Minnesota Legislature
HF 437
5th Engrossment - 83rd Legislature (2003 - 2004) Posted on 12/15/2009 12:00am
KEY: stricken = removed, old language.
underscored = added, new language.
Current Version - 5th Engrossment
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; 1.30 144.343, subdivision 1; 144.551, subdivision 1; 1.31 144A.04, subdivision 3, by adding a subdivision; 1.32 144A.071, subdivision 4a; 144A.10, by adding a 1.33 subdivision; 144A.4605, subdivision 4; 144E.11, 1.34 subdivision 6; 145.88; 145.881, subdivision 2; 1.35 145.882, subdivisions 1, 2, 3, 7, by adding a 1.36 subdivision; 145.883, subdivisions 1, 9; 145A.02, 1.37 subdivisions 5, 6, 7; 145A.06, subdivision 1; 145A.09, 1.38 subdivisions 2, 4, 7; 145A.10, subdivisions 2, 10, by 1.39 adding a subdivision; 145A.11, subdivisions 2, 4; 1.40 145A.12, subdivisions 1, 2, by adding a subdivision; 1.41 145A.13, by adding a subdivision; 145A.14, subdivision 1.42 2, by adding a subdivision; 147A.08; 148.5194, 1.43 subdivisions 1, 2, 3, by adding a subdivision; 1.44 148.6445, subdivision 7; 153A.17; 174.30, subdivision 1.45 1; 179A.03, subdivision 7; 245.4932, subdivision 1; 1.46 245A.035, subdivision 3; 245A.04, subdivisions 3, 3b, 2.1 3d; 245A.09, subdivision 7; 245A.10; 245A.11, 2.2 subdivisions 2a, 2b, by adding a subdivision; 245B.03, 2.3 subdivision 2, by adding a subdivision; 245B.04, 2.4 subdivision 2; 245B.06, subdivisions 2, 5, 8; 245B.07, 2.5 subdivisions 6, 9, 11; 245B.08, subdivision 1; 246.54; 2.6 252.27, subdivision 2a; 252.32, subdivisions 1, 1a, 3, 2.7 3c; 252.41, subdivision 3; 252.46, subdivision 1; 2.8 253B.04, subdivision 1; 253B.05, subdivision 3; 2.9 256.01, subdivision 2; 256.012; 256.046, subdivision 2.10 1; 256.0471, subdivision 1; 256.476, subdivisions 3, 2.11 4, 5; 256.482, subdivision 8; 256.935, subdivision 1; 2.12 256.955, subdivisions 2a, 3, by adding subdivisions; 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 4, 5; 256B.31; 256B.32, subdivision 1; 2.34 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.31, subdivision 4; 256J.32, 2.53 subdivisions 2, 4, 5a, by adding a subdivision; 2.54 256J.37, subdivision 9, by adding subdivisions; 2.55 256J.38, subdivisions 3, 4; 256J.40; 256J.42, 2.56 subdivisions 4, 5, 6; 256J.425, subdivisions 1, 1a, 2, 2.57 3, 4, 6, 7; 256J.45, subdivision 2; 256J.46, 2.58 subdivisions 1, 2, 2a; 256J.49, subdivisions 4, 5, 9, 2.59 13, by adding subdivisions; 256J.50, subdivisions 1, 2.60 8, 9, 10; 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; 326.42; 393.07, subdivisions 1, 5, 10; 3.4 466.03, 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; 641.15, subdivision 2; Laws 3.8 1997, chapter 203, article 9, section 21, as amended; 3.9 proposing coding for new law as Minnesota Statutes, 3.10 chapter 256M; proposing coding for new law in 3.11 Minnesota Statutes, chapters 62S; 119B; 144; 144A; 3.12 145; 145A; 148C; 256; 256B; 256D; 256I; 256J; 514; 3.13 repealing Minnesota Statutes 2002, sections 16A.151, 3.14 subdivision 5; 16A.87; 62J.17; 62J.66; 62J.68; 3.15 62J.694; 119B.061; 144.126; 144.1484; 144.1494; 3.16 144.1495; 144.1496; 144.1497; 144.395; 144.396; 3.17 144.401; 144.9507, subdivision 3; 144A.071, 3.18 subdivision 5; 144A.35; 144A.36; 144A.38; 145.56, 3.19 subdivision 2; 145.882, subdivisions 4, 5, 6, 8; 3.20 145.883, subdivisions 4, 7; 145.884; 145.885; 145.886; 3.21 145.888; 145.889; 145.890; 145.9266, subdivisions 2, 3.22 4, 5, 6, 7; 145.928, subdivision 9; 145A.02, 3.23 subdivisions 9, 10, 11, 12, 13, 14; 145A.09, 3.24 subdivision 6; 145A.10, subdivisions 5, 6, 8; 145A.11, 3.25 subdivision 3; 145A.12, subdivisions 3, 4, 5; 145A.14, 3.26 subdivisions 3, 4; 145A.17, subdivisions 2, 9; 3.27 148.5194, subdivision 3a; 148.6445, subdivision 9; 3.28 245.4712, subdivision 2; 245.478; 245.4886; 245.4888; 3.29 245.496; 245.714; 252.32, subdivision 2; 254A.17; 3.30 256.955, subdivision 8; 256.973; 256.9772; 256B.055, 3.31 subdivision 10a; 256B.056, subdivision 3c; 256B.057, 3.32 subdivision 1b; 256B.0625, subdivisions 35, 36; 3.33 256B.0928; 256B.0945, subdivisions 6, 7, 8, 9, 10; 3.34 256B.195, subdivision 5; 256B.437, subdivision 2; 3.35 256B.83; 256E.01; 256E.02; 256E.03; 256E.04; 256E.05; 3.36 256E.06; 256E.07; 256E.08; 256E.081; 256E.09; 256E.10; 3.37 256E.11; 256E.115; 256E.13; 256E.14; 256E.15; 256F.01; 3.38 256F.02; 256F.03; 256F.04; 256F.05; 256F.06; 256F.07; 3.39 256F.08; 256F.10, subdivision 7; 256F.11; 256F.12; 3.40 256F.14; 256J.02, subdivision 3; 256J.08, subdivisions 3.41 28, 70; 256J.24, subdivision 8; 256J.30, subdivision 3.42 10; 256J.462; 256J.47; 256J.48; 256J.49, subdivisions 3.43 1a, 2, 6, 7; 256J.50, subdivisions 2, 3, 3a, 5, 7; 3.44 256J.52; 256J.62, subdivisions 1, 2a, 4, 6, 7, 8; 3.45 256J.625; 256J.655; 256J.74, subdivision 3; 256J.751, 3.46 subdivisions 3, 4; 256J.76; 256K.30; 256L.02, 3.47 subdivision 3; 256L.04, subdivision 9; 257.075; 3.48 257.81; 260.152; 626.562; Laws 1998, chapter 407, 3.49 article 4, section 63; Laws 2000, chapter 488, article 3.50 10, section 29; Laws 2001, First Special Session 3.51 chapter 3, article 1, section 16; Laws 2001, First 3.52 Special Session chapter 9, article 13, section 24; 3.53 Laws 2002, chapter 374, article 9, section 8; 3.54 Minnesota Rules, parts 4705.0100; 4705.0200; 3.55 4705.0300; 4705.0400; 4705.0500; 4705.0600; 4705.0700; 3.56 4705.0800; 4705.0900; 4705.1000; 4705.1100; 4705.1200; 3.57 4705.1300; 4705.1400; 4705.1500; 4705.1600; 4736.0010; 3.58 4736.0020; 4736.0030; 4736.0040; 4736.0050; 4736.0060; 3.59 4736.0070; 4736.0080; 4736.0090; 4736.0120; 4736.0130; 3.60 4763.0100; 4763.0110; 4763.0125; 4763.0135; 4763.0140; 3.61 4763.0150; 4763.0160; 4763.0170; 4763.0180; 4763.0190; 3.62 4763.0205; 4763.0215; 4763.0220; 4763.0230; 4763.0240; 3.63 4763.0250; 4763.0260; 4763.0270; 4763.0285; 4763.0295; 3.64 4763.0300; 9505.0324; 9505.0326; 9505.0327; 9505.3045; 3.65 9505.3050; 9505.3055; 9505.3060; 9505.3068; 9505.3070; 3.66 9505.3075; 9505.3080; 9505.3090; 9505.3095; 9505.3100; 3.67 9505.3105; 9505.3107; 9505.3110; 9505.3115; 9505.3120; 3.68 9505.3125; 9505.3130; 9505.3138; 9505.3139; 9505.3140; 3.69 9505.3680; 9505.3690; 9505.3700; 9545.2000; 9545.2010; 3.70 9545.2020; 9545.2030; 9545.2040; 9550.0010; 9550.0020; 3.71 9550.0030; 9550.0040; 9550.0050; 9550.0060; 9550.0070; 4.1 9550.0080; 9550.0090; 9550.0091; 9550.0092; 9550.0093. 4.2 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 4.3 ARTICLE 1 4.4 WELFARE REFORM; PUBLIC ASSISTANCE MODIFICATIONS 4.5 Section 1. Minnesota Statutes 2002, section 256.984, 4.6 subdivision 1, is amended to read: 4.7 Subdivision 1. [DECLARATION.] Every application for public 4.8 assistance under this chapterand/oror chapters 256B, 256D, 4.9256K, MFIP program256J, and food stamps or food support under 4.10 chapter 393 shall be in writing or reduced to writing as 4.11 prescribed by the state agency and shall contain the following 4.12 declaration which shall be signed by the applicant: 4.13 "I declare under the penalties of perjury that this 4.14 application has been examined by me and to the best of my 4.15 knowledge is a true and correct statement of every material 4.16 point. I understand that a person convicted of perjury may 4.17 be sentenced to imprisonment of not more than five years or 4.18 to payment of a fine of not more than $10,000, or both." 4.19 Sec. 2. Minnesota Statutes 2002, section 256D.06, 4.20 subdivision 2, is amended to read: 4.21 Subd. 2. [EMERGENCY NEED.] Notwithstanding the provisions 4.22 of subdivision 1, a grant of emergency general assistance shall, 4.23 to the extent funds are available, be made to an eligible single 4.24 adult, married couple, or family for an emergency need, as 4.25 defined in rules promulgated by the commissioner, where the 4.26 recipient requests temporary assistance not exceeding 30 days if 4.27 an emergency situation appears to exist and(a) until March 31,4.281998, the individual is ineligible for the program of emergency4.29assistance under aid to families with dependent children and is4.30not a recipient of aid to families with dependent children at4.31the time of application; or (b)the individual or family is(i)4.32 ineligible for MFIP or is not a participant of MFIP; and (ii) is4.33ineligible for emergency assistance under section 256J.48. If 4.34 an applicant or recipient relates facts to the county agency 4.35 which may be sufficient to constitute an emergency situation, 4.36 the county agency shall, to the extent funds are available, 5.1 advise the person of the procedure for applying for assistance 5.2 according to this subdivision. An emergency general assistance 5.3 grant is available to a recipient not more than once in any 5.4 12-month period. Funding for an emergency general assistance 5.5 program is limited to the appropriation. Each fiscal year, the 5.6 commissioner shall allocate to counties the money appropriated 5.7 for emergency general assistance grants based on each county 5.8 agency's average share of state's emergency general expenditures 5.9 for the immediate past three fiscal years as determined by the 5.10 commissioner, and may reallocate any unspent amounts to other 5.11 counties. Any emergency general assistance expenditures by a 5.12 county above the amount of the commissioner's allocation to the 5.13 county must be made from county funds. 5.14 Sec. 3. Minnesota Statutes 2002, section 256D.44, 5.15 subdivision 5, is amended to read: 5.16 Subd. 5. [SPECIAL NEEDS.] In addition to the state 5.17 standards of assistance established in subdivisions 1 to 4, 5.18 payments are allowed for the following special needs of 5.19 recipients of Minnesota supplemental aid who are not residents 5.20 of a nursing home, a regional treatment center, or a group 5.21 residential housing facility. 5.22 (a) The county agency shall pay a monthly allowance for 5.23 medically prescribed dietspayable under the Minnesota family5.24investment programif the cost of those additional dietary needs 5.25 cannot be met through some other maintenance benefit. The need 5.26 for special diets or dietary items must be prescribed by a 5.27 licensed physician. Costs for special diets shall be determined 5.28 as percentages of the allotment for a one-person household under 5.29 the thrifty food plan as defined by the United States Department 5.30 of Agriculture. The types of diets and the percentages of the 5.31 thrifty food plan that are covered are as follows: 5.32 (1) high protein diet, at least 80 grams daily, 25 percent 5.33 of thrifty food plan; 5.34 (2) controlled protein diet, 40 to 60 grams and requires 5.35 special products, 100 percent of thrifty food plan; 5.36 (3) controlled protein diet, less than 40 grams and 6.1 requires special products, 125 percent of thrifty food plan; 6.2 (4) low cholesterol diet, 25 percent of thrifty food plan; 6.3 (5) high residue diet, 20 percent of thrifty food plan; 6.4 (6) pregnancy and lactation diet, 35 percent of thrifty 6.5 food plan; 6.6 (7) gluten-free diet, 25 percent of thrifty food plan; 6.7 (8) lactose-free diet, 25 percent of thrifty food plan; 6.8 (9) antidumping diet, 15 percent of thrifty food plan; 6.9 (10) hypoglycemic diet, 15 percent of thrifty food plan; or 6.10 (11) ketogenic diet, 25 percent of thrifty food plan. 6.11 (b) Payment for nonrecurring special needs must be allowed 6.12 for necessary home repairs or necessary repairs or replacement 6.13 of household furniture and appliances using the payment standard 6.14 of the AFDC program in effect on July 16, 1996, for these 6.15 expenses, as long as other funding sources are not available. 