.13 (c) The household size to be used in determining the amount 514.14 of contribution under paragraph (b) includes natural and 514.15 adoptive parents and their dependents under age 21, including 514.16 the child receiving services. Adjustments in the contribution 514.17 amount due to annual changes in the federal poverty guidelines 514.18 shall be implemented on the first day of July following 514.19 publication of the changes. 514.20 (d) For purposes of paragraph (b), "income" means the 514.21 adjusted gross income of the natural or adoptive parents 514.22 determined according to the previous year's federal tax form. 514.23 (e) The contribution shall be explained in writing to the 514.24 parents at the time eligibility for services is being 514.25 determined. The contribution shall be made on a monthly basis 514.26 effective with the first month in which the child receives 514.27 services. Annually upon redetermination or at termination of 514.28 eligibility, if the contribution exceeded the cost of services 514.29 provided, the local agency or the state shall reimburse that 514.30 excess amount to the parents, either by direct reimbursement if 514.31 the parent is no longer required to pay a contribution, or by a 514.32 reduction in or waiver of parental fees until the excess amount 514.33 is exhausted. 514.34 (f) The monthly contribution amount must be reviewed at 514.35 least every 12 months; when there is a change in household size; 514.36 and when there is a loss of or gain in income from one month to 515.1 another in excess of ten percent. The local agency shall mail a 515.2 written notice 30 days in advance of the effective date of a 515.3 change in the contribution amount. A decrease in the 515.4 contribution amount is effective in the month that the parent 515.5 verifies a reduction in income or change in household size. 515.6 (g) Parents of a minor child who do not live with each 515.7 other shall each pay the contribution required under paragraph 515.8 (a), except that a. An amount equal to the annual court-ordered 515.9 child support payment actually paid on behalf of the child 515.10 receiving services shall be deducted from thecontribution515.11 adjusted gross income of the parent making the payment prior to 515.12 calculating the parental contribution under paragraph (b). 515.13 (h) The contribution under paragraph (b) shall be increased 515.14 by an additional five percent if the local agency determines 515.15 that insurance coverage is available but not obtained for the 515.16 child. For purposes of this section, "available" means the 515.17 insurance is a benefit of employment for a family member at an 515.18 annual cost of no more than five percent of the family's annual 515.19 income. For purposes of this section, "insurance" means health 515.20 and accident insurance coverage, enrollment in a nonprofit 515.21 health service plan, health maintenance organization, 515.22 self-insured plan, or preferred provider organization. 515.23 Parents who have more than one child receiving services 515.24 shall not be required to pay more than the amount for the child 515.25 with the highest expenditures. There shall be no resource 515.26 contribution from the parents. The parent shall not be required 515.27 to pay a contribution in excess of the cost of the services 515.28 provided to the child, not counting payments made to school 515.29 districts for education-related services. Notice of an increase 515.30 in fee payment must be given at least 30 days before the 515.31 increased fee is due. 515.32 (i) The contribution under paragraph (b) shall be reduced 515.33 by $300 per fiscal year if, in the 12 months prior to July 1: 515.34 (1) the parent applied for insurance for the child; 515.35 (2) the insurer denied insurance; 515.36 (3) the parents submitted a complaint or appeal, in writing 516.1 to the insurer, submitted a complaint or appeal, in writing, to 516.2 the commissioner of health or the commissioner of commerce, or 516.3 litigated the complaint or appeal; and 516.4 (4) as a result of the dispute, the insurer reversed its 516.5 decision and granted insurance. 516.6 For purposes of this section, "insurance" has the meaning 516.7 given in paragraph (h). 516.8 A parent who has requested a reduction in the contribution 516.9 amount under this paragraph shall submit proof in the form and 516.10 manner prescribed by the commissioner or county agency, 516.11 including, but not limited to, the insurer's denial of 516.12 insurance, the written letter or complaint of the parents, court 516.13 documents, and the written response of the insurer approving 516.14 insurance. The determinations of the commissioner or county 516.15 agency under this paragraph are not rules subject to chapter 14. 516.16 [EFFECTIVE DATE.] This section is effective July 1, 2003. 516.17 Sec. 22. Minnesota Statutes 2002, section 253B.04, 516.18 subdivision 1, is amended to read: 516.19 Subdivision 1. [VOLUNTARY ADMISSION AND TREATMENT.] (a) 516.20 Voluntary admission is preferred over involuntary commitment and 516.21 treatment. Any person 16 years of age or older may request to 516.22 be admitted to a treatment facility as a voluntary patient for 516.23 observation, evaluation, diagnosis, care and treatment without 516.24 making formal written application. Any person under the age of 516.25 16 years may be admitted as a patient with the consent of a 516.26 parent or legal guardian if it is determined by independent 516.27 examination that there is reasonable evidence that (1) the 516.28 proposed patient has a mental illness, or is mentally retarded 516.29 or chemically dependent; and (2) the proposed patient is 516.30 suitable for treatment. The head of the treatment facility 516.31 shall not arbitrarily refuse any person seeking admission as a 516.32 voluntary patient. In making decisions regarding admissions, 516.33 the facility shall use clinical admission criteria consistent 516.34 with the current applicable inpatient admission standards 516.35 established by the American Psychiatric Association or the 516.36 American Academy of Child and Adolescent Psychiatry. These 517.1 criteria must be no more restrictive than, and must be 517.2 consistent with, the requirements of section 62Q.53. The 517.3 facility may not refuse to admit a person voluntarily solely 517.4 because the person does not meet the criteria for involuntary 517.5 holds under section 253B.05 or the definition of mental illness 517.6 under section 253B.02, subdivision 13. 517.7 (b) In addition to the consent provisions of paragraph (a), 517.8 a person who is 16 or 17 years of age who refuses to consent 517.9 personally to admission may be admitted as a patient for mental 517.10 illness or chemical dependency treatment with the consent of a 517.11 parent or legal guardian if it is determined by an independent 517.12 examination that there is reasonable evidence that the proposed 517.13 patient is chemically dependent or has a mental illness and is 517.14 suitable for treatment. The person conducting the examination 517.15 shall notify the proposed patient and the parent or legal 517.16 guardian of this determination. 517.17 (c) A person who is voluntarily participating in treatment 517.18 for a mental illness is not subject to civil commitment under 517.19 this chapter if the person: 517.20 (1) has given informed consent or, if lacking capacity, is 517.21 a person for whom legally valid substitute consent has been 517.22 given; and 517.23 (2) is participating in a medically appropriate course of 517.24 treatment, including clinically appropriate and lawful use of 517.25 neuroleptic medication and electroconvulsive therapy. 517.26 Notwithstanding this paragraph, the court may commit the 517.27 person if the court finds that, based on the person's recent 517.28 history, it is unlikely the person will remain in and cooperate 517.29 with treatment absent commitment. This paragraph does not apply 517.30 to a person for whom commitment proceedings are initiated 517.31 pursuant to rule 20.01 or 20.02 of the Rules of Criminal 517.32 Procedure, or a person found by the court to meet the 517.33 requirements under section 253B.02, subdivision 17. 517.34 Legally valid substitute consent may be provided by a proxy 517.35 under a health care directive, a guardian or conservator with 517.36 authority to consent to mental health treatment, or consent to 518.1 admission under subdivision 1a or 1b. 518.2 Sec. 23. Minnesota Statutes 2002, section 253B.05, 518.3 subdivision 3, is amended to read: 518.4 Subd. 3. [DURATION OF HOLD.] (a) Any person held pursuant 518.5 to this section may be held up to 72 hours, exclusive of 518.6 Saturdays, Sundays, and legal holidays after admission. If a 518.7 petition for the commitment of the person is filed in the 518.8 district court in the county of the person's residence or of the 518.9 county in which the treatment facility is located, the court may 518.10 issue a judicial hold order pursuant to section 253B.07, 518.11 subdivision 2b. 518.12 (b) During the 72-hour hold period, a court may not release 518.13 a person held under this section unless the court has received a 518.14 written petition for release and held a summary hearing 518.15 regarding the release. The petition must include the name of 518.16 the person being held, the basis for and location of the hold, 518.17 and a statement as to why the hold is improper. The petition 518.18 also must include copies of any written documentation under 518.19 subdivision 1 or 2 in support of the hold, unless the person 518.20 holding the petitioner refuses to supply the documentation. The 518.21 hearing must be held as soon as practicable and may be conducted 518.22 by means of a telephone conference call or similar method by 518.23 which the participants are able to simultaneously hear each 518.24 other. If the court decides to release the person, the court 518.25 shall direct the release and shall issue written findings 518.26 supporting the decision. The release may not be delayed pending 518.27 the written order. Before deciding to release the person, the 518.28 court shall make every reasonable effort to provide notice of 518.29 the proposed release to: 518.30 (1) any specific individuals identified in a statement 518.31 under subdivision 1 or 2 or individuals identified in the record 518.32 who might be endangered if the person was not held; 518.33 (2) the examiner whose written statement was a basis for a 518.34 hold under subdivision 1; and 518.35 (3) the peace or health officer who applied for a hold 518.36 under subdivision 2. 519.1 (c) If a person is intoxicated in public and held under 519.2 this section for detoxification, a treatment facility may 519.3 release the person without providing notice under paragraph (d) 519.4 as soon as the treatment facility determines the person is no 519.5 longer intoxicated. 519.6(c)(d) If a treatment facility releases a person during 519.7 the 72-hour hold period, the head of the treatment facility 519.8 shall immediately notify the agency which employs the peace or 519.9 health officer who transported the person to the treatment 519.10 facility under this section. 519.11 (e) A person held under a 72-hour emergency hold must be 519.12 released by the facility within 72 hours unless a court order to 519.13 hold the person is obtained. A consecutive emergency hold order 519.14 under this section may not be issued. 519.15 Sec. 24. Minnesota Statutes 2002, section 256.012, is 519.16 amended to read: 519.17 256.012 [MINNESOTA MERIT SYSTEM.] 519.18 Subdivision 1. [PERSONNEL STANDARDS.] The commissioner of 519.19 human services shall promulgate by rule personnel standards on a 519.20 merit basis in accordance with federal standards for a merit 519.21 system of personnel administration for all employees of county 519.22 boards engaged in the administration of community social 519.23 services or income maintenance programs, all employees of human 519.24 services boards that have adopted the rules of the Minnesota 519.25 merit system, and all employees of local social services 519.26 agencies. 519.27 Excluded from the rules are employees of institutions and 519.28 hospitals under the jurisdiction of the aforementioned boards 519.29 and agencies; employees of county personnel systems otherwise 519.30 provided for by law that meet federal merit system requirements; 519.31 duly appointed or elected members of the aforementioned boards 519.32 and agencies; and the director of community social services and 519.33 employees in positions that, upon the request of the appointing 519.34 authority, the commissioner chooses to exempt, provided the 519.35 exemption accords with the federal standards for a merit system 519.36 of personnel administration. 520.1 Subd. 2. [PAYMENT FOR SERVICES PROVIDED.] (a) The cost of 520.2 merit system operations shall be paid by counties and other 520.3 entities that utilize merit system services. Total costs shall 520.4 be determined by the commissioner annually and must be set at a 520.5 level that neither significantly over-recovers nor 520.6 under-recovers the costs of providing the service. The costs of 520.7 merit system services shall be prorated among participating 520.8 counties in accordance with an agreement between the 520.9 commissioner and these counties. Participating counties will be 520.10 billed quarterly in advance and shall pay their share of the 520.11 costs upon receipt of the billing. 520.12 (b) This subdivision does not apply to counties with 520.13 personnel systems otherwise provided by law that meet federal 520.14 merit system requirements. A county that applies to withdraw 520.15 from the merit system must notify the commissioner of the 520.16 county's intent to develop its own personnel system. This 520.17 notice must be provided in writing by December 31 of the year 520.18 preceding the year of final participation in the merit system. 520.19 The county may withdraw after the commissioner has certified 520.20 that its personnel system meets federal merit system 520.21 requirements. 520.22 (c) A county merit system operations account is established 520.23 in the special revenue fund. Payments received by the 520.24 commissioner for merit system costs must be deposited in the 520.25 merit system operations account and must be used for the purpose 520.26 of providing the services and administering the merit system. 520.27 (d) County payment of merit system costs is effective July 520.28 1, 2003, however payment for the period from July 1, 2003 520.29 through December 31, 2003, shall be made no later than January 520.30 31, 2004. 520.31 Subd. 3. [PARTICIPATING COUNTY CONSULTATION.] The 520.32 commissioner shall ensure that participating counties are 520.33 consulted regularly and offered the opportunity to provide input 520.34 on the management of the merit system to ensure effective use of 520.35 resources and to monitor system performance. 520.36 Sec. 25. Minnesota Statutes 2002, section 256.935, 521.1 subdivision 1, is amended to read: 521.2 Subdivision 1. [FUNERALBURIAL OR CREMATION EXPENSES.] On 521.3 the death of any person receiving public assistance through 521.4 MFIP, the county agency shall pay an amount forfuneralburial 521.5 or cremation expenses not exceeding the amount paid for 521.6 comparable services under section 261.035 plus actual cemetery 521.7 charges. The county agency may pay for cremation instead of 521.8 burial expenses being respectful of cultural and religious 521.9 preferences of the decedent or the decedent's next of kin. No 521.10funeralburial or cremation expenses shall be paid if the estate 521.11 of the deceased is sufficient to pay such expenses or if the 521.12 spouse, who was legally responsible for the support of the 521.13 deceased while living, is able to pay such expenses; provided,521.14that the additional payment or donation of the cost of cemetery521.15lot, interment, religious service, or for the transportation of521.16the body into or out of the community in which the deceased521.17resided, shall not limit payment by the county agency as herein521.18authorized. Freedom of choice in the selection of a funeral521.19director shall be granted to persons lawfully authorized to make521.20arrangements for the burial of any such deceased recipient. In 521.21 determining the sufficiency of such estate, due regard shall be 521.22 had for the nature and marketability of the assets of the 521.23 estate. The county agency may grantfuneralburial or cremation 521.24 expenses where the sale would cause undue loss to the estate. 521.25 Any amount paid forfuneralburial or cremation expenses shall 521.26 be a prior claim against the estate, as provided in section 521.27 524.3-805, and any amount recovered shall be reimbursed to the 521.28 agency which paid the expenses.The commissioner shall specify521.29requirements for reports, including fiscal reports, according to521.30section 256.01, subdivision 2, paragraph (17). The state share521.31shall pay the entire amount of county agency expenditures.521.32 Benefits shall be issued to recipients by thestate orcounty 521.33 subject to provisions of section 256.017. 521.34 Sec. 26. Minnesota Statutes 2002, section 256B.0911, 521.35 subdivision 3, is amended to read: 521.36 Subd. 3. [LONG-TERM CARE CONSULTATION TEAM.](a)A 522.1 long-term care consultation team shall be established by the 522.2 county board of commissioners. Each local consultation team 522.3 shall consist of at least one social worker and at least one 522.4 public health nurse from their respective county agencies. The 522.5 board may designate public health or social services as the lead 522.6 agency for long-term care consultation services. If a county 522.7 does not have a public health nurse available, it may request 522.8 approval from the commissioner to assign a county registered 522.9 nurse with at least one year experience in home care to 522.10 participate on the team. Two or more counties may collaborate 522.11 to establish a joint local consultation team or teams. 522.12(b) The team is responsible for providing long-term care522.13consultation services to all persons located in the county who522.14request the services, regardless of eligibility for Minnesota522.15health care programs.522.16 Sec. 27. Minnesota Statutes 2002, section 256F.13, 522.17 subdivision 1, is amended to read: 522.18 Subdivision 1. [FEDERAL REVENUE ENHANCEMENT.] (a) [DUTIES 522.19 OF COMMISSIONER OF HUMAN SERVICES.] The commissioner of human 522.20 services may enter into an agreement with one or more family 522.21 services collaboratives to enhance federal reimbursement under 522.22 Title IV-E of the Social Security Act and federal administrative 522.23 reimbursement under Title XIX of the Social Security Act. The 522.24 commissioner may contract with the department of children, 522.25 families, and learning for purposes of transferring the federal 522.26 reimbursement to the commissioner of children, families, and 522.27 learning to be distributed to the collaboratives according to 522.28 clause (2). The commissioner shall have the following authority 522.29 and responsibilities regarding family services collaboratives: 522.30 (1) the commissioner shall submit amendments to state plans 522.31 and seek waivers as necessary to implement the provisions of 522.32 this section; 522.33 (2) the commissioner shall pay the federal reimbursement 522.34 earned under this subdivision to each collaborative based on 522.35 their earnings. Payments to collaboratives for expenditures 522.36 under this subdivision will only be made of federal earnings 523.1 from services provided by the collaborative; 523.2 (3) the commissioner shall review expenditures of family 523.3 services collaboratives using reports specified in the agreement 523.4 with the collaborative to ensurethat the base level of523.5expenditures is continued andnew federal reimbursement is used 523.6 toexpandfund education, social, health, or health-related 523.7 services to young children and their families; 523.8 (4)the commissioner may reduce, suspend, or eliminate a523.9family services collaborative's obligations to continue the base523.10level of expenditures or expansion of services if the523.11commissioner determines that one or more of the following523.12conditions apply:523.13(i) imposition of levy limits that significantly reduce523.14available funds for social, health, or health-related services523.15to families and children;523.16(ii) reduction in the net tax capacity of the taxable523.17property eligible to be taxed by the lead county or523.18subcontractor that significantly reduces available funds for523.19education, social, health, or health-related services to523.20families and children;523.21(iii) reduction in the number of children under age 19 in523.22the county, collaborative service delivery area, subcontractor's523.23district, or catchment area when compared to the number in the523.24base year using the most recent data provided by the state523.25demographer's office; or523.26(iv) termination of the federal revenue earned under the523.27family services collaborative agreement;523.28(5)the commissioner shall not use the federal 523.29 reimbursement earned under this subdivision in determining the 523.30 allocation or distribution of other funds to counties or 523.31 collaboratives; 523.32(6)(5) the commissioner may suspend, reduce, or terminate 523.33 the federal reimbursement to a provider that does not meet the 523.34 reporting or other requirements of this subdivision; 523.35(7)(6) the commissioner shall recover from the family 523.36 services collaborative any federal fiscal disallowances or 524.1 sanctions for audit exceptions directly attributable to the 524.2 family services collaborative's actions in the integrated fund, 524.3 or the proportional share if federal fiscal disallowances or 524.4 sanctions are based on a statewide random sample; and 524.5(8)(7) the commissioner shall establish criteria for the 524.6 family services collaborative for the accounting and financial 524.7 management system that will support claims for federal 524.8 reimbursement. 524.9 (b) [FAMILY SERVICES COLLABORATIVE RESPONSIBILITIES.] The 524.10 family services collaborative shall have the following authority 524.11 and responsibilities regarding federal revenue enhancement: 524.12 (1) the family services collaborative shall be the party 524.13 with which the commissioner contracts. A lead county shall be 524.14 designated as the fiscal agency for reporting, claiming, and 524.15 receiving payments; 524.16 (2) the family services collaboratives may enter into 524.17 subcontracts with other counties, school districts, special 524.18 education cooperatives, municipalities, and other public and 524.19 nonprofit entities for purposes of identifying and claiming 524.20 eligible expenditures to enhance federal reimbursement, or to 524.21 expand education, social, health, or health-related services to 524.22 families and children; 524.23 (3)the family services collaborative must continue the524.24base level of expenditures for education, social, health, or524.25health-related services to families and children from any state,524.26county, federal, or other public or private funding source524.27which, in the absence of the new federal reimbursement earned524.28under this subdivision, would have been available for those524.29services, except as provided in subdivision 1, paragraph (a),524.30clause (4). The base year for purposes of this subdivision524.31shall be the four-quarter calendar year ending at least two524.32calendar quarters before the first calendar quarter in which the524.33new federal reimbursement is earned;524.34 (4) the family services collaborative must use all new 524.35 federal reimbursement resulting from federal revenue enhancement 524.36 toexpandmake expenditures for education, social, health, or 525.1 health-related services to families and childrenbeyond the base525.2level, except as provided in subdivision 1, paragraph (a),525.3clause (4); 525.4 (5) the family services collaborative must ensure that 525.5 expenditures submitted for federal reimbursement are not made 525.6 from federal funds or funds used to match other federal funds. 525.7 Notwithstanding section 256B.19, subdivision 1, for the purposes 525.8 of family services collaborative expenditures under agreement 525.9 with the department, the nonfederal share of costs shall be 525.10 provided by the family services collaborative from sources other 525.11 than federal funds or funds used to match other federal funds; 525.12 (6) the family services collaborative must develop and 525.13 maintain an accounting and financial management system adequate 525.14 to support all claims for federal reimbursement, including a 525.15 clear audit trail and any provisions specified in the agreement; 525.16 and 525.17 (7) the family services collaborative shall submit an 525.18 annual report to the commissioner as specified in the agreement. 525.19 Sec. 28. Minnesota Statutes 2002, section 256F.13, 525.20 subdivision 2, is amended to read: 525.21 Subd. 2. [AGREEMENTS WITH FAMILY SERVICES COLLABORATIVES.] 525.22 At a minimum, the agreement between the commissioner and the 525.23 family services collaborative shall include the following 525.24 provisions: 525.25 (1) specific documentation of the expenditures eligible for 525.26 federal reimbursement; 525.27 (2) the process for developing and submitting claims to the 525.28 commissioner; 525.29 (3) specific identification of the education, social, 525.30 health, or health-related services to families and children 525.31 which areto be expandedfunded with the federal reimbursement; 525.32 (4) reporting and review proceduresensuring that the525.33family services collaborative must continue the base level of525.34expenditures for the education, social, health, or525.35health-related services for families and children as specified525.36in subdivision 2, clause (3)that emphasize the minimum number 526.1 of data elements necessary; 526.2 (5) reporting and review procedures to ensure that federal 526.3 revenue earned under this section is spent specifically to 526.4expandfund education, social, health, or health-related 526.5 services for families and children as specified in subdivision 526.6 2, clause (4); 526.7 (6) the period of time, not to exceed three years, 526.8 governing the terms of the agreement and provisions for 526.9 amendments to, and renewal of the agreement; and 526.10 (7) an annual report prepared by the family services 526.11 collaborative. 526.12 Sec. 29. Minnesota Statutes 2002, section 261.035, is 526.13 amended to read: 526.14 261.035 [FUNERALSBURIAL AT EXPENSE OF COUNTY.] 526.15 When a person dies in any county without apparent means to 526.16 provide for that person'sfuneral or final dispositionburial or 526.17 cremation, the county board shall first investigate to determine 526.18 whether that person had contracted for any prepaid funeral 526.19 arrangements. If arrangements have been made, the county shall 526.20 authorize arrangements to be implemented in accord with the 526.21 instructions of the deceased. If it is determined that the 526.22 person did not leave sufficient means to defray the necessary 526.23 expenses of afuneral and final dispositionburial or cremation, 526.24 nor any spouse of sufficient ability to procure the burial or 526.25 cremation, the county board shall provide for afuneral and526.26final dispositionburial or cremation, being respectful of 526.27 cultural and religious preferences, of the person's remains to 526.28 be made at the expense of the county. Anyfuneral and final526.29dispositionburial or cremation provided at the expense of the 526.30 county shall be in accordance with religious and moral beliefs 526.31 of the decedentor the decedent's spouse or the decedent's next526.32of kin. If the wishes of the decedent are not known and the 526.33 county has no information about the existence of or location of 526.34 any next of kin, the county may determine the method of final 526.35 disposition. 526.36 Sec. 30. Minnesota Statutes 2002, section 393.07, 527.1 subdivision 1, is amended to read: 527.2 Subdivision 1. [PUBLIC CHILD WELFARE PROGRAM.] (a) To 527.3 assist in carrying out the child protection, delinquency 527.4 prevention and family assistance responsibilities of the state, 527.5 the local social services agency shall administer a program of 527.6 social services and financial assistance to be known as the 527.7 public child welfare program. The public child welfare program 527.8 shall be supervised by the commissioner of human services and 527.9 administered by the local social services agency in accordance 527.10 with law and with rules of the commissioner. 527.11 (b) The purpose of the public child welfare program is to 527.12 assure protection for and financial assistance to children who 527.13 are confronted with social, physical, or emotional problems 527.14 requiring protection and assistance. These problems include, 527.15 but are not limited to the following: 527.16 (1) mental, emotional, or physical handicap; 527.17 (2) birth of a child to a mother who was not married to the 527.18 child's father when the child was conceived nor when the child 527.19 was born, including but not limited to costs of prenatal care, 527.20 confinement and other care necessary for the protection of a 527.21 child born to a mother who was not married to the child's father 527.22 at the time of the child's conception nor at the birth; 527.23 (3) dependency, neglect; 527.24 (4) delinquency; 527.25 (5) abuse or rejection of a child by its parents; 527.26 (6) absence of a parent or guardian able and willing to 527.27 provide needed care and supervision; 527.28 (7) need of parents for assistance with child rearing 527.29 problems, or in placing the child in foster care. 527.30 (c) A local social services agency shall make the services 527.31 of its public child welfare program available as required by 527.32 law, by the commissioner, or by the courts and shall cooperate 527.33 with other agencies, public or private, dealing with the 527.34 problems of children and their parents as provided in this 527.35 subdivision. 527.36The public child welfare program shall be available in528.1divorce cases for investigations of children and home conditions528.2and for supervision of children when directed by the court528.3hearing the divorce.528.4 (d) A local social services agency may rent, lease, or 528.5 purchase property, or in any other way approved by the 528.6 commissioner, contract with individuals or agencies to provide 528.7 needed facilities for foster care of children. It may purchase 528.8 services or child care from duly authorized individuals, 528.9 agencies or institutions when in its judgment the needs of a 528.10 child or the child's family can best be met in this way. 528.11 Sec. 31. Minnesota Statutes 2002, section 393.07, 528.12 subdivision 5, is amended to read: 528.13 Subd. 5. [COMPLIANCE WITH FEDERAL SOCIAL SECURITY ACT; 528.14 MERIT SYSTEM.] The commissioner of human services shall have 528.15 authority to require such methods of administration as are 528.16 necessary for compliance with requirements of the federal Social 528.17 Security Act, as amended, and for the proper and efficient 528.18 operation of all welfare programs. This authority to require 528.19 methods of administration includes methods relating to the 528.20 establishment and maintenance of personnel standards on a merit 528.21 basis as concerns all employees of local social services 528.22 agencies except those employed in an institution, sanitarium, or 528.23 hospital. The commissioner of human services shall exercise no 528.24 authority with respect to the selection, tenure of office, and 528.25 compensation of any individual employed in accordance with such 528.26 methods. The adoption of methods relating to the establishment 528.27 and maintenance of personnel standards on a merit basis of all 528.28 such employees of the local social services agencies and the 528.29 examination thereof, and the administration thereof shall be 528.30 directed and controlled exclusively by the commissioner of human 528.31 services. 528.32 Notwithstanding the provisions of any other law to the 528.33 contrary, every employee of every local social services agency 528.34 who occupies a position which requires as prerequisite to 528.35 eligibility therefor graduation from an accredited four year 528.36 college or a certificate of registration as a registered nurse 529.1 under section 148.231, must be employed in such position under 529.2 the merit system established under authority of this 529.3 subdivision. Every such employee now employed by a local social 529.4 services agency and who is not under said merit system is 529.5 transferred, as of January 1, 1962, to a position of comparable 529.6 classification in the merit system with the same status therein 529.7 as the employee had in the county of employment prior thereto 529.8 and every such employee shall be subject to and have the benefit 529.9 of the merit system, including seniority within the local social 529.10 services agency, as though the employee had served thereunder 529.11 from the date of entry into the service of the local social 529.12 services agency. 529.13By March 1, 1996, the commissioner of human services shall529.14report to the chair of the senate health care and family529.15services finance division and the chair of the house health and529.16human services finance division on options for the delivery of529.17merit-based employment services by entities other than the529.18department of human services in order to reduce the529.19administrative costs to the state while maintaining compliance529.20with applicable federal regulations.529.21 Sec. 32. Minnesota Statutes 2002, section 518.167, 529.22 subdivision 1, is amended to read: 529.23 Subdivision 1. [COURT ORDER.] In contested custody 529.24 proceedings, and in other custody proceedings if a parent or the 529.25 child's custodian requests, the court may order an investigation 529.26 and report concerning custodial arrangements for the child. If 529.27 the county elects to conduct an investigation, the county may 529.28 charge a fee. The investigation and report may be made by the 529.29 county welfare agency or department of court services or a 529.30 private vendor. 529.31 Sec. 33. Minnesota Statutes 2002, section 518.551, 529.32 subdivision 7, is amended to read: 529.33 Subd. 7. [SERVICE FEEFEES AND COST RECOVERY FEES FOR IV-D 529.34 SERVICES.]When the public agency responsible for child support529.35enforcement provides child support collection services either to529.36a public assistance recipient or to a party who does not receive530.1public assistance, the public agency may upon written notice to530.2the obligor charge a monthly collection fee equivalent to the530.3full monthly cost to the county of providing collection530.4services, in addition to the amount of the child support which530.5was ordered by the court. The fee shall be deposited in the530.6county general fund. The service fee assessed is limited to ten530.7percent of the monthly court ordered child support and shall not530.8be assessed to obligors who are current in payment of the530.9monthly court ordered child support.(a) When a recipient of 530.10 IV-D services is no longer receiving assistance under the 530.11 state's title IV-A, IV-E foster care, medical assistance, or 530.12 MinnesotaCare programs, the public authority responsible for 530.13 child support enforcement must notify the recipient, within five 530.14 working days of the notification of ineligibility, that IV-D 530.15 services will be continued unless the public authority is 530.16 notified to the contrary by the recipient. The notice must 530.17 include the implications of continuing to receive IV-D services, 530.18 including the available services and fees, cost recovery fees, 530.19 and distribution policies relating to fees. 530.20 (b) An application fee of $25 shall be paid by the person 530.21 who applies for child support and maintenance collection 530.22 services, except persons who are receiving public assistance as 530.23 defined in section 256.741 and, if enacted, the diversionary 530.24 work program under section 256J.95, persons who transfer from 530.25 public assistance to nonpublic assistance status, and minor 530.26 parents and parents enrolled in a public secondary school, area 530.27 learning center, or alternative learning program approved by the 530.28 commissioner of children, families, and learning. 530.29 (c) When the public authority provides full IV-D services 530.30 to an obligee who has applied for those services, upon written 530.31 notice to the obligee, the public authority must charge a cost 530.32 recovery fee of two percent of the amount collected. This fee 530.33 must be deducted from the amount of the child support and 530.34 maintenance collected and not assigned under section 256.741, 530.35 before disbursement to the obligee. This fee does not apply to 530.36 an obligee who: 531.1 (1) is currently receiving assistance under the state's 531.2 title IV-A, IV-E foster care, medical assistance, or 531.3 MinnesotaCare programs; or 531.4 (2) has received assistance under the state's title IV-A or 531.5 IV-E foster care programs, until the person has not received 531.6 this assistance for 24 consecutive months. 531.7 (d) When the public authority provides full IV-D services 531.8 to an obligor who has applied for such services, upon written 531.9 notice to the obligor, the public authority must charge a cost 531.10 recovery fee of two percent of the monthly court ordered child 531.11 support and maintenance obligation. The fee may be collected 531.12 through income withholding, as well as by any other enforcement 531.13 remedy available to the public authority responsible for child 531.14 support enforcement. 