6.16 (c) A fee for guardian or conservator service is allowed at 6.17 a reasonable rate negotiated by the county or approved by the 6.18 court. This rate shall not exceed five percent of the 6.19 assistance unit's gross monthly income up to a maximum of $100 6.20 per month. If the guardian or conservator is a member of the 6.21 county agency staff, no fee is allowed. 6.22 (d) The county agency shall continue to pay a monthly 6.23 allowance of $68 for restaurant meals for a person who was 6.24 receiving a restaurant meal allowance on June 1, 1990, and who 6.25 eats two or more meals in a restaurant daily. The allowance 6.26 must continue until the person has not received Minnesota 6.27 supplemental aid for one full calendar month or until the 6.28 person's living arrangement changes and the person no longer 6.29 meets the criteria for the restaurant meal allowance, whichever 6.30 occurs first. 6.31 (e) A fee of ten percent of the recipient's gross income or 6.32 $25, whichever is less, is allowed for representative payee 6.33 services provided by an agency that meets the requirements under 6.34 SSI regulations to charge a fee for representative payee 6.35 services. This special need is available to all recipients of 6.36 Minnesota supplemental aid regardless of their living 7.1 arrangement. 7.2 (f) Notwithstanding the language in this subdivision, an 7.3 amount equal to the maximum allotment authorized by the federal 7.4 Food Stamp Program for a single individual which is in effect on 7.5 the first day of January of the previous year will be added to 7.6 the standards of assistance established in subdivisions 1 to 4 7.7 for individuals under the age of 65 who are relocating from an 7.8 institution and who are shelter needy. An eligible individual 7.9 who receives this benefit prior to age 65 may continue to 7.10 receive the benefit after the age of 65. 7.11 "Shelter needy" means that the assistance unit incurs 7.12 monthly shelter costs that exceed 40 percent of the assistance 7.13 unit's gross income before the application of this special needs 7.14 standard. "Gross income" for the purposes of this section is 7.15 the applicant's or recipient's income as defined in section 7.16 256D.35, subdivision 10, or the standard specified in 7.17 subdivision 3, whichever is greater. A recipient of a federal 7.18 or state housing subsidy, that limits shelter costs to a 7.19 percentage of gross income, shall not be considered shelter 7.20 needy for purposes of this paragraph. 7.21 Sec. 4. Minnesota Statutes 2002, section 256D.46, 7.22 subdivision 1, is amended to read: 7.23 Subdivision 1. [ELIGIBILITY.] A county agency must grant 7.24 emergency Minnesota supplemental aidmust be granted, to the 7.25 extent funds are available, if the recipient is without adequate 7.26 resources to resolve an emergency that, if unresolved, will 7.27 threaten the health or safety of the recipient. For the 7.28 purposes of this section, the term "recipient" includes persons 7.29 for whom a group residential housing benefit is being paid under 7.30 sections 256I.01 to 256I.06. 7.31 Sec. 5. Minnesota Statutes 2002, section 256D.46, 7.32 subdivision 3, is amended to read: 7.33 Subd. 3. [PAYMENT AMOUNT.] The amount of assistance 7.34 granted under emergency Minnesota supplemental aid is limited to 7.35 the amount necessary to resolve the emergency. An emergency 7.36 Minnesota supplemental aid grant is available to a recipient no 8.1 more than once in any 12-month period. Funding for emergency 8.2 Minnesota supplemental aid is limited to the appropriation. 8.3 Each fiscal year, the commissioner shall allocate to counties 8.4 the money appropriated for emergency Minnesota supplemental aid 8.5 grants based on each county agency's average share of state's 8.6 emergency Minnesota supplemental aid expenditures for the 8.7 immediate past three fiscal years as determined by the 8.8 commissioner, and may reallocate any unspent amounts to other 8.9 counties. Any emergency Minnesota supplemental aid expenditures 8.10 by a county above the amount of the commissioner's allocation to 8.11 the county must be made from county funds. 8.12 Sec. 6. Minnesota Statutes 2002, section 256D.48, 8.13 subdivision 1, is amended to read: 8.14 Subdivision 1. [NEED FOR PROTECTIVE PAYEE.] The county 8.15 agency shall determine whether a recipient needs a protective 8.16 payee when a physical or mental condition renders the recipient 8.17 unable to manage funds and when payments to the recipient would 8.18 be contrary to the recipient's welfare. Protective payments 8.19 must be issued when there is evidence of: (1) repeated 8.20 inability to plan the use of income to meet necessary 8.21 expenditures; (2) repeated observation that the recipient is not 8.22 properly fed or clothed; (3) repeated failure to meet 8.23 obligations for rent, utilities, food, and other essentials; (4) 8.24 evictions or a repeated incurrence of debts; or (5) lost or 8.25 stolen checks; or (6) use of emergency Minnesota supplemental8.26aid more than twice in a calendar year. The determination of 8.27 representative payment by the Social Security Administration for 8.28 the recipient is sufficient reason for protective payment of 8.29 Minnesota supplemental aid payments. 8.30 Sec. 7. Minnesota Statutes 2002, section 256J.01, 8.31 subdivision 5, is amended to read: 8.32 Subd. 5. [COMPLIANCE SYSTEM.] The commissioner shall 8.33 administer a compliance system for the state's temporary 8.34 assistance for needy families (TANF) program, the food stamp 8.35 program,emergency assistance,general assistance, medical 8.36 assistance, general assistance medical care, emergency general 9.1 assistance, Minnesota supplemental aid, preadmission screening, 9.2 child support program, and alternative care grants under the 9.3 powers and authorities named in section 256.01, subdivision 2. 9.4 The purpose of the compliance system is to permit the 9.5 commissioner to supervise the administration of public 9.6 assistance programs and to enforce timely and accurate 9.7 distribution of benefits, completeness of service and efficient 9.8 and effective program management and operations, to increase 9.9 uniformity and consistency in the administration and delivery of 9.10 public assistance programs throughout the state, and to reduce 9.11 the possibility of sanction and fiscal disallowances for 9.12 noncompliance with federal regulations and state statutes. 9.13 Sec. 8. Minnesota Statutes 2002, section 256J.02, 9.14 subdivision 2, is amended to read: 9.15 Subd. 2. [USE OF MONEY.] State money appropriated for 9.16 purposes of this section and TANF block grant money must be used 9.17 for: 9.18 (1) financial assistance to or on behalf of any minor child 9.19 who is a resident of this state under section 256J.12; 9.20 (2)employment and training services under this chapter or9.21chapter 256K;9.22(3) emergency financial assistance and services under9.23section 256J.48;9.24(4) diversionary assistance under section 256J.47;9.25(5)the health care and human services training and 9.26 retention program under chapter 116L, for costs associated with 9.27 families with children with incomes below 200 percent of the 9.28 federal poverty guidelines; 9.29(6)(3) the pathways program under section 116L.04, 9.30 subdivision 1a; 9.31(7) welfare-to-work extended employment services for MFIP9.32participants with severe impairment to employment as defined in9.33section 268A.15, subdivision 1a;9.34(8) the family homeless prevention and assistance program9.35under section 462A.204;9.36(9) the rent assistance for family stabilization10.1demonstration project under section 462A.205;10.2(10)(4) welfare to work transportation authorized under 10.3 Public LawNumber105-178; 10.4(11)(5) reimbursements for the federal share of child 10.5 support collections passed through to the custodial parent; 10.6(12)(6) reimbursements for the working family credit under 10.7 section 290.0671; 10.8(13) intensive ESL grants under Laws 2000, chapter 489,10.9article 1;10.10(14) transitional housing programs under section 119A.43;10.11(15) programs and pilot projects under chapter 256K; and10.12(16)(7) program administration under this chapter; 10.13 (8) the diversionary work program under section 256J.95; 10.14 (9) the MFIP consolidated fund under section 256J.626; and 10.15 (10) the Minnesota department of health consolidated fund 10.16 under Laws 2001, First Special Session chapter 9, article 17, 10.17 section 3, subdivision 2. 10.18 Sec. 9. Minnesota Statutes 2002, section 256J.021, is 10.19 amended to read: 10.20 256J.021 [SEPARATE STATE PROGRAM FOR USE OF STATE MONEY.] 10.21 Beginning October 1, 2001, and each year thereafter, the 10.22 commissioner of human services must treatfinancial assistance10.23 MFIP expenditures made to or on behalf of any minor child under 10.24 section 256J.02, subdivision 2, clause (1), who is a resident of 10.25 this state under section 256J.12, and who is part of a 10.26 two-parent eligible household as expenditures under a separately 10.27 funded state program and report those expenditures to the 10.28 federal Department of Health and Human Services as separate 10.29 state program expenditures under Code of Federal Regulations, 10.30 title 45, section 263.5. 10.31 Sec. 10. Minnesota Statutes 2002, section 256J.08, is 10.32 amended by adding a subdivision to read: 10.33 Subd. 11a. [CHILD ONLY CASE.] "Child only case" means a 10.34 case that would be part of the child only TANF program under 10.35 section 256J.88. 10.36 Sec. 11. Minnesota Statutes 2002, section 256J.08, is 11.1 amended by adding a subdivision to read: 11.2 Subd. 24b. [DIVERSIONARY WORK PROGRAM OR DWP.] 11.3 "Diversionary work program" or "DWP" has the meaning given in 11.4 section 256J.95. 11.5 Sec. 12. Minnesota Statutes 2002, section 256J.08, is 11.6 amended by adding a subdivision to read: 11.7 Subd. 28b. [EMPLOYABLE.] "Employable" means a person is 11.8 capable of performing existing positions in the local labor 11.9 market, regardless of the current availability of openings for 11.10 those positions. 11.11 Sec. 13. Minnesota Statutes 2002, section 256J.08, is 11.12 amended by adding a subdivision to read: 11.13 Subd. 34a. [FAMILY VIOLENCE.] (a) "Family violence" means 11.14 the following, if committed against a family or household member 11.15 by a family or household member: 11.16 (1) physical harm, bodily injury, or assault; 11.17 (2) the infliction of fear of imminent physical harm, 11.18 bodily injury, or assault; or 11.19 (3) terroristic threats, within the meaning of section 11.20 609.713, subdivision 1; criminal sexual conduct, within the 11.21 meaning of section 609.342, 609.343, 609.344, 609.345, or 11.22 609.3451; or interference with an emergency call within the 11.23 meaning of section 609.78, subdivision 2. 11.24 (b) For the purposes of family violence, "family or 11.25 household member" means: 11.26 (1) spouses and former spouses; 11.27 (2) parents and children; 11.28 (3) persons related by blood; 11.29 (4) persons who are residing together or who have resided 11.30 together in the past; 11.31 (5) persons who have a child in common regardless of 11.32 whether they have been married or have lived together at any 11.33 time; 11.34 (6) a man and woman if the woman is pregnant and the man is 11.35 alleged to be the father, regardless of whether they have been 11.36 married or have lived together at anytime; and 12.1 (7) persons involved in a current or past significant 12.2 romantic or sexual relationship. 12.3 Sec. 14. Minnesota Statutes, section 256J.08, is amended 12.4 by adding a subdivision to read: 12.5 Subd. 34b. [FAMILY VIOLENCE WAIVER.] "Family violence 12.6 waiver" means a waiver of the 60-month time limit for victims of 12.7 family violence who meet the criteria in section 256J.545 and 12.8 are complying with an employment plan in section 256J.521, 12.9 subdivision 3. 12.10 Sec. 15. Minnesota Statutes 2002, section 256J.08, 12.11 subdivision 35, is amended to read: 12.12 Subd. 35. [FAMILY WAGE LEVEL.] "Family wage level" means 12.13 110 percent of the transitional standard as specified in section 12.14 256J.24, subdivision 7. 12.15 Sec. 16. Minnesota Statutes 2002, section 256J.08, is 12.16 amended by adding a subdivision to read: 12.17 Subd. 51b. [LEARNING DISABLED.] "Learning disabled," for 12.18 purposes of an extension to the 60-month time limit under 12.19 section 256J.425, subdivision 3, clause (3), means the person 12.20 has a disorder in one or more of the psychological processes 12.21 involved in perceiving, understanding, or using concepts through 12.22 verbal language or nonverbal means. Learning disabled does not 12.23 include learning problems that are primarily the result of 12.24 visual, hearing, or motor handicaps, mental retardation, 12.25 emotional disturbance, or due to environmental, cultural, or 12.26 economic disadvantage. 12.27 Sec. 17. Minnesota Statutes 2002, section 256J.08, 12.28 subdivision 65, is amended to read: 12.29 Subd. 65. [PARTICIPANT.] "Participant" means a person who 12.30 is currently receiving cash assistance or the food portion 12.31 available through MFIPas funded by TANF and the food stamp12.32program. A person who fails to withdraw or access 12.33 electronically any portion of the person's cash and food 12.34 assistance payment by the end of the payment month, who makes a 12.35 written request for closure before the first of a payment month 12.36 and repays cash and food assistance electronically issued for 13.1 that payment month within that payment month, or who returns any 13.2 uncashed assistance check and food coupons and withdraws from 13.3 the program is not a participant. A person who withdraws a cash 13.4 or food assistance payment by electronic transfer or receives 13.5 and cashes an MFIP assistance check or food coupons and is 13.6 subsequently determined to be ineligible for assistance for that 13.7 period of time is a participant, regardless whether that 13.8 assistance is repaid. The term "participant" includes the 13.9 caregiver relative and the minor child whose needs are included 13.10 in the assistance payment. A person in an assistance unit who 13.11 does not receive a cash and food assistance payment because the 13.12personcase has been suspended from MFIP is a participant. A 13.13 person who receives cash payments under the diversionary work 13.14 program under section 256J.95 is a participant. 13.15 Sec. 18. Minnesota Statutes 2002, section 256J.08, is 13.16 amended by adding a subdivision to read: 13.17 Subd. 65a. [PARTICIPATION REQUIREMENTS OF 13.18 TANF.] "Participation requirements of TANF" means activities and 13.19 hourly requirements allowed under title IV-A of the federal 13.20 Social Security Act. 13.21 Sec. 19. Minnesota Statutes 2002, section 256J.08, is 13.22 amended by adding a subdivision to read: 13.23 Subd. 73a. [QUALIFIED PROFESSIONAL.] (a) For physical 13.24 illness, injury, or incapacity, a "qualified professional" means 13.25 a licensed physician, a physician's assistant, a nurse 13.26 practitioner, or in the case of spinal subluxation, a licensed 13.27 chiropractor. 13.28 (b) For mental retardation and intelligence testing, a 13.29 "qualified professional" means an individual qualified by 13.30 training and experience to administer the tests necessary to 13.31 make determinations, such as tests of intellectual functioning, 13.32 assessments of adaptive behavior, adaptive skills, and 13.33 developmental functioning. These professionals include licensed 13.34 psychologists, certified school psychologists, or certified 13.35 psychometrists working under the supervision of a licensed 13.36 psychologist. 14.1 (c) For learning disabilities, a "qualified professional" 14.2 means a licensed psychologist or school psychologist with 14.3 experience determining learning disabilities. 14.4 (d) For mental health, a "qualified professional" means a 14.5 licensed physician or a qualified mental health professional. A 14.6 "qualified mental health professional" means: 14.7 (1) for children, in psychiatric nursing, a registered 14.8 nurse who is licensed under sections 148.171 to 148.285, and who 14.9 is certified as a clinical specialist in child and adolescent 14.10 psychiatric or mental health nursing by a national nurse 14.11 certification organization or who has a master's degree in 14.12 nursing or one of the behavioral sciences or related fields from 14.13 an accredited college or university or its equivalent, with at 14.14 least 4,000 hours of post-master's supervised experience in the 14.15 delivery of clinical services in the treatment of mental 14.16 illness; 14.17 (2) for adults, in psychiatric nursing, a registered nurse 14.18 who is licensed under sections 148.171 to 148.285, and who is 14.19 certified as a clinical specialist in adult psychiatric and 14.20 mental health nursing by a national nurse certification 14.21 organization or who has a master's degree in nursing or one of 14.22 the behavioral sciences or related fields from an accredited 14.23 college or university or its equivalent, with at least 4,000 14.24 hours of post-master's supervised experience in the delivery of 14.25 clinical services in the treatment of mental illness; 14.26 (3) in clinical social work, a person licensed as an 14.27 independent clinical social worker under section 148B.21, 14.28 subdivision 6, or a person with a master's degree in social work 14.29 from an accredited college or university, with at least 4,000 14.30 hours of post-master's supervised experience in the delivery of 14.31 clinical services in the treatment of mental illness; 14.32 (4) in psychology, an individual licensed by the board of 14.33 psychology under sections 148.88 to 148.98, who has stated to 14.34 the board of psychology competencies in the diagnosis and 14.35 treatment of mental illness; 14.36 (5) in psychiatry, a physician licensed under chapter 147 15.1 and certified by the American Board of Psychiatry and Neurology 15.2 or eligible for board certification in psychiatry; and 15.3 (6) in marriage and family therapy, the mental health 15.4 professional must be a marriage and family therapist licensed 15.5 under sections 148B.29 to 148B.39, with at least two years of 15.6 post-master's supervised experience in the delivery of clinical 15.7 services in the treatment of mental illness. 15.8 Sec. 20. Minnesota Statutes 2002, section 256J.08, 15.9 subdivision 82, is amended to read: 15.10 Subd. 82. [SANCTION.] "Sanction" means the reduction of a 15.11 family's assistance payment by a specified percentage of the 15.12 MFIP standard of need because: a nonexempt participant fails to 15.13 comply with the requirements of sections256J.52256J.515 to 15.14256J.55256J.57; a parental caregiver fails without good cause 15.15 to cooperate with the child support enforcement requirements; or 15.16 a participant fails to comply withthe insurance, tort15.17liability, orother requirements of this chapter. 15.18 Sec. 21. Minnesota Statutes 2002, section 256J.08, is 15.19 amended by adding a subdivision to read: 15.20 Subd. 84a. [SSI RECIPIENT.] "SSI recipient" means a person 15.21 who receives at least $1 in SSI benefits, or who is not 15.22 receiving an SSI benefit due to recoupment or a one month 15.23 suspension by the Social Security Administration due to excess 15.24 income. 15.25 Sec. 22. Minnesota Statutes 2002, section 256J.08, 15.26 subdivision 85, is amended to read: 15.27 Subd. 85. [TRANSITIONAL STANDARD.] "Transitional standard" 15.28 means the basic standard for a familywith no other income or a15.29nonworking familywithout earned income and is a combination of 15.30 the cashassistance needsportion and foodassistance needs for15.31a family of that sizeportion as specified in section 256J.24, 15.32 subdivision 5. 15.33 Sec. 23. Minnesota Statutes 2002, section 256J.08, is 15.34 amended by adding a subdivision to read: 15.35 Subd. 90. [SEVERE FORMS OF TRAFFICKING IN 15.36 PERSONS.] "Severe forms of trafficking in persons" means: (1) 16.1 sex trafficking in which a commercial sex act is induced by 16.2 force, fraud, or coercion, or in which the person induced to 16.3 perform the act has not attained 18 years of age; or (2) the 16.4 recruitment, harboring, transportation, provision, or obtaining 16.5 of a person for labor or services through the use of force, 16.6 fraud, or coercion for the purposes of subjection to involuntary 16.7 servitude, peonage, debt bondage, or slavery. 16.8 Sec. 24. Minnesota Statutes 2002, section 256J.09, 16.9 subdivision 2, is amended to read: 16.10 Subd. 2. [COUNTY AGENCY RESPONSIBILITY TO PROVIDE 16.11 INFORMATION.] When a person inquires about assistance, a county 16.12 agency must: 16.13 (1) explain the eligibility requirements of, and how to 16.14 apply for, diversionary assistance as provided in section16.15256J.47; emergency assistance as provided in section 256J.48;16.16MFIP as provided in section 256J.10; oranyotherassistance for 16.17 which the person may be eligible; and 16.18 (2) offer the person brochures developed or approved by the 16.19 commissioner that describe how to apply for assistance. 