531.15 (e) Fees assessed by state and federal tax agencies for 531.16 collection of overdue support owed to or on behalf of a person 531.17 not receiving public assistance must be imposed on the person 531.18 for whom these services are provided. The public authority upon 531.19 written notice to the obligee shall assess a fee of $25 to the 531.20 person not receiving public assistance for each successful 531.21 federal tax interception. The fee must be withheld prior to the 531.22 release of the funds received from each interception and 531.23 deposited in the general fund. 531.24 (f) Cost recovery fees collected under paragraphs (c) and 531.25 (d) shall be considered child support program income according 531.26 to Code of Federal Regulations, title 45, section 304.50, and 531.27 shall be deposited in the cost recovery fee account established 531.28 under paragraph (h). The commissioner of human services must 531.29 elect to recover costs based on either actual or standardized 531.30 costs. 531.31However,(g) The limitations of this subdivision on the 531.32 assessment of fees shall not apply to the extent inconsistent 531.33 with the requirements of federal law for receiving funds for the 531.34 programs under Title IV-A and Title IV-D of the Social Security 531.35 Act, United States Code, title 42, sections 601 to 613 and 531.36 United States Code, title 42, sections 651 to 662. 532.1 (h) The commissioner of human services is authorized to 532.2 establish a special revenue fund account to receive child 532.3 support cost recovery fees. A portion of the nonfederal share 532.4 of these fees may be retained for expenditures necessary to 532.5 administer the fee, and must be transferred to the child support 532.6 system special revenue account. The remaining nonfederal share 532.7 of the cost recovery fee must be retained by the commissioner 532.8 and dedicated to the child support general fund county 532.9 performance based grant account authorized under sections 532.10 256.979 and 256.9791. 532.11 [EFFECTIVE DATE.] This section is effective July 1, 2004, 532.12 except paragraph (d) is effective July 1, 2005. 532.13 Sec. 34. Minnesota Statutes 2002, section 518.6111, 532.14 subdivision 2, is amended to read: 532.15 Subd. 2. [APPLICATION.] This section applies to all 532.16 support orders issued by a court or an administrative tribunal 532.17 and orders for or notices of withholding issued by the public 532.18 authorityaccording to section 518.5513, subdivision 5,532.19paragraph (a), clause (5). 532.20 [EFFECTIVE DATE.] This section is effective July 1, 2004. 532.21 Sec. 35. Minnesota Statutes 2002, section 518.6111, 532.22 subdivision 3, is amended to read: 532.23 Subd. 3. [ORDER.] Every support order must address income 532.24 withholding. Whenever a support order is initially entered or 532.25 modified, the full amount of the support order must be 532.26withheldsubject to income withholding from the income of the 532.27 obligor. If the obligee or obligor applies for either full IV-D 532.28 services or for income withholding only services from the public 532.29 authority responsible for child support enforcement, the full 532.30 amount of the support order must be withheld from the income of 532.31 the obligor and forwarded to the public authority. Every order 532.32 for support or maintenance shall provide for a conspicuous 532.33 notice of the provisions of this section that complies with 532.34 section 518.68, subdivision 2. An order without this notice 532.35 remains subject to this section. This section applies 532.36 regardless of the source of income of the person obligated to 533.1 pay the support or maintenance. 533.2 A payor of funds shall implement income withholding 533.3 according to this section upon receipt of an order for or notice 533.4 of withholding. The notice of withholding shall be on a form 533.5 provided by the commissioner of human services. 533.6 [EFFECTIVE DATE.] This section is effective July 1, 2004. 533.7 Sec. 36. Minnesota Statutes 2002, section 518.6111, 533.8 subdivision 4, is amended to read: 533.9 Subd. 4. [COLLECTION SERVICES.] (a) The commissioner of 533.10 human services shall prepare and make available to the courts a 533.11 notice of services that explains child support and maintenance 533.12 collection services available through the public authority, 533.13 including income withholding, and the fees for such services. 533.14 Upon receiving a petition for dissolution of marriage or legal 533.15 separation, the court administrator shall promptly send the 533.16 notice of services to the petitioner and respondent at the 533.17 addresses stated in the petition. 533.18 (b) Either the obligee or obligor may at any time apply to 533.19 the public authority for either full IV-D services or for income 533.20 withholding only services. 533.21Upon receipt of a support order requiring income533.22withholding, a petitioner or respondent, who is not a recipient533.23of public assistance and does not receive child support services533.24from the public authority, shall apply to the public authority533.25for either full child support collection services or for income533.26withholding only services.533.27 (c) For those persons applying for income withholding only 533.28 services, a monthly service fee of $15 must be charged to the 533.29 obligor. This fee is in addition to the amount of the support 533.30 order and shall be withheld through income withholding. The 533.31 public authority shall explain the service options in this 533.32 section to the affected parties and encourage the application 533.33 for full child support collection services. 533.34 (d) If the obligee is not a current recipient of public 533.35 assistance as defined in section 256.741, the person who applied 533.36 for services may at any time choose to terminate either full 534.1 IV-D services or income withholding only services regardless of 534.2 whether income withholding is currently in place. The obligee 534.3 or obligor may reapply for either full IV-D services or income 534.4 withholding only services at any time. Unless the applicant is 534.5 a recipient of public assistance as defined in section 256.741, 534.6 a $25 application fee shall be charged at the time of each 534.7 application. 534.8 (e) When a person terminates IV-D services, if an arrearage 534.9 for public assistance as defined in section 256.741 exists, the 534.10 public authority may continue income withholding, as well as use 534.11 any other enforcement remedy for the collection of child 534.12 support, until all public assistance arrears are paid in full. 534.13 Income withholding shall be in an amount equal to 20 percent of 534.14 the support order in effect at the time the services terminated. 534.15 [EFFECTIVE DATE.] This section is effective July 1, 2004. 534.16 Sec. 37. Minnesota Statutes 2002, section 518.6111, 534.17 subdivision 16, is amended to read: 534.18 Subd. 16. [WAIVER.] (a) If the public authority is 534.19 providing child support and maintenance enforcement services and 534.20 child support or maintenance is not assigned under section 534.21 256.741, the court may waive the requirements of this section if 534.22the court finds there is no arrearage in child support and534.23maintenance as of the date of the hearing and: 534.24 (1) one party demonstrates and the courtfindsdetermines 534.25 there is good cause to waive the requirements of this section or 534.26 to terminate an order for or notice of income withholding 534.27 previously entered under this section. The court must make 534.28 written findings to include the reasons income withholding would 534.29 not be in the best interests of the child. In cases involving a 534.30 modification of support, the court must also make a finding that 534.31 support payments have been timely made; or 534.32 (2)all parties reach anthe obligee and obligor sign a 534.33 written agreementand the agreementproviding for an alternative 534.34 payment arrangement which isapprovedreviewed and entered in 534.35 the record by the courtafter a finding that the agreement is534.36likely to result in regular and timely payments. The court's535.1findings waiving the requirements of this paragraph shall535.2include a written explanation of the reasons why income535.3withholding would not be in the best interests of the child. 535.4In addition to the other requirements in this subdivision,535.5if the case involves a modification of support, the court shall535.6make a finding that support has been timely made.535.7 (b) If the public authority is not providing child support 535.8 and maintenance enforcement services and child support or 535.9 maintenance is not assigned under section 256.741, the court may 535.10 waive the requirements of this section if the parties sign a 535.11 written agreement. 535.12 (c) If the court waives income withholding, the obligee or 535.13 obligor may at any time request income withholding under 535.14 subdivision 7. 535.15 [EFFECTIVE DATE.] This section is effective July 1, 2004. 535.16 Sec. 38. [MANDATE IDENTIFICATION; REPORT TO LEGISLATURE.] 535.17 The commissioners of health and human services must 535.18 identify required state services or programs in law or rule that 535.19 are under each agency's respective jurisdictions, the 535.20 administration or provision of which the state has delegated to 535.21 the counties. For each state-mandated service or program, the 535.22 commissioner must describe: 535.23 (1) the year enacted and the scope of the service or 535.24 program; 535.25 (2) the funding sources for the service or program; and 535.26 (3) related federal requirements and support. 535.27 The commissioners must seek the advice of the county officials 535.28 knowledgeable about the state-mandated services and programs, 535.29 county associations, consumer representatives, and service or 535.30 program providers. Each commissioner must submit a report to 535.31 the house and senate committees with jurisdiction over the 535.32 budget of departments of health and human services by January 535.33 15, 2004. 535.34 [EFFECTIVE DATE; EXPIRATION DATE.] This section is 535.35 effective the day following final enactment and expires June 30, 535.36 2005. 536.1 Sec. 39. [STATE-OPERATED SERVICES STUDY.] 536.2 (a) Before restructuring state-operated services, 536.3 redesigning the mental health safety net, or reducing reliance 536.4 on large institutions, the commissioner shall review and study 536.5 the President's New Freedom Commission on Mental Health final 536.6 report. The commissioner shall report on whether the 536.7 commissioner's plan to restructure state-operated services is 536.8 consistent with the recommendations in the final report and how 536.9 the state can implement the recommendations in the final report. 536.10 (b) The commissioner of human services shall study 536.11 alternate methods of providing services to persons with 536.12 developmental disabilities served by state-operated community 536.13 services (SOCS) and other providers, including, but not limited 536.14 to, the needs of the persons served, the cost effectiveness of 536.15 the services provided, whether alternate populations can be 536.16 served in SOCS, and if the services could be privatized. The 536.17 commissioner shall also study the Minnesota extended treatment 536.18 options, including an analysis of the population served by the 536.19 program and the effectiveness of the program. The commissioner 536.20 shall report on the results of the study under this section to 536.21 the chairs of the house and senate committees with jurisdiction 536.22 over state-operated services by January 15, 2004. 536.23 Sec. 40. [REDUCING DUPLICATIVE HEALTH AND HUMAN SERVICES 536.24 LICENSING ACTIVITIES; REPORT TO LEGISLATURE.] 536.25 (a) The commissioners of health and human services shall 536.26 submit a report to the chairs of the house and senate committees 536.27 with jurisdiction over health and human services licensing by 536.28 December 15, 2003, regarding how to reduce duplicative licensing 536.29 activities by the departments of health and human services. 536.30 (b) The report must include draft legislation providing for: 536.31 (1) the licensure of intermediate care facilities for 536.32 persons with mental retardation or related conditions or ICFs/MR 536.33 by either the commissioner of health or human services. In 536.34 developing the draft legislation, the commissioners, in 536.35 consultation with provider and advocacy organizations, shall 536.36 review: 537.1 (i) current state regulations enforced by the commissioner 537.2 of human services under Minnesota Statutes, chapter 245B; the 537.3 psychotropic medication use checklist under Minnesota Statutes, 537.4 section 245B.02, subdivision 19; and Minnesota Rules, parts 537.5 9525.2700 to 9525.2810, governing the use of aversive and 537.6 deprivation procedures; and 537.7 (ii) current state regulations enforced by the commissioner 537.8 of health under Minnesota Statutes, chapter 144, and Minnesota 537.9 Rules, chapter 4665. 537.10 The draft legislation must codify the regulations and 537.11 provisions listed in items (i) and (ii) in Minnesota Statutes, 537.12 chapter 144 or 245B, depending upon which commissioner is 537.13 recommended to license ICFs/MR. The draft legislation also must 537.14 repeal all rules made obsolete by the proposed codification of 537.15 the regulations; and 537.16 (2) the licensure of residential adult mental illness 537.17 treatment programs and chemical dependency treatment programs by 537.18 the commissioner of human services. The commissioners, in 537.19 consultation with provider and advocacy organizations, shall 537.20 review current regulations enforced by the commissioner of 537.21 health in nonhospital-based residential adult mental illness and 537.22 chemical dependency treatment programs to determine whether the 537.23 commissioner of human services should enforce the regulations. 537.24 If the commissioners determine that the commissioner of human 537.25 services should enforce the regulations, the draft legislation 537.26 must address how the provisions in the regulations should be 537.27 codified in Minnesota Statutes, chapter 245A. 537.28 (c) The report also must include an analysis of: 537.29 (1) whether the international fire and building codes, 537.30 effective in calendar year 2003, provide comparable and adequate 537.31 physical plant safeguards when compared to the supervised living 537.32 facility class B licensing standards. The commissioner must 537.33 analyze whether a board and lodging license combined with a 537.34 human services program license will maintain at least the 537.35 current safety levels in supervised living facility class B 537.36 facilities. If the commissioners determine that there is likely 538.1 no adverse effect on the health and safety of persons receiving 538.2 services from the adult mental illness or chemical dependency 538.3 programs or ICFs/MR, the draft legislation must repeal the 538.4 supervised living facility regulations and require board and 538.5 lodging licensure for these programs; and 538.6 (2) the funding implications for any proposed change to the 538.7 commissioners' responsibilities for licensing activities, 538.8 including the impact on the general fund and the state 538.9 government special revenue fund. 538.10 Sec. 41. [REVISOR'S INSTRUCTION.] 538.11 For sections in Minnesota Statutes and Minnesota Rules 538.12 affected by the repealed sections in this article, the revisor 538.13 shall delete internal cross-references where appropriate and 538.14 make changes necessary to correct the punctuation, grammar, or 538.15 structure of the remaining text and preserve its meaning. 538.16 Sec. 42. [REPEALER.] 538.17 (a) Minnesota Statutes 2002, sections 145A.17, subdivision 538.18 9; 245.478; 245.4888; 245.714; 256B.0945, subdivisions 6, 7, 8, 538.19 and 10; 256B.83; and 256F.10, subdivision 7, are repealed. 538.20 (b) Minnesota Rules, parts 9545.2000; 9545.2010; 9545.2020; 538.21 9545.2030; and 9545.2040, are repealed. 538.22 ARTICLE 8 538.23 HEALTH DEPARTMENT MISCELLANEOUS 538.24 Section 1. Minnesota Statutes 2002, section 62A.65, 538.25 subdivision 7, is amended to read: 538.26 Subd. 7. [SHORT-TERM COVERAGE.] (a) For purposes of this 538.27 section, "short-term coverage" means an individual health plan 538.28 that: 538.29 (1) is issued to provide coverage for a period of 185 days 538.30 or less, except that the health plan may permit coverage to 538.31 continue until the end of a period of hospitalization for a 538.32 condition for which the covered person was hospitalized on the 538.33 day that coverage would otherwise have ended; 538.34 (2) is nonrenewable, provided that the health carrier may 538.35 provide coverage for one or more subsequent periods that satisfy 538.36 clause (1), if the total of the periods of coverage do not 539.1 exceed a total of185555 days out of any365-day730-day 539.2 period, plus any additional days covered as a result of 539.3 hospitalization on the day that a period of coverage would 539.4 otherwise have ended; 539.5 (3) does not cover any preexisting conditions, including 539.6 ones that originated during a previous identical policy or 539.7 contract with the same health carrier where coverage was 539.8 continuous between the previous and the current policy or 539.9 contract; and 539.10 (4) is available with an immediate effective date without 539.11 underwriting upon receipt of a completed application indicating 539.12 eligibility under the health carrier's eligibility requirements, 539.13 provided that coverage that includes optional benefits may be 539.14 offered on a basis that does not meet this requirement. 539.15 (b) Short-term coverage is not subject to subdivisions 2 539.16 and 5. Short-term coverage may exclude as a preexisting 539.17 condition any injury, illness, or condition for which the 539.18 covered person had medical treatment, symptoms, or any 539.19 manifestations before the effective date of the coverage, but 539.20 dependent children born or placed for adoption during the policy 539.21 period must not be subject to this provision. 539.22 (c) Notwithstanding subdivision 3, and section 62A.021, a 539.23 health carrier may combine short-term coverage with its most 539.24 commonly sold individual qualified plan, as defined in section 539.25 62E.02, other than short-term coverage, for purposes of 539.26 complying with the loss ratio requirement. 539.27 (d) The185555 day coverage limitation provided in 539.28 paragraph (a) applies to the total number of days of short-term 539.29 coverage that covers a person, regardless of the number of 539.30 policies, contracts, or health carriers that provide the 539.31 coverage. A written application for short-term coverage must 539.32 ask the applicant whether the applicant has been covered by 539.33 short-term coverage by any health carrier within the365730 539.34 days immediately preceding the effective date of the coverage 539.35 being applied for. Short-term coverage issued in violation of 539.36 the185-day555-day limitation is valid until the end of its 540.1 term and does not lose its status as short-term coverage, in 540.2 spite of the violation. A health carrier that knowingly issues 540.3 short-term coverage in violation of the185-day555-day 540.4 limitation is subject to the administrative penalties otherwise 540.5 available to the commissioner of commerce or the commissioner of 540.6 health, as appropriate. 540.7 (e) Time spent under short-term coverage counts as time 540.8 spent under a preexisting condition limitation for purposes of 540.9 group or individual health plans, other than short-term 540.10 coverage, subsequently issued to that person, or to cover that 540.11 person, by any health carrier, if the person maintains 540.12 continuous coverage as defined in section 62L.02. Short-term 540.13 coverage is a health plan and is qualifying coverage as defined 540.14 in section 62L.02. Notwithstanding any other law to the 540.15 contrary, a health carrier is not required under any 540.16 circumstances to provide a person covered by short-term coverage 540.17 the right to obtain coverage on a guaranteed issue basis under 540.18 another health plan offered by the health carrier, as a result 540.19 of the person's enrollment in short-term coverage. 540.20 [EFFECTIVE DATE.] This section is effective the day 540.21 following final enactment and applies to policies issued on or 540.22 after that date. 540.23 Sec. 2. Minnesota Statutes 2002, section 62D.095, 540.24 subdivision 2, is amended to read: 540.25 Subd. 2. [CO-PAYMENTS.] (a) A health maintenance contract 540.26 may impose a co-payment as authorized under Minnesota Rules, 540.27 part 4685.0801, or under this section. 540.28 (b) A health maintenance contract may impose a flat fee 540.29 co-payment on outpatient office visits and prescription drugs 540.30 not to exceed 50 percent of the median provider's charges for 540.31 similar services or goods received by enrollees as calculated 540.32 under Minnesota Rules, part 4685.0801, subparts 3 and 4. 540.33 (c) If a health maintenance contract is permitted to impose 540.34 a co-payment for preexisting health status under sections 62D.01 540.35 to 62D.30, these provisions may vary with respect to length of 540.36 enrollment in the health plan. 541.1 Sec. 3. Minnesota Statutes 2002, section 62D.095, is 541.2 amended by adding a subdivision to read: 541.3 Subd. 6. [PUBLIC PROGRAMS.] This section does not apply to 541.4 the prepaid medical assistance program, the MinnesotaCare 541.5 program, the prepaid general assistance program, the federal 541.6 Medicare program, or the health plans provided through any of 541.7 those programs. 541.8 Sec. 4. Minnesota Statutes 2002, section 62J.692, 541.9 subdivision 4, is amended to read: 541.10 Subd. 4. [DISTRIBUTION OF FUNDS.] (a) The commissioner 541.11 shall annually distribute medical education funds to all 541.12 qualifying applicants based on the following criteria: 541.13 (1) total medical education funds available for 541.14 distribution; 541.15 (2) total number of eligible trainee FTEs in each clinical 541.16 medical education program; and 541.17 (3) the statewide average cost per trainee as determined by 541.18 the application information provided in the first year of the 541.19 biennium, by type of trainee, in each clinical medical education 541.20 program. 541.21 (b) Funds distributed shall not be used to displace current 541.22 funding appropriations from federal or state sources. 541.23 (c) Funds shall be distributed to the sponsoring 541.24 institutions indicating the amount to be distributed to each of 541.25 the sponsor's clinical medical education programs based on the 541.26 criteria in this subdivision and in accordance with the 541.27 commissioner's approval letter. Each clinical medical education 541.28 program must distribute funds to the training sites as specified 541.29 in the commissioner's approval letter. Sponsoring institutions, 541.30 which are accredited through an organization recognized by the 541.31 department of education or the Centers for Medicare and Medicaid 541.32 Services, may contract directly with training sites to provide 541.33 clinical training. To ensure the quality of clinical training, 541.34 those accredited sponsoring institutions must: 541.35 (1) develop contracts specifying the terms, expectations, 541.36 and outcomes of the clinical training conducted at sites; and 542.1 (2) take necessary action if the contract requirements are 542.2 not met. Action may include the withholding of payments under 542.3 this section or the removal of students from the site. 542.4 (d) Any funds not distributed in accordance with the 542.5 commissioner's approval letter must be returned to the medical 542.6 education and research fund within 30 days of receiving notice 542.7 from the commissioner. The commissioner shall distribute 542.8 returned funds to the appropriate training sites in accordance 542.9 with the commissioner's approval letter. 542.10 (e) The commissioner shall distribute by June 30 of each 542.11 year an amount equal to the funds transferred undersection542.1262J.694, subdivision 2a, paragraph (b)subdivision 10, plus five 542.13 percent interest to the University of Minnesota board of regents 542.14 for thecosts of the academic health center as specified under542.15section 62J.694, subdivision 2a, paragraph (a).instructional 542.16 costs of health professional programs at the academic health 542.17 center and for interdisciplinary academic initiatives within the 542.18 academic health center. 542.19 (f) A maximum of $150,000 of the funds dedicated to the 542.20 commissioner under section 297F.10, subdivision 1, paragraph 542.21 (b), clause (2), may be used by the commissioner for 542.22 administrative expenses associated with implementing this 542.23 section. 542.24 Sec. 5. Minnesota Statutes 2002, section 62J.692, is 542.25 amended by adding a subdivision to read: 542.26 Subd. 10. [TRANSFERS FROM UNIVERSITY OF MINNESOTA.] Of the 542.27 funds dedicated to the academic health center under section 542.28 297F.10, subdivision 1, paragraph (b), clause (1), $4,850,000 542.29 shall be transferred annually to the commissioner of health no 542.30 later than April 15 of each year for distribution under 542.31 subdivision 4, paragraph (e). 542.32 Sec. 6. Minnesota Statutes 2002, section 62Q.19, 542.33 subdivision 1, is amended to read: 542.34 Subdivision 1. [DESIGNATION.] (a) The commissioner shall 542.35 designate essential community providers. The criteria for 542.36 essential community provider designation shall be the following: 543.1 (1) a demonstrated ability to integrate applicable 543.2 supportive and stabilizing services with medical care for 543.3 uninsured persons and high-risk and special needs populations, 543.4 underserved, and other special needs populations; and 543.5 (2) a commitment to serve low-income and underserved 543.6 populations by meeting the following requirements: 543.7 (i) has nonprofit status in accordance with chapter 317A; 543.8 (ii) has tax exempt status in accordance with the Internal 543.9 Revenue Service Code, section 501(c)(3); 543.10 (iii) charges for services on a sliding fee schedule based 543.11 on current poverty income guidelines; and 543.12 (iv) does not restrict access or services because of a 543.13 client's financial limitation; 543.14 (3) status as a local government unit as defined in section 543.15 62D.02, subdivision 11, a hospital district created or 543.16 reorganized under sections 447.31 to 447.37, an Indian tribal 543.17 government, an Indian health service unit, or a community health 543.18 board as defined in chapter 145A; 543.19 (4) a former state hospital that specializes in the 543.20 treatment of cerebral palsy, spina bifida, epilepsy, closed head 543.21 injuries, specialized orthopedic problems, and other disabling 543.22 conditions; or 543.23 (5)a rural hospital that has qualified fora sole 543.24 community hospitalfinancial assistance grant in the past three543.25years under section 144.1484, subdivision 1. For these rural 543.26 hospitals, the essential community provider designation applies 543.27 to all health services provided, including both inpatient and 543.28 outpatient services. For purposes of this section, "sole 543.29 community hospital" means a rural hospital that: 543.30 (i) is eligible to be classified as a sole community 543.31 hospital according to Code of Federal Regulations, title 42, 543.32 section 412.92, or is located in a community with a population 543.33 of less than 5,000 and located more than 25 miles from a like 543.34 hospital currently providing acute short-term services; 543.35 (ii) has experienced net operating income losses in two of 543.36 the previous three most recent consecutive hospital fiscal years 544.1 for which audited financial information is available; and 544.2 (iii) consists of 40 or fewer licensed beds. 544.3 (b) Prior to designation, the commissioner shall publish 544.4 the names of all applicants in the State Register. The public 544.5 shall have 30 days from the date of publication to submit 544.6 written comments to the commissioner on the application. No 544.7 designation shall be made by the commissioner until the 30-day 544.8 period has expired. 544.9 (c) The commissioner may designate an eligible provider as 544.10 an essential community provider for all the services offered by 544.11 that provider or for specific services designated by the 544.12 commissioner. 544.13 (d) For the purpose of this subdivision, supportive and 544.14 stabilizing services include at a minimum, transportation, child 544.15 care, cultural, and linguistic services where appropriate. 544.16 Sec. 7. Minnesota Statutes 2002, section 144.1222, is 544.17 amended by adding a subdivision to read: 544.18 Subd. 1a. [FEES.] All plans and specifications for public 544.19 swimming pool and spa construction, installation, or alteration 544.20 or requests for a variance that are submitted to the 544.21 commissioner according to Minnesota Rules, part 4717.3975, shall 544.22 be accompanied by the appropriate fees. If the commissioner 544.23 determines, upon review of the plans, that inadequate fees were 544.24 paid, the necessary additional fees shall be paid before plan 544.25 approval. For purposes of determining fees, a project is 544.26 defined as a proposal to construct or install a public pool, 544.27 spa, special purpose pool, or wading pool and all associated 544.28 water treatment equipment and drains, gutters, decks, water 544.29 recreation features, spray pads, and those design and safety 544.30 features that are within five feet of any pool or spa. The 544.31 commissioner shall charge the following fees for plan review and 544.32 inspection of public pools and spas and for requests for 544.33 variance from the public pool and spa rules: 544.34 (1) each spa pool, $500; 544.35 (2) projects valued at $250,000 or less, a minimum of $800 544.36 per pool plus: 545.1 (i) for each slide, an additional $400; and 545.2 (ii) for each spa pool, an additional $500; 545.3 (3) projects valued at $250,000 or more, 0.5 percent of 545.4 documented estimated project cost to a maximum fee of $10,000; 545.5 (4) alterations to an existing pool without changing the 545.6 size or configuration of the pool, $400; 545.7 (5) removal or replacement of pool disinfection equipment 545.8 only, $75; and 545.9 (6) request for variance from the public pool and spa 545.10 rules, $500. 545.11 Sec. 8. Minnesota Statutes 2002, section 144.125, is 545.12 amended to read: 545.13 144.125 [TESTS OF INFANTS FORINBORN METABOLIC ERRORS545.14 HERITABLE AND CONGENITAL DISORDERS.] 545.15 Subdivision 1. [DUTY TO PERFORM TESTING.] It is the duty 545.16 of (1) the administrative officer or other person in charge of 545.17 each institution caring for infants 28 days or less of age, (2) 545.18 the person required in pursuance of the provisions of section 545.19 144.215, to register the birth of a child, or (3) the nurse 545.20 midwife or midwife in attendance at the birth, to arrange to 545.21 have administered to every infant or child in its care tests for 545.22inborn errors of metabolism in accordance withheritable and 545.23 congenital disorders according to subdivision 2 and rules 545.24 prescribed by the state commissioner of health.In determining545.25which tests must be administered, the commissioner shall take545.26into consideration the adequacy of laboratory methods to detect545.27the inborn metabolic error, the ability to treat or prevent545.28medical conditions caused by the inborn metabolic error, and the545.29severity of the medical conditions caused by the inborn545.30metabolic error.Testing and the recording and reporting of 545.31 test results shall be performed at the times and in the manner 545.32 prescribed by the commissioner of health. The commissioner 545.33 shall charge laboratory service fees so that the total of fees 545.34 collected will approximate the costs of conducting the tests and 545.35 implementing and maintaining a system to follow-up infants with 545.36inborn metabolic errorsheritable or congenital disorders. The 546.1 laboratory service fee is $61 per specimen. Costs associated 546.2 with capital expenditures and the development of new procedures 546.3 may be prorated over a three-year period when calculating the 546.4 amount of the fees. 546.5 Subd. 2. [DETERMINATION OF TESTS TO BE ADMINISTERED.] The 546.6 commissioner shall periodically revise the list of tests to be 546.7 administered for determining the presence of a heritable or 546.8 congenital disorder. Revisions to the list shall reflect 546.9 advances in medical science, new and improved testing methods, 546.10 or other factors that will improve the public health. In 546.11 determining whether a test must be administered, the 546.12 commissioner shall take into consideration the adequacy of 546.13 laboratory methods to detect the heritable or congenital 546.14 disorder, the ability to treat or prevent medical conditions 546.15 caused by the heritable or congenital disorder, and the severity 546.16 of the medical conditions caused by the heritable or congenital 546.17 disorder. The list of tests to be performed may be revised if 546.18 the changes are recommended by the advisory committee 546.19 established under section 144.1255, approved by the 546.20 commissioner, and published in the State Register. The revision 546.21 is exempt from the rulemaking requirements in chapter 14 and 546.22 sections 14.385 and 14.386 do not apply. 546.23 Subd. 3. [OBJECTION OF PARENTS TO TEST.] Persons with a 546.24 duty to perform testing under subdivision 1 shall advise parents 546.25 of infants that the blood or tissue samples used to perform 546.26 testing thereunder as well as the results of such testing may be 546.27 retained by the department of health. If the parents of an 546.28 infant object in writing to testing for heritable and congenital 546.29 disorders, the objection shall be recorded on a form that is 546.30 signed by a parent or legal guardian and made part of the 546.31 infant's medical record. A written objection exempts an infant 546.32 from the requirements of this section and section 144.128. 546.33 Sec. 9. [144.1255] [ADVISORY COMMITTEE ON HERITABLE AND 546.34 CONGENITAL DISORDERS.] 546.35 Subdivision 1. [CREATION AND MEMBERSHIP.] (a) By July 1, 546.36 2003, the commissioner of health shall appoint an advisory 547.1 committee to provide advice and recommendations to the 547.2 commissioner concerning tests and treatments for heritable and 547.3 congenital disorders found in newborn children. Membership of 547.4 the committee shall include, but not be limited to, at least one 547.5 member from each of the following representative groups: 547.6 (1) parents and other consumers; 547.7 (2) primary care providers; 547.8 (3) clinicians and researchers specializing in newborn 547.9 diseases and disorders; 547.10 (4) genetic counselors; 547.11 (5) birth hospital representatives; 547.12 (6) newborn screening laboratory professionals; 547.13 (7) nutritionists; and 547.14 (8) other experts as needed representing related fields 547.15 such as emerging technologies and health insurance. 547.16 (b) The terms and removal of members are governed by 547.17 section 15.059. Members shall not receive per diems but shall 547.18 be compensated for expenses. Notwithstanding section 15.059, 547.19 subdivision 5, the advisory committee does not expire. 547.20 Subd. 2. [FUNCTION AND OBJECTIVES.] The committee's 547.21 activities include, but are not limited to: 547.22 (1) collection of information on the efficacy and 547.23 reliability of various tests for heritable and congenital 547.24 disorders; 547.25 (2) collection of information on the availability and 547.26 efficacy of treatments for heritable and congenital disorders; 547.27 (3) collection of information on the severity of medical 547.28 conditions caused by heritable and congenital disorders; 547.29 (4) discussion and assessment of the benefits of performing 547.30 tests for heritable or congenital disorders as compared to the 547.31 costs, treatment limitations, or other potential disadvantages 547.32 of requiring the tests; 547.33 (5) discussion and assessment of ethical considerations 547.34 surrounding the testing, treatment, and handling of data and 547.35 specimens generated by the testing requirements of sections 547.36 144.125 to 144.128; and 548.1 (6) providing advice and recommendations to the 548.2 commissioner concerning tests and treatments for heritable and 548.3 congenital disorders found in newborn children. 548.4 [EFFECTIVE DATE.] This section is effective the day 548.5 following final enactment. 548.6 Sec. 10. Minnesota Statutes 2002, section 144.128, is 548.7 amended to read: 548.8 144.128 [TREATMENT FOR POSITIVE DIAGNOSIS, REGISTRY OF548.9CASESCOMMISSIONER'S DUTIES.] 548.10 The commissioner shall: 548.11 (1) makearrangementsreferrals for the necessary treatment 548.12 of diagnosed cases ofhemoglobinopathy, phenylketonuria, and548.13other inborn errors of metabolismheritable or congenital 548.14 disorders when treatment is indicatedand the family is548.15uninsured and, because of a lack of available income, is unable548.16to pay the cost of the treatment; 548.17 (2) maintain a registry of the cases ofhemoglobinopathy,548.18phenylketonuria, and other inborn errors of metabolismheritable 548.19 and congenital disorders detected by the screening program for 548.20 the purpose of follow-up services; and 548.21 (3) adopt rules to carry outsection 144.126 and this548.22sectionsections 144.125 to 144.128. 548.23 Sec. 11. Minnesota Statutes 2002, section 144.1483, is 548.24 amended to read: 548.25 144.1483 [RURAL HEALTH INITIATIVES.] 548.26 The commissioner of health, through the office of rural 548.27 health, and consulting as necessary with the commissioner of 548.28 human services, the commissioner of commerce, the higher 548.29 education services office, and other state agencies, shall: 548.30 (1) develop a detailed plan regarding the feasibility of 548.31 coordinating rural health care services by organizing individual 548.32 medical providers and smaller hospitals and clinics into 548.33 referral networks with larger rural hospitals and clinics that 548.34 provide a broader array of services; 548.35 (2) develop and implement a program to assist rural 548.36 communities in establishing community health centers, as 549.1 required by section 144.1486; 549.2 (3)administer the program of financial assistance549.3established under section 144.1484 for rural hospitals in549.4isolated areas of the state that are in danger of closing549.5without financial assistance, and that have exhausted local549.6sources of support;549.7(4)develop recommendations regarding health education and 549.8 training programs in rural areas, including but not limited to a 549.9 physician assistants' training program, continuing education 549.10 programs for rural health care providers, and rural outreach 549.11 programs for nurse practitioners within existing training 549.12 programs; 549.13(5)(4) develop a statewide, coordinated recruitment 549.14 strategy for health care personnel and maintain a database on 549.15 health care personnel as required under section 144.1485; 549.16(6)(5) develop and administer technical assistance 549.17 programs to assist rural communities in: (i) planning and 549.18 coordinating the delivery of local health care services; and 549.19 (ii) hiring physicians, nurse practitioners, public health 549.20 nurses, physician assistants, and other health personnel; 549.21(7)(6) study and recommend changes in the regulation of 549.22 health care personnel, such as nurse practitioners and physician 549.23 assistants, related to scope of practice, the amount of on-site 549.24 physician supervision, and dispensing of medication, to address 549.25 rural health personnel shortages; 549.26(8)(7) support efforts to ensure continued funding for 549.27 medical and nursing education programs that will increase the 549.28 number of health professionals serving in rural areas; 549.29(9)(8) support efforts to secure higher reimbursement for 549.30 rural health care providers from the Medicare and medical 549.31 assistance programs; 549.32(10)(9) coordinate the development of a statewide plan for 549.33 emergency medical services, in cooperation with the emergency 549.34 medical services advisory council; 549.35(11)(10) establish a Medicare rural hospital flexibility 549.36 program pursuant to section 1820 of the federal Social Security 550.1 Act, United States Code, title 42, section 1395i-4, by 550.2 developing a state rural health plan and designating, consistent 550.3 with the rural health plan, rural nonprofit or public hospitals 550.4 in the state as critical access hospitals. Critical access 550.5 hospitals shall include facilities that are certified by the 550.6 state as necessary providers of health care services to 550.7 residents in the area. Necessary providers of health care 550.8 services are designated as critical access hospitals on the 550.9 basis of being more than 20 miles, defined as official mileage 550.10 as reported by the Minnesota department of transportation, from 550.11 the next nearest hospital, being the sole hospital in the 550.12 county, being a hospital located in a county with a designated 550.13 medically underserved area or health professional shortage area, 550.14 or being a hospital located in a county contiguous to a county 550.15 with a medically underserved area or health professional 550.16 shortage area. A critical access hospital located in a county 550.17 with a designated medically underserved area or a health 550.18 professional shortage area or in a county contiguous to a county 550.19 with a medically underserved area or health professional 550.20 shortage area shall continue to be recognized as a critical 550.21 access hospital in the event the medically underserved area or 550.22 health professional shortage area designation is subsequently 550.23 withdrawn; and 550.24(12)(11) carry out other activities necessary to address 550.25 rural health problems. 550.26 Sec. 12. Minnesota Statutes 2002, section 144.1488, 550.27 subdivision 4, is amended to read: 550.28 Subd. 4. [ELIGIBLE HEALTH PROFESSIONALS.] (a) To be 550.29 eligible to apply to the commissioner for the loan repayment 550.30 program, health professionals must be citizens or nationals of 550.31 the United States, must not have any unserved obligations for 550.32 service to a federal, state, or local government, or other 550.33 entity, must have a current and unrestricted Minnesota license 550.34 to practice, and must be ready to begin full-time clinical 550.35 practice upon signing a contract for obligated service. 550.36 (b) Eligible providers are those specified by the federal 551.1 Bureau ofPrimary Health CareHealth Professions in the policy 551.2 information notice for the state's current federal grant 551.3 application. A health professional selected for participation 551.4 is not eligible for loan repayment until the health professional 551.5 has an employment agreement or contract with an eligible loan 551.6 repayment site and has signed a contract for obligated service 551.7 with the commissioner. 551.8 Sec. 13. Minnesota Statutes 2002, section 144.1491, 551.9 subdivision 1, is amended to read: 551.10 Subdivision 1. [PENALTIES FOR BREACH OF CONTRACT.] A 551.11 program participant who fails to completetwothe required years 551.12 of obligated service shall repay the amount paid, as well as a 551.13 financial penaltybased upon the length of the service551.14obligation not fulfilled. If the participant has served at551.15least one year, the financial penalty is the number of unserved551.16months multiplied by $1,000. If the participant has served less551.17than one year, the financial penalty is the total number of551.18obligated months multiplied by $1,000specified by the federal 551.19 Bureau of Health Professions in the policy information notice 551.20 for the state's current federal grant application. The 551.21 commissioner shall report to the appropriate health-related 551.22 licensing board a participant who fails to complete the service 551.23 obligation and fails to repay the amount paid or fails to pay 551.24 any financial penalty owed under this subdivision. 551.25 Sec. 14. [144.1501] [HEALTH PROFESSIONAL EDUCATION LOAN 551.26 FORGIVENESS PROGRAM.] 551.27 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 551.28 section, the following definitions apply. 551.29 (b) "Designated rural area" means: 551.30 (1) an area in Minnesota outside the counties of Anoka, 551.31 Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, 551.32 excluding the cities of Duluth, Mankato, Moorhead, Rochester, 551.33 and St. Cloud; or 551.34 (2) a municipal corporation, as defined under section 551.35 471.634, that is physically located, in whole or in part, in an 551.36 area defined as a designated rural area under clause (1). 552.1 (c) "Emergency circumstances" means those conditions that 552.2 make it impossible for the participant to fulfill the service 552.3 commitment, including death, total and permanent disability, or 552.4 temporary disability lasting more than two years. 552.5 (d) "Medical resident" means an individual participating in 552.6 a medical residency in family practice, internal medicine, 552.7 obstetrics and gynecology, pediatrics, or psychiatry. 552.8 (e) "Midlevel practitioner" means a nurse practitioner, 552.9 nurse-midwife, nurse anesthetist, advanced clinical nurse 552.10 specialist, or physician assistant. 552.11 (f) "Nurse" means an individual who has completed training 552.12 and received all licensing or certification necessary to perform 552.13 duties as a licensed practical nurse or registered nurse. 552.14 (g) "Nurse-midwife" means a registered nurse who has 552.15 graduated from a program of study designed to prepare registered 552.16 nurses for advanced practice as nurse-midwives. 552.17 (h) "Nurse practitioner" means a registered nurse who has 552.18 graduated from a program of study designed to prepare registered 552.19 nurses for advanced practice as nurse practitioners. 552.20 (i) "Physician" means an individual who is licensed to 552.21 practice medicine in the areas of family practice, internal 552.22 medicine, obstetrics and gynecology, pediatrics, or psychiatry. 552.23 (j) "Physician assistant" means a person registered under 552.24 chapter 147A. 552.25 (k) "Qualified educational loan" means a government, 552.26 commercial, or foundation loan for actual costs paid for 552.27 tuition, reasonable education expenses, and reasonable living 552.28 expenses related to the graduate or undergraduate education of a 552.29 health care professional. 552.30 (l) "Underserved urban community" means a Minnesota urban 552.31 area or population included in the list of designated primary 552.32 medical care health professional shortage areas (HPSAs), 552.33 medically underserved areas (MUAs), or medically underserved 552.34 populations (MUPs) maintained and updated by the United States 552.35 Department of Health and Human Services. 552.36 Subd. 2. [CREATION OF ACCOUNT.] A health professional 553.1 education loan forgiveness program account is established. The 553.2 commissioner of health shall use money from the account to 553.3 establish a loan forgiveness program for medical residents 553.4 agreeing to practice in designated rural areas or underserved 553.5 urban communities, for midlevel practitioners agreeing to 553.6 practice in designated rural areas, and for nurses who agree to 553.7 practice in a Minnesota nursing home or intermediate care 553.8 facility for persons with mental retardation or related 553.9 conditions. Appropriations made to the account do not cancel 553.10 and are available until expended, except that at the end of each 553.11 biennium, any remaining balance in the account that is not 553.12 committed by contract and not needed to fulfill existing 553.13 commitments shall cancel to the fund. 553.14 Subd. 3. [ELIGIBILITY.] (a) To be eligible to participate 553.15 in the loan forgiveness program, an individual must: 553.16 (1) be a medical resident or be enrolled in a midlevel 553.17 practitioner, registered nurse, or a licensed practical nurse 553.18 training program; and 553.19 (2) submit an application to the commissioner of health. 553.20 (b) An applicant selected to participate must sign a 553.21 contract to agree to serve a minimum three-year full-time 553.22 service obligation according to subdivision 2, which shall begin 553.23 no later than March 31 following completion of required training. 553.24 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 553.25 may select applicants each year for participation in the loan 553.26 forgiveness program, within the limits of available funding. 553.27 The commissioner shall distribute available funds for loan 553.28 forgiveness proportionally among the eligible professions 553.29 according to the vacancy rate for each profession in the 553.30 required geographic area or facility type specified in 553.31 subdivision 2. The commissioner shall allocate funds for 553.32 physician loan forgiveness so that 75 percent of the funds 553.33 available are used for rural physician loan forgiveness and 25 553.34 percent of the funds available are used for underserved urban 553.35 communities loan forgiveness. If the commissioner does not 553.36 receive enough qualified applicants each year to use the entire 554.1 allocation of funds for urban underserved communities, the 554.2 remaining funds may be allocated for rural physician loan 554.3 forgiveness. Applicants are responsible for securing their own 554.4 qualified educational loans. The commissioner shall select 554.5 participants based on their suitability for practice serving the 554.6 required geographic area or facility type specified in 554.7 subdivision 2, as indicated by experience or training. The 554.8 commissioner shall give preference to applicants closest to 554.9 completing their training. For each year that a participant 554.10 meets the service obligation required under subdivision 3, up to 554.11 a maximum of four years, the commissioner shall make annual 554.12 disbursements directly to the participant equivalent to 15 554.13 percent of the average educational debt for indebted graduates 554.14 in their profession in the year closest to the applicant's 554.15 selection for which information is available, not to exceed the 554.16 balance of the participant's qualifying educational loans. 554.17 Before receiving loan repayment disbursements and as requested, 554.18 the participant must complete and return to the commissioner an 554.19 affidavit of practice form provided by the commissioner 554.20 verifying that the participant is practicing as required under 554.21 subdivisions 2 and 3. The participant must provide the 554.22 commissioner with verification that the full amount of loan 554.23 repayment disbursement received by the participant has been 554.24 applied toward the designated loans. After each disbursement, 554.25 verification must be received by the commissioner and approved 554.26 before the next loan repayment disbursement is made. 554.27 Participants who move their practice remain eligible for loan 554.28 repayment as long as they practice as required under subdivision 554.29 2. 554.30 Subd. 5. [PENALTY FOR NONFULFILLMENT.] If a participant 554.31 does not fulfill the required minimum commitment of service 554.32 according to subdivision 3, the commissioner of health shall 554.33 collect from the participant the total amount paid to the 554.34 participant under the loan forgiveness program plus interest at 554.35 a rate established according to section 270.75. The 554.36 commissioner shall deposit the money collected in the health 555.1 care access fund to be credited to the health professional 555.2 education loan forgiveness program account established in 555.3 subdivision 2. The commissioner shall allow waivers of all or 555.4 part of the money owed the commissioner as a result of a 555.5 nonfulfillment penalty if emergency circumstances prevented 555.6 fulfillment of the minimum service commitment. 555.7 Subd. 6. [RULES.] The commissioner may adopt rules to 555.8 implement this section. 555.9 Sec. 15. Minnesota Statutes 2002, section 144.1502, 555.10 subdivision 4, is amended to read: 555.11 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 555.12 may acceptup to 14applicantspereach year for participation 555.13 in the loan forgiveness program, within the limits of available 555.14 funding. Applicants are responsible for securing their own 555.15 loans. The commissioner shall select participants based on 555.16 their suitability for practice serving public program patients, 555.17 as indicated by experience or training. The commissioner shall 555.18 give preference to applicants who have attended a Minnesota 555.19 dentistry educational institution and to applicants closest to 555.20 completing their training. For each year that a participant 555.21 meets the service obligation required under subdivision 3, up to 555.22 a maximum of four years, the commissioner shall make annual 555.23 disbursements directly to the participant equivalent to$10,000555.24per year of service, not to exceed $40,00015 percent of the 555.25 average educational debt for indebted dental school graduates in 555.26 the year closest to the applicant's selection for which 555.27 information is available or the balance of the qualifying 555.28 educational loans, whichever is less. Before receiving loan 555.29 repayment disbursements and as requested, the participant must 555.30 complete and return to the commissioner an affidavit of practice 555.31 form provided by the commissioner verifying that the participant 555.32 is practicing as required under subdivision 3. The participant 555.33 must provide the commissioner with verification that the full 555.34 amount of loan repayment disbursement received by the 555.35 participant has been applied toward the designated loans. After 555.36 each disbursement, verification must be received by the 556.1 commissioner and approved before the next loan repayment 556.2 disbursement is made. Participants who move their practice 556.3 remain eligible for loan repayment as long as they practice as 556.4 required under subdivision 3. 556.5 Sec. 16. Minnesota Statutes 2002, section 144.551, 556.6 subdivision 1, is amended to read: 556.7 Subdivision 1. [RESTRICTED CONSTRUCTION OR MODIFICATION.] 556.8 (a) The following construction or modification may not be 556.9 commenced: 556.10 (1) any erection, building, alteration, reconstruction, 556.11 modernization, improvement, extension, lease, or other 556.12 acquisition by or on behalf of a hospital that increases the bed 556.13 capacity of a hospital, relocates hospital beds from one 556.14 physical facility, complex, or site to another, or otherwise 556.15 results in an increase or redistribution of hospital beds within 556.16 the state; and 556.17 (2) the establishment of a new hospital. 556.18 (b) This section does not apply to: 556.19 (1) construction or relocation within a county by a 556.20 hospital, clinic, or other health care facility that is a 556.21 national referral center engaged in substantial programs of 556.22 patient care, medical research, and medical education meeting 556.23 state and national needs that receives more than 40 percent of 556.24 its patients from outside the state of Minnesota; 556.25 (2) a project for construction or modification for which a 556.26 health care facility held an approved certificate of need on May 556.27 1, 1984, regardless of the date of expiration of the 556.28 certificate; 556.29 (3) a project for which a certificate of need was denied 556.30 before July 1, 1990, if a timely appeal results in an order 556.31 reversing the denial; 556.32 (4) a project exempted from certificate of need 556.33 requirements by Laws 1981, chapter 200, section 2; 556.34 (5) a project involving consolidation of pediatric 556.35 specialty hospital services within the Minneapolis-St. Paul 556.36 metropolitan area that would not result in a net increase in the 557.1 number of pediatric specialty hospital beds among the hospitals 557.2 being consolidated; 557.3 (6) a project involving the temporary relocation of 557.4 pediatric-orthopedic hospital beds to an existing licensed 557.5 hospital that will allow for the reconstruction of a new 557.6 philanthropic, pediatric-orthopedic hospital on an existing site 557.7 and that will not result in a net increase in the number of 557.8 hospital beds. Upon completion of the reconstruction, the 557.9 licenses of both hospitals must be reinstated at the capacity 557.10 that existed on each site before the relocation; 557.11 (7) the relocation or redistribution of hospital beds 557.12 within a hospital building or identifiable complex of buildings 557.13 provided the relocation or redistribution does not result in: 557.14 (i) an increase in the overall bed capacity at that site; (ii) 557.15 relocation of hospital beds from one physical site or complex to 557.16 another; or (iii) redistribution of hospital beds within the 557.17 state or a region of the state; 557.18 (8) relocation or redistribution of hospital beds within a 557.19 hospital corporate system that involves the transfer of beds 557.20 from a closed facility site or complex to an existing site or 557.21 complex provided that: (i) no more than 50 percent of the 557.22 capacity of the closed facility is transferred; (ii) the 557.23 capacity of the site or complex to which the beds are 557.24 transferred does not increase by more than 50 percent; (iii) the 557.25 beds are not transferred outside of a federal health systems 557.26 agency boundary in place on July 1, 1983; and (iv) the 557.27 relocation or redistribution does not involve the construction 557.28 of a new hospital building; 557.29 (9) a construction project involving up to 35 new beds in a 557.30 psychiatric hospital in Rice county that primarily serves 557.31 adolescents and that receives more than 70 percent of its 557.32 patients from outside the state of Minnesota; 557.33 (10) a project to replace a hospital or hospitals with a 557.34 combined licensed capacity of 130 beds or less if: (i) the new 557.35 hospital site is located within five miles of the current site; 557.36 and (ii) the total licensed capacity of the replacement 558.1 hospital, either at the time of construction of the initial 558.2 building or as the result of future expansion, will not exceed 558.3 70 licensed hospital beds, or the combined licensed capacity of 558.4 the hospitals, whichever is less; 558.5 (11) the relocation of licensed hospital beds from an 558.6 existing state facility operated by the commissioner of human 558.7 services to a new or existing facility, building, or complex 558.8 operated by the commissioner of human services; from one 558.9 regional treatment center site to another; or from one building 558.10 or site to a new or existing building or site on the same 558.11 campus; 558.12 (12) the construction or relocation of hospital beds 558.13 operated by a hospital having a statutory obligation to provide 558.14 hospital and medical services for the indigent that does not 558.15 result in a net increase in the number of hospital beds; 558.16 (13) a construction project involving the addition of up to 558.17 31 new beds in an existing nonfederal hospital in Beltrami 558.18 county;or558.19 (14) a construction project involving the addition of up to 558.20 eight new beds in an existing nonfederal hospital in Otter Tail 558.21 county with 100 licensed acute care beds; 558.22 (15) a construction project involving the addition of 20 558.23 new hospital beds used for rehabilitation services in an 558.24 existing hospital in Carver county serving the southwest 558.25 suburban metropolitan area; or 558.26 (16) a project for the construction or relocation of up to 558.27 20 hospital beds for the operation of up to two psychiatric 558.28 facilities or units for children provided that the operation of 558.29 the facilities or units have received the approval of the 558.30 commissioner of human services. 558.31 Sec. 17. [144.706] [CITATION.] 558.32 Sections 144.706 to 144.7069 may be cited as the Minnesota 558.33 Adverse Health Care Events Reporting Act of 2003. 558.34 [EFFECTIVE DATE.] This section is effective July 1, 2005, 558.35 contingent upon obtaining independent funding. 558.36 Sec. 18. [144.7063] [DEFINITIONS.] 559.1 Subdivision 1. [SCOPE.] Unless the context clearly 559.2 indicates otherwise, for the purposes of sections 144.706 to 559.3 144.7069, the terms defined in this section have the meanings 559.4 given them. 559.5 Subd. 2. [COMMISSIONER.] "Commissioner" means the 559.6 commissioner of health. 559.7 Subd. 3. [FACILITY.] "Facility" means a hospital licensed 559.8 under sections 144.50 to 144.58. 559.9 Subd. 4. [SERIOUS DISABILITY.] "Serious disability" means 559.10 (1) a physical or mental impairment that substantially limits 559.11 one or more of the major life activities of an individual or a 559.12 loss of bodily function, if the impairment or loss lasts more 559.13 than seven days or is still present at the time of discharge 559.14 from an inpatient health care facility or (2) loss of a body 559.15 part. 559.16 Subd. 5. [SURGERY.] "Surgery" means the treatment of 559.17 disease, injury, or deformity by manual or operative methods. 559.18 Surgery includes endoscopies and other invasive procedures. 559.19 [EFFECTIVE DATE.] This section is effective July 1, 2005, 559.20 contingent upon obtaining independent funding. 559.21 Sec. 19. [144.7065] [FACILITY REQUIREMENTS TO REPORT, 559.22 ANALYZE, AND CORRECT.] 559.23 Subdivision 1. [REPORTS OF ADVERSE HEALTH CARE EVENTS 559.24 REQUIRED.] Each facility shall report to the commissioner the 559.25 occurrence of any of the adverse health care events described in 559.26 subdivisions 2 to 7 as soon as is reasonably and practically 559.27 possible, but no later than 15 working days after discovery of 559.28 the event. The report shall be filed in a format specified by 559.29 the commissioner and shall identify the facility but shall not 559.30 identify any of the health care professionals, facility 559.31 employees, or patients involved. The report shall not contain 559.32 the name, address, social security number, date of birth, 559.33 telephone number, federal patient identification number, 559.34 subscriber number, medical record number, or any other 559.35 identifying information of the patient involved. The report 559.36 shall not contain the name, social security number, federal 560.1 provider identification number, license number, or other 560.2 identifying information of the health care professionals 560.3 involved. The report shall not contain the name, employee 560.4 number, social security number, or any other identifying 560.5 information of the facility employee involved. The commissioner 560.6 may consult with experts and organizations familiar with patient 560.7 safety when developing the format for reporting and in further 560.8 defining events in order to be consistent with industry 560.9 standards. 560.10 Subd. 2. [SURGICAL EVENTS.] Events reportable under this 560.11 subdivision are: 560.12 (1) surgery performed on a wrong body part that is not 560.13 consistent with the documented informed consent for that 560.14 patient. Reportable events under this clause do not include 560.15 situations requiring prompt action that occur in the course of 560.16 surgery or situations whose urgency precludes obtaining informed 560.17 consent; 560.18 (2) surgery performed on the wrong patient; 560.19 (3) the wrong surgical procedure performed on a patient 560.20 that is not consistent with the documented informed consent for 560.21 that patient. Reportable events under this clause do not 560.22 include situations requiring prompt action that occur in the 560.23 course of surgery or situations whose urgency precludes 560.24 obtaining informed consent; 560.25 (4) retention of a foreign object in a patient after 560.26 surgery or other procedure, excluding objects intentionally 560.27 implanted as part of a planned intervention and objects present 560.28 prior to surgery that are intentionally retained; and 560.29 (5) death during or immediately after surgery of a normal, 560.30 healthy patient who has no organic, physiologic, biochemical, or 560.31 psychiatric disturbance and for whom the pathologic processes 560.32 for which the operation is to be performed are localized and do 560.33 not entail a systemic disturbance. 560.34 Subd. 3. [PRODUCT OR DEVICE EVENTS.] Events reportable 560.35 under this subdivision are: 560.36 (1) patient death or serious disability associated with the 561.1 use of contaminated drugs, devices, or biologics provided by the 561.2 facility when the contamination is the result of generally 561.3 detectable contaminants in drugs, devices, or biologics 561.4 regardless of the source of the contamination or the product; 561.5 (2) patient death or serious disability associated with the 561.6 use or function of a device in patient care in which the device 561.7 is used or functions other than as intended. "Device" includes, 561.8 but is not limited to, catheters, drains, and other specialized 561.9 tubes, infusion pumps, and ventilators; and 561.10 (3) patient death or serious disability associated with 561.11 intravascular air embolism that occurs while being cared for in 561.12 a facility, excluding deaths associated with neurosurgical 561.13 procedures known to present a high risk of intravascular air 561.14 embolism. 561.15 Subd. 4. [PATIENT PROTECTION EVENTS.] Events reportable 561.16 under this subdivision are: 561.17 (1) an infant discharged to the wrong person; 561.18 (2) patient death or serious disability associated with 561.19 patient disappearance for more than four hours, excluding events 561.20 involving adults who have decision making capacity; and 561.21 (3) patient suicide or attempted suicide resulting in 561.22 serious disability while being cared for in a facility due to 561.23 patient actions after admission to the facility, excluding 561.24 deaths resulting from self-inflicted injuries that were the 561.25 reason for admission to the facility. 561.26 Subd. 5. [CARE MANAGEMENT EVENTS.] Events reportable under 561.27 this subdivision are: 561.28 (1) patient death or serious disability associated with a 561.29 medication error, including, but not limited to, errors 561.30 involving the wrong drug, the wrong dose, the wrong patient, the 561.31 wrong time, the wrong rate, the wrong preparation, or the wrong 561.32 route of administration, excluding reasonable differences in 561.33 clinical judgment on drug selection and dose; 561.34 (2) patient death or serious disability associated with a 561.35 hemolytic reaction due to the administration of ABO-incompatible 561.36 blood or blood products; 562.1 (3) maternal death or serious disability associated with 562.2 labor or delivery in a low-risk pregnancy while being cared for 562.3 in a facility, including events that occur within 42 days 562.4 postdelivery and excluding deaths from pulmonary or amniotic 562.5 fluid embolism, acute fatty liver of pregnancy, or 562.6 cardiomyopathy; 562.7 (4) patient death or serious disability directly related to 562.8 hypoglycemia, the onset of which occurs while the patient is 562.9 being cared for in a facility; 562.10 (5) death or serious disability, including kernicterus, 562.11 associated with failure to identify and treat hyperbilirubinemia 562.12 in neonates during the first 28 days of life. 562.13 "Hyperbilirubinemia" means bilirubin levels greater than 30 562.14 milligrams per deciliter; 562.15 (6) stage 3 or 4 ulcers acquired after admission to a 562.16 facility, excluding progression from stage 2 to stage 3 if stage 562.17 2 was recognized upon admission; and 562.18 (7) patient death or serious disability due to spinal 562.19 manipulative therapy. 562.20 Subd. 6. [ENVIRONMENTAL EVENTS.] Events reportable under 562.21 this subdivision are: 562.22 (1) patient death or serious disability associated with an 562.23 electric shock while being cared for in a facility, excluding 562.24 events involving planned treatments such as electric 562.25 countershock; 562.26 (2) any incident in which a line designated for oxygen or 562.27 other gas to be delivered to a patient contains the wrong gas or 562.28 is contaminated by toxic substances; 562.29 (3) patient death or serious disability associated with a 562.30 burn incurred from any source while being cared for in a 562.31 facility; 562.32 (4) patient death associated with a fall while being cared 562.33 for in a facility; and 562.34 (5) patient death or serious disability associated with the 562.35 use or lack of restraints or bedrails while being cared for in a 562.36 facility. 563.1 Subd. 7. [CRIMINAL EVENTS.] Events reportable under this 563.2 subdivision are: 563.3 (1) any instance of care ordered by or provided by someone 563.4 impersonating a physician, nurse, pharmacist, or other licensed 563.5 health care provider; 563.6 (2) abduction of a patient of any age; 563.7 (3) sexual assault on a patient within or on the grounds of 563.8 a facility; and 563.9 (4) death or significant injury of a patient or staff 563.10 member resulting from a physical assault that occurs within or 563.11 on the grounds of a facility. 563.12 Subd. 8. [ROOT CAUSE ANALYSIS; CORRECTIVE ACTION 563.13 PLAN.] Following the occurrence of an adverse health care event, 563.14 the facility must conduct a root cause analysis of the event. 563.15 Following the analysis, the facility must: (1) implement a 563.16 corrective action plan to implement the findings of the 563.17 analysis, or (2) report to the commissioner any reasons for not 563.18 taking corrective action. If the root cause analysis and the 563.19 implementation of a corrective action plan are complete at the 563.20 time an event must be reported, the findings of the analysis and 563.21 the corrective action plan must be included in the report of the 563.22 event. The findings of the root cause analysis and a copy of 563.23 the corrective action plan must otherwise be filed with the 563.24 commissioner within 60 days of the event. 563.25 Subd. 9. [ELECTRONIC REPORTING.] The commissioner must 563.26 design the reporting system so that a facility may file by 563.27 electronic means the reports required under this section. The 563.28 commissioner shall encourage a facility to use the electronic 563.29 filing option when that option is feasible for the facility. 563.30 Subd. 10. [RELATION TO OTHER LAW.] (a) Adverse health 563.31 events described in subdivisions 2 to 6 do not constitute 563.32 "maltreatment" or "a physical injury that is not reasonably 563.33 explained" under section 626.557 and are excluded from the 563.34 reporting requirements of section 626.557, provided the facility 563.35 makes a determination within 24 hours of the discovery of the 563.36 event that this section is applicable and the facility files the 564.1 reports required under this section in a timely fashion. 564.2 (b) A facility that has determined that an event described 564.3 in subdivisions 2 to 6 has occurred must inform persons who are 564.4 mandated reporters under section 626.5572, subdivision 16, of 564.5 that determination. A mandated reporter otherwise required to 564.6 report under section 626.557, subdivision 3, paragraph (e), is 564.7 relieved of the duty to report an event that the facility 564.8 determines under paragraph (a) to be reportable under 564.9 subdivisions 2 to 6. 564.10 (c) The protections and immunities applicable to voluntary 564.11 reports under section 626.557 are not affected by this section. 564.12 (d) Notwithstanding section 626.557, a lead agency under 564.13 section 626.5572, subdivision 13, is not required to conduct an 564.14 investigation of an event described in subdivisions 2 to 6. 564.15 [EFFECTIVE DATE.] This section is effective July 1, 2005, 564.16 contingent upon obtaining independent funding. 564.17 Sec. 20. [144.7067] [COMMISSIONER DUTIES AND 564.18 RESPONSIBILITIES.] 564.19 Subdivision 1. [ESTABLISHMENT OF REPORTING SYSTEM.] (a) 564.20 The commissioner shall establish an adverse health event 564.21 reporting system designed to facilitate quality improvement in 564.22 the health care system. The reporting system shall not be 564.23 designed to punish errors by health care practitioners or health 564.24 care facility employees. 564.25 (b) The reporting system shall consist of: 564.26 (1) mandatory reporting by facilities of 27 adverse health 564.27 care events; 564.28 (2) mandatory completion of a root cause analysis and a 564.29 corrective action plan by the facility and reporting of the 564.30 findings of the analysis and the plan to the commissioner or 564.31 reporting of reasons for not taking corrective action; 564.32 (3) analysis of reported information by the commissioner to 564.33 determine patterns of systemic failure in the health care system 564.34 and successful methods to correct these failures; 564.35 (4) sanctions against facilities for failure to comply with 564.36 reporting system requirements; and 565.1 (5) communication from the commissioner to facilities, 565.2 health care purchasers, and the public to maximize the use of 565.3 the reporting system to improve health care quality. 565.4 (c) Reports, analyses, and corrective action plans 565.5 submitted under section 144.7065, subdivisions 1 and 8, shall be 565.6 considered aggregate data as contemplated by section 145.64, 565.7 subdivision 1, paragraph (b), and afforded the protections and 565.8 immunities provided in section 145.64. 565.9 (d) Nothing in this section shall authorize the 565.10 commissioner to select from or between competing alternative 565.11 medical practices. 565.12 Subd. 2. [DUTY TO ANALYZE REPORTS; COMMUNICATE 565.13 FINDINGS.] The commissioner shall: 565.14 (1) analyze adverse event reports, corrective action plans, 565.15 and the findings of the root cause analyses, to determine 565.16 patterns of systemic failure in the health care system and 565.17 successful methods to correct these failures; 565.18 (2) communicate to individual facilities the commissioner's 565.19 conclusions, if any, regarding an adverse event reported by the 565.20 facility; 565.21 (3) communicate with relevant health care facilities any 565.22 recommendations for corrective action resulting from the 565.23 commissioner's analysis of submissions from facilities; and 565.24 (4) publish an annual report: 565.25 (i) describing, by institution, adverse events reported; 565.26 (ii) outlining, in aggregate, corrective action plans, and 565.27 the findings of the root cause analyses; and 565.28 (iii) making recommendations for modifications of state 565.29 health care operations. 565.30 Subd. 3. [SANCTIONS.] (a) The commissioner shall take 565.31 steps necessary to determine if adverse event reports, the 565.32 findings of the root cause analyses, and corrective action plans 565.33 are filed in a timely manner. The commissioner may sanction a 565.34 facility for: 565.35 (1) failure to file a timely adverse event report under 565.36 section 144.7065, subdivision 1; or 566.1 (2) failure to conduct a root cause analysis, to implement 566.2 a corrective action plan, or to provide the findings of a root 566.3 cause analysis or corrective action plan in a timely fashion 566.4 under section 144.7065, subdivision 8. 