16.20 Sec. 25. Minnesota Statutes 2002, section 256J.09, 16.21 subdivision 3, is amended to read: 16.22 Subd. 3. [SUBMITTING THE APPLICATION FORM.] (a) A county 16.23 agency must offer, in person or by mail, the application forms 16.24 prescribed by the commissioner as soon as a person makes a 16.25 written or oral inquiry. At that time, the county agency must: 16.26 (1) inform the person that assistance begins with the date 16.27 the signed application is received by the county agency or the 16.28 date all eligibility criteria are met, whichever is later; 16.29 (2) inform the person that any delay in submitting the 16.30 application will reduce the amount of assistance paid for the 16.31 month of application; 16.32 (3) inform a person that the person may submit the 16.33 application before an interview; 16.34 (4) explain the information that will be verified during 16.35 the application process by the county agency as provided in 16.36 section 256J.32; 17.1 (5) inform a person about the county agency's average 17.2 application processing time and explain how the application will 17.3 be processed under subdivision 5; 17.4 (6) explain how to contact the county agency if a person's 17.5 application information changes and how to withdraw the 17.6 application; 17.7 (7) inform a person that the next step in the application 17.8 process is an interview and what a person must do if the 17.9 application is approved including, but not limited to, attending 17.10 orientation under section 256J.45 and complying with employment 17.11 and training services requirements in sections256J.52256J.515 17.12 to256J.55256J.57; 17.13 (8) explain the child care and transportation services that 17.14 are available under paragraph (c) to enable caregivers to attend 17.15 the interview, screening, and orientation; and 17.16 (9) identify any language barriers and arrange for 17.17 translation assistance during appointments, including, but not 17.18 limited to, screening under subdivision 3a, orientation under 17.19 section 256J.45, andthe initialassessment under section 17.20256J.52256J.521. 17.21 (b) Upon receipt of a signed application, the county agency 17.22 must stamp the date of receipt on the face of the application. 17.23 The county agency must process the application within the time 17.24 period required under subdivision 5. An applicant may withdraw 17.25 the application at any time by giving written or oral notice to 17.26 the county agency. The county agency must issue a written 17.27 notice confirming the withdrawal. The notice must inform the 17.28 applicant of the county agency's understanding that the 17.29 applicant has withdrawn the application and no longer wants to 17.30 pursue it. When, within ten days of the date of the agency's 17.31 notice, an applicant informs a county agency, in writing, that 17.32 the applicant does not wish to withdraw the application, the 17.33 county agency must reinstate the application and finish 17.34 processing the application. 17.35 (c) Upon a participant's request, the county agency must 17.36 arrange for transportation and child care or reimburse the 18.1 participant for transportation and child care expenses necessary 18.2 to enable participants to attend the screening under subdivision 18.3 3a and orientation under section 256J.45. 18.4 Sec. 26. Minnesota Statutes 2002, section 256J.09, 18.5 subdivision 3a, is amended to read: 18.6 Subd. 3a. [SCREENING.] The county agency, or at county 18.7 option, the county's employment and training service provider as 18.8 defined in section 256J.49, must screen each applicant to 18.9 determine immediate needs and to determine if the applicant may 18.10 be eligible for:18.11(1)another program that is not partially funded through 18.12 the federal temporary assistance to needy families block grant 18.13 under Title I of Public LawNumber104-193, including the 18.14 expedited issuance of food stamps under section 256J.28, 18.15 subdivision 1.If the applicant may be eligible for another18.16program, a county caseworker must provide the appropriate18.17referral to the program;18.18(2) the diversionary assistance program under section18.19256J.47; or18.20(3) the emergency assistance program under section18.21256J.48.If the applicant appears eligible for another program, 18.22 including any program funded by the MFIP consolidated fund, the 18.23 county must make a referral to the appropriate program. 18.24 Sec. 27. Minnesota Statutes 2002, section 256J.09, 18.25 subdivision 3b, is amended to read: 18.26 Subd. 3b. [INTERVIEW TO DETERMINE REFERRALS AND SERVICES.] 18.27 If the applicant is not diverted from applying for MFIP, and if 18.28 the applicant meets the MFIP eligibility requirements, then a 18.29 county agency must: 18.30 (1) identify an applicant who is under the age of 18.31 20 without a high school diploma or its equivalent and explain 18.32 to the applicant the assessment procedures and employment plan 18.33 requirementsfor minor parentsunder section 256J.54; 18.34 (2) explain to the applicant the eligibility criteria in 18.35 section 256J.545 foran exemption underthe family violence 18.36provisions in section 256J.52, subdivision 6waiver, andexplain19.1 what an applicant should do to develop analternativeemployment 19.2 plan; 19.3 (3) determine if an applicant qualifies for an exemption 19.4 under section 256J.56 from employment and training services 19.5 requirements, explain how a person should report to the county 19.6 agency any status changes, and explain that an applicant who is 19.7 exempt may volunteer to participate in employment and training 19.8 services; 19.9 (4) for applicants who are not exempt from the requirement 19.10 to attend orientation, arrange for an orientation under section 19.11 256J.45 and aninitialassessment under section256J.5219.12 256J.521; 19.13 (5) inform an applicant who is not exempt from the 19.14 requirement to attend orientation that failure to attend the 19.15 orientation is considered an occurrence of noncompliance with 19.16 program requirements and will result in an imposition of a 19.17 sanction under section 256J.46; and 19.18 (6) explain how to contact the county agency if an 19.19 applicant has questions about compliance with program 19.20 requirements. 19.21 Sec. 28. Minnesota Statutes 2002, section 256J.09, 19.22 subdivision 8, is amended to read: 19.23 Subd. 8. [ADDITIONAL APPLICATIONS.] Until a county agency 19.24 issues notice of approval or denial, additional applications 19.25 submitted by an applicant are void. However, an application for 19.26 monthly assistance or other benefits funded under section 19.27 256J.626 and an application foremergency assistance or19.28 emergency general assistance may exist concurrently. More than 19.29 one application for monthly assistance, emergency assistance,or 19.30 emergency general assistance may exist concurrently when the 19.31 county agency decisions on one or more earlier applications have 19.32 been appealed to the commissioner, and the applicant asserts 19.33 that a change in circumstances has occurred that would allow 19.34 eligibility. A county agency must require additional 19.35 application forms or supplemental forms as prescribed by the 19.36 commissioner when a payee's name changes, or when a caregiver 20.1 requests the addition of another person to the assistance unit. 20.2 Sec. 29. Minnesota Statutes 2002, section 256J.09, 20.3 subdivision 10, is amended to read: 20.4 Subd. 10. [APPLICANTS WHO DO NOT MEET ELIGIBILITY 20.5 REQUIREMENTS FOR MFIP OR THE DIVERSIONARY WORK PROGRAM.] When an 20.6 applicant is not eligible for MFIP or the diversionary work 20.7 program under section 256J.95 because the applicant does not 20.8 meet eligibility requirements, the county agency must determine 20.9 whether the applicant is eligible for food stamps, medical20.10assistance, diversionary assistance, or has a need for emergency20.11assistance when the applicant meets the eligibility requirements20.12for those programsor health care programs. The county must 20.13 also inform applicants about resources available through the 20.14 county or other agencies to meet short-term emergency needs. 20.15 Sec. 30. Minnesota Statutes 2002, section 256J.14, is 20.16 amended to read: 20.17 256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 20.18 (a) The definitions in this paragraph only apply to this 20.19 subdivision. 20.20 (1) "Household of a parent, legal guardian, or other adult 20.21 relative" means the place of residence of: 20.22 (i) a natural or adoptive parent; 20.23 (ii) a legal guardian according to appointment or 20.24 acceptance under section 260C.325, 525.615, or 525.6165, and 20.25 related laws; 20.26 (iii) a caregiver as defined in section 256J.08, 20.27 subdivision 11; or 20.28 (iv) an appropriate adult relative designated by a county 20.29 agency. 20.30 (2) "Adult-supervised supportive living arrangement" means 20.31 a private family setting which assumes responsibility for the 20.32 care and control of the minor parent and minor child, or other 20.33 living arrangement, not including a public institution, licensed 20.34 by the commissioner of human services which ensures that the 20.35 minor parent receives adult supervision and supportive services, 20.36 such as counseling, guidance, independent living skills 21.1 training, or supervision. 21.2 (b) A minor parent and the minor child who is in the care 21.3 of the minor parent must reside in the household of a parent, 21.4 legal guardian, other adult relative, or in an adult-supervised 21.5 supportive living arrangement in order to receive MFIP unless: 21.6 (1) the minor parent has no living parent, other adult 21.7 relative, or legal guardian whose whereabouts is known; 21.8 (2) no living parent, other adult relative, or legal 21.9 guardian of the minor parent allows the minor parent to live in 21.10 the parent's, other adult relative's, or legal guardian's home; 21.11 (3) the minor parent lived apart from the minor parent's 21.12 own parent or legal guardian for a period of at least one year 21.13 before either the birth of the minor child or the minor parent's 21.14 application for MFIP; 21.15 (4) the physical or emotional health or safety of the minor 21.16 parent or minor child would be jeopardized if the minor parent 21.17 and the minor child resided in the same residence with the minor 21.18 parent's parent, other adult relative, or legal guardian; or 21.19 (5) an adult supervised supportive living arrangement is 21.20 not available for the minor parent and child in the county in 21.21 which the minor parent and child currently reside. If an adult 21.22 supervised supportive living arrangement becomes available 21.23 within the county, the minor parent and child must reside in 21.24 that arrangement. 21.25 (c) The county agency shall inform minor applicants both 21.26 orally and in writing about the eligibility requirements, their 21.27 rights and obligations under the MFIP program, and any other 21.28 applicable orientation information. The county must advise the 21.29 minor of the possible exemptions under section 256J.54, 21.30 subdivision 5, and specifically ask whether one or more of these 21.31 exemptions is applicable. If the minor alleges one or more of 21.32 these exemptions, then the county must assist the minor in 21.33 obtaining the necessary verifications to determine whether or 21.34 not these exemptions apply. 