566.5 (b) If a facility fails to develop and implement a 566.6 corrective action plan or report to the commissioner why 566.7 corrective action is not needed, the commissioner may suspend, 566.8 revoke, fail to renew, or place conditions on the license under 566.9 which the facility operates. 566.10 [EFFECTIVE DATE.] This section is effective July 1, 2005, 566.11 contingent upon obtaining independent funding. 566.12 Sec. 21. [144.7069] [INTERSTATE COORDINATION; REPORTS.] 566.13 The commissioner shall report the definitions and the list 566.14 of reportable events adopted in this act to the National Quality 566.15 Forum and, working in coordination with the National Quality 566.16 Forum, to the other states. The commissioner shall monitor 566.17 discussions by the National Quality Forum of amendments to the 566.18 forum's list of reportable events and shall report to the 566.19 legislature whenever the list is modified. The commissioner 566.20 shall also monitor implementation efforts in other states to 566.21 establish a list of reportable events and shall make 566.22 recommendations to the legislature as necessary for 566.23 modifications in the Minnesota list or in the other components 566.24 of the Minnesota reporting system to keep the system as nearly 566.25 uniform as possible with similar systems in other states. 566.26 Sec. 22. Minnesota Statutes 2002, section 147A.08, is 566.27 amended to read: 566.28 147A.08 [EXEMPTIONS.] 566.29 (a) This chapter does not apply to, control, prevent, or 566.30 restrict the practice, service, or activities of persons listed 566.31 in section 147.09, clauses (1) to (6) and (8) to (13), persons 566.32 regulated under section 214.01, subdivision 2, or persons 566.33 defined in section144.1495144.1501, subdivision 1, 566.34 paragraphs(a) to (d)(e), (g), and (h). 566.35 (b) Nothing in this chapter shall be construed to require 566.36 registration of: 567.1 (1) a physician assistant student enrolled in a physician 567.2 assistant or surgeon assistant educational program accredited by 567.3 the Committee on Allied Health Education and Accreditation or by 567.4 its successor agency approved by the board; 567.5 (2) a physician assistant employed in the service of the 567.6 federal government while performing duties incident to that 567.7 employment; or 567.8 (3) technicians, other assistants, or employees of 567.9 physicians who perform delegated tasks in the office of a 567.10 physician but who do not identify themselves as a physician 567.11 assistant. 567.12 Sec. 23. Minnesota Statutes 2002, section 148.5194, 567.13 subdivision 1, is amended to read: 567.14 Subdivision 1. [FEE PRORATION.] The commissioner shall 567.15 prorate the registration fee for clinical fellowship, temporary, 567.16 and first time registrants according to the number of months 567.17 that have elapsed between the date registration is issued and 567.18 the date registration expires or must be renewed under section 567.19 148.5191, subdivision 4. 567.20 Sec. 24. Minnesota Statutes 2002, section 148.5194, 567.21 subdivision 2, is amended to read: 567.22 Subd. 2. [BIENNIAL REGISTRATION FEE.] The fee for initial 567.23 registration and biennial registration, clinical fellowship 567.24 registration, temporary registration, or renewal is $200. 567.25 Sec. 25. Minnesota Statutes 2002, section 148.5194, 567.26 subdivision 3, is amended to read: 567.27 Subd. 3. [BIENNIAL REGISTRATION FEE FOR DUAL 567.28 REGISTRATION.] The fee for initial registration and biennial 567.29 registration, clinical fellowship registration, temporary 567.30 registration, or renewal is $200. 567.31 Sec. 26. Minnesota Statutes 2002, section 148.5194, is 567.32 amended by adding a subdivision to read: 567.33 Subd. 6. [VERIFICATION OF CREDENTIAL.] The fee for written 567.34 verification of credentialed status is $25. 567.35 Sec. 27. Minnesota Statutes 2002, section 148.6445, 567.36 subdivision 7, is amended to read: 568.1 Subd. 7. [CERTIFICATIONVERIFICATION TO OTHER STATES.] The 568.2 fee forcertificationverification of licensure to other states 568.3 is $25. 568.4 Sec. 28. [148C.12] [FEES.] 568.5 Subdivision 1. [APPLICATION.] The application fee for a 568.6 license to practice alcohol and drug counseling is $295. 568.7 Subd. 2. [BIENNIAL RENEWAL.] The license renewal fee is 568.8 $295. If the commissioner changes the renewal schedule and the 568.9 expiration date is less than two years, the fee must be prorated. 568.10 Subd. 3. [TEMPORARY PRACTICE STATUS.] The initial fee for 568.11 applicants under section 148C.04, subdivision 6, paragraph (a), 568.12 clause (1), item (i), is $100. The initial fee for applicants 568.13 under section 148C.04, subdivision 6, paragraph (a), clause (1), 568.14 item (ii) or (iii), is the license application fee under 568.15 subdivision 1. The fee for annual renewal of temporary practice 568.16 status is $100. 568.17 Subd. 4. [EXAMINATION.] The examination fee is $95 for the 568.18 written examination and $200 for the oral examination. 568.19 Subd. 5. [INACTIVE RENEWAL.] The inactive renewal fee is 568.20 $150. 568.21 Subd. 6. [LATE FEE.] The late fee is 25 percent of the 568.22 biennial renewal fee, the inactive renewal fee, or the annual 568.23 fee for renewal of temporary practice status. 568.24 Subd. 7. [RENEWAL AFTER EXPIRATION.] The fee for renewal 568.25 of a license that has expired is the total of the biennial 568.26 renewal fee, the late fee, and a fee of $100 for review and 568.27 approval of the continuing education report. 568.28 Subd. 8. [LICENSE VERIFICATION.] The fee for license 568.29 verification to institutions and other jurisdictions is $25. 568.30 Subd. 9. [SURCHARGE.] Notwithstanding section 16A.1285, 568.31 subdivision 2, a surcharge of $172 shall be paid at the time of 568.32 application for or renewal of an alcohol and drug counseling 568.33 license until June 30, 2009. 568.34 Subd. 10. [NONREFUNDABLE FEES.] All fees are nonrefundable. 568.35 Sec. 29. Minnesota Statutes 2002, section 153A.17, is 568.36 amended to read: 569.1 153A.17 [EXPENSES; FEES.] 569.2 The expenses for administering the certification 569.3 requirements including the complaint handling system for hearing 569.4 aid dispensers in sections 153A.14 and 153A.15 and the consumer 569.5 information center under section 153A.18 must be paid from 569.6 initial application and examination fees, renewal fees, 569.7 penalties, and fines. All fees are nonrefundable. The 569.8 certificate application fee is$165 for audiologists registered569.9under section 148.511 and $490 for all others$350, the 569.10 examination fee is$200$250 for the written portion and 569.11$200$250 for the practical portion each time one or the other 569.12 is taken, and the trainee application fee 569.13 is$100$200.Notwithstanding the policy set forth in section569.1416A.1285, subdivision 2, a surcharge of $165 for audiologists569.15registered under section 148.511 and $330 for all others shall569.16be paid at the time of application or renewal until June 30,569.172003, to recover the commissioner's accumulated direct569.18expenditures for administering the requirements of this569.19chapter.The penalty fee for late submission of a renewal 569.20 application is $200. The fee for verification of certification 569.21 to other jurisdictions or entities is $25. All fees, penalties, 569.22 and fines received must be deposited in the state government 569.23 special revenue fund. The commissioner may prorate the 569.24 certification fee for new applicants based on the number of 569.25 quarters remaining in the annual certification period. 569.26 Sec. 30. Minnesota Statutes 2002, section 179A.03, 569.27 subdivision 7, is amended to read: 569.28 Subd. 7. [ESSENTIAL EMPLOYEE.] "Essential employee" means 569.29 firefighters, peace officers subject to licensure under sections 569.30 626.84 to 626.863, 911 system and police and fire department 569.31 public safety dispatchers, guards at correctional facilities, 569.32 confidential employees, supervisory employees, assistant county 569.33 attorneys, assistant city attorneys, principals, and assistant 569.34 principals. However, for state employees, "essential employee" 569.35 means all employees in law enforcement, health care 569.36 professionals, health care nonprofessionals, correctional 570.1 guards, professional engineering, and supervisory collective 570.2 bargaining units, irrespective of severance, and no other 570.3 employees. For University of Minnesota employees, "essential 570.4 employee" means all employees in law enforcement, nursing 570.5 professional and supervisory units, irrespective of severance, 570.6 and no other employees. "Firefighters" means salaried employees 570.7 of a fire department whose duties include, directly or 570.8 indirectly, controlling, extinguishing, preventing, detecting, 570.9 or investigating fires. Employees for whom the state court 570.10 administrator is the negotiating employer are not essential 570.11 employees. 570.12 Sec. 31. Minnesota Statutes 2002, section 256B.195, 570.13 subdivision 1, is amended to read: 570.14 Subdivision 1. [FEDERAL APPROVAL REQUIRED.]Sections570.15145.9268,Section 256.969, subdivision 26, and this section are 570.16 contingent on federal approval of the intergovernmental 570.17 transfers and payments to safety net hospitalsand community570.18clinicsauthorized under this section. These sections are also 570.19 contingent on current payment, by the government entities, of 570.20 intergovernmental transfers under section 256B.19 and this 570.21 section. 570.22 Sec. 32. Minnesota Statutes 2002, section 256B.195, 570.23 subdivision 3, is amended to read: 570.24 Subd. 3. [PAYMENTS TO CERTAIN SAFETY NET PROVIDERS.] (a) 570.25 Effective July 15, 2001, the commissioner shall make the 570.26 following payments to the hospitals indicated after noon on the 570.27 15th of each month: 570.28 (1) to Hennepin County Medical Center, any federal matching 570.29 funds available to match the payments received by the medical 570.30 center under subdivision 2, to increase payments for medical 570.31 assistance admissions and to recognize higher medical assistance 570.32 costs in institutions that provide high levels of charity care; 570.33 and 570.34 (2) to Regions hospital, any federal matching funds 570.35 available to match the payments received by the hospital under 570.36 subdivision 2, to increase payments for medical assistance 571.1 admissions and to recognize higher medical assistance costs in 571.2 institutions that provide high levels of charity care. 571.3 (b)EffectiveDuring the fiscal years beginning July 15, 571.4 2001 and July 1, 2002, the following percentages of the 571.5 transfers under subdivision 2 shall be retained by the 571.6 commissioner for deposit each month into the general fund: 571.7 (1) 18 percent, plus any federal matching funds, shall be 571.8 allocated for the following purposes: 571.9 (i) during the fiscal year beginning July 1, 2001, of the 571.10 amount available under this clause, 39.7 percent shall be 571.11 allocated to make increased hospital payments under section 571.12 256.969, subdivision 26; 34.2 percent shall be allocated to fund 571.13 the amounts due from small rural hospitals, as defined in 571.14 section 144.148, for overpayments under section 256.969, 571.15 subdivision 5a, resulting from a determination that medical 571.16 assistance and general assistance payments exceeded the charge 571.17 limit during the period from 1994 to 1997; and 26.1 percent 571.18 shall be allocated to the commissioner of health for rural 571.19 hospital capital improvement grants under section 144.148; and 571.20 (ii) during the fiscalyearsyear beginningon or after571.21 July 1, 2002, of the amount available under this clause, 55 571.22 percent shall be allocated to make increased hospital payments 571.23 under section 256.969, subdivision 26, and 45 percent shall be 571.24 allocated to the commissioner of health for rural hospital 571.25 capital improvement grants under section 144.148; and 571.26 (2) 11 percent shall be allocated to the commissioner of 571.27 health to fund community clinic grants under section 145.9268. 571.28 (c) Effective July 15, 2003, 29 percent of the transfers 571.29 under subdivision 2 shall be retained by the commissioner for 571.30 deposit each month into the general fund. Of the amount in this 571.31 paragraph, 9.9 percent of the transfers shall be allocated to 571.32 make increased hospital payments under section 256.969, 571.33 subdivision 26. 571.34 (d) This subdivision shall apply to fee-for-service 571.35 payments only and shall not increase capitation payments or 571.36 payments made based on average rates. 572.1(d)(e) Medical assistance rate or payment changes, 572.2 including those required to obtain federal financial 572.3 participation under section 62J.692, subdivision 8, shall 572.4 precede the determination of intergovernmental transfer amounts 572.5 determined in this subdivision. Participation in the 572.6 intergovernmental transfer program shall not result in the 572.7 offset of any health care provider's receipt of medical 572.8 assistance payment increases other than limits resulting from 572.9 hospital-specific charge limits and limits on disproportionate 572.10 share hospital payments. 572.11 Sec. 33. Minnesota Statutes 2002, section 256B.195, 572.12 subdivision 5, is amended to read: 572.13 Subd. 5. [INCLUSION OF FAIRVIEW UNIVERSITY MEDICAL 572.14 CENTER.] (a) Upon federal approval of the inclusion of Fairview 572.15 University Medical Center in thenonstate government572.16 nongovernment category, the commissioner shall establish an 572.17 intergovernmental transfer with the University of Minnesota in 572.18 an amount determined by the commissioner based on the increase 572.19 in the Medicare upper payment limit due solely to the inclusion 572.20 of Fairview University Medical Center as anonstate government572.21 nongovernment hospital and limited by hospital-specific charge 572.22 limits and the amount available under the hospital-specific 572.23 disproportionate share limit. 572.24 (b) The commissioner shall increase payments for medical 572.25 assistance admissions at Fairview University Medical Center by 572.26 71 percent of the transfer plus any federal matching payments on 572.27 that amount, to increase payments for medical assistance 572.28 admissions and to recognize higher medical assistance costs in 572.29 institutions that provide high levels of charity care. From 572.30 this payment, Fairview University Medical Center shall pay to 572.31 the University of Minnesota the cost of the transfer, on the 572.32 same day the payment is received. Eighteen percent of the 572.33 transfer plus any federal matching payments shall be used as 572.34 specified in subdivision 3, paragraph (b), clause (1). Payments 572.35 under section 256.969, subdivision 26, may be increased above 572.36 the 90 percent level specified in that subdivision within the 573.1 limits of additional funding available under this subdivision. 573.2Eleven percent of the transfer shall be used to increase the573.3grants under section 145.9268.573.4 Sec. 34. Minnesota Statutes 2002, section 256B.69, 573.5 subdivision 5c, is amended to read: 573.6 Subd. 5c. [MEDICAL EDUCATION AND RESEARCH FUND.] (a) The 573.7 commissioner of human services shall transfer each year to the 573.8 medical education and research fund established under section 573.9 62J.692, the following: 573.10 (1) an amount equal to the reduction in the prepaid medical 573.11 assistance and prepaid general assistance medical care payments 573.12 as specified in this clause. Until January 1, 2002, the county 573.13 medical assistance and general assistance medical care 573.14 capitation base rate prior to plan specific adjustments and 573.15 after the regional rate adjustments under section 256B.69, 573.16 subdivision 5b, is reduced 6.3 percent for Hennepin county, two 573.17 percent for the remaining metropolitan counties, and no 573.18 reduction for nonmetropolitan Minnesota counties; and after 573.19 January 1, 2002, the county medical assistance and general 573.20 assistance medical care capitation base rate prior to plan 573.21 specific adjustments is reduced 6.3 percent for Hennepin county, 573.22 two percent for the remaining metropolitan counties, and 1.6 573.23 percent for nonmetropolitan Minnesota counties. Nursing 573.24 facility and elderly waiver payments and demonstration project 573.25 payments operating under subdivision 23 are excluded from this 573.26 reduction. The amount calculated under this clause shall not be 573.27 adjusted for periods already paid due to subsequent changes to 573.28 the capitation payments; 573.29 (2) beginning July 1, 2001,$2,537,000$2,157,000 from the 573.30 capitation rates paid under this section plus any federal 573.31 matching funds on this amount; 573.32 (3) beginning July 1, 2002, an additional $12,700,000 from 573.33 the capitation rates paid under this section; and 573.34 (4) beginning July 1, 2003, an additional $4,700,000 from 573.35 the capitation rates paid under this section. 573.36 (b) This subdivision shall be effective upon approval of a 574.1 federal waiver which allows federal financial participation in 574.2 the medical education and research fund. 574.3 Sec. 35. Minnesota Statutes 2002, section 295.55, 574.4 subdivision 2, is amended to read: 574.5 Subd. 2. [ESTIMATED TAX; HOSPITALS; SURGICAL CENTERS.] (a) 574.6 Each hospital or surgical center must make estimated payments of 574.7 the taxes for the calendar year in monthly installments to the 574.8 commissioner within 15 days after the end of the month. 574.9 (b) Estimated tax payments are not required of hospitals or 574.10 surgical centers if: (1) the tax for the current calendar year 574.11 is less than $500; or (2) the tax for the previous calendar year 574.12 is less than $500, if the taxpayer had a tax liability and was 574.13 doing business the entire year; or (3) if a hospital has been574.14allowed a grant under section 144.1484, subdivision 2, for the574.15year. 574.16 (c) Underpayment of estimated installments bear interest at 574.17 the rate specified in section 270.75, from the due date of the 574.18 payment until paid or until the due date of the annual return 574.19 whichever comes first. An underpayment of an estimated 574.20 installment is the difference between the amount paid and the 574.21 lesser of (1) 90 percent of one-twelfth of the tax for the 574.22 calendar year or (2) one-twelfth of the total tax for the 574.23 previous calendar year if the taxpayer had a tax liability and 574.24 was doing business the entire year. 574.25 Sec. 36. Minnesota Statutes 2002, section 326.42, is 574.26 amended to read: 574.27 326.42 [APPLICATIONS, FEES.] 574.28 Subdivision 1. [APPLICATION.] Applications for plumber's 574.29 license shall be made to the state commissioner of health, with 574.30 fee. Unless the applicant is entitled to a renewal, the 574.31 applicant shall be licensed by the state commissioner of health 574.32 only after passing a satisfactory examination by the examiners 574.33 showing fitness. Examination fees for both journeyman and 574.34 master plumbers shall be in an amount prescribed by the state 574.35 commissioner of health pursuant to section 144.122. Upon being 574.36 notified that of having successfully passed the examination for 575.1 original license the applicant shall submit an application, with 575.2 the license fee herein provided. License fees shall be in an 575.3 amount prescribed by the state commissioner of health pursuant 575.4 to section 144.122. Licenses shall expire and be renewed as 575.5 prescribed by the commissioner pursuant to section 144.122. 575.6 Subd. 2. [FEES.] Plumbing system plans and specifications 575.7 that are submitted to the commissioner for review shall be 575.8 accompanied by the appropriate plan examination fees. If the 575.9 commissioner determines, upon review of the plans, that 575.10 inadequate fees were paid, the necessary additional fees shall 575.11 be paid prior to plan approval. The commissioner shall charge 575.12 the following fees for plan reviews and audits of plumbing 575.13 installations for public, commercial, and industrial buildings: 575.14 (1) systems with both water distribution and drain, waste, 575.15 and vent systems and having: 575.16 (i) 25 or fewer drainage fixture units, $150; 575.17 (ii) 26 to 50 drainage fixture units, $250; 575.18 (iii) 51 to 150 drainage fixture units, $350; 575.19 (iv) 151 to 249 drainage fixture units, $500; 575.20 (v) 250 or more drainage fixture units, $3 per drainage 575.21 fixture unit to a maximum of $4,000; and 575.22 (vi) interceptors, separators, or catch basins, $70 per 575.23 interceptor, separator, or catch basin; 575.24 (2) building sewer service only, $150; 575.25 (3) building water service only, $150; 575.26 (4) building water distribution system only, no drainage 575.27 system, $5 per supply fixture unit or $150, whichever is 575.28 greater; 575.29 (5) storm drainage system, a minimum fee of $150 or: 575.30 (i) $50 per drain opening, up to a maximum of $500; and 575.31 (ii) $70 per interceptor, separator, or catch basin; 575.32 (6) manufactured home park or campground, 1 to 25 sites, 575.33 $300; 575.34 (7) manufactured home park or campground, 26 to 50 sites, 575.35 $350; 575.36 (8) manufactured home park or campground, 51 to 125 sites, 576.1 $400; 576.2 (9) manufactured home park or campground, more than 125 576.3 sites, $500; 576.4 (10) accelerated review, double the regular fee, one-half 576.5 to be refunded if no response from the commissioner within 15 576.6 business days; and 576.7 (11) revision to previously reviewed or incomplete plans: 576.8 (i) review of plans for which commissioner has issued two 576.9 or more requests for additional information, per review, $100 or 576.10 ten percent of the original fee, whichever is greater; 576.11 (ii) proposer-requested revision with no increase in 576.12 project scope, $50 or ten percent of original fee, whichever is 576.13 greater; and 576.14 (iii) proposer-requested revision with an increase in 576.15 project scope, $50 plus the difference between the original 576.16 project fee and the revised project fee. 576.17 Sec. 37. [AUTHORITY TO COLLECT CERTAIN FEES SUSPENDED.] 576.18 (a) The commissioner's authority to collect the certificate 576.19 application fee from hearing instrument dispensers under 576.20 Minnesota Statutes, section 153A.17, is suspended for certified 576.21 hearing instrument dispensers renewing certification in fiscal 576.22 year 2004. 576.23 (b) The commissioner's authority to collect the license 576.24 renewal fee from occupational therapy practitioners under 576.25 Minnesota Statutes, section 148.6445, subdivision 2, is 576.26 suspended for fiscal years 2004 and 2005. 576.27 Sec. 38. [TRANSITION PERIOD.] 576.28 From July 1, 2003, through June 30, 2005, facilities are 576.29 required to report any adverse health care events as defined in 576.30 Minnesota Statutes, section 144.7067, to the incident reporting 576.31 system currently maintained by the Minnesota Hospital 576.32 Association. The commissioner of health will work with the 576.33 Minnesota Hospital Association to obtain access to, or receive 576.34 reports of, adverse health care events by category only. The 576.35 commissioner will not receive any identifying information from 576.36 such access or reports. The commissioner will work with 577.1 organizations and experts familiar with patient safety to review 577.2 reporting categories in Minnesota Statutes, section 144.7067, 577.3 and will monitor discussions of the National Quality Forum, 577.4 other states and the federal government in the area of patient 577.5 safety. The commissioner of health will submit reports to the 577.6 legislature by January 15, 2004, and January 15, 2005, including 577.7 a listing of the number of reported events by type and 577.8 recommendations, if any, of additional categories of events that 577.9 should be included. From July 1, 2003, through June 30, 2005, 577.10 the department of health shall not make a final disposition as 577.11 defined in Minnesota Statutes, section 626.5572, subdivision 8, 577.12 for investigations conducted in licensed hospitals under the 577.13 provisions of Minnesota Statutes, section 626.557. The 577.14 department of health's findings in these cases shall identify 577.15 noncompliance with federal certification or state licensure 577.16 rules or laws. From July 1, 2003, through June 30, 2005, the 577.17 commissioner will solicit funds to provide for full 577.18 implementation of the Minnesota Adverse Health Care Reporting 577.19 Act of 2003 on a pilot or demonstration basis. If funds are 577.20 available, the commissioner will advise the legislature and 577.21 recommend full implementation of the Act on an earlier date. 577.22 [EFFECTIVE DATE.] This section is effective to the extent 577.23 independent funds are obtained. 577.24 Sec. 39. [HOSPITAL MORATORIUM STUDY.] 577.25 (a) Utilizing existing resources, the commissioner of 577.26 health, working with the Minnesota Hospital Association and 577.27 other affected parties, shall study and report to the 577.28 legislature by January 1, 2005, on the moratorium on hospital 577.29 beds. The study and report shall: 577.30 (1) evaluate the moratorium's impact on access, cost, and 577.31 quality of care; 577.32 (2) recommend appropriate criteria to be considered by the 577.33 legislature in judging applications for moratorium exceptions; 577.34 (3) assess the impact of "niche" and ambulatory services on 577.35 a system of controlling capacity; 577.36 (4) identify demographic and health care delivery changes 578.1 that have occurred since the inception of the moratorium, 578.2 projected future trends in technology, and their impact on 578.3 future inpatient hospitals' utilization and future demand for 578.4 inpatient services; and 578.5 (5) include a comprehensive national survey of inpatient 578.6 and outpatient capacity controls. 578.7 (b) As an outcome of the study, the commissioner shall 578.8 recommend: 578.9 (1) criteria for judging exception requests; 578.10 (2) processes to be used in considering exception requests; 578.11 and 578.12 (3) other changes in the moratorium law needed to work with 578.13 future trends and demographic changes. 578.14 (c) A progress report shall be presented to the legislature 578.15 by March 15, 2004. 578.16 Sec. 40. [REVISOR'S INSTRUCTION.] 578.17 (a) The revisor of statutes shall delete the reference to 578.18 "144.1495" in Minnesota Statutes, section 62Q.145, and insert 578.19 "144.1501." 578.20 (b) For sections in Minnesota Statutes and Minnesota Rules 578.21 affected by the repealed sections in this article, the revisor 578.22 shall delete internal cross-references where appropriate and 578.23 make changes necessary to correct the punctuation, grammar, or 578.24 structure of the remaining text and preserve its meaning. 578.25 Sec. 41. [REPEALER; EXPENDITURE REPORTING.] 578.26 Minnesota Statutes 2002, sections 16A.151, subdivision 5, 578.27 and 62J.17, are repealed effective the day following final 578.28 enactment. 578.29 Sec. 42. [REPEALER.] 578.30 (a) Minnesota Statutes 2002, sections 16A.87; 62J.694; 578.31 144.126; 144.1484; 144.1494; 144.1495; 144.1496; 144.1497; 578.32 144.395; 144.396; 144A.36; 144A.38; 148.5194, subdivision 3a; 578.33 and 148.6445, subdivision 9, are repealed. 578.34 (b) Minnesota Rules, parts 4763.0100; 4763.0110; 4763.0125; 578.35 4763.0135; 4763.0140; 4763.0150; 4763.0160; 4763.0170; 578.36 4763.0180; 4763.0190; 4763.0205; 4763.0215; 4763.0220; 579.1 4763.0230; 4763.0240; 4763.0250; 4763.0260; 4763.0270; 579.2 4763.0285; 4763.0295; and 4763.0300, are repealed. 579.3 ARTICLE 9 579.4 LOCAL PUBLIC HEALTH GRANTS 579.5 Section 1. Minnesota Statutes 2002, section 144E.11, 579.6 subdivision 6, is amended to read: 579.7 Subd. 6. [REVIEW CRITERIA.] When reviewing an application 579.8 for licensure, the board and administrative law judge shall 579.9 consider the following factors: 579.10 (1)the relationship of the proposed service or expansion579.11in primary service area to the current community health plan as579.12approved by the commissioner of health under section 145A.12,579.13subdivision 4;579.14(2)the recommendations or comments of the governing bodies 579.15 of the counties, municipalities, community health boards as 579.16 defined under section 145A.09, subdivision 2, and regional 579.17 emergency medical services system designated under section 579.18 144E.50 in which the service would be provided; 579.19(3)(2) the deleterious effects on the public health from 579.20 duplication, if any, of ambulance services that would result 579.21 from granting the license; 579.22(4)(3) the estimated effect of the proposed service or 579.23 expansion in primary service area on the public health; and 579.24(5)(4) whether any benefit accruing to the public health 579.25 would outweigh the costs associated with the proposed service or 579.26 expansion in primary service area. The administrative law judge 579.27 shall recommend that the board either grant or deny a license or 579.28 recommend that a modified license be granted. The reasons for 579.29 the recommendation shall be set forth in detail. The 579.30 administrative law judge shall make the recommendations and 579.31 reasons available to any individual requesting them. 579.32 Sec. 2. Minnesota Statutes 2002, section 145.88, is 579.33 amended to read: 579.34 145.88 [PURPOSE.] 579.35The legislature finds that it is in the public interest to579.36assure:580.1(a) statewide planning and coordination of maternal and580.2child health services through the acquisition and analysis of580.3population-based health data, provision of technical support and580.4training, and coordination of the various public and private580.5maternal and child health efforts; and580.6(b) support for targeted maternal and child health services580.7in communities with significant populations of high risk, low580.8income families through a grants process.580.9 Federal money received by the Minnesota department of 580.10 health, pursuant to United States Code, title 42, sections 701 580.11 to 709, shall be expended to: 580.12 (1) assure access to quality maternal and child health 580.13 services for mothers and children, especially those of low 580.14 income and with limited availability to health services and 580.15 those children at risk of physical, neurological, emotional, and 580.16 developmental problems arising from chemical abuse by a mother 580.17 during pregnancy; 580.18 (2) reduce infant mortality and the incidence of 580.19 preventable diseases and handicapping conditions among children; 580.20 (3) reduce the need for inpatient and long-term care 580.21 services and to otherwise promote the health of mothers and 580.22 children, especially by providing preventive and primary care 580.23 services for low-income mothers and children and prenatal, 580.24 delivery and postpartum care for low-income mothers; 580.25 (4) provide rehabilitative services for blind and disabled 580.26 children under age 16 receiving benefits under title XVI of the 580.27 Social Security Act; and 580.28 (5) provide and locate medical, surgical, corrective and 580.29 other service for children who are crippled or who are suffering 580.30 from conditions that lead to crippling. 580.31 Sec. 3. Minnesota Statutes 2002, section 145.881, 580.32 subdivision 2, is amended to read: 580.33 Subd. 2. [DUTIES.] The advisory task force shall meet on a 580.34 regular basis to perform the following duties: 580.35 (a) review and report on the health care needs of mothers 580.36 and children throughout the state of Minnesota; 581.1 (b) review and report on the type, frequency and impact of 581.2 maternal and child health care services provided to mothers and 581.3 children under existing maternal and child health care programs, 581.4 including programs administered by the commissioner of health; 581.5 (c) establish, review, and report to the commissioner a 581.6 list of program guidelines and criteria which the advisory task 581.7 force considers essential to providing an effective maternal and 581.8 child health care program to low income populations and high 581.9 risk persons and fulfilling the purposes defined in section 581.10 145.88; 581.11 (d)review staff recommendations of the department of581.12health regarding maternal and child health grant awards before581.13the awards are made;581.14(e)make recommendations to the commissioner for the use of 581.15 other federal and state funds available to meet maternal and 581.16 child health needs; 581.17(f)(e) make recommendations to the commissioner of health 581.18 on priorities for funding the following maternal and child 581.19 health services: (1) prenatal, delivery and postpartum care, (2) 581.20 comprehensive health care for children, especially from birth 581.21 through five years of age, (3) adolescent health services, (4) 581.22 family planning services, (5) preventive dental care, (6) 581.23 special services for chronically ill and handicapped children 581.24 and (7) any other services which promote the health of mothers 581.25 and children; and 581.26(g) make recommendations to the commissioner of health on581.27the process to distribute, award and administer the maternal and581.28child health block grant funds; and581.29(h) review the measures that are used to define the581.30variables of the funding distribution formula in section581.31145.882, subdivision 4, every two years and make recommendations581.32to the commissioner of health for changes based upon principles581.33established by the advisory task force for this purpose.581.34 (f) establish, in consultation with the commissioner and 581.35 the state community health advisory committee established under 581.36 section 145A.10, subdivision 10, paragraph (a), statewide 582.1 outcomes that will improve the health status of mothers and 582.2 children as required in section 145A.12, subdivision 7. 582.3 Sec. 4. Minnesota Statutes 2002, section 145.882, 582.4 subdivision 1, is amended to read: 582.5 Subdivision 1. [FUNDINGLEVELS AND ADVISORY TASK FORCE582.6REVIEW.] Any decrease in the amount of federal funding to the 582.7 state for the maternal and child health block grant must be 582.8 apportioned to reflect a proportional decrease for each 582.9 recipient. Any increase in the amount of federal funding to the 582.10 state must be distributed under subdivisions 2,and 3, and 4. 582.11The advisory task force shall review and recommend the582.12proportion of maternal and child health block grant funds to be582.13expended for indirect costs, direct services and special582.14projects.582.15 Sec. 5. Minnesota Statutes 2002, section 145.882, 582.16 subdivision 2, is amended to read: 582.17 Subd. 2. [ALLOCATION TO THE COMMISSIONER OF HEALTH.] 582.18 Beginning January 1, 1986, up to one-third of the total maternal 582.19 and child health block grant money may be retained by the 582.20 commissioner of healthfor administrative and technical582.21assistance services, projects of regional or statewide582.22significance, direct services to children with handicaps, and582.23other activities of the commissioner.to: 582.24 (1) meet federal maternal and child block grant 582.25 requirements of a statewide needs assessment every five years 582.26 and prepare the annual federal block grant application and 582.27 report; 582.28 (2) collect and disseminate statewide data on the health 582.29 status of mothers and children within one year of the end of the 582.30 year; 582.31 (3) provide technical assistance to community health boards 582.32 in meeting statewide outcomes under section 145A.12, subdivision 582.33 7; 582.34 (4) evaluate the impact of maternal and child health 582.35 activities on the health status of mothers and children; 582.36 (5) provide services to children under age 16 receiving 583.1 benefits under title XVI of the Social Security Act; and 583.2 (6) perform other maternal and child health activities 583.3 listed in section 145.88 and as deemed necessary by the 583.4 commissioner. 583.5 Sec. 6. Minnesota Statutes 2002, section 145.882, 583.6 subdivision 3, is amended to read: 583.7 Subd. 3. [ALLOCATION TO COMMUNITY HEALTHSERVICES583.8AREASBOARDS.](a)The maternal and child health block grant 583.9 money remaining after distributions made under subdivision 2 583.10 must be allocated according to the formula insubdivision 4 to583.11community health services areassection 145A.131, subdivision 2, 583.12 for distributionbyto community health boards.as defined in583.13section 145A.02, subdivision 5, to qualified programs that583.14provide essential services within the community health services583.15area as long as:583.16(1) the Minneapolis community health service area is583.17allocated at least $1,626,215 per year;583.18(2) the St. Paul community health service area is allocated583.19at least $822,931 per year; and583.20(3) all other community health service areas are allocated583.21at least $30,000 per county per year or their 1988-1989 funding583.22cycle award, whichever is less.583.23(b) Notwithstanding paragraph (a), if the total amount of583.24maternal and child health block grant funding decreases, the583.25decrease must be apportioned to reflect a proportional decrease583.26for each recipient, including recipients who would otherwise583.27receive a guaranteed minimum allocation under paragraph (a).583.28 Sec. 7. Minnesota Statutes 2002, section 145.882, is 583.29 amended by adding a subdivision to read: 583.30 Subd. 5a. [NONPARTICIPATING COMMUNITY HEALTH BOARDS.] If a 583.31 community health board decides not to participate in maternal 583.32 and child health block grant activities under subdivision 3 or 583.33 the commissioner determines under section 145A.131, subdivision 583.34 7, not to fund the community health board, the commissioner is 583.35 responsible for directing maternal and child health block grant 583.36 activities in that community health board's geographic area. 584.1 The commissioner may elect to directly provide public health 584.2 activities to meet the statewide outcomes or to contract with 584.3 other governmental units or nonprofit organizations. 584.4 Sec. 8. Minnesota Statutes 2002, section 145.882, 584.5 subdivision 7, is amended to read: 584.6 Subd. 7. [USE OF BLOCK GRANT MONEY.](a)Maternal and 584.7 child health block grant money allocated to a community health 584.8 boardor community health services areaunder this section must 584.9 be used for qualified programs for high risk and low-income 584.10 individuals. Block grant money must be used for programs that: 584.11 (1) specifically address the highest risk populations, 584.12 particularly low-income and minority groups with a high rate of 584.13 infant mortality and children with low birth weight, by 584.14 providing services, including prepregnancy family planning 584.15 services, calculated to produce measurable decreases in infant 584.16 mortality rates, instances of children with low birth weight, 584.17 and medical complications associated with pregnancy and 584.18 childbirth, including infant mortality, low birth rates, and 584.19 medical complications arising from chemical abuse by a mother 584.20 during pregnancy; 584.21 (2) specifically target pregnant women whose age, medical 584.22 condition, maternal history, or chemical abuse substantially 584.23 increases the likelihood of complications associated with 584.24 pregnancy and childbirth or the birth of a child with an 584.25 illness, disability, or special medical needs; 584.26 (3) specifically address the health needs of young children 584.27 who have or are likely to have a chronic disease or disability 584.28 or special medical needs, including physical, neurological, 584.29 emotional, and developmental problems that arise from chemical 584.30 abuse by a mother during pregnancy; 584.31 (4) provide family planning and preventive medical care for 584.32 specifically identified target populations, such as minority and 584.33 low-income teenagers, in a manner calculated to decrease the 584.34 occurrence of inappropriate pregnancy and minimize the risk of 584.35 complications associated with pregnancy and childbirth;or584.36 (5) specifically address the frequency and severity of 585.1 childhood and adolescent health issues, including injuries in 585.2 high risk target populations by providing services calculated to 585.3 produce measurable decreases in mortality and morbidity.; 585.4However, money may be used for this purpose only if the585.5community health board's application includes program components585.6for the purposes in clauses (1) to (4) in the proposed585.7geographic service area and the total expenditure for585.8injury-related programs under this clause does not exceed ten585.9percent of the total allocation under subdivision 3.585.10(b) Maternal and child health block grant money may be used585.11for purposes other than the purposes listed in this subdivision585.12only under the following conditions:585.13(1) the community health board or community health services585.14area can demonstrate that existing programs fully address the585.15needs of the highest risk target populations described in this585.16subdivision; or585.17(2) the money is used to continue projects that received585.18funding before creation of the maternal and child health block585.19grant in 1981.585.20(c) Projects that received funding before creation of the585.21maternal and child health block grant in 1981, must be allocated585.22at least the amount of maternal and child health special project585.23grant funds received in 1989, unless (1) the local board of585.24health provides equivalent alternative funding for the project585.25from another source; or (2) the local board of health585.26demonstrates that the need for the specific services provided by585.27the project has significantly decreased as a result of changes585.28in the demographic characteristics of the population, or other585.29factors that have a major impact on the demand for services. If585.30the amount of federal funding to the state for the maternal and585.31child health block grant is decreased, these projects must585.32receive a proportional decrease as required in subdivision 1.585.33Increases in allocation amounts to local boards of health under585.34subdivision 4 may be used to increase funding levels for these585.35projects.585.36 (6) specifically address preventing child abuse and 586.1 neglect, reducing juvenile delinquency, promoting positive 586.2 parenting and resiliency in children, and promoting family 586.3 health and economic sufficiency through public health nurse home 586.4 visits under section 145A.17; or 586.5 (7) specifically address nutritional issues of women, 586.6 infants, and young children through WIC clinic services. 586.7 Sec. 9. [145.8821] [ACCOUNTABILITY.] 586.8 (a) Coordinating with the statewide outcomes established 586.9 under section 145A.12, subdivision 7, and with accountability 586.10 measures outlined in section 145A.131, subdivision 7, each 586.11 community health board that receives money under section 586.12 145.882, subdivision 3, shall select by February 1, 2005, and 586.13 every five years thereafter, up to two statewide maternal and 586.14 child health outcomes. 586.15 (b) For the period January 1, 2004, to December 31, 2005, 586.16 each community health board must work toward the Healthy People 586.17 2010 goal to reduce the state's percentage of low birth weight 586.18 infants. 586.19 (c) The commissioner shall monitor and evaluate whether 586.20 each community health board has made sufficient progress toward 586.21 the selected outcomes established in paragraph (b) and under 586.22 section 145A.12, subdivision 7. 586.23 (d) Community health boards shall provide the commissioner 586.24 with annual information necessary to evaluate progress toward 586.25 selected statewide outcomes and to meet federal reporting 586.26 requirements. 586.27 Sec. 10. Minnesota Statutes 2002, section 145.883, 586.28 subdivision 1, is amended to read: 586.29 Subdivision 1. [SCOPE.] For purposes of sections 145.881 586.30 to145.888145.883, the terms defined in this section shall have 586.31 the meanings given them. 586.32 Sec. 11. Minnesota Statutes 2002, section 145.883, 586.33 subdivision 9, is amended to read: 586.34 Subd. 9. [COMMUNITY HEALTHSERVICES AREABOARD.] 586.35 "Community healthservices areaboard" meansa city, county, or586.36multicounty area that is organized as a community health board587.1under section 145A.09 and for which a state subsidy is received587.2under sections 145A.09 to 145A.13a board of health established, 587.3 operating, and eligible for a local public health grant under 587.4 sections 145A.09 to 145A.131. 587.5 Sec. 12. Minnesota Statutes 2002, section 145A.02, 587.6 subdivision 5, is amended to read: 587.7 Subd. 5. [COMMUNITY HEALTH BOARD.] "Community health 587.8 board" means a board of health established, operating, and 587.9 eligible for asubsidylocal public health grant under sections 587.10 145A.09 to145A.13145A.131. 587.11 Sec. 13. Minnesota Statutes 2002, section 145A.02, 587.12 subdivision 6, is amended to read: 587.13 Subd. 6. [COMMUNITY HEALTH SERVICES.] "Community health 587.14 services" means activities designed to protect and promote the 587.15 health of the general population within a community health 587.16 service area by emphasizing the prevention of disease, injury, 587.17 disability, and preventable death through the promotion of 587.18 effective coordination and use of community resources, and by 587.19 extending health services into the community.Program587.20categories of community health services include disease587.21prevention and control, emergency medical care, environmental587.22health, family health, health promotion, and home health care.587.23 Sec. 14. Minnesota Statutes 2002, section 145A.02, 587.24 subdivision 7, is amended to read: 587.25 Subd. 7. [COMMUNITY HEALTH SERVICE AREA.] "Community 587.26 health service area" means a city, county, or multicounty area 587.27 that is organized as a community health board under section 587.28 145A.09 and for which asubsidylocal public health grant is 587.29 received under sections 145A.09 to145A.13145A.131. 587.30 Sec. 15. Minnesota Statutes 2002, section 145A.06, 587.31 subdivision 1, is amended to read: 587.32 Subdivision 1. [GENERALLY.] In addition to other powers 587.33 and duties provided by law, the commissioner has the powers 587.34 listed in subdivisions 2 to45. 587.35 Sec. 16. Minnesota Statutes 2002, section 145A.09, 587.36 subdivision 2, is amended to read: 588.1 Subd. 2. [COMMUNITY HEALTH BOARD; ELIGIBILITY.] A board of 588.2 health that meets the requirements of sections 145A.09 588.3 to145A.13145A.131 is a community health board and is eligible 588.4 for acommunity health subsidylocal public health grant under 588.5 section145A.13145A.131. 588.6 Sec. 17. Minnesota Statutes 2002, section 145A.09, 588.7 subdivision 4, is amended to read: 588.8 Subd. 4. [CITIES.] A city that received a subsidy under 588.9 section 145A.13 and that meets the requirements of sections 588.10 145A.09 to145A.13145A.131 is eligible for acommunity health588.11subsidylocal public health grant under section 588.12145A.13145A.131. 588.13 Sec. 18. Minnesota Statutes 2002, section 145A.09, 588.14 subdivision 7, is amended to read: 588.15 Subd. 7. [WITHDRAWAL.] (a) A county or city that has 588.16 established or joined a community health board may withdraw from 588.17 thesubsidylocal public health grant program authorized by 588.18 sections 145A.09 to145A.13145A.131 by resolution of its 588.19 governing body in accordance with section 145A.03, subdivision 588.20 3, and this subdivision. 588.21 (b) A county or city may not withdraw from a joint powers 588.22 community health board during the first two calendar years 588.23 following that county's or city's initial adoption of the joint 588.24 powers agreement. 588.25 (c) The withdrawal of a county or city from a community 588.26 health board does not affect the eligibility for thecommunity588.27health subsidylocal public health grant of any remaining county 588.28 or city for one calendar year following the effective date of 588.29 withdrawal. 588.30 (d)The amount of additional annual payment for calendar588.31year 1985 made pursuant to Minnesota Statutes 1984, section588.32145.921, subdivision 4, must be subtracted from the subsidy for588.33a county that, due to withdrawal from a community health board,588.34ceases to meet the terms and conditions under which that588.35additional annual payment was madeThe local public health grant 588.36 for a county that chooses to withdraw from a multicounty 589.1 community health board shall be reduced by the amount of the 589.2 local partnership incentive under section 145A.131, subdivision 589.3 2, paragraph (c). 589.4 Sec. 19. Minnesota Statutes 2002, section 145A.10, 589.5 subdivision 2, is amended to read: 589.6 Subd. 2. [PREEMPTION.] (a) Not later than 365 days after 589.7 theapproval of a community health plan by the589.8commissionerformation of a community health board, any other 589.9 board of health within the community health service area for 589.10 which the plan has been prepared must cease operation, except as 589.11 authorized in a joint powers agreement under section 145A.03, 589.12 subdivision 2, or delegation agreement under section 145A.07, 589.13 subdivision 2, or as otherwise allowed by this subdivision. 589.14 (b) This subdivision does not preempt or otherwise change 589.15 the powers and duties of any city or county eligible forsubsidy589.16 a local public health grant under section 145A.09. 589.17 (c) This subdivision does not preempt the authority to 589.18 operate a community health services program of any city of the 589.19 first or second class operating an existing program of community 589.20 health services located within a county with a population of 589.21 300,000 or more persons until the city council takes action to 589.22 allow the county to preempt the city's powers and duties. 589.23 Sec. 20. Minnesota Statutes 2002, section 145A.10, is 589.24 amended by adding a subdivision to read: 589.25 Subd. 5a. [DUTIES.] (a) Consistent with the guidelines and 589.26 standards established under section 145A.12, and with input from 589.27 the community, the community health board shall: 589.28 (1) establish local public health priorities based on an 589.29 assessment of community health needs and assets; and 589.30 (2) determine the mechanisms by which the community health 589.31 board will address the local public health priorities 589.32 established under clause (1) and achieve the statewide outcomes 589.33 established under sections 145.8821 and 145A.12, subdivision 7, 589.34 within the limits of available funding. In determining the 589.35 mechanisms to address local public health priorities and achieve 589.36 statewide outcomes, the community health board shall seek public 590.1 input or consider the recommendations of the community health 590.2 advisory committee and the following essential public health 590.3 services: 590.4 (i) monitor health status to identify community health 590.5 problems; 590.6 (ii) diagnose and investigate problems and health hazards 590.7 in the community; 590.8 (iii) inform, educate, and empower people about health 590.9 issues; 590.10 (iv) mobilize community partnerships to identify and solve 590.11 health problems; 590.12 (v) develop policies and plans that support individual and 590.13 community health efforts; 590.14 (vi) enforce laws and regulations that protect health and 590.15 ensure safety; 590.16 (vii) link people to needed personal health care services; 590.17 (viii) ensure a competent public health and personal health 590.18 care workforce; 590.19 (ix) evaluate effectiveness, accessibility, and quality of 590.20 personal and population-based health services; and 590.21 (x) research for new insights and innovative solutions to 590.22 health problems. 590.23 (b) By February 1, 2005, and every five years thereafter, 590.24 each community health board that receives a local public health 590.25 grant under section 145A.131 shall notify the commissioner in 590.26 writing of the statewide outcomes established under sections 590.27 145.8821 and 145A.12, subdivision 7, that the board will address 590.28 and the local priorities established under paragraph (a) that 590.29 the board will address. 590.30 (c) Each community health board receiving a local public 590.31 health grant under section 145A.131 must submit an annual report 590.32 to the commissioner documenting progress towards the achievement 590.33 of statewide outcomes established under sections 145.8821 and 590.34 145A.12, subdivision 7, and the local public health priorities 590.35 established under paragraph (a), using reporting standards and 590.36 procedures established by the commissioner and in compliance 591.1 with all applicable federal requirements. If a community health 591.2 board has identified additional local priorities for use of the 591.3 local public health grant since the last notification of 591.4 outcomes and priorities under paragraph (b), the community 591.5 health board shall notify the commissioner of the additional 591.6 local public health priorities in the annual report. 591.7 Sec. 21. Minnesota Statutes 2002, section 145A.10, 591.8 subdivision 10, is amended to read: 591.9 Subd. 10. [STATE AND LOCAL ADVISORY COMMITTEES.] (a) A 591.10 state community health advisory committee is established to 591.11 advise, consult with, and make recommendations to the 591.12 commissioner on the development, maintenance, funding, and 591.13 evaluation of community health services. Each community health 591.14 board may appoint a member to serve on the committee. The 591.15 committee must meet at least quarterly, and special meetings may 591.16 be called by the committee chair or a majority of the members. 591.17 Members or their alternates mayreceive a per diem and mustbe 591.18 reimbursed for travel and other necessary expenses while engaged 591.19 in their official duties. 591.20 (b) The city councils or county boards that have 591.21 established or are members of a community health boardmustmay 591.22 appoint a community health advisory committee to advise, consult 591.23 with, and make recommendations to the community health board on 591.24matters relating to the development, maintenance, funding, and591.25evaluation of community health services. The committee must591.26consist of at least five members and must be generally591.27representative of the population and health care providers of591.28the community health service area. The committee must meet at591.29least three times a year and at the call of the chair or a591.30majority of the members. Members may receive a per diem and591.31reimbursement for travel and other necessary expenses while591.32engaged in their official duties.591.33(c) State and local advisory committees must adopt bylaws591.34or operating procedures that specify the length of terms of591.35membership, procedures for assuring that no more than half of591.36these terms expire during the same year, and other matters592.1relating to the conduct of committee business. Bylaws or592.2operating procedures may allow one alternate to be appointed for592.3each member of a state or local advisory committee. Alternates592.4may be given full or partial powers and duties of membersthe 592.5 duties under subdivision 5a. 592.6 Sec. 22. Minnesota Statutes 2002, section 145A.11, 592.7 subdivision 2, is amended to read: 592.8 Subd. 2. [CONSIDERATION OFCOMMUNITY HEALTH PLANLOCAL 592.9 PUBLIC HEALTH PRIORITIES AND STATEWIDE OUTCOMES IN TAX LEVY.] In 592.10 levying taxes authorized under section 145A.08, subdivision 3, a 592.11 city council or county board that has formed or is a member of a 592.12 community health board must consider the income and expenditures 592.13 required to meetthe objectives of the community health plan for592.14its arealocal public health priorities established under 592.15 section 145A.10, subdivision 5a, and statewide outcomes 592.16 established under section 145A.12, subdivision 7. 592.17 Sec. 23. Minnesota Statutes 2002, section 145A.11, 592.18 subdivision 4, is amended to read: 592.19 Subd. 4. [ORDINANCES RELATING TO COMMUNITY HEALTH 592.20 SERVICES.] A city council or county board that has established 592.21 or is a member of a community health board may by ordinance 592.22 adopt and enforce minimum standards for services provided 592.23 according to sections 145A.02 and 145A.10, subdivision 5. An 592.24 ordinance must not conflict with state law or with more 592.25 stringent standards established either by rule of an agency of 592.26 state government or by the provisions of the charter or 592.27 ordinances of any city organized under section 145A.09, 592.28 subdivision 4. 592.29 Sec. 24. Minnesota Statutes 2002, section 145A.12, 592.30 subdivision 1, is amended to read: 592.31 Subdivision 1. [ADMINISTRATIVE AND PROGRAM SUPPORT.] The 592.32 commissioner must assist community health boards in the 592.33 development, administration, and implementation of community 592.34 health services. This assistance may consist of but is not 592.35 limited to: 592.36 (1) informational resources, consultation, and training to 593.1 help community health boards plan, develop, integrate, provide 593.2 and evaluate community health services; and 593.3 (2) administrative and program guidelines and standards, 593.4 developed with the advice of the state community health advisory 593.5 committee.Adoption of these guidelines by a community health593.6board is not a prerequisite for plan approval as prescribed in593.7subdivision 4.593.8 Sec. 25. Minnesota Statutes 2002, section 145A.12, 593.9 subdivision 2, is amended to read: 593.10 Subd. 2. [PERSONNEL STANDARDS.] In accordance with chapter 593.11 14, and in consultation with the state community health advisory 593.12 committee, the commissioner may adopt rules to set standards for 593.13 administrative and program personnel to ensure competence in 593.14 administration and planningand in each program area defined in593.15section 145A.02. 593.16 Sec. 26. Minnesota Statutes 2002, section 145A.12, is 593.17 amended by adding a subdivision to read: 593.18 Subd. 7. [STATEWIDE OUTCOMES.] (a) The commissioner, in 593.19 consultation with the state community health advisory committee 593.20 established under section 145A.10, subdivision 10, paragraph 593.21 (a), shall establish statewide outcomes for local public health 593.22 grant funds allocated to community health boards between January 593.23 1, 2004, and December 31, 2005. 593.24 (b) At least one statewide outcome must be established in 593.25 each of the following public health areas: 593.26 (1) preventing diseases; 593.27 (2) protecting against environmental hazards; 593.28 (3) preventing injuries; 593.29 (4) promoting healthy behavior; 593.30 (5) responding to disasters; and 593.31 (6) ensuring access to health services. 593.32 (c) The commissioner shall use Minnesota's public health 593.33 goals established under section 62J.212 and the essential public 593.34 health services under section 145A.10, subdivision 5a, as a 593.35 basis for the development of statewide outcomes. 593.36 (d) The statewide maternal and child health outcomes 594.1 established under section 145.8821 shall be included as 594.2 statewide outcomes under this section. 594.3 (e) By December 31, 2004, and every five years thereafter, 594.4 the commissioner, in consultation with the state community 594.5 health advisory committee established under section 145A.10, 594.6 subdivision 10, paragraph (a), and the maternal and child health 594.7 advisory task force established under section 145.881, shall 594.8 develop statewide outcomes for the local public health grant 594.9 established under section 145A.131, based on state and local 594.10 assessment data regarding the health of Minnesota residents, the 594.11 essential public health services under section 145A.10, and 594.12 current Minnesota public health goals established under section 594.13 62J.212. 594.14 Sec. 27. Minnesota Statutes 2002, section 145A.13, is 594.15 amended by adding a subdivision to read: 594.16 Subd. 4. [EXPIRATION.] This section expires January 1, 594.17 2004. 594.18 Sec. 28. [145A.131] [LOCAL PUBLIC HEALTH GRANT.] 594.19 Subdivision 1. [FUNDING FORMULA FOR COMMUNITY HEALTH 594.20 BOARDS] (a) The state community health advisory committee shall 594.21 recommend a formula to the commissioner to use in distributing 594.22 state and federal funds to community health boards organized and 594.23 operating under sections 145A.09 to 145A.131 to achieve locally 594.24 identified priorities under section 145A.10, subdivision 5a, and 594.25 selected statewide outcomes under section 145A.12, subdivision 594.26 7, by July 1, 2004, for use of distributing funds to community 594.27 health boards beginning January 1, 2006, and thereafter. 594.28 (b) This paragraph and paragraph (c) create base funding 594.29 for the local public health grant formula. A community health 594.30 board eligible for a local public health grant under section 594.31 145A.09, subdivision 2, shall receive no less for any calendar 594.32 year than 50 percent of the board's 2002-2003 fiscal year 594.33 allocations, prior to unallotment in fiscal year 2003, of the 594.34 following awards: community health services subsidy; maternal 594.35 and child health special projects grants; and state allocations 594.36 of women, infants, and children. 595.1 (c) A community health board eligible for a local public 595.2 health grant under section 145A.09, subdivision 2, shall receive 595.3 no less for any calendar year than a combination of 50 percent 595.4 of the board's 2002-2003 fiscal year award for family home 595.5 visiting and 50 percent of the board's anticipated 2004-2005 595.6 fiscal year award for family home visiting. 595.7 (d) Base funding for a community health board eligible for 595.8 a local public health grant under section 145A.09, subdivision 595.9 2, shall be reduced or increased equally among all community 595.10 health boards. 595.11 (e) Multicounty community health boards shall receive a 595.12 local partnership base of up to $15,000 per year for each county 595.13 included in the community health board. The multicounty base 595.14 will be limited in fiscal years 2004 and 2005 so as not to 595.15 exceed a community health board's allocations as defined in 595.16 paragraphs (b) and (c). 595.17 Subd. 2. [LOCAL MATCH.] (a) A community health board that 595.18 receives a local public health grant shall provide a 50 percent 595.19 match for the local public health grant funds described in 595.20 paragraph (b), subject to paragraphs (b) to (e). 595.21 (b) Eligible funds must be used to meet match requirements. 595.22 Eligible funds include funds from local property taxes, 595.23 reimbursements from third parties, fees, other state funds, and 595.24 donations or nonfederal grants that are used for community 595.25 health services described in section 145A.02, subdivision 6. 595.26 (c) Community health boards must provide documentation that 595.27 the 50 percent match for funds received under United States 595.28 Code, title 42, sections 701 to 709, is used for maternal and 595.29 child health activities as described in section 145.882, 595.30 subdivision 7. 595.31 (d) When the amount of local matching funds for a community 595.32 health board is less than the amount required under paragraph 595.33 (a), the local public health grant provided for that community 595.34 health board under this section shall be reduced proportionally. 595.35 (e) A city organized under the provision of sections 595.36 145A.09 to 145A.131 that levies a tax for provision of community 596.1 health services is exempt from any county levy for the same 596.2 services to the extent of the levy imposed by the city. 596.3 Subd. 3. [ADDITIONAL FUNDS.] Additional state or federal 596.4 funds distributed to community health boards to achieve specific 596.5 outcomes shall be distributed as part of the local public health 596.6 grant established in subdivision 1. Additional outcomes for 596.7 these funds, if not specified by federal or state law, shall be 596.8 developed by the commissioner in consultation with the state 596.9 community health advisory committee established under section 596.10 145A.10, subdivision 10, and the maternal and child health 596.11 advisory task force established under section 145.881. 596.12 Subd. 4. [SPECIAL PROJECT GRANTS.] Notwithstanding other 596.13 requirements of this section, the commissioner in consultation 596.14 with the state community health advisory committee may choose to 596.15 fund noncompetitive special project grants for projects by 596.16 select community health boards, according to state or federal 596.17 law. These special project grant funds shall be distributed as 596.18 a part of a community health board's local public health grant 596.19 established in subdivision 1. 596.20 Subd. 5. [RESPONSIBILITY OF COMMISSIONER TO ENSURE A 596.21 STATEWIDE PUBLIC HEALTH SYSTEM.] If a county withdraws from a 596.22 community health board and operates as a board of health or if a 596.23 community health board elects not to accept the local public 596.24 health grant, the commissioner may retain the amount of funding 596.25 that would have been allocated to the community health board 596.26 using the formula described in subdivision 1 and assume 596.27 responsibility for public health activities to meet the 596.28 statewide outcomes in the geographic area served by the board of 596.29 health or community health board. The commissioner may elect to 596.30 directly provide public health activities to meet the statewide 596.31 outcomes or contract with other units of government or with 596.32 community-based organizations. If a city that is currently a 596.33 community health board withdraws from a community health board 596.34 or elects not to accept the local public health grant, the local 596.35 public health grant funds that would have been allocated to that 596.36 city shall be distributed to the county in which the city is 597.1 located, if the county is part of a community health board. 597.2 Subd. 6. [ACCOUNTABILITY.] (a) Community health boards 597.3 accepting local public health grants must document progress 597.4 towards the selected statewide outcomes established in section 597.5 145A.12, subdivision 7, to maintain eligibility to receive the 597.6 local public health grant. 597.7 (b) If the commissioner determines that a community health 597.8 board has not by the applicable deadline documented progress in 597.9 one or more of the statewide outcomes established under section 597.10 145.8821 or 145A.12, subdivision 7, then the commissioner may 597.11 determine not to distribute future funds to the community health 597.12 board under subdivision 1. If the commissioner determines not 597.13 to distribute future funds, the commissioner must give the 597.14 community health board written notice of this determination. In 597.15 determining whether or not to distribute future funds to the 597.16 community health board, the commissioner shall consider the 597.17 following factors with respect to the statewide outcomes for 597.18 which the community health board did not demonstrate sufficient 597.19 progress: 597.20 (1) the difficulty of meeting the statewide outcome; 597.21 (2) the effort put forth by the community health board to 597.22 meet the statewide outcome; 597.23 (3) the number of statewide outcomes that the community 597.24 health board did not meet; 597.25 (4) whether the community health board has previously 597.26 failed to meet statewide outcomes under this section; 597.27 (5) the amount of funding received by the community health 597.28 board to address the statewide outcomes; and 597.29 (6) other factors as justice may require, if the 597.30 commissioner specifically identifies the additional factors in 597.31 the commissioner's written notice of determination. 597.32 (c) If a community health board does not document progress 597.33 towards the selected statewide outcomes, the commissioner may 597.34 retain local public health grant funds and assume responsibility 597.35 for directly carrying out activities to meet the statewide 597.36 outcomes or contract with other units of government or 598.1 community-based organizations to assume responsibility for the 598.2 statewide outcomes. If the community health board that does not 598.3 document progress towards the selected statewide outcomes is a 598.4 city, the commissioner shall distribute the local public health 598.5 grant funds that would have been allocated to that city to the 598.6 county in which the city is located, if the county is part of a 598.7 community health board. 598.8 (d) The commissioner shall establish a reporting system for 598.9 community health boards to report their progress. The system 598.10 shall be developed in consultation with the state community 598.11 health advisory committee established under section 145A.10, 598.12 subdivision 10, paragraph (a), and the maternal and child health 598.13 advisory task force established under section 145.881. 598.14 Subd. 7. [LOCAL PUBLIC HEALTH PRIORITIES.] Community 598.15 health boards may use their local public health grant to address 598.16 local public health priorities identified under section 145A.10, 598.17 subdivision 5a. 598.18 Sec. 29. Minnesota Statutes 2002, section 145A.14, 598.19 subdivision 2, is amended to read: 598.20 Subd. 2. [INDIAN HEALTH GRANTS.] (a) The commissioner may 598.21 make special grants tocommunity health boards toestablish, 598.22 operate, or subsidize clinic facilities and services to furnish 598.23 health services for American Indians who reside off reservations. 598.24 (b)To qualify for a grant under this subdivision the598.25community health plan submitted by the community health board598.26must contain a proposal for the delivery of the services and598.27documentation that representatives of the Indian community598.28affected by the plan were involved in its development.598.29(c)Applicants must submit for approval a plan and budget 598.30 for the use of the funds in the form and detail specified by the 598.31 commissioner. 598.32(d)(c) Applicants must keep records, including records of 598.33 expenditures to be audited, as the commissioner specifies. 598.34 Sec. 30. Minnesota Statutes 2002, section 145A.14, is 598.35 amended by adding a subdivision to read: 598.36 Subd. 2a. [TRIBAL GOVERNMENTS.] (a) Of the funding 599.1 available for local public health grants, $2,000,000 per year is 599.2 available to tribal governments for: 599.3 (1) maternal and child health activities under section 599.4 145.882, subdivision 7; 599.5 (2) activities to reduce health disparities under section 599.6 145.928, subdivision 10; and 599.7 (3) emergency preparedness. 599.8 (b) The commissioner, in consultation with tribal 599.9 governments, shall establish a formula for distributing the 599.10 funds and developing the outcomes to be measured. 599.11 Sec. 31. [REVISOR'S INSTRUCTION.] 599.12 (a) The revisor of statutes shall delete "145A.13" and 599.13 insert "145A.131" in Minnesota Statutes, sections 145A.03, 599.14 subdivision 1; 145A.04, subdivision 4; 145A.10, subdivision 1; 599.15 256E.03, subdivision 2; 383B.221, subdivision 2; and 402.02, 599.16 subdivision 2. 599.17 (b) For sections in Minnesota Statutes and Minnesota Rules 599.18 affected by the repealed sections in this article, the revisor 599.19 shall delete internal cross-references where appropriate and 599.20 make changes necessary to correct the punctuation, grammar, or 599.21 structure of the remaining text and preserve its meaning. 599.22 Sec. 32. [REPEALER.] 599.23 (a) Minnesota Statutes 2002, sections 144.401; 144.9507, 599.24 subdivision 3; 145.56, subdivision 2; 145.882, subdivisions 4, 599.25 5, 6, and 8; 145.883, subdivisions 4 and 7; 145.884; 145.885; 599.26 145.886; 145.888; 145.889; 145.890; 145.9266, subdivisions 2, 4, 599.27 5, 6, and 7; 145.928, subdivision 9; 145A.02, subdivisions 9, 599.28 10, 11, 12, 13, and 14; 145A.09, subdivision 6; 145A.10, 599.29 subdivisions 5, 6, and 8; 145A.11, subdivision 3; 145A.12, 599.30 subdivisions 3, 4, and 5; 145A.14, subdivisions 3 and 4; and 599.31 145A.17, subdivision 2, are repealed. 599.32 (b) Minnesota Rules, parts 4736.0010; 4736.0020; 4736.0030; 599.33 4736.0040; 4736.0050; 4736.0060; 4736.0070; 4736.0080; 599.34 4736.0090; 4736.0120; and 4736.0130, are repealed effective 599.35 January 1, 2004. 599.36 (c) Minnesota Rules, parts 4705.0100; 4705.0200; 4705.0300; 600.1 4705.0400; 4705.0500; 4705.0600; 4705.0700; 4705.0800; 600.2 4705.0900; 4705.1000; 4705.1100; 4705.1200; 4705.1300; 600.3 4705.1400; 4705.1500; and 4705.1600, are repealed effective June 600.4 30, 2004. 600.5 ARTICLE 10 600.6 CHILD CARE AND MISCELLANEOUS PROVISIONS 600.7 Section 1. Minnesota Statutes 2002, section 119B.011, 600.8 subdivision 5, is amended to read: 600.9 Subd. 5. [CHILD CARE.] "Child care" means the care of a 600.10 child by someone other than a parentor, stepparent, legal 600.11 guardian, eligible relative caregiver, or the spouses of any of 600.12 the foregoing in or outside the child's own home for gain or 600.13 otherwise, on a regular basis, for any part of a 24-hour day. 600.14 Sec. 2. Minnesota Statutes 2002, section 119B.011, 600.15 subdivision 6, is amended to read: 600.16 Subd. 6. [CHILD CARE FUND.] "Child care fund" means a 600.17 program under this chapter providing: 600.18 (1) financial assistance for child care to parents engaged 600.19 in employment, job search, or education and training leading to 600.20 employment, or an at-home infant care subsidy; and 600.21 (2) grants to develop, expand, and improve the access and 600.22 availability of child care services statewide. 600.23 Sec. 3. Minnesota Statutes 2002, section 119B.011, 600.24 subdivision 15, is amended to read: 600.25 Subd. 15. [INCOME.] "Income" means earned or unearned 600.26 income received by all family members, including public 600.27 assistance cash benefitsand at-home infant care subsidy600.28payments, unless specifically excluded and child support and 600.29 maintenance distributed to the family under section 256.741, 600.30 subdivision 15. The following are excluded from income: funds 600.31 used to pay for health insurance premiums for family members, 600.32 Supplemental Security Income, scholarships, work-study income, 600.33 and grants that cover costs or reimbursement for tuition, fees, 600.34 books, and educational supplies; student loans for tuition, 600.35 fees, books, supplies, and living expenses; state and federal 600.36 earned income tax credits; assistance specifically excluded as 601.1 income by law; in-kind income such as food stamps, energy 601.2 assistance, foster care assistance, medical assistance, child 601.3 care assistance, and housing subsidies; earned income of 601.4 full-time or part-time students up to the age of 19, who have 601.5 not earned a high school diploma or GED high school equivalency 601.6 diploma including earnings from summer employment; grant awards 601.7 under the family subsidy program; nonrecurring lump sum income 601.8 only to the extent that it is earmarked and used for the purpose 601.9 for which it is paid; and any income assigned to the public 601.10 authority according to section 256.741. 