21.35 (d) If the county worker has reason to suspect that the 21.36 physical or emotional health or safety of the minor parent or 22.1 minor child would be jeopardized if they resided with the minor 22.2 parent's parent, other adult relative, or legal guardian, then 22.3 the county worker must make a referral to child protective 22.4 services to determine if paragraph (b), clause (4), applies. A 22.5 new determination by the county worker is not necessary if one 22.6 has been made within the last six months, unless there has been 22.7 a significant change in circumstances which justifies a new 22.8 referral and determination. 22.9 (e) If a minor parent is not living with a parent, legal 22.10 guardian, or other adult relative due to paragraph (b), clause 22.11 (1), (2), or (4), the minor parent must reside, when possible, 22.12 in a living arrangement that meets the standards of paragraph 22.13 (a), clause (2). 22.14 (f) Regardless of living arrangement, MFIP must be paid, 22.15 when possible, in the form of a protective payment on behalf of 22.16 the minor parent and minor child according to section 256J.39, 22.17 subdivisions 2 to 4. 22.18 Sec. 31. Minnesota Statutes 2002, section 256J.20, 22.19 subdivision 3, is amended to read: 22.20 Subd. 3. [OTHER PROPERTY LIMITATIONS.] To be eligible for 22.21 MFIP, the equity value of all nonexcluded real and personal 22.22 property of the assistance unit must not exceed $2,000 for 22.23 applicants and $5,000 for ongoing participants. The value of 22.24 assets in clauses (1) to (19) must be excluded when determining 22.25 the equity value of real and personal property: 22.26 (1) a licensed vehicle up to a loan value of less than or 22.27 equal to $7,500. The county agency shall apply any excess loan 22.28 value as if it were equity value to the asset limit described in 22.29 this section. If the assistance unit owns more than one 22.30 licensed vehicle, the county agency shall determine the vehicle 22.31 with the highest loan value and count only the loan value over 22.32 $7,500, excluding: (i) the value of one vehicle per physically 22.33 disabled person when the vehicle is needed to transport the 22.34 disabled unit member; this exclusion does not apply to mentally 22.35 disabled people; (ii) the value of special equipment for a 22.36 handicapped member of the assistance unit; and (iii) any vehicle 23.1 used for long-distance travel, other than daily commuting, for 23.2 the employment of a unit member. 23.3 The county agency shall count the loan value of all other 23.4 vehicles and apply this amount as if it were equity value to the 23.5 asset limit described in this section. To establish the loan 23.6 value of vehicles, a county agency must use the N.A.D.A. 23.7 Official Used Car Guide, Midwest Edition, for newer model cars. 23.8 When a vehicle is not listed in the guidebook, or when the 23.9 applicant or participant disputes the loan value listed in the 23.10 guidebook as unreasonable given the condition of the particular 23.11 vehicle, the county agency may require the applicant or 23.12 participant document the loan value by securing a written 23.13 statement from a motor vehicle dealer licensed under section 23.14 168.27, stating the amount that the dealer would pay to purchase 23.15 the vehicle. The county agency shall reimburse the applicant or 23.16 participant for the cost of a written statement that documents a 23.17 lower loan value; 23.18 (2) the value of life insurance policies for members of the 23.19 assistance unit; 23.20 (3) one burial plot per member of an assistance unit; 23.21 (4) the value of personal property needed to produce earned 23.22 income, including tools, implements, farm animals, inventory, 23.23 business loans, business checking and savings accounts used at 23.24 least annually and used exclusively for the operation of a 23.25 self-employment business, and any motor vehicles if at least 50 23.26 percent of the vehicle's use is to produce income and if the 23.27 vehicles are essential for the self-employment business; 23.28 (5) the value of personal property not otherwise specified 23.29 which is commonly used by household members in day-to-day living 23.30 such as clothing, necessary household furniture, equipment, and 23.31 other basic maintenance items essential for daily living; 23.32 (6) the value of real and personal property owned by a 23.33 recipient of Supplemental Security Income or Minnesota 23.34 supplemental aid; 23.35 (7) the value of corrective payments, but only for the 23.36 month in which the payment is received and for the following 24.1 month; 24.2 (8) a mobile home or other vehicle used by an applicant or 24.3 participant as the applicant's or participant's home; 24.4 (9) money in a separate escrow account that is needed to 24.5 pay real estate taxes or insurance and that is used for this 24.6 purpose; 24.7 (10) money held in escrow to cover employee FICA, employee 24.8 tax withholding, sales tax withholding, employee worker 24.9 compensation, business insurance, property rental, property 24.10 taxes, and other costs that are paid at least annually, but less 24.11 often than monthly; 24.12 (11) monthly assistance, emergency assistance, and24.13diversionarypayments for the current month'sneedsor 24.14 short-term emergency needs under section 256J.626, subdivision 24.15 2; 24.16 (12) the value of school loans, grants, or scholarships for 24.17 the period they are intended to cover; 24.18 (13) payments listed in section 256J.21, subdivision 2, 24.19 clause (9), which are held in escrow for a period not to exceed 24.20 three months to replace or repair personal or real property; 24.21 (14) income received in a budget month through the end of 24.22 the payment month; 24.23 (15) savings from earned income of a minor child or a minor 24.24 parent that are set aside in a separate account designated 24.25 specifically for future education or employment costs; 24.26 (16) the federal earned income credit, Minnesota working 24.27 family credit, state and federal income tax refunds, state 24.28 homeowners and renters credits under chapter 290A, property tax 24.29 rebates and other federal or state tax rebates in the month 24.30 received and the following month; 24.31 (17) payments excluded under federal law as long as those 24.32 payments are held in a separate account from any nonexcluded 24.33 funds; 24.34 (18) the assets of children ineligible to receive MFIP 24.35 benefits because foster care or adoption assistance payments are 24.36 made on their behalf; and 25.1 (19) the assets of persons whose income is excluded under 25.2 section 256J.21, subdivision 2, clause (43). 25.3 Sec. 32. Minnesota Statutes 2002, section 256J.21, 25.4 subdivision 1, is amended to read: 25.5 Subdivision 1. [INCOME INCLUSIONS.] To determine MFIP 25.6 eligibility, the county agency must evaluate income received by 25.7 members of an assistance unit, or by other persons whose income 25.8 is considered available to the assistance unit, and only count 25.9 income that is available to the member of the assistance unit. 25.10 Income is available if the individual has legal access to the 25.11 income. All payments, unless specifically excluded in 25.12 subdivision 2, must be counted as income. The county agency 25.13 shall verify the income of all MFIP recipients and applicants. 25.14 Sec. 33. Minnesota Statutes 2002, section 256J.21, 25.15 subdivision 2, is amended to read: 25.16 Subd. 2. [INCOME EXCLUSIONS.] The following must be 25.17 excluded in determining a family's available income: 25.18 (1) payments for basic care, difficulty of care, and 25.19 clothing allowances received for providing family foster care to 25.20 children or adults under Minnesota Rules, parts 9545.0010 to 25.21 9545.0260 and 9555.5050 to 9555.6265, and payments received and 25.22 used for care and maintenance of a third-party beneficiary who 25.23 is not a household member; 25.24 (2) reimbursements for employment training received through 25.25 theJob Training PartnershipWorkforce Investment Act 1998, 25.26 United States Code, title2920, chapter1973,sections 150125.27to 1792bsection 9201; 25.28 (3) reimbursement for out-of-pocket expenses incurred while 25.29 performing volunteer services, jury duty, employment, or 25.30 informal carpooling arrangements directly related to employment; 25.31 (4) all educational assistance, except the county agency 25.32 must count graduate student teaching assistantships, 25.33 fellowships, and other similar paid work as earned income and, 25.34 after allowing deductions for any unmet and necessary 25.35 educational expenses, shall count scholarships or grants awarded 25.36 to graduate students that do not require teaching or research as 26.1 unearned income; 26.2 (5) loans, regardless of purpose, from public or private 26.3 lending institutions, governmental lending institutions, or 26.4 governmental agencies; 26.5 (6) loans from private individuals, regardless of purpose, 26.6 provided an applicant or participant documents that the lender 26.7 expects repayment; 26.8 (7)(i) state income tax refunds; and 26.9 (ii) federal income tax refunds; 26.10 (8)(i) federal earned income credits; 26.11 (ii) Minnesota working family credits; 26.12 (iii) state homeowners and renters credits under chapter 26.13 290A; and 26.14 (iv) federal or state tax rebates; 26.15 (9) funds received for reimbursement, replacement, or 26.16 rebate of personal or real property when these payments are made 26.17 by public agencies, awarded by a court, solicited through public 26.18 appeal, or made as a grant by a federal agency, state or local 26.19 government, or disaster assistance organizations, subsequent to 26.20 a presidential declaration of disaster; 26.21 (10) the portion of an insurance settlement that is used to 26.22 pay medical, funeral, and burial expenses, or to repair or 26.23 replace insured property; 26.24 (11) reimbursements for medical expenses that cannot be 26.25 paid by medical assistance; 26.26 (12) payments by a vocational rehabilitation program 26.27 administered by the state under chapter 268A, except those 26.28 payments that are for current living expenses; 26.29 (13) in-kind income, including any payments directly made 26.30 by a third party to a provider of goods and services; 26.31 (14) assistance payments to correct underpayments, but only 26.32 for the month in which the payment is received; 26.33 (15)emergency assistancepayments for short-term emergency 26.34 needs under section 256J.626, subdivision 2; 26.35 (16) funeral and cemetery payments as provided by section 26.36 256.935; 27.1 (17) nonrecurring cash gifts of $30 or less, not exceeding 27.2 $30 per participant in a calendar month; 27.3 (18) any form of energy assistance payment made through 27.4 Public LawNumber97-35, Low-Income Home Energy Assistance Act 27.5 of 1981, payments made directly to energy providers by other 27.6 public and private agencies, and any form of credit or rebate 27.7 payment issued by energy providers; 27.8 (19) Supplemental Security Income (SSI), including 27.9 retroactive SSI payments and other income of an SSI recipient, 27.10 except as described in