601.11 Sec. 4. Minnesota Statutes 2002, section 119B.011, 601.12 subdivision 19, is amended to read: 601.13 Subd. 19. [PROVIDER.] "Provider" means: (1) an individual 601.14 or child care center or facility, either licensed or unlicensed, 601.15 providing legal child care services as defined under section 601.16 245A.03; or (2) an individual or child care center or facility 601.17 holding a valid child care license issued by another state or a 601.18 tribe and providing child care services in the licensing state 601.19 or in the area under the licensing tribe's jurisdiction. A 601.20 legally unlicensedregisteredfamily child care provider must be 601.21 at least 18 years of age, and not a member of the MFIP 601.22 assistance unit or a member of the family receiving child care 601.23 assistance to be authorized under this chapter. 601.24 Sec. 5. Minnesota Statutes 2002, section 119B.011, is 601.25 amended by adding a subdivision to read: 601.26 Subd. 19a. [REGISTRATION.] "Registration" means the 601.27 process used by a county to determine whether the provider 601.28 selected by a family applying for or receiving child care 601.29 assistance to care for that family's children meets the 601.30 requirements necessary for payment of child care assistance for 601.31 care provided by that provider. 601.32 Sec. 6. Minnesota Statutes 2002, section 119B.011, 601.33 subdivision 21, is amended to read: 601.34 Subd. 21. [RECOUPMENT OF OVERPAYMENTS.] "Recoupment of 601.35 overpayments" means the reduction of child care assistance 601.36 payments to an eligible family or a child care provider in order 602.1 to correct an overpaymentto the family even when the602.2overpayment is due to agency error or other circumstances602.3outside the responsibility or control of the familyof child 602.4 care assistance. 602.5 Sec. 7. Minnesota Statutes 2002, section 119B.011, is 602.6 amended by adding a subdivision to read: 602.7 Subd. 23. [FEDERAL POVERTY GUIDELINES.] "Federal poverty 602.8 guidelines" means the annual poverty guidelines for a family of 602.9 four, adjusted for family size, published annually by the United 602.10 States Department of Health and Human Services in the Federal 602.11 Register. 602.12 Sec. 8. Minnesota Statutes 2002, section 119B.02, 602.13 subdivision 1, is amended to read: 602.14 Subdivision 1. [CHILD CARE SERVICES.] The commissioner 602.15 shall develop standards for county and human services boards to 602.16 provide child care services to enable eligible families to 602.17 participate in employment, training, or education programs. 602.18 Within the limits of available appropriations, the commissioner 602.19 shall distribute money to counties to reduce the costs of child 602.20 care for eligible families. The commissioner shall adopt rules 602.21 to govern the program in accordance with this section. The 602.22 rules must establish a sliding schedule of fees for parents 602.23 receiving child care services. The rules shall provide that 602.24 funds received as a lump sum payment of child support arrearages 602.25 shall not be counted as income to a family in the month received 602.26 but shall be prorated over the 12 months following receipt and 602.27 added to the family income during those months.In the rules602.28adopted under this section, county and human services boards602.29shall be authorized to establish policies for payment of child602.30care spaces for absent children, when the payment is required by602.31the child's regular provider. The rules shall not set a maximum602.32number of days for which absence payments can be made, but602.33instead shall direct the county agency to set limits and pay for602.34absences according to the prevailing market practice in the602.35county. County policies for payment of absences shall be602.36subject to the approval of the commissioner.The commissioner 603.1 shall maximize the use of federal money under title I and title 603.2 IV of Public Law Number 104-193, the Personal Responsibility and 603.3 Work Opportunity Reconciliation Act of 1996, and other programs 603.4 that provide federal or state reimbursement for child care 603.5 services for low-income families who are in education, training, 603.6 job search, or other activities allowed under those programs. 603.7 Money appropriated under this section must be coordinated with 603.8 the programs that provide federal reimbursement for child care 603.9 services to accomplish this purpose. Federal reimbursement 603.10 obtained must be allocated to the county that spent money for 603.11 child care that is federally reimbursable under programs that 603.12 provide federal reimbursement for child care services. The 603.13 counties shall use the federal money to expand child care 603.14 services. The commissioner may adopt rules under chapter 14 to 603.15 implement and coordinate federal program requirements. 603.16 Sec. 9. [119B.025] [DUTIES OF COUNTIES.] 603.17 Subdivision 1. [FACTORS WHICH MUST BE VERIFIED.] (a) The 603.18 county shall verify the following at all initial child care 603.19 applications and all recertifications using the universal 603.20 application: 603.21 (1) identity of adults; 603.22 (2) presence of the minor child in the home, if 603.23 questionable; 603.24 (3) relationship of minor child to caregivers; 603.25 (4) age; 603.26 (5) immigration status, if related to eligibility; 603.27 (6) social security number, if given; 603.28 (7) income; 603.29 (8) spousal support and child support payments made to 603.30 persons outside the household; 603.31 (9) residence; 603.32 (10) inconsistent information, if related to eligibility; 603.33 and 603.34 (11) any other information the county deems necessary to 603.35 determine eligibility. 603.36 (b) Each county shall develop a recertification form to 604.1 redetermine eligibility that minimizes paperwork for the county 604.2 and the participant. 604.3 Subd. 2. [SOCIAL SECURITY NUMBERS.] The county must 604.4 request social security numbers from all applicants for child 604.5 care assistance under this chapter. A county may not deny child 604.6 care assistance solely on the basis of failure of an applicant 604.7 to report a social security number. 604.8 Sec. 10. Minnesota Statutes 2002, section 119B.03, 604.9 subdivision 9, is amended to read: 604.10 Subd. 9. [PORTABILITY POOL.] (a) The commissioner shall 604.11 establish a pool of up to five percent of the annual 604.12 appropriation for the basic sliding fee program to provide 604.13 continuous child care assistance for eligible families who move 604.14 between Minnesota counties. At the end of each allocation 604.15 period, any unspent funds in the portability pool must be used 604.16 for assistance under the basic sliding fee program. If 604.17 expenditures from the portability pool exceed the amount of 604.18 money available, the reallocation pool must be reduced to cover 604.19 these shortages. 604.20 (b) To be eligible for portable basic sliding fee 604.21 assistance, a family that has moved from a county in which it 604.22 was receiving basic sliding fee assistance to a county with a 604.23 waiting list for the basic sliding fee program must: 604.24 (1) meet the income and eligibility guidelines for the 604.25 basic sliding fee program; and 604.26 (2) notify the new county of residence within3060 days of 604.27 moving andapply for basic sliding fee assistance insubmit 604.28 information to the new county of residence to verify eligibility 604.29 for the basic sliding fee program. 604.30 (c) The receiving county must: 604.31 (1) accept administrative responsibility for applicants for 604.32 portable basic sliding fee assistance at the end of the two 604.33 months of assistance under the Unitary Residency Act; 604.34 (2) continue basic sliding fee assistance for the lesser of 604.35 six months or until the family is able to receive assistance 604.36 under the county's regular basic sliding program; and 605.1 (3) notify the commissioner through the quarterly reporting 605.2 process of any family that meets the criteria of the portable 605.3 basic sliding fee assistance pool. 605.4 Sec. 11. Minnesota Statutes 2002, section 119B.05, 605.5 subdivision 1, is amended to read: 605.6 Subdivision 1. [ELIGIBLE PARTICIPANTS.] Families eligible 605.7 for child care assistance under the MFIP child care program are: 605.8 (1) MFIP participants who are employed or in job search and 605.9 meet the requirements of section 119B.10; 605.10 (2) persons who are members of transition year families 605.11 under section 119B.011, subdivision 20, and meet the 605.12 requirements of section 119B.10; 605.13 (3) families who are participating in employment 605.14 orientation or job search, or other employment or training 605.15 activities that are included in an approved employability 605.16 development plan under chapter 256K; 605.17 (4) MFIP families who are participating in work job search, 605.18 job support, employment, or training activities as required in 605.19 their job search support or employment plan, or in appeals, 605.20 hearings, assessments, or orientations according to chapter 605.21 256J; 605.22 (5) MFIP families who are participating in social services 605.23 activities under chapter 256J or 256K as required in their 605.24 employment plan approved according to chapter 256J or 256K; and 605.25 (6) families who are participating in programs as required 605.26 in tribal contracts under section 119B.02, subdivision 2, or 605.27 256.01, subdivision 2. 605.28 Sec. 12. Minnesota Statutes 2002, section 119B.08, 605.29 subdivision 3, is amended to read: 605.30 Subd. 3. [CHILD CARE FUND PLAN.] The county and designated 605.31 administering agency shall submit a biennial child care fund 605.32 plan to the commissioneran annual child care fund plan in its605.33biennial community social services plan. The commissioner shall 605.34 establish the dates by which the county must submit the plans. 605.35 The plan shall include: 605.36 (1)a narrative of the total program for child care606.1services, including all policies and procedures that affect606.2eligible families and are used to administer the child care606.3funds;606.4(2) the methods used by the county to inform eligible606.5families of the availability of child care assistance and606.6related services;606.7(3) the provider rates paid for all children with special606.8needs by provider type;606.9(4) the county prioritization policy for all eligible606.10families under the basic sliding fee program; and606.11(5) othera description of strategies to coordinate and 606.12 maximize public and private community resources, including 606.13 school districts, health care facilities, government agencies, 606.14 neighborhood organizations, and other resources knowledgeable in 606.15 early childhood development, in particular to coordinate child 606.16 care assistance with existing community-based programs and 606.17 service providers including child care resource and referral 606.18 programs, early childhood family education, school readiness, 606.19 Head Start, local interagency early intervention committees, 606.20 special education services, early childhood screening, and other 606.21 early childhood care and education services and programs to the 606.22 extent possible, to foster collaboration among agencies and 606.23 other community-based programs that provide flexible, 606.24 family-focused services to families with young children and to 606.25 facilitate transition into kindergarten. The county must 606.26 describe a method by which to share information, responsibility, 606.27 and accountability among service and program providers; 606.28 (2) a description of procedures and methods to be used to 606.29 make copies of the proposed state plan reasonably available to 606.30 the public, including members of the public particularly 606.31 interested in child care policies such as parents, child care 606.32 providers, culturally specific service organizations, child care 606.33 resource and referral programs, interagency early intervention 606.34 committees, potential collaborative partners and agencies 606.35 involved in the provision of care and education to young 606.36 children, and allowing sufficient time for public review and 607.1 comment; and 607.2 (3) information as requested by the department to ensure 607.3 compliance with the child care fund statutes and rules 607.4 promulgated by the commissioner. 607.5 The commissioner shall notify counties within6090 days of 607.6 the date the plan is submitted whether the plan is approved or 607.7 the corrections or information needed to approve the plan. The 607.8 commissioner shall withhold a county's allocation until it has 607.9 an approved plan. Plans not approved by the end of the second 607.10 quarter after the plan is due may result in a 25 percent 607.11 reduction in allocation. Plans not approved by the end of the 607.12 third quarter after the plan is due may result in a 100 percent 607.13 reduction in the allocation to the county. Counties are to 607.14 maintain services despite any reduction in their allocation due 607.15 to plans not being approved. 607.16 Sec. 13. Minnesota Statutes 2002, section 119B.09, 607.17 subdivision 1, is amended to read: 607.18 Subdivision 1. [GENERAL ELIGIBILITY REQUIREMENTS FOR ALL 607.19 APPLICANTS FOR CHILD CARE ASSISTANCE.] (a) Child care services 607.20 must be available to families who need child care to find or 607.21 keep employment or to obtain the training or education necessary 607.22 to find employment and who: 607.23 (1) meet the requirements of section 119B.05; receive MFIP 607.24 assistance; and are participating in employment and training 607.25 services under chapter 256J or 256K; 607.26 (2) have household income below the eligibility levels for 607.27 MFIP; or 607.28 (3) have household incomewithin a range established by the607.29commissionerno greater than 250 percent of the federal poverty 607.30 guidelines, adjusted for family size. 607.31 (b) Child care services must be made available as in-kind 607.32 services. 607.33 (c) All applicants for child care assistance and families 607.34 currently receiving child care assistance must be assisted and 607.35 required to cooperate in establishment of paternity and 607.36 enforcement of child support obligations for all children in the 608.1 family as a condition of program eligibility. For purposes of 608.2 this section, a family is considered to meet the requirement for 608.3 cooperation when the family complies with the requirements of 608.4 section 256.741. 608.5 Sec. 14. Minnesota Statutes 2002, section 119B.09, 608.6 subdivision 2, is amended to read: 608.7 Subd. 2. [SLIDING FEE.] Child care services to 608.8 familieswith incomes in the commissioner's established range608.9 must be made available on a sliding fee basis.The upper limit608.10of the range must be neither less than 70 percent nor more than608.1190 percent of the state median income for a family of four,608.12adjusted for family size.608.13 Sec. 15. Minnesota Statutes 2002, section 119B.09, 608.14 subdivision 7, is amended to read: 608.15 Subd. 7. [DATE OF ELIGIBILITY FOR ASSISTANCE.] (a) The 608.16 date of eligibility for child care assistance under this chapter 608.17 is the later of the date the application was signed; the 608.18 beginning date of employment, education, or training; or the 608.19 date a determination has been made that the applicant is a 608.20 participant in employment and training services under Minnesota 608.21 Rules, part 3400.0080, subpart 2a, or chapter 256J or 256K.The608.22date of eligibility for the basic sliding fee at-home infant608.23child care program is the later of the date the infant is born608.24or, in a county with a basic sliding fee waiting list, the date608.25the family applies for at-home infant child care.608.26 (b)Payment ceases for a family under the at-home infant608.27child care program when a family has used a total of 12 months608.28of assistance as specified under section 119B.061.Payment of 608.29 child care assistance for employed persons on MFIP is effective 608.30 the date of employment or the date of MFIP eligibility, 608.31 whichever is later. Payment of child care assistance for MFIP 608.32 or work first participants in employment and training services 608.33 is effective the date of commencement of the services or the 608.34 date of MFIP or work first eligibility, whichever is later. 608.35 Payment of child care assistance for transition year child care 608.36 must be made retroactive to the date of eligibility for 609.1 transition year child care. 609.2 Sec. 16. Minnesota Statutes 2002, section 119B.09, is 609.3 amended by adding a subdivision to read: 609.4 Subd. 9. [LICENSED AND LEGAL NONLICENSED FAMILY CHILD CARE 609.5 PROVIDERS; ASSISTANCE.] Licensed and legal nonlicensed family 609.6 child care providers are not eligible to receive child care 609.7 assistance subsidies under this chapter for their own children 609.8 or children in their custody. 609.9 Sec. 17. Minnesota Statutes 2002, section 119B.09, is 609.10 amended by adding a subdivision to read: 609.11 Subd. 10. [PAYMENT OF FUNDS.] All federal, state, and 609.12 local child care funds must be paid directly to the parent when 609.13 a provider cares for children in the children's own home. In 609.14 all other cases, all federal, state, and local child care funds 609.15 must be paid directly to the child care provider, either 609.16 licensed or legal nonlicensed, on behalf of the eligible family. 609.17 Sec. 18. Minnesota Statutes 2002, section 119B.11, 609.18 subdivision 2a, is amended to read: 609.19 Subd. 2a. [RECOVERY OF OVERPAYMENTS.] (a) An amount of 609.20 child care assistance paid to a recipient in excess of the 609.21 payment due is recoverable by the county agency under paragraphs 609.22 (b) and (c), even when the overpayment was caused by agency 609.23 error or circumstances outside the responsibility and control of 609.24 the family or provider. 609.25 (b) An overpayment must be recouped or recovered from the 609.26 family if the overpayment benefited the family by causing the 609.27 family to pay less for child care expenses than the family 609.28 otherwise would have been required to pay under child care 609.29 assistance program requirements. If the family remains eligible 609.30 for child care assistance, the overpayment must be recovered 609.31 through recoupment as identified in Minnesota Rules, 609.32 part3400.0140, subpart 193400.0187, except that the 609.33 overpayments must be calculated and collected on a service 609.34 period basis. If the family no longer remains eligible for 609.35 child care assistance, the county may choose to initiate efforts 609.36 to recover overpayments from the family for overpayment less 610.1 than $50. If the overpayment is greater than or equal to $50, 610.2 the county shall seek voluntary repayment of the overpayment 610.3 from the family. If the county is unable to recoup the 610.4 overpayment through voluntary repayment, the county shall 610.5 initiate civil court proceedings to recover the overpayment 610.6 unless the county's costs to recover the overpayment will exceed 610.7 the amount of the overpayment. A family with an outstanding 610.8 debt under this subdivision is not eligible for child care 610.9 assistance until: (1) the debt is paid in full; or (2) 610.10 satisfactory arrangements are made with the county to retire the 610.11 debt consistent with the requirements of this chapter and 610.12 Minnesota Rules, chapter 3400, and the family is in compliance 610.13 with the arrangements. 610.14 (c) The county must recover an overpayment from a provider 610.15 if the overpayment did not benefit the family by causing it to 610.16 receive more child care assistance or to pay less for child care 610.17 expenses than the family otherwise would have been eligible to 610.18 receive or required to pay under child care assistance program 610.19 requirements, and benefited the provider by causing the provider 610.20 to receive more child care assistance than otherwise would have 610.21 been paid on the family's behalf under child care assistance 610.22 program requirements. If the provider continues to care for 610.23 children receiving child care assistance, the overpayment must 610.24 be recovered through reductions in child care assistance 610.25 payments for services as described in an agreement with the 610.26 county. The provider may not charge families using that 610.27 provider more to cover the cost of recouping the overpayment. 610.28 If the provider no longer cares for children receiving child 610.29 care assistance, the county may choose to initiate efforts to 610.30 recover overpayments of less than $50 from the provider. If the 610.31 overpayment is greater than or equal to $50, the county shall 610.32 seek voluntary repayment of the overpayment from the provider. 610.33 If the county is unable to recoup the overpayment through 610.34 voluntary repayment, the county shall initiate civil court 610.35 proceedings to recover the overpayment unless the county's costs 610.36 to recover the overpayment will exceed the amount of the 611.1 overpayment. A provider with an outstanding debt under this 611.2 subdivision is not eligible to care for children receiving child 611.3 care assistance until: (1) the debt is paid in full; or (2) 611.4 satisfactory arrangements are made with the county to retire the 611.5 debt consistent with the requirements of this chapter and 611.6 Minnesota Rules, chapter 3400, and the provider is in compliance 611.7 with the arrangements. 611.8 (d) When both the family and the provider acted together to 611.9 intentionally cause the overpayment, both the family and the 611.10 provider are jointly liable for the overpayment regardless of 611.11 who benefited from the overpayment. The county must recover the 611.12 overpayment as provided in paragraphs (b) and (c). When the 611.13 family or the provider is in compliance with a repayment 611.14 agreement, the party in compliance is eligible to receive child 611.15 care assistance or to care for children receiving child care 611.16 assistance despite the other party's noncompliance with 611.17 repayment arrangements. 611.18 Sec. 19. Minnesota Statutes 2002, section 119B.12, 611.19 subdivision 2, is amended to read: 611.20 Subd. 2. [PARENT FEE.] A family must be assessed a parent 611.21 fee for each service period. A family'smonthlyparent fee must 611.22 be a fixed percentage of its annual gross income. Parent fees 611.23 must apply to families eligible for child care assistance under 611.24 sections 119B.03 and 119B.05. Income must be as defined in 611.25 section 119B.011, subdivision 15. The fixed percent is based on 611.26 the relationship of the family's annual gross income to100250 611.27 percent ofstate median incomethe federal poverty 611.28 guidelines.Beginning January 1, 1998, parent fees must begin611.29at 75 percent of the poverty level. The minimum parent fees for611.30families between 75 percent and 100 percent of poverty level611.31must be $5 per month.Parent fees must be established in rule 611.32 and must provide for graduated movement to full payment. 611.33 Sec. 20. [119B.125] [PROVIDER REQUIREMENTS.] 611.34 Subdivision 1. [AUTHORIZATION.] Except as provided in 611.35 subdivision 5, a county must authorize a provider to receive 611.36 child care assistance payments before the county makes payment 612.1 for care provided by that provider. The commissioner must 612.2 establish the requirements necessary for authorization of 612.3 providers. 612.4 Subd. 2. [PERSONS WHO CANNOT BE AUTHORIZED.] (a) A person 612.5 who meets any of the conditions under paragraphs (b) to (n) must 612.6 not be authorized as a legal nonlicensed family child care 612.7 provider. For purposes of this subdivision, a finding that a 612.8 delinquency petition is proven in juvenile court must be 612.9 considered a conviction in state district court. 612.10 (b) The person has been convicted of one of the following 612.11 offenses or has admitted to committing or a preponderance of the 612.12 evidence indicates that the person has committed an act that 612.13 meets the definition of one of the following offenses: sections 612.14 609.185 to 609.195, murder in the first, second, or third 612.15 degree; 609.2661 to 609.2663, murder of an unborn child in the 612.16 first, second, or third degree; 609.322, solicitation, 612.17 inducement, or promotion of prostitution; 609.323, receiving 612.18 profit from prostitution; 609.342 to 609.345, criminal sexual 612.19 conduct in the first, second, third, or fourth degree; 609.352, 612.20 solicitation of children to engage in sexual conduct; 609.365, 612.21 incest; 609.377, felony malicious punishment of a child; 612.22 617.246, use of minors in sexual performance; 617.247, 612.23 possession of pictorial representation of a minor; 609.2242 to 612.24 609.2243, felony domestic assault; a felony offense of spousal 612.25 abuse; a felony offense of child abuse or neglect; a felony 612.26 offense of a crime against children; or an attempt or conspiracy 612.27 to commit any of these offenses as defined in Minnesota 612.28 Statutes; or an offense in any other state or country where the 612.29 elements are substantially similar to any of the offenses listed 612.30 in this paragraph. 612.31 (c) Less than 15 years have passed since the discharge of 612.32 the sentence imposed for the offense and the person has received 612.33 a felony conviction for one of the following offenses, or the 612.34 person has admitted to committing or a preponderance of the 612.35 evidence indicates that the person has committed an act that 612.36 meets the definition of a felony conviction for one of the 613.1 following offenses: sections 609.20 to 609.205, manslaughter in 613.2 the first or second degree; 609.21, criminal vehicular homicide; 613.3 609.215, aiding suicide or aiding attempted suicide; 609.221 to 613.4 609.2231, assault in the first, second, third, or fourth degree; 613.5 609.224, repeat offenses of fifth degree assault; 609.228, great 613.6 bodily harm caused by distribution of drugs; 609.2325, criminal 613.7 abuse of a vulnerable adult; 609.2335, financial exploitation of 613.8 a vulnerable adult; 609.235, use of drugs to injure or 613.9 facilitate a crime; 609.24, simple robbery; 617.241, repeat 613.10 offenses of obscene materials and performances; 609.245, 613.11 aggravated robbery; 609.25, kidnapping; 609.255, false 613.12 imprisonment; 609.2664 to 609.2665, manslaughter of an unborn 613.13 child in the first or second degree; 609.267 to 609.2672, 613.14 assault of an unborn child in the first, second, or third 613.15 degree; 609.268, injury or death of an unborn child in the 613.16 commission of a crime; 609.27, coercion; 609.275, attempt to 613.17 coerce; 609.324, subdivision 1, other prohibited acts, minor 613.18 engaged in prostitution; 609.3451, repeat offenses of criminal 613.19 sexual conduct in the fifth degree; 609.378, neglect or 613.20 endangerment of a child; 609.52, theft; 609.521, possession of 613.21 shoplifting gear; 609.561 to 609.563, arson in the first, 613.22 second, or third degree; 609.582, burglary in the first, second, 613.23 third, or fourth degree; 609.625, aggravated forgery; 609.63, 613.24 forgery; 609.631, check forgery, offering a forged check; 613.25 609.635, obtaining signature by false pretenses; 609.66, 613.26 dangerous weapon; 609.665, setting a spring gun; 609.67, 613.27 unlawfully owning, possessing, or operating a machine gun; 613.28 609.687, adulteration; 609.71, riot; 609.713, terrorist threats; 613.29 609.749, harassment, stalking; 260.221, grounds for termination 613.30 of parental rights; 152.021 to 152.022, controlled substance 613.31 crime in the first or second degree; 152.023, subdivision 1, 613.32 clause (3) or (4), or 152.023, subdivision 2, clause (4), 613.33 controlled substance crime in third degree; 152.024, subdivision 613.34 1, clause (2), (3), or (4), controlled substance crime in fourth 613.35 degree; 617.23, repeat offenses of indecent exposure; an attempt 613.36 or conspiracy to commit any of these offenses as defined in 614.1 Minnesota Statutes; or an offense in any other state or country 614.2 where the elements are substantially similar to any of the 614.3 offenses listed in this paragraph. 614.4 (d) Less than ten years have passed since the discharge of 614.5 the sentence imposed for the offense and the person has received 614.6 a gross misdemeanor conviction for one of the following offenses 614.7 or the person has admitted to committing or a preponderance of 614.8 the evidence indicates that the person has committed an act that 614.9 meets the definition of a gross misdemeanor conviction for one 614.10 of the following offenses: sections 609.224, fifth degree 614.11 assault; 609.2242 to 609.2243, domestic assault; 518B.01, 614.12 subdivision 14, violation of an order for protection; 609.3451, 614.13 fifth degree criminal sexual conduct; 609.746, repeat offenses 614.14 of interference with privacy; 617.23, repeat offenses of 614.15 indecent exposure; 617.241, obscene materials and performances; 614.16 617.243, indecent literature, distribution; 617.293, 614.17 disseminating or displaying harmful material to minors; 609.71, 614.18 riot; 609.66, dangerous weapons; 609.749, harassment, stalking; 614.19 609.224, subdivision 2, paragraph (c), fifth degree assault 614.20 against a vulnerable adult by a caregiver; 609.23, mistreatment 614.21 of persons confined; 609.231, mistreatment of residents or 614.22 patients; 609.2325, criminal abuse of a vulnerable adult; 614.23 609.2335, financial exploitation of a vulnerable adult; 609.233, 614.24 criminal neglect of a vulnerable adult; 609.234, failure to 614.25 report maltreatment of a vulnerable adult; 609.72, subdivision 614.26 3, disorderly conduct against a vulnerable adult; 609.265, 614.27 abduction; 609.378, neglect or endangerment of a child; 609.377, 614.28 malicious punishment of a child; 609.324, subdivision 1a, other 614.29 prohibited acts, minor engaged in prostitution; 609.33, 614.30 disorderly house; 609.52, theft; 609.582, burglary in the first, 614.31 second, third, or fourth degree; 609.631, check forgery, 614.32 offering a forged check; 609.275, attempt to coerce; an attempt 614.33 or conspiracy to commit any of these offenses as defined in 614.34 Minnesota Statutes; or an offense in any other state or country 614.35 where the elements are substantially similar to any of the 614.36 offenses listed in this paragraph. 615.1 (e) Less than seven years have passed since the discharge 615.2 of the sentence imposed for the offense and the person has 615.3 received a misdemeanor conviction for one of the following 615.4 offenses or the person has admitted to committing or a 615.5 preponderance of the evidence indicates that the person has 615.6 committed an act that meets the definition of a misdemeanor 615.7 conviction for one of the following offenses: sections 609.224, 615.8 fifth degree assault; 609.2242, domestic assault; 518B.01, 615.9 violation of an order for protection; 609.3232, violation of an 615.10 order for protection; 609.746, interference with privacy; 615.11 609.79, obscene or harassing telephone calls; 609.795, letter, 615.12 telegram, or package, opening, harassment; 617.23, indecent 615.13 exposure; 609.2672, assault of an unborn child, third degree; 615.14 617.293, dissemination and display of harmful materials to 615.15 minors; 609.66, dangerous weapons; 609.665, spring guns; an 615.16 attempt or conspiracy to commit any of these offenses as defined 615.17 in Minnesota Statutes; or an offense in any other state or 615.18 country where the elements are substantially similar to any of 615.19 the offenses listed in this paragraph. 615.20 (f) The person has been identified by the county's child 615.21 protection agency or by the statewide child protection database 615.22 as the person allegedly responsible for physical or sexual abuse 615.23 of a child within the last seven years. 615.24 (g) The person has been identified by the county's adult 615.25 protection agency or by the statewide adult protection database 615.26 as the person responsible for abuse or neglect of a vulnerable 615.27 adult within the last seven years. 615.28 (h) The person has refused to give written consent for 615.29 disclosure of criminal history records. 615.30 (i) The person has been denied a family child care license 615.31 or has received a fine or a sanction as a licensed child care 615.32 provider that has not been reversed on appeal. 615.33 (j) The person has a family child care licensing 615.34 disqualification that has not been set aside. 615.35 (k) The person has admitted or a county has found that 615.36 there is a preponderance of evidence that fraudulent information 616.1 was given to the county for application purposes or was used in 616.2 submitting bills for payment. 616.3 (l) The person has been convicted or there is a 616.4 preponderance of evidence of the crime of theft by wrongfully 616.5 obtaining public assistance. 616.6 (m) The person has a household member age 13 or older who 616.7 has access to children during the hours that care is provided 616.8 and who meets one of the conditions listed in paragraphs (b) to 616.9 (l). 616.10 (n) The person has a household member ages ten to 12 who 616.11 has access to children during the hours that care is provided; 616.12 information or circumstances exist which provide the county with 616.13 articulable suspicion that further pertinent information may 616.14 exist showing the household member meets one of the conditions 616.15 listed in paragraphs (b) to (l); and the household member 616.16 actually meets one of the conditions listed in paragraphs (b) to 616.17 (l). 616.18 Subd. 3. [AUTHORIZATION EXCEPTION.] When a county denies a 616.19 person authorization as a legal nonlicensed family child care 616.20 provider under subdivision 2, the county later may authorize 616.21 that person as a provider if the following conditions are met: 616.22 (1) after receiving notice of the denial of the 616.23 authorization, the person applies for and obtains a valid child 616.24 care license issued under chapter 245A, issued by a tribe, or 616.25 issued by another state; 616.26 (2) the person maintains the valid child care license; and 616.27 (3) the person is providing child care in the state of 616.28 licensure or in the area under the jurisdiction of the licensing 616.29 tribe. 616.30 Subd. 4. [UNSAFE CARE.] A county may deny authorization as 616.31 a child care provider to any applicant or rescind authorization 616.32 of any provider when the county knows or has reason to believe 616.33 that the provider is unsafe or that the circumstances of the 616.34 chosen child care arrangement are unsafe, even when the grounds 616.35 supporting this determination are not listed in subdivision 2. 616.36 The county must include in the county's child care fund plan 617.1 under section 119B.08, subdivision 3, the standards used to 617.2 determine whether a provider or care arrangement is unsafe. 617.3 Subd. 5. [RETROACTIVE PAYMENT.] Once a provider receives 617.4 county authorization, the county may issue retroactive payment 617.5 to the provider for child care services provided during the time 617.6 between the county's receipt of the completed application and 617.7 final authorization of the provider. 617.8 Subd. 6. [RECORD KEEPING REQUIREMENT.] All providers must 617.9 keep daily attendance records for children receiving child care 617.10 assistance and must make those records available immediately to 617.11 the county upon request. The daily attendance records must be 617.12 retained for six years after the date of service. A county may 617.13 deny authorization as a child care provider to any applicant or 617.14 rescind authorization of any provider when the county knows or 617.15 has reason to believe that the provider has not complied with 617.16 the record keeping requirement in this subdivision. 617.17 Sec. 21. Minnesota Statutes 2002, section 119B.13, 617.18 subdivision 1, is amended to read: 617.19 Subdivision 1. [SUBSIDY RESTRICTIONS.] The maximum rate 617.20 paid for child care assistance under the child care fund may not 617.21 exceed the75th60th percentile rate for like-care arrangements 617.22 in the county as surveyed by the commissioner. A rate which 617.23 includes a provider bonus paid under subdivision 2 or a special 617.24 needs rate paid under subdivision 3 may be in excess of the 617.25 maximum rate allowed under this subdivision. The department 617.26 shall monitor the effect of this paragraph on provider rates. 617.27 The county shall pay the provider's full charges for every child 617.28 in care up to the maximum established. The commissioner shall 617.29 determine the maximum rate for each type of care on an hourly, 617.30 full-day, and weekly basis, including special needs and 617.31 handicapped care. Not less than once every two years, the 617.32 commissioner shall evaluate market practices for payment of 617.33 absences and shall establish policies for payment of absent days 617.34 that reflect current market practice. 617.35 When the provider charge is greater than the maximum 617.36 provider rate allowed, the parentis responsible for payment of618.1the difference in the rates in addition tomust pay any family 618.2 copayment fee but the provider cannot require the parent to pay 618.3 the difference between the maximum rate allowed and the provider 618.4 charge. 