section 256J.37, subdivision 3b; 27.11 (20) Minnesota supplemental aid, including retroactive 27.12 payments; 27.13 (21) proceeds from the sale of real or personal property; 27.14 (22) adoption assistance payments under section 259.67; 27.15 (23) state-funded family subsidy program payments made 27.16 under section 252.32 to help families care for children with 27.17 mental retardation or related conditions, consumer support grant 27.18 funds under section 256.476, and resources and services for a 27.19 disabled household member under one of the home and 27.20 community-based waiver services programs under chapter 256B; 27.21 (24) interest payments and dividends from property that is 27.22 not excluded from and that does not exceed the asset limit; 27.23 (25) rent rebates; 27.24 (26) income earned by a minor caregiver, minor child 27.25 through age 6, or a minor child who is at least a half-time 27.26 student in an approved elementary or secondary education 27.27 program; 27.28 (27) income earned by a caregiver under age 20 who is at 27.29 least a half-time student in an approved elementary or secondary 27.30 education program; 27.31 (28) MFIP child care payments under section 119B.05; 27.32 (29) all other payments made through MFIP to support a 27.33 caregiver's pursuit of greaterself-supporteconomic stability; 27.34 (30) income a participant receives related to shared living 27.35 expenses; 27.36 (31) reverse mortgages; 28.1 (32) benefits provided by the Child Nutrition Act of 1966, 28.2 United States Code, title 42, chapter 13A, sections 1771 to 28.3 1790; 28.4 (33) benefits provided by the women, infants, and children 28.5 (WIC) nutrition program, United States Code, title 42, chapter 28.6 13A, section 1786; 28.7 (34) benefits from the National School Lunch Act, United 28.8 States Code, title 42, chapter 13, sections 1751 to 1769e; 28.9 (35) relocation assistance for displaced persons under the 28.10 Uniform Relocation Assistance and Real Property Acquisition 28.11 Policies Act of 1970, United States Code, title 42, chapter 61, 28.12 subchapter II, section 4636, or the National Housing Act, United 28.13 States Code, title 12, chapter 13, sections 1701 to 1750jj; 28.14 (36) benefits from the Trade Act of 1974, United States 28.15 Code, title 19, chapter 12, part 2, sections 2271 to 2322; 28.16 (37) war reparations payments to Japanese Americans and 28.17 Aleuts under United States Code, title 50, sections 1989 to 28.18 1989d; 28.19 (38) payments to veterans or their dependents as a result 28.20 of legal settlements regarding Agent Orange or other chemical 28.21 exposure under Public LawNumber101-239, section 10405, 28.22 paragraph (a)(2)(E); 28.23 (39) income that is otherwise specifically excluded from 28.24 MFIP consideration in federal law, state law, or federal 28.25 regulation; 28.26 (40) security and utility deposit refunds; 28.27 (41) American Indian tribal land settlements excluded under 28.28 PublicLaw NumbersLaws 98-123, 98-124, and 99-377 to the 28.29 Mississippi Band Chippewa Indians of White Earth, Leech Lake, 28.30 and Mille Lacs reservations and payments to members of the White 28.31 Earth Band, under United States Code, title 25, chapter 9, 28.32 section 331, and chapter 16, section 1407; 28.33 (42) all income of the minor parent's parents and 28.34 stepparents when determining the grant for the minor parent in 28.35 households that include a minor parent living with parents or 28.36 stepparents on MFIP with other children; 29.1 (43) income of the minor parent's parents and stepparents 29.2 equal to 200 percent of the federal poverty guideline for a 29.3 family size not including the minor parent and the minor 29.4 parent's child in households that include a minor parent living 29.5 with parents or stepparents not on MFIP when determining the 29.6 grant for the minor parent. The remainder of income is deemed 29.7 as specified in section 256J.37, subdivision 1b; 29.8 (44) payments made to children eligible for relative 29.9 custody assistance under section 257.85; 29.10 (45) vendor payments for goods and services made on behalf 29.11 of a client unless the client has the option of receiving the 29.12 payment in cash; and 29.13 (46) the principal portion of a contract for deed payment. 29.14 Sec. 34. Minnesota Statutes 2002, section 256J.24, 29.15 subdivision 3, is amended to read: 29.16 Subd. 3. [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 29.17 ASSISTANCE UNIT.] (a) The following individuals who are part of 29.18 the assistance unit determined under subdivision 2 are 29.19 ineligible to receive MFIP: 29.20 (1) individualsreceivingwho are recipients of 29.21 Supplemental Security Income or Minnesota supplemental aid; 29.22 (2) individuals disqualified from the food stamp program or 29.23 MFIP, until the disqualification ends; 29.24 (3) children on whose behalf federal, state or local foster 29.25 care payments are made, except as provided in sections 256J.13, 29.26 subdivision 2, and 256J.74, subdivision 2; and 29.27 (4) children receiving ongoing monthly adoption assistance 29.28 payments under section 259.67. 29.29 (b) The exclusion of a person under this subdivision does 29.30 not alter the mandatory assistance unit composition. 29.31 Sec. 35. Minnesota Statutes 2002, section 256J.24, 29.32 subdivision 5, is amended to read: 29.33 Subd. 5. [MFIP TRANSITIONAL STANDARD.] Thefollowing table29.34represents theMFIP transitional standardtable when all members29.35ofis based on the number of persons in the assistance unitare29.36 eligible for both food and cash assistance unless the 30.1 restrictions in subdivision 6 on the birth of a child apply. 30.2 The following table represents the transitional standards 30.3 effective October 1, 2002. 30.4 Number of Transitional Cash Food 30.5 Eligible People Standard Portion Portion 30.6 1$351$370: $250 $120 30.7 2$609$658: $437 $221 30.8 3$763$844: $532 $312 30.9 4$903$998: $621 $377 30.10 5$1,025$1,135: $697 $438 30.11 6$1,165$1,296: $773 $523 30.12 7$1,273$1,414: $850 $564 30.13 8$1,403$1,558: $916 $642 30.14 9$1,530$1,700: $980 $720 30.15 10$1,653$1,836: $1,035 $801 30.16 over 10 add$121$136: $53 $83 30.17 per additional member. 30.18 The commissioner shall annually publish in the State 30.19 Register the transitional standard for an assistance unit sizes 30.20 1 to 10 including a breakdown of the cash and food portions. 30.21 Sec. 36. Minnesota Statutes 2002, section 256J.24, 30.22 subdivision 6, is amended to read: 30.23 Subd. 6. [APPLICATION OF ASSISTANCE STANDARDSFAMILY CAP.] 30.24The standards apply to the number of eligible persons in the30.25assistance unit.(a) MFIP assistance units shall not receive an 30.26 increase in the cash portion of the transitional standard as a 30.27 result of the birth of a child, unless one of the conditions 30.28 under paragraph (b) is met. The child shall be considered a 30.29 member of the assistance unit according to subdivisions 1 to 3, 30.30 but shall be excluded in determining family size for purposes of 30.31 determining the amount of the cash portion of the transitional 30.32 standard under subdivision 5. The child shall be included in 30.33 determining family size for purposes of determining the food 30.34 portion of the transitional standard. The transitional standard 30.35 under this subdivision shall be the total of the cash and food 30.36 portions as specified in this paragraph. The family wage level 31.1 under this subdivision shall be based on the family size used to 31.2 determine the food portion of the transitional standard. 31.3 (b) A child shall be included in determining family size 31.4 for purposes of determining the amount of the cash portion of 31.5 the MFIP transitional standard when at least one of the 31.6 following conditions is met: 31.7 (1) for families receiving MFIP assistance on July 1, 2003, 31.8 the child is born to the adult parent before May 1, 2004; 31.9 (2) for families who apply for the diversionary work 31.10 program under section 256J.95 or MFIP assistance on or after 31.11 July 1, 2003, the child is born to the adult parent within ten 31.12 months of the date the family is eligible for assistance; 31.13 (3) the child was conceived as a result of a sexual assault 31.14 or incest, provided that: 31.15 (i) the incident has been reported to a law enforcement 31.16 agency which determines that there is probable cause to believe 31.17 the crime occurred; and 31.18 (ii) a physician verifies that there is reason to believe 31.19 the pregnancy or birth resulted from the reported incident; 31.20 (4) the child's mother is a minor caregiver as defined in 31.21 section 256J.08, subdivision 59, and the child, or multiple 31.22 children, are the mother's first birth; or 31.23 (5) any child previously excluded in determining family 31.24 size under paragraph (a) shall be included if the adult parent 31.25 or parents have not received benefits from the diversionary work 31.26 program under section 256J.95 or MFIP assistance in the previous 31.27 ten months. An adult parent or parents who reapply and have 31.28 received benefits from the diversionary work program or MFIP 31.29 assistance in the past ten months shall be under the ten-month 31.30 grace period of their previous application under clause (2). 31.31 (c) Income and resources of a child excluded under this 31.32 subdivision must be considered using the same policies as for 31.33 other children when determining the grant amount of the 31.34 assistance unit. 31.35 (d) The caregiver must assign support and cooperate with 31.36 the child support enforcement agency to establish paternity and 32.1 collect child support on behalf of the excluded child. Failure 32.2 to cooperate results in the sanction specified in section 32.3 256J.46, subdivisions 2 and 2a. Current support paid on behalf 32.4 of the excluded child shall be distributed according to section 32.5 256.741, subdivision 15, and counted to determine the grant 32.6 amount of the assistance unit. 32.7 (e) County agencies must inform applicants of the 32.8 provisions under this subdivision at the time of each 32.9 application and at recertification. 32.10 (f) Children excluded under this provision shall be deemed 32.11 MFIP recipients for purposes of child care under chapter 119B. 32.12 Sec. 37. Minnesota Statutes 2002, section 256J.24, 32.13 subdivision 7, is amended to read: 32.14 Subd. 7. [FAMILY WAGE LEVELSTANDARD.] The family wage 32.15 levelstandardis 110 percent of the transitional standard under 32.16 subdivision 5 or 6, when applicable, and is the standard used 32.17 when there is earned income in the assistance unit. As 32.18 specified in section 256J.21, earned income is subtracted from 32.19 the family wage level to determine the amount of the assistance 32.20 payment.Not includingThefamily wage level standard,32.21 assistancepaymentspayment may not exceed theMFIP standard of32.22needtransitional standard under subdivision 5 or 6, or the 32.23 shared household standard under subdivision 9, whichever is 32.24 applicable, for the assistance unit. 32.25 Sec. 38. Minnesota Statutes 2002, section 256J.24, 32.26 subdivision 10, is amended to read: 32.27 Subd. 10. [MFIP EXIT LEVEL.] The commissioner shall adjust 32.28 the MFIP earned income disregard to ensure that most 32.29 participants do not lose eligibility for MFIP until their income 32.30 reaches at least120115 percent of the federal poverty 32.31 guidelines in effect in October of each fiscal year. The 32.32 adjustment to the disregard shall be based on a household size 32.33 of three, and the resulting earned income disregard percentage 32.34 must be applied to all household sizes. The adjustment under 32.35 this subdivision must be implemented at the same time as the 32.36 October food stamp cost-of-living adjustment is reflected in the 33.1 food portion of MFIP transitional standard as required under 33.2 subdivision 5a. 33.3 Sec. 39. Minnesota Statutes 2002, section 256J.30, 33.4 subdivision 9, is amended to read: 33.5 Subd. 9. [CHANGES THAT MUST BE REPORTED.] A caregiver must 33.6 report the changes or anticipated changes specified in clauses 33.7 (1) to(17)(16) within ten days of the date they occur, at the 33.8 time of the periodic recertification of eligibility under 33.9 section 256J.32, subdivision 6, or within eight calendar days of 33.10 a reporting period as in subdivision 5 or 6, whichever occurs 33.11 first. A caregiver must report other changes at the time of the 33.12 periodic recertification of eligibility under section 256J.32, 33.13 subdivision 6, or at the end of a reporting period under 33.14 subdivision 5 or 6, as applicable. A caregiver must make these 33.15 reports in writing to the county agency. When a county agency 33.16 could have reduced or terminated assistance for one or more 33.17 payment months if a delay in reporting a change specified under 33.18 clauses (1) to(16)(15) had not occurred, the county agency 33.19 must determine whether a timely notice under section 256J.31, 33.20 subdivision 4, could have been issued on the day that the change 33.21 occurred. When a timely notice could have been issued, each 33.22 month's overpayment subsequent to that notice must be considered 33.23 a client error overpayment under section 256J.38. Calculation 33.24 of overpayments for late reporting under clause(17)(16) is 33.25 specified in section 256J.09, subdivision 9. Changes in 33.26 circumstances which must be reported within ten days must also 33.27 be reported on the MFIP household report form for the reporting 33.28 period in which those changes occurred. Within ten days, a 33.29 caregiver must report: 33.30 (1) a change in initial employment; 33.31 (2) a change in initial receipt of unearned income; 33.32 (3) a recurring change in unearned income; 33.33 (4) a nonrecurring change of unearned income that exceeds 33.34 $30; 33.35 (5) the receipt of a lump sum; 33.36 (6) an increase in assets that may cause the assistance 34.1 unit to exceed asset limits; 34.2 (7) a change in the physical or mental status of an 34.3 incapacitated member of the assistance unit if the physical or 34.4 mental status is the basis of exemption from an MFIP employment 34.5 services program under section 256J.56, or as the basis for 34.6 reducing the hourly participation requirements under section 34.7 256J.55, subdivision 1, or the type of activities included in an 34.8 employment plan under section 256J.521, subdivision 2; 34.9 (8) a change in employment status; 34.10 (9) information affecting an exception under section 34.11 256J.24, subdivision 9; 34.12 (10)a change in health insurance coverage;34.13(11)the marriage or divorce of an assistance unit member; 34.14(12)(11) the death of a parent, minor child, or 34.15 financially responsible person; 34.16(13)(12) a change in address or living quarters of the 34.17 assistance unit; 34.18(14)(13) the sale, purchase, or other transfer of 34.19 property; 34.20(15)(14) a change in school attendance of acustodial34.21parentcaregiver under age 20 or an employed child; 34.22(16)(15) filing a lawsuit, a workers' compensation claim, 34.23 or a monetary claim against a third party; and 34.24(17)(16) a change in household composition, including 34.25 births, returns to and departures from the home of assistance 34.26 unit members and financially responsible persons, or a change in 34.27 the custody of a minor child. 34.28 Sec. 40. Minnesota Statutes 2002, section 256J.31, 34.29 subdivision 4, is amended to read: 34.30 Subd. 4. [PARTICIPANT'S RIGHT TO NOTICE.] A county agency 34.31 must give a participant written notice of all adverse actions 34.32 affecting the participant including payment reductions, 34.33 suspensions, terminations, and use of protective, vendor, or 34.34 two-party payments. The notice of adverse action must be on a 34.35 form prescribed or approved by the commissioner, must be 34.36 understandable at a seventh grade reading level, and must be 35.1 mailed to the last known mailing address provided by the 35.2 participant. A notice written in English must include the 35.3 department of human services language block and must be sent to 35.4 every applicable participant. The county agency must state on 35.5 the notice of adverse action the action it intends to take, the 35.6 reasons for the action, the participant's right to appeal the 35.7 action, the conditions under which assistance can be continued 35.8 pending an appeal decision, and the related consequences of the 35.9 action. A county agency shall combine the information required 35.10 in this notice with the information required in a notice of 35.11 intent to sanction under section 256J.57, subdivision 2. 35.12 Sec. 41. Minnesota Statutes 2002, section 256J.32, 35.13 subdivision 2, is amended to read: 35.14 Subd. 2. [DOCUMENTATION.] The applicant or participant 35.15 must document the information required under subdivisions 4 to 6 35.16 or authorize the county agency to verify the information. The 35.17 applicant or participant has the burden of providing documentary 35.18 evidence to verify eligibility. The county agency shall assist 35.19 the applicant or participant in obtaining required documents 35.20 when the applicant or participant is unable to do so.When an35.21applicant or participant and the county agency are unable to35.22obtain documents needed to verify information, the county agency35.23may accept an affidavit from an applicant or participant as35.24sufficient documentation.The county agency may accept an 35.25 affidavit only for factors specified under subdivision 8. 35.26 Sec. 42. Minnesota Statutes 2002, section 256J.32, 35.27 subdivision 4, is amended to read: 35.28 Subd. 4. [FACTORS TO BE VERIFIED.] The county agency shall 35.29 verify the following at application: 35.30 (1) identity of adults; 35.31 (2) presence of the minor child in the home, if 35.32 questionable; 35.33 (3) relationship of a minor child to caregivers in the 35.34 assistance unit; 35.35 (4) age, if necessary to determine MFIP eligibility; 35.36 (5) immigration status; 36.1 (6) social security number according to the requirements of 36.2 section 256J.30, subdivision 12; 36.3 (7) income; 36.4 (8) self-employment expenses used as a deduction; 36.5 (9) source and purpose of deposits and withdrawals from 36.6 business accounts; 36.7 (10) spousal support and child support payments made to 36.8 persons outside the household; 36.9 (11) real property; 36.10 (12) vehicles; 36.11 (13) checking and savings accounts; 36.12 (14) savings certificates, savings bonds, stocks, and 36.13 individual retirement accounts; 36.14 (15) pregnancy, if related to eligibility; 36.15 (16) inconsistent information, if related to eligibility; 36.16 (17)medical insurance;36.17(18)burial accounts; 36.18(19)(18) school attendance, if related to eligibility; 36.19(20)(19) residence; 36.20(21)(20) a claim of family violence if used as a basisfor36.21ato qualify for the family violence waiverfrom the 60-month36.22time limit in section 256J.42 and regular employment and36.23training services requirements in section 256J.56; 36.24(22)(21) disability if used as the basis for an exemption 36.25 from employment and training services requirements under section 36.26 256J.56 or as the basis for reducing the hourly participation 36.27 requirements under section 256J.55, subdivision 1, or the type 36.28 of activity included in an employment plan under section 36.29 256J.521, subdivision 2; and 36.30(23)(22) information needed to establish an exception 36.31 under section 256J.24, subdivision 9. 36.32 Sec. 43. Minnesota Statutes 2002, section 256J.32, 36.33 subdivision 5a, is amended to read: 36.34 Subd. 5a. [INCONSISTENT INFORMATION.] When the county 36.35 agency verifies inconsistent information under subdivision 4, 36.36 clause (16), or 6, clause(4)(5), the reason for verifying the 37.1 information must be documented in the financial case record. 37.2 Sec. 44. Minnesota Statutes 2002, section 256J.32, is 37.3 amended by adding a subdivision to read: 37.4 Subd. 8. [AFFIDAVIT.] The county agency may accept an 37.5 affidavit from the applicant or recipient as sufficient 37.6 documentation at the time of application or recertification only 37.7 for the following factors: 37.8 (1) a claim of family violence if used as a basis to 37.9 qualify for the family violence waiver; 37.10 (2) information needed to establish an exception under 37.11 section 256J.24, subdivision 9; 37.12 (3) relationship of a minor child to caregivers in the 37.13 assistance unit; and 37.14 (4) citizenship status from a noncitizen who reports to be, 37.15 or is identified as, a victim of severe forms of trafficking in 37.16 persons, if the noncitizen reports that the noncitizen's 37.17 immigration documents are being held by an individual or group 37.18 of individuals against the noncitizen's will. The noncitizen 37.19 must follow up with the Office of Refugee Resettlement (ORR) to 37.20 pursue certification. If verification that certification is 37.21 being pursued is not received within 30 days, the MFIP case must 37.22 be closed and the agency shall pursue overpayments. The ORR 37.23 documents certifying the noncitizen's status as a victim of 37.24 severe forms of trafficking in persons, or the reason for the 37.25 delay in processing, must be received within 90 days, or the 37.26 MFIP case must be closed and the agency shall pursue 37.27 overpayments. 37.28 Sec. 45. Minnesota Statutes 2002, section 256J.37, is 37.29 amended by adding a subdivision to read: 37.30 Subd. 3a. [RENTAL SUBSIDIES; UNEARNED INCOME.] (a) 37.31 Effective July 1, 2003, the county agency shall count $100 of 37.32 the value of public and assisted rental subsidies provided 37.33 through the Department of Housing and Urban Development (HUD) as 37.34 unearned income to the cash portion of the MFIP grant. The full 37.35 amount of the subsidy must be counted as unearned income when 37.36 the subsidy is less than $100. For the purposes of initial 38.1 implementation of this subdivision, the county shall budget the 38.2 income from the subsidy prospectively in the months of July and 38.3 August 2003. This shall be done regardless of whether the case 38.4 is in the retrospective or prospective budgeting cycle. 