618.5 Sec. 22. Minnesota Statutes 2002, section 119B.13, is 618.6 amended by adding a subdivision to read: 618.7 Subd. 1a. [CHILD CARE PROVIDERS; HOURLY RATES.] When a 618.8 family receiving child care assistance is authorized to receive 618.9 seven hours of care or less per day, child care assistance 618.10 payments for that care must be made on an hourly basis but may 618.11 not exceed the maximum full-day rate. 618.12 Sec. 23. Minnesota Statutes 2002, section 119B.13, is 618.13 amended by adding a subdivision to read: 618.14 Subd. 1b. [LEGAL NONLICENSED FAMILY CHILD CARE PROVIDER 618.15 RATES.] (a) Legal nonlicensed family child care providers 618.16 receiving reimbursement under this chapter must be paid on an 618.17 hourly basis for care provided to families receiving assistance. 618.18 (b) The maximum rate paid to legal nonlicensed family child 618.19 care providers must be 90 percent of the county maximum hourly 618.20 rate for licensed family child care providers. In counties 618.21 where the maximum hourly rate for licensed family child care 618.22 providers is higher than the maximum weekly rate for those 618.23 providers divided by 50, the maximum hourly rate that may be 618.24 paid to legal nonlicensed family child care providers is the 618.25 rate equal to the maximum weekly rate for licensed family child 618.26 care providers divided by 50 and then multiplied by 0.90. 618.27 (c) A rate which includes a provider bonus paid under 618.28 subdivision 2 or a special needs rate paid under subdivision 3 618.29 may be in excess of the maximum rate allowed under this 618.30 subdivision. 618.31 (d) Legal nonlicensed family child care providers receiving 618.32 reimbursement under this chapter may not be paid registration 618.33 fees for families receiving assistance. 618.34 Sec. 24. Minnesota Statutes 2002, section 119B.13, 618.35 subdivision 2, is amended to read: 618.36 Subd. 2. [PROVIDER RATE BONUS FOR ACCREDITATION.] A family 619.1 child care provider or child care center shall be paid a 619.2tenfive percent bonus above the maximum rate established in 619.3 subdivision 1, 1a, or 1b, if the provider or center holds a 619.4 current early childhood development credential approved by the 619.5 commissioner, up to the actual provider rate. 619.6 Sec. 25. Minnesota Statutes 2002, section 119B.13, 619.7 subdivision 6, is amended to read: 619.8 Subd. 6. [PROVIDER PAYMENTS.] (a) Counties or the state 619.9 shall make vendor payments to the child care provideror pay the619.10parent directlyfor eligible child care expenses, except when a 619.11 provider cares for children in the children's own home. When a 619.12 provider cares for children in the children's own home, the 619.13 county or the state shall make child care assistance payments 619.14 directly to the parent. 619.15 (b) Ifpayments for child care assistance are made to619.16providers,the child care facility is a center and has the 619.17 ability to bill electronically or keeps a detailed sign in/sign 619.18 out log, then the parent or guardian is not required to sign the 619.19 bill. If the provider does not keep detailed log sheets, both 619.20 the parent or guardian and the provider must sign the bill for 619.21 services rendered before payment is issued. For licensed family 619.22 child care and legal nonlicensed child care providers, both the 619.23 parent or guardian and the provider must sign the bill. The 619.24 provider shall bill the county for services provided within ten 619.25 days of the end of themonth ofservice period. If bills are 619.26 submittedin accordance with the provisions of this619.27subdivisionwithin ten days of the end of the service period, a 619.28 county or the state shall issue payment to the provider of child 619.29 care under the child care fund within 30 days of receivingan619.30invoicea bill from the provider. Counties or the state may 619.31 establish policies that make payments on a more frequent basis. 619.32 (c) All bills must be submitted within 90 days of the last 619.33 date of service on the bill. A county may pay a bill submitted 619.34 more than 90 days after the last date of service if the provider 619.35 shows good cause why the bill was not submitted within 90 days. 619.36 Good cause must be defined in the county's child care fund plan 620.1 under section 119B.08, subdivision 3, and the definition of good 620.2 cause must include county error. A county may not pay any bill 620.3 submitted more than one year after the last date of service on 620.4 the bill, unless the delay in payment is due to county error. 620.5 (d) A county may stop payment issued to a provider or may 620.6 refuse to pay a bill submitted by a provider if: 620.7 (1) the provider admits to intentionally providing the 620.8 county with false information on the provider's billing forms; 620.9 or 620.10 (2) a county finds by a preponderance of the evidence that 620.11 the provider intentionally gave the county false information on 620.12 the provider's billing forms. 620.13 (e) A county's payment policies must be included in the 620.14 county's child care plan under section 119B.08, subdivision 3. 620.15 If payments are made by the state, in addition to being in 620.16 compliance with this subdivision, the payments must be made in 620.17 compliance with section 16A.124. 620.18 Sec. 26. Minnesota Statutes 2002, section 119B.16, is 620.19 amended by adding a subdivision to read: 620.20 Subd. 1a. [FAIR HEARING ALLOWED FOR PROVIDERS.] (a) This 620.21 subdivision applies to providers caring for children receiving 620.22 child care assistance. 620.23 (b) A provider to whom a county agency has assigned 620.24 responsibility for an overpayment may request a fair hearing in 620.25 accordance with section 256.045 for the limited purpose of 620.26 challenging the assignment of responsibility for the overpayment 620.27 and the amount of the overpayment. The scope of the fair 620.28 hearing does not include the issues of whether the provider 620.29 wrongfully obtained public assistance in violation of section 620.30 256.98 or was properly disqualified under section 256.98, 620.31 subdivision 8, paragraph (c), unless the fair hearing has been 620.32 combined with an administrative disqualification hearing brought 620.33 against the provider under section 256.046. 620.34 Sec. 27. Minnesota Statutes 2002, section 119B.16, is 620.35 amended by adding a subdivision to read: 620.36 Subd. 1b. [JOINT FAIR HEARINGS.] When a provider requests 621.1 a fair hearing under subdivision 1a, the family in whose case 621.2 the overpayment was created must be made a party to the fair 621.3 hearing. All other issues raised by the family must be resolved 621.4 in the same proceeding. When a family requests a fair hearing 621.5 and claims that the county should have assigned responsibility 621.6 for an overpayment to a provider, the provider must be made a 621.7 party to the fair hearing. The referee assigned to a fair 621.8 hearing may join a family or a provider as a party to the fair 621.9 hearing whenever joinder of that party is necessary to fully and 621.10 fairly resolve overpayment issues raised in the appeal. 621.11 Sec. 28. Minnesota Statutes 2002, section 119B.16, 621.12 subdivision 2, is amended to read: 621.13 Subd. 2. [INFORMAL CONFERENCE.] The county agency shall 621.14 offer an informal conference to applicants and recipients 621.15 adversely affected by an agency action to attempt to resolve the 621.16 dispute. The county agency shall offer an informal conference 621.17 to providers to whom the county agency has assigned 621.18 responsibility for an overpayment in an attempt to resolve the 621.19 dispute. The county agency or the provider may ask the family 621.20 in whose case the overpayment arose to participate in the 621.21 informal conference, but the family may refuse to do so. The 621.22 county agency shall advise adversely affected applicantsand, 621.23 recipients, and providers that a request for a conference with 621.24 the agency is optional and does not delay or replace the right 621.25 to a fair hearing. 621.26 Sec. 29. Minnesota Statutes 2002, section 119B.19, 621.27 subdivision 7, is amended to read: 621.28 Subd. 7. [CHILD CARE RESOURCE AND REFERRAL PROGRAMS.] 621.29 Within each region, a child care resource and referral program 621.30 must: 621.31 (1) maintain one database of all existing child care 621.32 resources and services and one database of family referrals; 621.33 (2) provide a child care referral service for families; 621.34 (3) develop resources to meet the child care service needs 621.35 of families; 621.36 (4) increase the capacity to provide culturally responsive 622.1 child care services; 622.2 (5) coordinate professional development opportunities for 622.3 child care and school-age care providers; 622.4 (6) administer and award child care services grants; 622.5 (7) administer and provide loans for child development 622.6 education and training;and622.7 (8) cooperate with the Minnesota Child Care Resource and 622.8 Referral Network and its member programs to develop effective 622.9 child care services and child care resources; and 622.10 (9) assist in fostering coordination, collaboration, and 622.11 planning among child care programs and community programs such 622.12 as school readiness, Head Start, early childhood family 622.13 education, local interagency early intervention committees, 622.14 early childhood screening, special education services, and other 622.15 early childhood care and education services and programs that 622.16 provide flexible, family-focused services to families with young 622.17 children to the extent possible. 622.18 Sec. 30. Minnesota Statutes 2002, section 119B.21, 622.19 subdivision 11, is amended to read: 622.20 Subd. 11. [STATEWIDE ADVISORY TASK FORCE.] The 622.21 commissioner may convene a statewide advisory task force to 622.22 advise the commissioner on statewide grants or other child care 622.23 issues. The following groups must be represented: family child 622.24 care providers, child care center programs, school-age care 622.25 providers, parents who use child care services, health services, 622.26 social services, Head Start, public schools, school-based early 622.27 childhood programs, special education programs, employers, and 622.28 other citizens with demonstrated interest in child care issues. 622.29 Additional members may be appointed by the commissioner. The 622.30 commissioner may compensate members for their travel, child 622.31 care, and child care provider substitute expenses for attending 622.32 task force meetings. The commissioner may also pay a stipend to 622.33 parent representatives for participating in task force meetings. 622.34 Sec. 31. Minnesota Statutes 2002, section 119B.23, 622.35 subdivision 3, is amended to read: 622.36 Subd. 3. [BIENNIAL PLAN.] The county board shall 623.1 biennially develop a plan for the distribution of money for 623.2 child care services as part of thecommunity social services623.3plan described in section 256E.09child care fund plan under 623.4 section 119B.08. All licensed child care programs shall be 623.5 given written notice concerning the availability of money and 623.6 the application process. 623.7 Sec. 32. Minnesota Statutes 2002, section 256.046, 623.8 subdivision 1, is amended to read: 623.9 Subdivision 1. [HEARING AUTHORITY.] A local agency must 623.10 initiate an administrative fraud disqualification hearing for 623.11 individuals, including child care providers caring for children 623.12 receiving child care assistance, accused of wrongfully obtaining 623.13 assistance or intentional program violations, in lieu of a 623.14 criminal action when it has not been pursued, in the aid to 623.15 families with dependent children program formerly codified in 623.16 sections 256.72 to 256.87, MFIP, child care assistance programs, 623.17 general assistance, family general assistance program formerly 623.18 codified in section 256D.05, subdivision 1, clause (15), 623.19 Minnesota supplemental aid, medical care, or food stamp 623.20 programs. The hearing is subject to the requirements of section 623.21 256.045 and the requirements in Code of Federal Regulations, 623.22 title 7, section 273.16, for the food stamp program and title 623.23 45, section 235.112, as of September 30, 1995, for the cash 623.24 grantand, medical care programs, and child care assistance 623.25 under chapter 119B. 623.26 Sec. 33. Minnesota Statutes 2002, section 256.0471, 623.27 subdivision 1, is amended to read: 623.28 Subdivision 1. [QUALIFYING OVERPAYMENT.] Any overpayment 623.29 for assistance granted undersection 119B.05chapter 119B, the 623.30 MFIP program formerly codified under sections 256.031 to 623.31 256.0361, and the AFDC program formerly codified under sections 623.32 256.72 to 256.871; chapters 256B, 256D, 256I, 256J, and 256K; 623.33 and the food stamp program, except agency error claims, become a 623.34 judgment by operation of law 90 days after the notice of 623.35 overpayment is personally served upon the recipient in a manner 623.36 that is sufficient under rule 4.03(a) of the Rules of Civil 624.1 Procedure for district courts, or by certified mail, return 624.2 receipt requested. This judgment shall be entitled to full 624.3 faith and credit in this and any other state. 624.4 Sec. 34. Minnesota Statutes 2002, section 256.98, 624.5 subdivision 8, is amended to read: 624.6 Subd. 8. [DISQUALIFICATION FROM PROGRAM.] (a) Any person 624.7 found to be guilty of wrongfully obtaining assistance by a 624.8 federal or state court or by an administrative hearing 624.9 determination, or waiver thereof, through a disqualification 624.10 consent agreement, or as part of any approved diversion plan 624.11 under section 401.065, or any court-ordered stay which carries 624.12 with it any probationary or other conditions, in the Minnesota 624.13 family investment program, the food stamp program, the general 624.14 assistance program, the group residential housing program, or 624.15 the Minnesota supplemental aid program shall be disqualified 624.16 from that program. In addition, any person disqualified from 624.17 the Minnesota family investment program shall also be 624.18 disqualified from the food stamp program. The needs of that 624.19 individual shall not be taken into consideration in determining 624.20 the grant level for that assistance unit: 624.21 (1) for one year after the first offense; 624.22 (2) for two years after the second offense; and 624.23 (3) permanently after the third or subsequent offense. 624.24 The period of program disqualification shall begin on the 624.25 date stipulated on the advance notice of disqualification 624.26 without possibility of postponement for administrative stay or 624.27 administrative hearing and shall continue through completion 624.28 unless and until the findings upon which the sanctions were 624.29 imposed are reversed by a court of competent jurisdiction. The 624.30 period for which sanctions are imposed is not subject to 624.31 review. The sanctions provided under this subdivision are in 624.32 addition to, and not in substitution for, any other sanctions 624.33 that may be provided for by law for the offense involved. A 624.34 disqualification established through hearing or waiver shall 624.35 result in the disqualification period beginning immediately 624.36 unless the person has become otherwise ineligible for 625.1 assistance. If the person is ineligible for assistance, the 625.2 disqualification period begins when the person again meets the 625.3 eligibility criteria of the program from which they were 625.4 disqualified and makes application for that program. 625.5 (b) A family receiving assistance through child care 625.6 assistance programs under chapter 119B with a family member who 625.7 is found to be guilty of wrongfully obtaining child care 625.8 assistance by a federal court, state court, or an administrative 625.9 hearing determination or waiver, through a disqualification 625.10 consent agreement, as part of an approved diversion plan under 625.11 section 401.065, or a court-ordered stay with probationary or 625.12 other conditions, is disqualified from child care assistance 625.13 programs. The disqualifications must be for periods of three 625.14 months, six months, and two years for the first, second, and 625.15 third offenses respectively. Subsequent violations must result 625.16 in permanent disqualification. During the disqualification 625.17 period, disqualification from any child care program must extend 625.18 to all child care programs and must be immediately applied. 625.19 (c) A provider caring for children receiving assistance 625.20 through child care assistance programs under chapter 119B is 625.21 disqualified from receiving payment for child care services from 625.22 the child care assistance program under chapter 119B when the 625.23 provider is found to have wrongfully obtained child care 625.24 assistance by a federal court, state court, or an administrative 625.25 hearing determination or waiver under section 256.046, through a 625.26 disqualification consent agreement, as part of an approved 625.27 diversion plan under section 401.065, or a court-ordered stay 625.28 with probationary or other conditions. The disqualifications 625.29 must be for periods of one year and two years for the first and 625.30 second offenses respectively. Any subsequent violation must 625.31 result in permanent disqualification. The disqualification 625.32 period must be imposed immediately after a determination is made 625.33 under this paragraph. During the disqualification period, the 625.34 provider is disqualified from receiving payment from any child 625.35 care assistance program under chapter 119B. 625.36 Sec. 35. Minnesota Statutes 2002, section 466.03, 626.1 subdivision 6d, is amended to read: 626.2 Subd. 6d. [LICENSING AND AUTHORIZATION OF PROVIDERS.] A 626.3 claim against a municipality based on the failure of a provider 626.4 to meet the standards needed for a license to operate a day care 626.5 facility under chapter 245A for children, unless the626.6municipality had actual knowledge of a failure to meet licensing626.7standards that resulted in a dangerous condition that626.8foreseeably threatened the plaintiffor to meet the standards 626.9 needed for authorization as a provider for the child care 626.10 assistance program under chapter 119B. A municipality shall be 626.11 immune from liability for a claim arising out of a provider's 626.12 use of a swimming pool located at a family day care or group 626.13 family day care home under section 245A.14, subdivision 10, 626.14 unless the municipality had actual knowledge of a provider's 626.15 failure to meet the licensing standards under section 245A.14, 626.16 subdivision 10, paragraph (a), clauses (1) to (3), that resulted 626.17 in a dangerous condition that foreseeably threatened the 626.18 plaintiff. 626.19 Sec. 36. [DIRECTION TO COMMISSIONER; PROVIDER RATES.] 626.20 The provider rates determined under Minnesota Statutes, 626.21 section 119B.13, for fiscal years 2003-2004 and implemented on 626.22 July 1, 2003, are to be continued in effect through June 30, 626.23 2005. The commissioner of human services is directed to 626.24 evaluate the costs of child care in Minnesota, to examine the 626.25 differences in the cost of child care in rural and metropolitan 626.26 areas, and to make recommendations to the legislature for 626.27 containing future cost increases in the child care program under 626.28 Minnesota Statutes, chapter 119B, in a manner that complies with 626.29 federal child care and development block grant requirements for 626.30 promoting parental choice and permits the department to track 626.31 the effect of rate changes on child care assistance program 626.32 costs, the availability of different types of care throughout 626.33 the state, the length of waiting lists, and the care options 626.34 available to program participants. The commissioner shall also 626.35 examine the allocation formula under Minnesota Statutes, section 626.36 119B.03, and make recommendations to the legislature in order to 627.1 create a more equitable formula. The commissioner shall 627.2 consider the impact any recommendations might have on work 627.3 incentives for low and middle income families and possible 627.4 changes to MFIP child care, basic sliding fee child care, and 627.5 the dependent care tax credit. The commissioner shall make 627.6 recommendations to the legislature by January 15, 2004. 627.7 Sec. 37. [CHILD CARE WAITING LIST.] 627.8 Notwithstanding Minnesota Statutes, section 119B.03, 627.9 subdivision 6, the commissioner may manage the child care 627.10 assistance waiting list under Minnesota Statutes, section 627.11 119B.03, subdivision 2, on a regional or statewide basis in 627.12 order to ensure that families listed under higher priority 627.13 categories, as determined by Minnesota Statutes, section 627.14 119B.03, subdivision 4, are served before families listed under 627.15 lower priority categories. 627.16 Sec. 38. [CHILD CARE ASSISTANCE PARENT FEE SCHEDULE.] 627.17 Notwithstanding Minnesota Rules, part 3400.0100, subpart 4, 627.18 the parent fee schedule is as follows: 627.19 Income Range Co-payment (as a percentage of 627.20 (as a percentage of the adjusted gross income) 627.21 federal poverty guidelines) 627.22 0-74.99% $15/month 627.23 75.00-99.99% $25/month 627.24 100.00-104.99% 2.50% 627.25 105.00-109.99% 2.60% 627.26 110.00-114.99% 3.30% 627.27 115.00-119.99% 5.10% 627.28 120.00-124.99% 7.50% 627.29 125.00-139.99% 7.70% 627.30 140.00-144.99% 10.20% 627.31 145.00-149.99% 10.40% 627.32 150.00-154.99% 10.60% 627.33 155.00-159.99% 10.80% 627.34 160.00-164.99% 11.00% 627.35 165.00-169.99% 12.00% 627.36 170.00-174.99% 12.20% 628.1 175.00-179.99% 12.40% 628.2 180.00-184.99% 12.50% 628.3 185.00-189.99% 12.70% 628.4 190.00-194.99% 12.90% 628.5 195.00-199.99% 13.10% 628.6 200.00-209.99% 13.20% 628.7 210.00-224.99% 13.30% 628.8 225.00-229.99% 13.40% 628.9 230.00-234.99% 13.70% 628.10 235.00-239.99% 14.10% 628.11 240.00-244.99% 14.20% 628.12 245.00-249.99% 15.40% 628.13 250% ineligible 628.14 Sec. 39. [REPEALER.] 628.15 (a) Minnesota Statutes 2002, section 119B.061, is repealed. 628.16 (b) Laws 2001, First Special Session chapter 3, article 1, 628.17 section 16, is repealed. 628.18 ARTICLE 11A 628.19 HEALTH AND HUMAN SERVICES FORECAST ADJUSTMENTS 628.20 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 628.21 The dollar amounts shown in the columns marked 628.22 "APPROPRIATIONS" are added to or, if shown in parentheses, are 628.23 subtracted from the appropriations in Laws 2001, First Special 628.24 Session chapter 9, as amended by Laws 2002, chapter 220, and 628.25 Laws 2002, chapter 374, and are appropriated from the general 628.26 fund, or any other fund named, to the agencies and for the 628.27 purposes specified in this article, to be available for the 628.28 fiscal year indicated for each purpose. The figure "2003" used 628.29 in this article means that the appropriation or appropriations 628.30 listed under them are available for the fiscal year ending June 628.31 30, 2003. 628.32 SUMMARY BY FUND 628.33 2003 628.34 General $103,756,000 628.35 Health Care Access (1,492,000) 628.36 Federal TANF 20,419,000 629.1 APPROPRIATIONS 629.2 Available for the Year 629.3 Ending June 30, 2003 629.4 Sec. 2. COMMISSIONER OF 629.5 HUMAN SERVICES 629.6 Subdivision 1. Total 629.7 Appropriation $128,203,000 629.8 Summary by Fund 629.9 General 109,276,000 629.10 Health Care Access (1,492,000) 629.11 Federal TANF 20,419,000 629.12 Subd. 2. Administrative 629.13 Reimbursement/Pass-through 1,180,000 629.14 Subd. 3. Basic Health Care 629.15 Grants 629.16 General 59,364,000 629.17 Health Care Access (1,492,000) 629.18 The amounts that may be spent from this 629.19 appropriation for each purpose are as 629.20 follows: 629.21 (a) MinnesotaCare Grants 629.22 Health Care Access (1,492,000) 629.23 (b) MA Basic Health Care Grants - 629.24 Families and Children 629.25 General 14,708,000 629.26 (c) MA Basic Health Care Grants - 629.27 Elderly and Disabled 629.28 General 15,137,000 629.29 (d) General Assistance Medical Care 629.30 Grants 629.31 General 29,519,000 629.32 Subd. 4. Continuing Care Grants 629.33 General 56,615,000 629.34 The amounts that may be spent from this 629.35 appropriation for each purpose are as 629.36 follows: 629.37 (a) Medical Assistance Long-Term Care 629.38 Waivers and Home Care Grants 629.39 General 57,388,000 629.40 (b) Medical Assistance Long-Term Care 629.41 Facilities Grants 629.42 General 678,000 629.43 (c) Group Residential Housing Grants 630.1 General (1,451,000) 630.2 Subd. 5. Economic Support Grants 630.3 General (6,703,000) 630.4 Federal TANF 19,239,000 630.5 The amounts that may be spent from the 630.6 appropriation for each purpose are as 630.7 follows: 630.8 (a) Assistance to Families Grants 630.9 General (9,306,000) 630.10 Federal TANF 19,239,000 630.11 (b) General Assistance Grants 630.12 General 3,491,000 630.13 (c) Minnesota Supplemental Aid Grants 630.14 General (888,000) 630.15 Sec. 3. COMMISSIONER OF HEALTH 630.16 Subdivision 1. Total Appropriation (5,520,000) 630.17 Summary by Fund 630.18 General (5,520,000) 630.19 Subd. 2. Access and Quality Improvement (5,520,000) 630.20 Sec. 4. [EFFECTIVE DATE.] 630.21 Sections 1 to 3 are effective the day following final 630.22 enactment. 630.23 ARTICLE 11B 630.24 DEPARTMENT OF CHILDREN, FAMILIES, AND LEARNING 630.25 FORECAST ADJUSTMENT 630.26 Section 1. The dollar amounts shown are added to or, if shown 630.27 in parentheses, are subtracted from the appropriations in Laws 630.28 2001, First Special Session chapter 6, as amended by Laws 2002, 630.29 chapter 220, and Laws 2002, chapter 374, or other law, and are 630.30 appropriated from the general fund to the department of 630.31 children, families, and learning for the purposes specified in 630.32 this article, to be available for the fiscal year indicated for 630.33 each purpose. The figure "2003" used in this article means that 630.34 the appropriation or appropriations listed are available for the 630.35 fiscal year ending June 30, 2003. 630.36 2003 630.37 APPROPRIATION CHANGE 631.1 Sec. 2. APPROPRIATIONS; EARLY CHILDHOOD 631.2 AND FAMILY EDUCATION 631.3 MFIP Child Care 6,817,000 631.6 ARTICLE 11C 631.7 APPROPRIATIONS 631.8 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 631.9 The sums shown in the columns marked "APPROPRIATIONS" are 631.10 appropriated from the general fund, or any other fund named, to 631.11 the agencies and for the purposes specified in the sections of 631.12 this article, to be available for the fiscal years indicated for 631.13 each purpose. The figures "2004" and "2005" where used in this 631.14 article, mean that the appropriation or appropriations listed 631.15 under them are available for the fiscal year ending June 30, 631.16 2004, or June 30, 2005, respectively. Where a dollar amount 631.17 appears in parentheses, it means a reduction of an appropriation. 631.18 SUMMARY BY FUND 631.19 BIENNIAL 631.20 2004 2005 TOTAL 631.21 General $3,623,751,000 $3,535,232,000 $7,158,983,000 631.22 State Government 631.23 Special Revenue 45,162,000 44,899,000 90,061,000 631.24 Health Care 631.25 Access 262,386,000 328,686,000 591,072,000 631.26 Federal TANF 267,349,000 267,037,000 534,386,000 631.27 Lottery Prize 631.28 Fund 1,306,000 1,306,000 2,612,000 631.29 TOTAL $4,199,954,000 $4,177,160,000 $8,377,114,000 631.30 APPROPRIATIONS 631.31 Available for the Year 631.32 Ending June 30 631.33 2004 2005 631.34 Sec. 2. COMMISSIONER OF 631.35 HUMAN SERVICES 631.36 Subdivision 1. Total 631.37 Appropriation $4,071,623,000 $4,059,850,000 631.38 Summary by Fund 631.39 General 3,552,321,000 3,474,560,000 631.40 State Government 631.41 Special Revenue 534,000 534,000 632.1 Health Care 632.2 Access 256,113,000 322,413,000 632.3 Federal TANF 261,349,000 261,037,000 632.4 Lottery Cash 632.5 Flow 1,306,000 1,306,000 632.7 [RECEIPTS FOR SYSTEMS PROJECTS.] 632.8 Appropriations and federal receipts for 632.9 information system projects for MAXIS, 632.10 PRISM, MMIS, and SSIS must be deposited 632.11 in the state system account authorized 632.12 in Minnesota Statutes, section 632.13 256.014. Money appropriated for 632.14 computer projects approved by the 632.15 Minnesota office of technology, funded 632.16 by the legislature, and approved by the 632.17 commissioner of finance may be 632.18 transferred from one project to another 632.19 and from development to operations as 632.20 the commissioner of human services 632.21 considers necessary. Any unexpended 632.22 balance in the appropriation for these 632.23 projects does not cancel but is 632.24 available for ongoing development and 632.25 operations. 632.26 [GIFTS.] Notwithstanding Minnesota 632.27 Statutes, chapter 7, the commissioner 632.28 may accept on behalf of the state 632.29 additional funding from sources other 632.30 than state funds for the purpose of 632.31 financing the cost of assistance 632.32 program grants or nongrant 632.33 administration. All additional funding 632.34 is appropriated to the commissioner for 632.35 use as designated by the grantor of 632.36 funding. 632.37 [SYSTEMS CONTINUITY.] In the event of 632.38 disruption of technical systems or 632.39 computer operations, the commissioner 632.40 may use available grant appropriations 632.41 to ensure continuity of payments for 632.42 maintaining the health, safety, and 632.43 well-being of clients served by 632.44 programs administered by the department 632.45 of human services. Grant funds must be 632.46 used in a manner consistent with the 632.47 original intent of the appropriation. 632.48 [NONFEDERAL SHARE TRANSFERS.] The 632.49 nonfederal share of activities for 632.50 which federal administrative 632.51 reimbursement is appropriated to the 632.52 commissioner may be transferred to the 632.53 special revenue fund. 632.54 [TANF FUNDS APPROPRIATED TO OTHER 632.55 ENTITIES.] Any expenditures from the 632.56 TANF block grant shall be expended in 632.57 accordance with the requirements and 632.58 limitations of part A of title IV of 632.59 the Social Security Act, as amended, 632.60 and any other applicable federal 632.61 requirement or limitation. Prior to 632.62 any expenditure of these funds, the 632.63 commissioner shall assure that funds 633.1 are expended in compliance with the 633.2 requirements and limitations of federal 633.3 law and that any reporting requirements 633.4 of federal law are met. It shall be 633.5 the responsibility of any entity to 633.6 which these funds are appropriated to 633.7 implement a memorandum of understanding 633.8 with the commissioner that provides the 633.9 necessary assurance of compliance prior 633.10 to any expenditure of funds. The 633.11 commissioner shall receipt TANF funds 633.12 appropriated to other state agencies 633.13 and coordinate all related interagency 633.14 accounting transactions necessary to 633.15 implement these appropriations. 633.16 Unexpended TANF funds appropriated to 633.17 any state, local, or nonprofit entity 633.18 cancel at the end of the state fiscal 633.19 year unless appropriating language 633.20 permits otherwise. 633.21 [TANF FUNDS TRANSFERRED TO OTHER 633.22 FEDERAL GRANTS.] The commissioner must 633.23 authorize transfers from TANF to other 633.24 federal block grants so that funds are 633.25 available to meet the annual 633.26 expenditure needs as appropriated. 633.27 Transfers may be authorized prior to 633.28 the expenditure year with the agreement 633.29 of the receiving entity. Transferred 633.30 funds must be expended in the year for 633.31 which the funds were appropriated 633.32 unless appropriation language permits 633.33 otherwise. In accelerating transfer 633.34 authorizations, the commissioner must 633.35 aim to preserve the future potential 633.36 transfer capacity from TANF to other 633.37 block grants. 633.38 [TANF MAINTENANCE OF EFFORT.] (a) In 633.39 order to meet the basic maintenance of 633.40 effort (MOE) requirements of the TANF 633.41 block grant specified under Code of 633.42 Federal Regulations, title 45, section 633.43 263.1, the commissioner may only report 633.44 nonfederal money expended for allowable 633.45 activities listed in the following 633.46 clauses as TANF/MOE expenditures: 633.47 (1) MFIP cash, diversionary work 633.48 program, and food assistance benefits 633.49 under Minnesota Statutes, chapter 256J; 633.50 (2) the child care assistance programs 633.51 under Minnesota Statutes, sections 633.52 119B.03 and 119B.05, and county child 633.53 care administrative costs under 633.54 Minnesota Statutes, section 119B.15; 633.55 (3) state and county MFIP 633.56 administrative costs under Minnesota 633.57 Statutes, chapters 256J and 256K; 633.58 (4) state, county, and tribal MFIP 633.59 employment services under Minnesota 633.60 Statutes, chapters 256J and 256K; 633.61 (5) expenditures made on behalf of 633.62 noncitizen MFIP recipients who qualify 633.63 for the medical assistance without 633.64 federal financial participation program 634.1 under Minnesota Statutes, section 634.2 256B.06, subdivision 4, paragraphs (d), 634.3 (e), and (j). 634.4 (6) qualifying working family credit 634.5 expenditures under Minnesota Statutes, 634.6 section 290.0671. 634.7 (b) The commissioner shall ensure that 634.8 sufficient qualified nonfederal 634.9 expenditures are made each year to meet 634.10 the state's TANF/MOE requirements. For 634.11 the activities listed in paragraph (a), 634.12 clauses (2) to (6), the commissioner 634.13 may only report expenditures that are 634.14 excluded from the definition of 634.15 assistance under Code of Federal 634.16 Regulations, title 45, section 260.31. 634.17 (c) By August 31 of each year, the 634.18 commissioner shall make a preliminary 634.19 calculation to determine the likelihood 634.20 that the state will meet its annual 634.21 federal work participation requirement 634.22 under Code of Federal Regulations, 634.23 title 45, sections 261.21 and 261.23, 634.24 after adjustment for any caseload 634.25 reduction credit under Code of Federal 634.26 Regulations, title 45, section 261.41. 634.27 If the commissioner determines that the 634.28 state will meet its federal work 634.29 participation rate for the federal 634.30 fiscal year ending that September, the 634.31 commissioner may reduce the expenditure 634.32 under paragraph (a), clause (1), to the 634.33 extent allowed under Code of Federal 634.34 Regulations, title 45, section 634.35 263.1(a)(2). 634.36 (d) For fiscal years beginning with 634.37 state fiscal year 2003, the 634.38 commissioner shall assure that the 634.39 maintenance of effort used by the 634.40 commissioner of finance for the 634.41 February and November forecasts 634.42 required under Minnesota Statutes, 634.43 section 16A.103, contains expenditures 634.44 under paragraph (a), clause (1), equal 634.45 to at least 25 percent of the total 634.46 required under Code of Federal 634.47 Regulations, title 45, section 263.1. 634.48 (e) If nonfederal expenditures for the 634.49 programs and purposes listed in 634.50 paragraph (a) are insufficient to meet 634.51 the state's TANF/MOE requirements, the 634.52 commissioner shall recommend additional 634.53 allowable sources of nonfederal 634.54 expenditures to the legislature, if the 634.55 legislature is or will be in session to 634.56 take action to specify additional 634.57 sources of nonfederal expenditures for 634.58 TANF/MOE before a federal penalty is 634.59 imposed. The commissioner shall 634.60 otherwise provide notice to the 634.61 legislative commission on planning and 634.62 fiscal policy under paragraph (g). 634.63 (f) If the commissioner uses authority 634.64 granted under section 11, or similar 634.65 authority granted by a subsequent 635.1 legislature, to meet the state's 635.2 TANF/MOE requirement in a reporting 635.3 period, the commissioner shall inform 635.4 the chairs of the appropriate 635.5 legislative committees about all 635.6 transfers made under that authority for 635.7 this purpose. 635.8 (g) If the commissioner determines that 635.9 nonfederal expenditures under paragraph 635.10 (a) are insufficient to meet TANF/MOE 635.11 expenditure requirements, and if the 635.12 legislature is not or will not be in 635.13 session to take timely action to avoid 635.14 a federal penalty, the commissioner may 635.15 report nonfederal expenditures from 635.16 other allowable sources as TANF/MOE 635.17 expenditures after the requirements of 635.18 this paragraph are met. The 635.19 commissioner may report nonfederal 635.20 expenditures in addition to those 635.21 specified under paragraph (a) as 635.22 nonfederal TANF/MOE expenditures, but 635.23 only ten days after the commissioner of 635.24 finance has first submitted the 635.25 commissioner's recommendations for 635.26 additional allowable sources of 635.27 nonfederal TANF/MOE expenditures to the 635.28 members of the legislative commission 635.29 on planning and fiscal policy for their 635.30 review. 635.31 (h) The commissioner of finance shall 635.32 not incorporate any changes in federal 635.33 TANF expenditures or nonfederal 635.34 expenditures for TANF/MOE that may 635.35 result from reporting additional 635.36 allowable sources of nonfederal 635.37 TANF/MOE expenditures under the interim 635.38 procedures in paragraph (g) into the 635.39 February or November forecasts required 635.40 under Minnesota Statutes, section 635.41 16A.103, unless the commissioner of 635.42 finance has approved the additional 635.43 sources of expenditures under paragraph 635.44 (g). 635.45 (i) Minnesota Statutes, section 635.46 256.011, subdivision 3, which requires 635.47 that federal grants or aids secured or 635.48 obtained under that subdivision be used 635.49 to reduce any direct appropriations 635.50 provided by law, do not apply if the 635.51 grants or aids are federal TANF funds. 635.52 (j) Notwithstanding section 14, 635.53 paragraph (a), clauses (1) to (5), and 635.54 paragraphs (b) to (j) expire June 30, 635.55 2007. 635.56 [SHIFT COUNTY PAYMENT.] The 635.57 commissioner shall make up to 100 635.58 percent of the calendar year 2005 635.59 payments to counties for developmental 635.60 disabilities semi-independent living 635.61 services grants, developmental 635.62 disabilities family support grants, and 635.63 adult mental health grants from fiscal 635.64 year 2006 appropriations. This is a 635.65 onetime payment shift. Calendar year 635.66 2006 and future payments for these 636.1 grants are not affected by this shift. 636.2 This provision expires June 30, 2006. 636.3 [CAPITATION RATE INCREASE.] Of the 636.4 health care access fund appropriations 636.5 to the University of Minnesota in the 636.6 higher education omnibus appropriation 636.7 bill, $2,157,000 in fiscal year 2004 636.8 and $2,157,000 in fiscal year 2005 are 636.9 to be used to increase the capitation 636.10 payments under Minnesota Statutes, 636.11 section 256B.69. Notwithstanding the 636.12 provisions of section 14, this 636.13 provision shall not expire. 636.14 Subd. 2. Agency Management 636.15 Summary by Fund 636.16 General 41,534,000 27,868,000 636.17 State Government 636.18 Special Revenue 415,000 415,000 636.19 Health Care Access 3,673,000 3,673,000 636.20 Federal TANF 320,000 320,000 636.21 The amounts that may be spent from the 636.22 appropriation for each purpose are as 636.23 follows: 636.24 (a) Financial Operations 636.25 General 8,751,000 9,056,000 636.26 Health Care Access 828,000 828,000 636.27 Federal TANF 220,000 220,000 636.28 (b) Legal and 636.29 Regulation Operations 636.30 General 7,957,000 8,168,000 636.31 [CHILD CARE CENTER LICENSING.] $300,000 636.32 in fiscal year 2004 and $300,000 in 636.33 fiscal year 2005 are appropriated from 636.34 the general fund to ease the burden on 636.35 child care centers and other licensed 636.36 child care facilities during the 636.37 implementation of the department of 636.38 health's new child care license fee 636.39 increases. 636.40 State Government 636.41 Special Revenue 415,000 415,000 636.42 Health Care Access 244,000 244,000 636.43 Federal TANF 100,000 100,000 636.44 (c) Management Operations 636.45 General 17,373,000 3,076,000 636.46 Health Care Access 1,623,000 1,623,000 636.47 (d) Information Technology 636.48 Operations 637.1 General 7,453,000 7,568,000 637.2 Health Care Access 978,000 978,000 637.3 Subd. 3. Revenue and Pass-Through 637.4 Federal TANF 54,845,000 51,221,000 637.5 [TANF TRANSFER TO SOCIAL SERVICES BLOCK 637.6 GRANT.] $6,000,000 in fiscal year 2004 637.7 and $9,272,000 in fiscal year 2005 are 637.8 appropriated to the commissioner for 637.9 the purposes of providing services for 637.10 families with children whose incomes 637.11 are at or below 200 percent of the 637.12 federal poverty guidelines. The 637.13 commissioner shall authorize a 637.14 sufficient transfer of funds from the 637.15 state's federal TANF block grant to the 637.16 state's federal social services block 637.17 grant to meet this appropriation. The 637.18 funds shall be distributed to counties 637.19 for the children and community services 637.20 grant according to the formula for the 637.21 state appropriations in Minnesota 637.22 Statutes, chapter 256M. 637.23 [TANF FUNDS FOR FISCAL YEAR 2006 AND 637.24 FISCAL YEAR 2007 REFINANCING.] 637.25 $16,724,000 in fiscal year 2006 and 637.26 $16,827,000 in fiscal year 2007 in TANF 637.27 funds are available to the commissioner 637.28 to replace general funds in the amount 637.29 of $16,724,000 in fiscal year 2006 and 637.30 $16,827,000 in fiscal year 2007 in 637.31 expenditures that may be counted toward 637.32 TANF maintenance of effort requirements 637.33 or as an allowable TANF expenditure. 637.34 [REDUCTION IN TANF TRANSFER TO CHILD 637.35 CARE AND DEVELOPMENT FUND.] Transfers 637.36 of TANF to the child care development 637.37 fund for the purposes of MFIP child 637.38 care assistance shall be reduced by 637.39 $1,126,000 in fiscal year 2004 and 637.40 $118,000 in fiscal year 2005. 637.41 Subd. 4. Children's Services Grants 637.42 Summary by Fund 637.43 General 105,760,000 92,165,000 637.44 Federal TANF 6,000,000 9,272,000 637.45 [ADOPTION ASSISTANCE INCENTIVE GRANTS.] 637.46 Federal funds available during fiscal 637.47 year 2004 and fiscal year 2005, for 637.48 adoption incentive grants are 637.49 appropriated to the commissioner for 637.50 these purposes. 637.51 [ADOPTION ASSISTANCE AND RELATIVE 637.52 CUSTODY ASSISTANCE.] The commissioner 637.53 may transfer unencumbered appropriation 637.54 balances for adoption assistance and 637.55 relative custody assistance between 637.56 fiscal years and between programs. 637.57 Subd. 5. Children's Services Management 638.1 General 5,221,000 5,283,000 638.2 Subd. 6. Basic Health Care Grants 638.3 Summary by Fund 638.4 General 1,501,432,000 1,457,549,000 638.5 Health Care Access 236,638,000 303,184,000 638.6 [UPDATING FEDERAL POVERTY GUIDELINES.] 638.7 Annual updates to the federal poverty 638.8 guidelines are effective each July 1, 638.9 following publication by the United 638.10 States Department of Health and Human 638.11 Services for health care programs under 638.12 Minnesota Statutes, chapters 256, 256B, 638.13 256D, and 256L. 638.14 The amounts that may be spent from this 638.15 appropriation for each purpose are as 638.16 follows: 638.17 (a) MinnesotaCare Grants 638.18 Health Care Access 232,634,000 299,083,000 638.19 [MINNESOTACARE FEDERAL RECEIPTS.] 638.20 Receipts received as a result of 638.21 federal participation pertaining to 638.22 administrative costs of the Minnesota 638.23 health care reform waiver shall be 638.24 deposited as nondedicated revenue in 638.25 the health care access fund. Receipts 638.26 received as a result of federal 638.27 participation pertaining to grants 638.28 shall be deposited in the federal fund 638.29 and shall offset health care access 638.30 funds for payments to providers. 638.31 [MINNESOTACARE FUNDING.] The 638.32 commissioner may expend money 638.33 appropriated from the health care 638.34 access fund for MinnesotaCare in either 638.35 fiscal year of the biennium. 638.36 [MINNESOTACARE NOT AN ENTITLEMENT.] The 638.37 MinnesotaCare program is not an 638.38 entitlement. Enrollment in the 638.39 program, eligibility criteria, and 638.40 covered services are subject to the 638.41 availability of funding, and may be 638.42 modified by the commissioner of human 638.43 services to maintain program 638.44 expenditures within the level of 638.45 funding. Notwithstanding section 14, 638.46 this provision does not expire. 638.47 (b) MA Basic Health Care Grants - 638.48 Families and Children 638.49 General 560,143,000 575,614,000 638.50 (c) MA Basic Health Care Grants - Elderly 638.51 and Disabled 638.52 General 696,413,000 750,033,000 638.53 [DELAY MA FEE FOR SERVICE - ACUTE 638.54 CARE.] The last payment in fiscal year 638.55 2005 from the Medicaid Management 639.1 Information System that would otherwise 639.2 have been made to providers for medical 639.3 assistance and general assistance 639.4 medical care services shall be delayed 639.5 and included in the first payment in 639.6 fiscal year 2006. This payment delay 639.7 shall not include payments to skilled 639.8 nursing facilities, intermediate care 639.9 facilities for mental retardation, 639.10 prepaid health plans, home health 639.11 agencies, personal care nursing 639.12 providers, and providers of only waiver 639.13 services. The provisions of Minnesota 639.14 Statutes, section 16A.124, shall not 639.15 apply to these delayed payments. 639.16 Notwithstanding section 14, this 639.17 provision shall not expire. 639.18 (d) General Assistance Medical Care 639.19 Grants 639.20 General 232,650,000 119,904,000 639.21 (e) Health Care Grants - Other 639.22 Assistance 639.23 General 2,660,000 2,472,000 639.24 Health Care Access 4,004,000 4,101,000 639.25 (f) Prescription Drug Program 639.26 General 9,566,000 9,526,000 639.27 [TRANSFER FOR THE PRESCRIPTION DRUG 639.28 ASSISTANCE PROGRAM.] Of the 639.29 appropriation from the general fund for 639.30 the prescription drug program under 639.31 Minnesota Statutes, section 256.955, 639.32 for the biennium beginning July 1, 2003 639.33 $1,739,000 is for the commissioner of 639.34 human services to establish and 639.35 administer the prescription drug 639.36 assistance program through the 639.37 Minnesota board on aging. 639.38 [MINNESOTA PRESCRIPTION DRUG DEDICATED 639.39 FUND.] Of this appropriation, 639.40 $7,200,000 is appropriated from the 639.41 health care access fund to the 639.42 commissioner of human services for the 639.43 fiscal year beginning July 1, 2003, for 639.44 the Minnesota prescription drug 639.45 dedicated fund established under the 639.46 prescription drug discount program. 639.47 This is a onetime appropriation. 639.48 Subd. 7. Health Care Management 639.49 Summary by Fund 639.50 General 24,452,000 24,517,000 639.51 Health Care Access 14,453,000 14,207,000 639.52 The amounts that may be spent from this 639.53 appropriation for each purpose are as 639.54 follows: 639.55 (a) Health Care Policy Administration 640.1 General 4,222,000 5,466,000 640.2 Health Care Access 846,000 846,000 640.3 [MINNESOTACARE OUTREACH REIMBURSEMENT.] 640.4 Federal administrative reimbursement 640.5 resulting from MinnesotaCare outreach 640.6 is appropriated to the commissioner for 640.7 this activity. 640.8 [MINNESOTA SENIOR HEALTH OPTIONS 640.9 REIMBURSEMENT.] Federal administrative 640.10 reimbursement resulting from the 640.11 Minnesota senior health options project 640.12 is appropriated to the commissioner for 640.13 this activity. 640.14 [UTILIZATION REVIEW.] Federal 640.15 administrative reimbursement resulting 640.16 from prior authorization and inpatient 640.17 admission certification by a 640.18 professional review organization shall 640.19 be dedicated to the commissioner for 640.20 these purposes. A portion of these 640.21 funds must be used for activities to 640.22 decrease unnecessary pharmaceutical 640.23 costs in medical assistance. 640.24 (b) Health Care Options 640.25 General 20,230,000 20,051,000 640.26 Health Care Access 13,607,000 13,361,000 640.27 [PREPAID MEDICAL PROGRAMS.] For all 640.28 counties in which the PMAP program has 640.29 been operating for 12 or more months, 640.30 state funding for the nonfederal share 640.31 of prepaid medical assistance program 640.32 administration costs for county managed 640.33 care advocacy and enrollment operations 640.34 is eliminated. State funding will 640.35 continue for these activities for 640.36 counties and tribes establishing new 640.37 PMAP programs for a maximum of 16 640.38 months (four months prior to beginning 640.39 PMAP enrollment and through the first 640.40 12 months of their PMAP program 640.41 operation). Those counties operating 640.42 PMAP programs for less than 12 months 640.43 can continue to receive state funding 640.44 for advocacy and enrollment activities 640.45 through their first year of operation. 640.46 Subd. 8. State-operated Services 640.47 General 195,062,000 186,775,000 640.48 [MITIGATION RELATED TO STATE-OPERATED 640.49 SERVICES RESTRUCTURING.] Money 640.50 appropriated to finance mitigation 640.51 expenses related to restructuring 640.52 state-operated services programs and 640.53 administrative services may be 640.54 transferred between fiscal years within 640.55 the biennium. 640.56 [STATE-OPERATED SERVICES 640.57 RESTRUCTURING.] For purposes of 640.58 restructuring state-operated services, 640.59 any state-operated services employee 641.1 whose position is to be eliminated 641.2 shall be afforded the options provided 641.3 in applicable collective bargaining 641.4 agreements. All salary and mitigation 641.5 allocations from fiscal year 2004 shall 641.6 be carried forward into fiscal year 641.7 2005. Provided there is no conflict 641.8 with any collective bargaining 641.9 agreement, any state-operated services 641.10 position reduction must only be 641.11 accomplished through mitigation, 641.12 attrition, transfer, and other measures 641.13 as provided in state or applicable 641.14 collective bargaining agreements and in 641.15 Minnesota Statutes, section 252.50, 641.16 subdivision 11, and not through layoff. 641.17 [REPAIRS AND BETTERMENTS.] The 641.18 commissioner may transfer unencumbered 641.19 appropriation balances between fiscal 641.20 years within the biennium for the state 641.21 residential facilities repairs and 641.22 betterments account and special 641.23 equipment. 641.24 Subd. 9. Continuing Care Grants 641.25 Summary by Fund 641.26 General 1,504,983,000 1,503,331,000 641.27 Lottery Prize Fund 1,158,000 1,158,000 641.28 The amounts that may be spent from this 641.29 appropriation for each purpose are as 641.30 follows: 641.31 (a) Aging and Adult Service Grant 641.32 General 12,259,000 13,212,000 641.33 [LONG-TERM CARE PROGRAM REDUCTIONS.] 641.34 For the biennium ending June 30, 2005, 641.35 state funding for the following state 641.36 long-term care programs is reduced by 641.37 15 percent from the level of state 641.38 funding provided on June 30, 2003: 641.39 SAIL project grants under Minnesota 641.40 Statutes, section 256B.0917; 641.41 independent living demonstration 641.42 project for persons with epilepsy 641.43 established under Laws 1988, chapter 641.44 689, article 2, section 251; the 641.45 congregate meals portion of senior 641.46 nutrition programs under Minnesota 641.47 Statutes, section 256.9752; foster 641.48 grandparents program under Minnesota 641.49 Statutes, section 256.976; retired 641.50 senior volunteer program under 641.51 Minnesota Statutes, section 256.9753; 641.52 and the senior companion program under 641.53 Minnesota Statutes, section 256.977. 641.54 (b) Deaf and Hard-of-hearing 641.55 Service Grants 641.56 General 1,725,000 1,498,000 641.57 (c) Mental Health Grants 641.58 General 53,744,000 34,955,000 642.1 Lottery Prize Fund 1,158,000 1,158,000 642.2 [RESTRUCTURING OF ADULT MENTAL HEALTH 642.3 SERVICES.] The commissioner may make 642.4 budget neutral transfers to effectively 642.5 implement the restructuring of adult 642.6 mental health services. "Budget 642.7 neutral transfers" means transfers 642.8 which do not increase the state share 642.9 of costs. 642.10 (d) Community Support Grants 642.11 General 13,022,000 10,091,000 642.12 (e) Medical Assistance Long-Term 642.13 Care Waivers and Home Care Grants 642.14 General 666,828,000 729,808,000 642.15 [REDUCE GROWTH IN MR/RC WAIVER.] The 642.16 commissioner shall reduce the growth in 642.17 the MR/RC waiver by not allocating the 642.18 300 additional diversion allocations 642.19 that are included in the February 2003 642.20 forecast for the fiscal years that 642.21 begin on July 1, 2003, and July 1, 2004. 642.22 [MANAGE THE GROWTH IN THE TBI WAIVER.] 642.23 During the fiscal years beginning on 642.24 July 1, 2003, and July 1, 2004, the 642.25 commissioner shall allocate money for 642.26 this program in such a way so that the 642.27 caseload growth for this program does 642.28 not exceed 150 in each year of the 642.29 biennium. Priorities for the 642.30 allocation of funds shall be for 642.31 individuals anticipated to be 642.32 discharged from institutional settings 642.33 or who are at imminent risk of a 642.34 placement in an institutional setting. 642.35 [TARGETED CASE MANAGEMENT FOR HOME CARE 642.36 RECIPIENTS.] Implementation of the 642.37 targeted case management benefit for 642.38 home care recipients, according to 642.39 Minnesota Statutes, section 256B.0621, 642.40 subdivisions 2, 3, 5, 6, 7, 9, and 10, 642.41 will be delayed until July 1, 2005. 642.42 [COMMON SERVICE MENU.] Implementation 642.43 of the common service menu option 642.44 within the home and community-based 642.45 waivers, according to Minnesota 642.46 Statutes, section 256B.49, subdivision 642.47 16, will be delayed until July 1, 2005. 642.48 (f) Medical Assistance Long-term 642.49 Care Facilities Grants 642.50 General 540,712,000 521,251,000 642.51 (g) Alternative Care Grants 642.52 General 71,382,000 59,885,000 642.53 [ALTERNATIVE CARE TRANSFER.] Any money 642.54 allocated to the alternative care 642.55 program that is not spent for the 642.56 purposes indicated does not cancel but 642.57 shall be transferred to the medical 643.1 assistance account. 643.2 [ALTERNATIVE CARE APPROPRIATION.] The 643.3 commissioner may expend the money 643.4 appropriated for the alternative care 643.5 program for that purpose in either year 643.6 of the biennium. 643.7 [ALTERNATIVE CARE IMPLEMENTATION OF 643.8 CHANGES TO PREMIUMS AND ELIGIBILITY.] 643.9 Changes to Minnesota Statutes, section 643.10 256B.0913, subdivision 4, paragraph 643.11 (d), and subdivision 12, are effective 643.12 July 1, 2003, for all persons found 643.13 eligible for the alternative care 643.14 program on or after July 1, 2003. All 643.15 recipients of alternative care funding 643.16 as of June 30, 2003, shall be subject 643.17 to Minnesota Statutes, section 643.18 256B.0913, subdivision 4, paragraph 643.19 (d), and subdivision 12, on the annual 643.20 reassessment and review of their 643.21 eligibility after July 1, 2003, but no 643.22 later than January 1, 2004. 643.23 (h) Group Residential Housing Grants 643.24 General 94,583,000 80,728,000 643.25 [GROUP RESIDENTIAL HOUSING COSTS 643.26 REFINANCED.] Effective July 1, 2004, 643.27 the commissioner shall increase the 643.28 home and community-based service rates 643.29 and county allocations provided to 643.30 programs established under section 643.31 1915(c) of the Social Security Act to 643.32 the extent that these programs will be 643.33 paying for the costs above the rate 643.34 established in Minnesota Statutes, 643.35 section 256I.05, subdivision 1. 643.36 (i) Chemical Dependency 643.37 Entitlement Grants 643.38 General 49,673,000 50,848,000 643.39 (j) Chemical Dependency Nonentitlement 643.40 Grants 643.41 General 1,055,000 1,055,000 643.42 Subd. 10. Continuing Care Management 643.43 Summary by Fund 643.44 General 21,427,000 21,258,000 643.45 State Government 643.46 Special Revenue 119,000 119,000 643.47 Lottery Prize Fund 148,000 148,000 643.48 Subd. 11. Economic Support Grants 643.49 Summary by Fund 643.50 General 113,422,000 116,511,000 643.51 Federal TANF 199,816,000 199,856,000 643.52 The amounts that may be spent from this 644.1 appropriation for each purpose are as 644.2 follows: 644.3 (a) Minnesota Family Investment Program 644.4 General 50,947,000 38,938,000 644.5 Federal TANF 104,756,000 98,170,000 644.6 (b) Work Grants 644.7 General 666,000 14,678,000 644.8 Federal TANF 94,800,000 101,426,000 644.9 [MFIP SUPPORT SERVICES COUNTY AND 644.10 TRIBAL ALLOCATION.] When determining 644.11 the funds available for the 644.12 consolidated MFIP support services 644.13 grant in the 18-month period ending 644.14 December 31, 2004, the commissioner 644.15 shall apportion the funds appropriated 644.16 for fiscal year 2005 in such manner as 644.17 necessary to provide $14,000,000 more 644.18 to counties and tribes for the period 644.19 ending December 31, 2004, than would 644.20 have been available had the funds been 644.21 evenly divided within the fiscal year 644.22 between the period before December 31, 644.23 2004, and the period after December 31, 644.24 2004. 644.25 For allocations for the calendar years 644.26 starting January 1, 2005, the 644.27 commissioner shall apportion the funds 644.28 appropriated for each fiscal year in 644.29 such manner as necessary to provide 644.30 $14,000,000 more to counties and tribes 644.31 for the period ending December 31 of 644.32 that year than would have been 644.33 available had the funds been evenly 644.34 divided within the fiscal year between 644.35 the period before December 31 and the 644.36 period after December 31. 644.37 (c) Economic Support Grants - Other 644.38 Assistance 644.39 General 3,358,000 3,463,000 644.40 (d) Child Support Enforcement Grants 644.41 General 3,571,000 3,503,000 644.42 Federal TANF 260,000 260,000 644.43 (e) General Assistance Grants 644.44 General 24,651,000 24,482,000 644.45 [GENERAL ASSISTANCE STANDARD.] The 644.46 commissioner shall set the monthly 644.47 standard of assistance for general 644.48 assistance units consisting of an adult 644.49 recipient who is childless and 644.50 unmarried or living apart from parents 644.51 or a legal guardian at $203. The 644.52 commissioner may reduce this amount 644.53 according to Laws 1997, chapter 85, 644.54 article 3, section 54. 645.1 [EMERGENCY GENERAL ASSISTANCE.] The 645.2 amount appropriated for emergency 645.3 general assistance funds is limited to 645.4 no more than $7,889,812 in each fiscal 645.5 year of 2004 and 2005. Funds to 645.6 counties shall be allocated by the 645.7 commissioner using the allocation 645.8 method specified in Minnesota Statutes, 645.9 section 256D.06. 645.10 (f) Minnesota Supplemental Aid Grants 645.11 General 30,229,000 31,447,000 645.12 [EMERGENCY MINNESOTA SUPPLEMENTAL AID 645.13 FUNDS.] The amount appropriated for 645.14 emergency Minnesota supplemental aid 645.15 funds is limited to no more than 645.16 $1,138,707 in fiscal year 2004 and 645.17 $1,017,000 in fiscal year 2005. Funds 645.18 to counties shall be allocated by the 645.19 commissioner using the allocation 645.20 method specified in Minnesota Statutes, 645.21 section 256D.46. 645.22 Subd. 12. Economic Support 645.23 Management 645.24 Summary by Fund 645.25 General 39,028,000 39,303,000 645.26 Health Care Access 1,349,000 1,349,000 645.27 Federal TANF 368,000 368,000 645.28 The amounts that may be spent from this 645.29 appropriation for each purpose are as 645.30 follows: 645.31 (a) Economic Support 645.32 Policy Administration 645.33 General 5,360,000 5,587,000 645.34 Federal TANF 368,000 368,000 645.35 (b) Economic Support 645.36 Operations 645.37 General 33,668,000 33,716,000 645.38 Health Care Access 1,349,000 1,349,000 645.39 [CHILD SUPPORT PAYMENT CENTER.] 645.40 Payments to the commissioner from other 645.41 governmental units, private 645.42 enterprises, and individuals for 645.43 services performed by the child support 645.44 payment center must be deposited in the 645.45 state systems account authorized under 645.46 Minnesota Statutes, section 256.014. 645.47 These payments are appropriated to the 645.48 commissioner for the operation of the 645.49 child support payment center or system, 645.50 according to Minnesota Statutes, 645.51 section 256.014. 645.52 [CHILD SUPPORT COST RECOVERY FEES.] The 645.53 commissioner shall transfer $247,000 of 645.54 child support cost recovery fees 646.1 collected in fiscal year 2005 to the 646.2 PRISM special revenue account to offset 646.3 PRISM system costs of implementing the 646.4 fee. 646.5 [FINANCIAL INSTITUTION DATA MATCH AND 646.6 PAYMENT OF FEES.] The commissioner is 646.7 authorized to allocate up to $310,000 646.8 each year in fiscal year 2004 and 646.9 fiscal year 2005 from the PRISM special 646.10 revenue account to make payments to 646.11 financial institutions in exchange for 646.12 performing data matches between account 646.13 information held by financial 646.14 institutions and the public authority's 646.15 database of child support obligors as 646.16 authorized by Minnesota Statutes, 646.17 section 13B.06, subdivision 7. 646.18 Sec. 3. COMMISSIONER OF HEALTH 646.19 Subdivision 1. Total 646.20 Appropriation 103,880,000 103,292,000 646.21 Summary by Fund 646.22 General 58,727,000 58,402,000 646.23 State Government 646.24 Special Revenue 32,880,000 32,617,000 646.25 Health Care Access 6,273,000 6,273,000 646.26 Federal TANF 6,000,000 6,000,000 646.27 Subd. 2. Health Improvement 646.28 Summary by Fund 646.29 General 42,584,000 42,178,000 646.30 State Government 646.31 Special Revenue 1,987,000 1,987,000 646.32 Health Care Access 3,510,000 3,510,000 646.33 Federal TANF 6,000,000 6,000,000 646.34 [TOBACCO PREVENTION ENDOWMENT FUND 646.35 TRANSFERS.] (a) On July 1, 2003, the 646.36 commissioner of finance shall transfer 646.37 $4,000,000 from the tobacco use 646.38 prevention and local public health 646.39 endowment expendable trust fund to the 646.40 general fund. 646.41 (b) Notwithstanding Minnesota Statutes, 646.42 section 16A.62, any remaining 646.43 unexpended balance in the fund after 646.44 the transfer in paragraph (a) shall be 646.45 transferred to the miscellaneous 646.46 special revenue fund and dedicated to 646.47 the commissioner of health for a youth 646.48 tobacco prevention program. These 646.49 funds are available until expended. 646.50 [TANF APPROPRIATIONS.] TANF funds 646.51 appropriated to the commissioner are 646.52 available for home visiting and 646.53 nutritional activities listed under 646.54 Minnesota Statutes, section 145.882, 647.1 subdivision 7, clauses (6) and (7), and 647.2 eliminating health disparities 647.3 activities under Minnesota Statutes, 647.4 section 145.928, subdivision 10. 647.5 Funding shall be distributed to 647.6 community health boards and tribal 647.7 governments based on the formula in 647.8 Minnesota Statutes, section 145A.131, 647.9 subdivisions 1 and 2. 647.10 [TANF CARRYFORWARD.] Any unexpended 647.11 balance of the TANF appropriation in 647.12 the first year of the biennium does not 647.13 cancel but is available for the second 647.14 year. 647.15 [FAMILY PLANNING GRANTS.] Family 647.16 planning grants are reduced by 647.17 $2,166,000 in fiscal year 2004 and 647.18 $2,312,000 in fiscal year 2005. These 647.19 reductions are subtracted from base 647.20 level appropriations. 647.21 Subd. 3. Health Quality and 647.22 Access 647.23 Summary by Fund 647.24 General 1,173,000 1,114,000 647.25 State Government 647.26 Special Revenue 8,888,000 8,888,000 647.27 Health Care Access 2,763,000 2,763,000 647.28 [STATE GOVERNMENT SPECIAL REVENUE FUND 647.29 TRANSFERS.] On July 1, 2003, the 647.30 commissioner of finance shall transfer 647.31 $4,000,000 from the state government 647.32 special revenue fund to the general 647.33 fund. 647.34 [NURSING PROVIDERS WORK GROUP.] 647.35 Notwithstanding the provisions of 647.36 Minnesota Statutes, section 144A.10, 647.37 during the next biennium, the 647.38 commissioner of health shall not 647.39 conduct surveys under the provisions of 647.40 Minnesota Rules, chapter 4655, and 647.41 chapter 4658, parts 4658.0010 to 647.42 4658.2090 in nursing homes or boarding 647.43 care homes that are certified for 647.44 participation in the federal Medicaid 647.45 or Medicare program. During the next 647.46 biennium, the commissioner of health 647.47 shall establish a working group 647.48 consisting of nursing home and boarding 647.49 care home providers, representatives of 647.50 nursing home residents, and other 647.51 health care providers to review current 647.52 licensure provisions and evaluate the 647.53 continued appropriateness of these 647.54 provisions. The commissioner shall 647.55 present recommendations to the 647.56 legislature by January 1, 2005. 647.57 [MEDICAL EDUCATION ENDOWMENT FUND 647.58 TRANSFERS.] Notwithstanding Minnesota 647.59 Statutes, section 16A.62, any remaining 647.60 unexpended balances in the medical 647.61 education expendable trust fund shall 648.1 be transferred to the miscellaneous 648.2 special revenue fund and dedicated to 648.3 the commissioner for the purposes 648.4 identified in Minnesota Statutes, 648.5 section 62J.692. These funds are 648.6 available until expended. 648.7 [MEDICAL EDUCATION AND RESEARCH COSTS.] 648.8 $8,660,000 in fiscal year 2004 and 648.9 $8,616,000 in fiscal year 2005 are 648.10 appropriated from the medical education 648.11 and research costs special account for 648.12 medical education and research funding. 648.13 Subd. 4. Health Protection 648.14 Summary by Fund 648.15 General 8,855,000 8,855,000 648.16 State Government 648.17 Special Revenue 22,005,000 21,742,000 648.18 Subd. 5. Management and Support 648.19 Services 648.20 General 5,249,000 5,243,000 648.21 Sec. 4. VETERANS HOME BOARD 648.22 General 30,030,000 30,030,000 648.23 [VETERANS HOMES SPECIAL REVENUE 648.24 ACCOUNT.] The general fund 648.25 appropriations made to the board may be 648.26 transferred to a veterans homes special 648.27 revenue account in the special revenue 648.28 fund in the same manner as other 648.29 receipts are deposited according to 648.30 Minnesota Statutes, section 198.34, and 648.31 are appropriated to the board for the 648.32 operation of board facilities and 648.33 programs. 648.34 Sec. 5. HEALTH-RELATED BOARDS 648.35 Subdivision 1. Total 648.36 Appropriation 11,266,000 11,266,000 648.37 [STATE GOVERNMENT SPECIAL REVENUE 648.38 FUND.] The appropriations in this 648.39 section are from the state government 648.40 special revenue fund, except where 648.41 noted. 648.42 [NO SPENDING IN EXCESS OF REVENUES.] 648.43 The commissioner of finance shall not 648.44 permit the allotment, encumbrance, or 648.45 expenditure of money appropriated in 648.46 this section in excess of the 648.47 anticipated biennial revenues or 648.48 accumulated surplus revenues from fees 648.49 collected by the boards. Neither this 648.50 provision nor Minnesota Statutes, 648.51 section 214.06, applies to transfers 648.52 from the general contingent account. 648.53 [STATE GOVERNMENT SPECIAL REVENUE FUND 648.54 TRANSFERS.] On July 1, 2003, the 648.55 commissioner of finance shall transfer 648.56 $7,500,000 from the state government 649.1 special revenue fund to the general 649.2 fund. 649.3 Subd. 2. Board of Chiropractic 649.4 Examiners 384,000 384,000 649.5 Subd. 3. Board of Dentistry 649.6 State Government Special 649.7 Revenue Fund 858,000 858,000 649.8 Health Care 649.9 Access Fund 64,000 64,000 649.10 Subd. 4. Board of Dietetic and 649.11 Nutrition Practice 101,000 101,000 649.12 Subd. 5. Board of Marriage and 649.13 Family Therapy 118,000 118,000 649.14 Subd. 6. Board of Medical 649.15 Practice 3,498,000 3,498,000 649.16 Subd. 7. Board of Nursing 2,405,000 2,405,000 649.17 Subd. 8. Board of Nursing 649.18 Home Administrators 198,000 198,000 649.19 Subd. 9. Board of Optometry 96,000 96,000 649.20 Subd. 10. Board of Pharmacy 1,386,000 1,386,000 649.21 [ADMINISTRATIVE SERVICES UNIT.] Of this 649.22 appropriation, $359,000 the first year 649.23 and $359,000 the second year are for 649.24 the health boards administrative 649.25 services unit. The administrative 649.26 services unit may receive and expend 649.27 reimbursements for services performed 649.28 for other agencies. 649.29 Subd. 11. Board of Physical 649.30 Therapy 197,000 197,000 649.31 Subd. 12. Board of Podiatry 45,000 45,000 649.32 Subd. 13. Board of Psychology 680,000 680,000 649.33 Subd. 14. Board of Social 649.34 Work 1,073,000 1,073,000 649.35 Subd. 15. Board of Veterinary 649.36 Medicine 163,000 163,000 649.37 Sec. 6. EMERGENCY MEDICAL SERVICES BOARD 649.38 Subdivision 1. Total 649.39 Appropriation 2,850,000 2,850,000 649.40 Summary by Fund 649.41 General 2,304,000 2,304,000 649.42 State Government 649.43 Special Revenue 546,000 546,000 649.44 [HEALTH PROFESSIONAL SERVICES 649.45 ACTIVITY.] $546,000 each year from the 649.46 state government special revenue fund 649.47 is for the health professional services 649.48 activity. 650.1 Sec. 7. COUNCIL ON DISABILITY 650.2 General 500,000 500,000 650.3 Sec. 8. OMBUDSMAN FOR MENTAL HEALTH 650.4 AND MENTAL RETARDATION 650.5 General 1,243,000 1,242,000 650.6 Sec. 9. OMBUDSMAN FOR 650.7 FAMILIES 650.8 General 170,000 170,000 650.9 Sec. 10. DEPARTMENT OF CHILDREN, 650.10 FAMILIES, AND LEARNING 650.11 Subdivision 1. Total 650.12 Appropriation $ 127,638,000 $ 119,813,000 650.13 Summary by Fund 650.14 General 100,114,000 97,992,000 650.15 Federal TANF 24,002,000 20,525,000 650.16 State Special 650.17 Revenue 3,340,000 3,340,000 650.18 Subd. 2. Child Care 650.19 [BASIC SLIDING FEE CHILD CARE.] Of this 650.20 appropriation, $25,407,000 in fiscal 650.21 year 2004, and $20,821,000 in fiscal 650.22 year 2005 are for child care assistance 650.23 according to Minnesota Statutes, 650.24 section 119B.03. These appropriations 650.25 are available to be spent either year. 650.26 [MFIP CHILD CARE.] Of this 650.27 appropriation, $69,589,000 in fiscal 650.28 year 2004, and $70,253,000 in fiscal 650.29 year 2005 are for MFIP child care. 650.30 [CHILD CARE PROGRAM INTEGRITY.] Of this 650.31 appropriation, $425,000 in fiscal year 650.32 2004, and $376,000 in fiscal year 2005 650.33 are for the administrative costs of 650.34 program integrity and fraud prevention 650.35 for child care assistance under 650.36 Minnesota Statutes, chapter 119B. 650.37 [CHILD CARE DEVELOPMENT.] Of this 650.38 appropriation, $1,115,000 in fiscal 650.39 year 2004, and $1,164,000 in fiscal 650.40 year 2005 are for child care 650.41 development grants according to 650.42 Minnesota Statutes, section 119B.21. 650.43 [STATE SPECIAL REVENUE FUND 650.44 TRANSFER-CHILD SUPPORT CARE CHILD 650.45 ASSISTANCE.] On July 1, 2003, the 650.46 commissioner of finance shall transfer 650.47 $1,800,000 from the special revenue 650.48 fund to the general fund. 650.49 [MINNESOTA ECONOMIC OPPORTUNITY 650.50 GRANTS.] Of this appropriation, 650.51 $4,000,000 in fiscal year 2004, and 650.52 $4,000,000 in fiscal year 2005 are for 650.53 Minnesota economic opportunity grants. 651.1 [FOOD SHELF PROGRAMS.] Of this 651.2 appropriation, $1,278,000 in fiscal 651.3 year 2004, and $1,278,000 in fiscal 651.4 year 2005 are for food shelf programs 651.5 under Minnesota Statutes, section 651.6 119A.44. 651.7 [LEAD ABATEMENT.] Of this 651.8 appropriation, $100,000 in fiscal year 651.9 2004, and $100,000 in fiscal year 2005 651.10 are for lead abatement according to 651.11 Minnesota Statutes, section 119A.46. 651.12 Any balance in the first year does not 651.13 cancel but is available in the second 651.14 year. 651.15 Subd. 3. Child Support 651.16 Child Support Special 651.17 Revenue Account 3,340,000 3,340,000 651.18 [CHILD CARE ASSISTANCE.] Of this 651.19 appropriation, $3,340,000 in fiscal 651.20 year 2004, and $3,340,000 in fiscal 651.21 year 2005 are for child care assistance 651.22 according to Minnesota Statutes, 651.23 section 119B.03. 651.24 Subd. 4. Basic Sliding Fee and 651.25 Child Care Development 651.26 [FEDERAL TANF TRANSFERS.] The sums 651.27 indicated in this section are 651.28 transferred from the federal TANF fund 651.29 to the child care and development fund 651.30 and are appropriated to the department 651.31 of children, families, and learning for 651.32 the fiscal years indicated. The 651.33 commissioner shall ensure that all 651.34 transferred funds are expended 651.35 according to the child care and 651.36 development fund regulations and that 651.37 maximum allowable transferred funds are 651.38 used for the following programs: 651.39 (a) For basic sliding fee child care, 651.40 $17,686,000 in fiscal year 2004 and 651.41 $17,700,000 in fiscal year 2005, are 651.42 for child care assistance under 651.43 Minnesota Statutes, section 119B.03. 651.44 (b) For MFIP/TY, $6,302,000 in fiscal 651.45 year 2004 and $2,825,000 in fiscal year 651.46 2005 are for child care assistance 651.47 under Minnesota Statutes, section 651.48 119B.05. 651.49 (c) For child care development grants 651.50 under Minnesota Statutes, section 651.51 119B.21, $14,000 is available in fiscal 651.52 year 2004. 651.53 Sec. 11. [TRANSFERS.] 651.54 Subdivision 1. [GRANTS.] The commissioner of human 651.55 services, with the approval of the commissioner of finance, and 651.56 after notification of the chair of the senate health, human 651.57 services and corrections budget division and the chair of the 652.1 house health and human services finance committee, may transfer 652.2 unencumbered appropriation balances for the biennium ending June 652.3 30, 2005, within fiscal years among the MFIP, general 652.4 assistance, general assistance medical care, medical assistance, 652.5 Minnesota supplemental aid, and group residential housing 652.6 programs, and the entitlement portion of the chemical dependency 652.7 consolidated treatment fund, and between fiscal years of the 652.8 biennium. 652.9 Subd. 2. [ADMINISTRATION.] Positions, salary money, and 652.10 nonsalary administrative money may be transferred within the 652.11 departments of human services and health and within the programs 652.12 operated by the veterans nursing homes board as the 652.13 commissioners and the board consider necessary, with the advance 652.14 approval of the commissioner of finance. The commissioner or 652.15 the board shall inform the chairs of the house health and human 652.16 services finance committee and the senate health, human services 652.17 and corrections budget division quarterly about transfers made 652.18 under this provision. 652.19 Subd. 3. [PROHIBITED TRANSFERS.] Grant money shall not be 652.20 transferred to operations within the departments of human 652.21 services and health and within the programs operated by the 652.22 veterans nursing homes board without the approval of the 652.23 legislature. 652.24 Sec. 12. [INDIRECT COSTS NOT TO FUND PROGRAMS.] 652.25 The commissioners of health and of human services shall not 652.26 use indirect cost allocations to pay for the operational costs 652.27 of any program for which they are responsible. 652.28 Sec. 13. [CARRYOVER LIMITATION.] 652.29 The appropriations in this article which are allowed to be 652.30 carried forward from fiscal year 2004 to fiscal year 2005 shall 652.31 not become part of the base level funding for the 2006-2007 652.32 biennial budget, unless specifically directed by the legislature. 652.33 Sec. 14. [SUNSET OF UNCODIFIED LANGUAGE.] 652.34 All uncodified language contained in this article expires 652.35 on June 30, 2005, unless a different expiration date is explicit. 652.36 Sec. 15. [REPEALER.] 653.1 Laws 2002, chapter 374, article 9, section 8, is repealed 653.2 effective upon final enactment. 653.3 Sec. 16. [EFFECTIVE DATE.] 653.4 The provisions in this article are effective July 1, 2003, 653.5 unless a different effective date is specified.