38.5 Thereafter, the income from this subsidy shall be budgeted 38.6 according to section 256J.34. 38.7 (b) The provisions of this subdivision shall not apply to 38.8 an MFIP assistance unit which includes a participant who is: 38.9 (1) age 60 or older; 38.10 (2) a caregiver who is suffering from an illness, injury, 38.11 or incapacity that has been certified by a qualified 38.12 professional when the illness, injury, or incapacity is expected 38.13 to continue for more than 30 days and prevents the person from 38.14 obtaining or retaining employment; or 38.15 (3) a caregiver whose presence in the home is required due 38.16 to the illness or incapacity of another member in the assistance 38.17 unit, a relative in the household, or a foster child in the 38.18 household when the illness or incapacity and the need for the 38.19 participant's presence in the home has been certified by a 38.20 qualified professional and is expected to continue for more than 38.21 30 days. 38.22 (c) The provisions of this subdivision shall not apply to 38.23 an MFIP assistance unit where the parental caregiver is an SSI 38.24 recipient. 38.25 Sec. 46. Minnesota Statutes 2002, section 256J.37, is 38.26 amended by adding a subdivision to read: 38.27 Subd. 3b. [TREATMENT OF SUPPLEMENTAL SECURITY 38.28 INCOME.] Effective July 1, 2003, the county shall reduce the 38.29 cash portion of the MFIP grant by $175 per SSI recipient who 38.30 resides in the household, and who would otherwise be included in 38.31 the MFIP assistance unit under section 256J.24, subdivision 2, 38.32 but is excluded solely due to the SSI recipient status under 38.33 section 256J.24, subdivision 3, paragraph (a), clause (1). If 38.34 the SSI recipient receives less than $175 of SSI, only the 38.35 amount received shall be used in calculating the MFIP cash 38.36 assistance payment. This provision does not apply to relative 39.1 caregivers who could elect to be included in the MFIP assistance 39.2 unit under section 256J.24, subdivision 4, unless the 39.3 caregiver's children or stepchildren are included in the MFIP 39.4 assistance unit. 39.5 Sec. 47. Minnesota Statutes 2002, section 256J.37, 39.6 subdivision 9, is amended to read: 39.7 Subd. 9. [UNEARNED INCOME.](a)The county agency must 39.8 apply unearned income to the MFIP standard of need. When 39.9 determining the amount of unearned income, the county agency 39.10 must deduct the costs necessary to secure payments of unearned 39.11 income. These costs include legal fees, medical fees, and 39.12 mandatory deductions such as federal and state income taxes. 39.13(b) Effective July 1, 2003, the county agency shall count39.14$100 of the value of public and assisted rental subsidies39.15provided through the Department of Housing and Urban Development39.16(HUD) as unearned income. The full amount of the subsidy must39.17be counted as unearned income when the subsidy is less than $100.39.18(c) The provisions of paragraph (b) shall not apply to MFIP39.19participants who are exempt from the employment and training39.20services component because they are:39.21(i) individuals who are age 60 or older;39.22(ii) individuals who are suffering from a professionally39.23certified permanent or temporary illness, injury, or incapacity39.24which is expected to continue for more than 30 days and which39.25prevents the person from obtaining or retaining employment; or39.26(iii) caregivers whose presence in the home is required39.27because of the professionally certified illness or incapacity of39.28another member in the assistance unit, a relative in the39.29household, or a foster child in the household.39.30(d) The provisions of paragraph (b) shall not apply to an39.31MFIP assistance unit where the parental caregiver receives39.32supplemental security income.39.33 Sec. 48. Minnesota Statutes 2002, section 256J.38, 39.34 subdivision 3, is amended to read: 39.35 Subd. 3. [RECOVERING OVERPAYMENTSFROM FORMER39.36PARTICIPANTS.] A county agency must initiate efforts to recover 40.1 overpayments paid to a former participant or caregiver.Adults40.2 Caregivers, both parental and nonparental, and minor caregivers 40.3 of an assistance unit at the time an overpayment occurs, whether 40.4 receiving assistance or not, are jointly and individually liable 40.5 for repayment of the overpayment. The county agency must 40.6 request repayment from the former participants and caregivers. 40.7 When an agreement for repayment is not completed within six 40.8 months of the date of discovery or when there is a default on an 40.9 agreement for repayment after six months, the county agency must 40.10 initiate recovery consistent with chapter 270A, or section 40.11 541.05. When a person has been convicted of fraud under section 40.12 256.98, recovery must be sought regardless of the amount of 40.13 overpayment. When an overpayment is less than $35, and is not 40.14 the result of a fraud conviction under section 256.98, the 40.15 county agency must not seek recovery under this subdivision. 40.16 The county agency must retain information about all overpayments 40.17 regardless of the amount. When an adult, adult caregiver, or 40.18 minor caregiver reapplies for assistance, the overpayment must 40.19 be recouped under subdivision 4. 40.20 Sec. 49. Minnesota Statutes 2002, section 256J.38, 40.21 subdivision 4, is amended to read: 40.22 Subd. 4. [RECOUPING OVERPAYMENTS FROM PARTICIPANTS.] A 40.23 participant may voluntarily repay, in part or in full, an 40.24 overpayment even if assistance is reduced under this 40.25 subdivision, until the total amount of the overpayment is 40.26 repaid. When an overpayment occurs due to fraud, the county 40.27 agency must recover from the overpaid assistance unit, including 40.28 child only cases, ten percent of the applicable standard or the 40.29 amount of the monthly assistance payment, whichever is less. 40.30 When a nonfraud overpayment occurs, the county agency must 40.31 recover from the overpaid assistance unit, including child only 40.32 cases, three percent of the MFIP standard of need or the amount 40.33 of the monthly assistance payment, whichever is less. 40.34 Sec. 50. Minnesota Statutes 2002, section 256J.40, is 40.35 amended to read: 40.36 256J.40 [FAIR HEARINGS.] 41.1 Caregivers receiving a notice of intent to sanction or a 41.2 notice of adverse action that includes a sanction, reduction in 41.3 benefits, suspension of benefits, denial of benefits, or 41.4 termination of benefits may request a fair hearing. A request 41.5 for a fair hearing must be submitted in writing to the county 41.6 agency or to the commissioner and must be mailed within 30 days 41.7 after a participant or former participant receives written 41.8 notice of the agency's action or within 90 days when a 41.9 participant or former participant shows good cause for not 41.10 submitting the request within 30 days. A former participant who 41.11 receives a notice of adverse action due to an overpayment may 41.12 appeal the adverse action according to the requirements in this 41.13 section. Issues that may be appealed are: 41.14 (1) the amount of the assistance payment; 41.15 (2) a suspension, reduction, denial, or termination of 41.16 assistance; 41.17 (3) the basis for an overpayment, the calculated amount of 41.18 an overpayment, and the level of recoupment; 41.19 (4) the eligibility for an assistance payment; and 41.20 (5) the use of protective or vendor payments under section 41.21 256J.39, subdivision 2, clauses (1) to (3). 41.22 Except for benefits issued under section 256J.95, a county 41.23 agency must not reduce, suspend, or terminate payment when an 41.24 aggrieved participant requests a fair hearing prior to the 41.25 effective date of the adverse action or within ten days of the 41.26 mailing of the notice of adverse action, whichever is later, 41.27 unless the participant requests in writing not to receive 41.28 continued assistance pending a hearing decision. An appeal 41.29 request cannot extend benefits for the diversionary work program 41.30 under section 256J.95 beyond the four-month time limit. 41.31 Assistance issued pending a fair hearing is subject to recovery 41.32 under section 256J.38 when as a result of the fair hearing 41.33 decision the participant is determined ineligible for assistance 41.34 or the amount of the assistance received. A county agency may 41.35 increase or reduce an assistance payment while an appeal is 41.36 pending when the circumstances of the participant change and are 42.1 not related to the issue on appeal. The commissioner's order is 42.2 binding on a county agency. No additional notice is required to 42.3 enforce the commissioner's order. 42.4 A county agency shall reimburse appellants for reasonable 42.5 and necessary expenses of attendance at the hearing, such as 42.6 child care and transportation costs and for the transportation 42.7 expenses of the appellant's witnesses and representatives to and 42.8 from the hearing. Reasonable and necessary expenses do not 42.9 include legal fees. Fair hearings must be conducted at a 42.10 reasonable time and date by an impartial referee employed by the 42.11 department. The hearing may be conducted by telephone or at a 42.12 site that is readily accessible to persons with disabilities. 42.13 The appellant may introduce new or additional evidence 42.14 relevant to the issues on appeal. Recommendations of the 42.15 appeals referee and decisions of the commissioner must be based 42.16 on evidence in the hearing record and are not limited to a 42.17 review of the county agency action. 42.18 Sec. 51. Minnesota Statutes 2002, section 256J.42, 42.19 subdivision 4, is amended to read: 42.20 Subd. 4. [VICTIMS OF FAMILY VIOLENCE.] Any cash assistance 42.21 received by an assistance unit in a month when a caregiver 42.22 complied with a safety plan, an alternative employment plan, or 42.23 an employment planor after October 1, 2001, complied or is42.24complying with an alternative employment planunder section 42.25256J.49256J.521, subdivision1a3, does not count toward the 42.26 60-month limitation on assistance. 42.27 Sec. 52. Minnesota Statutes 2002, section 256J.42, 42.28 subdivision 5, is amended to read: 42.29 Subd. 5. [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 42.30 assistance received by an assistance unit does not count toward 42.31 the 60-month limit on assistance during a month in which the 42.32 caregiver isin the category inage 60 or older, including 42.33 months during which the caregiver was exempt under section 42.34 256J.56, paragraph (a), clause (1). 42.35 (b) From July 1, 1997, until the date MFIP is operative in 42.36 the caregiver's county of financial responsibility, any cash 43.1 assistance received by a caregiver who is complying with 43.2 Minnesota Statutes 1996, section 256.73, subdivision 5a, and 43.3 Minnesota Statutes 1998, section 256.736, if applicable, does 43.4 not count toward the 60-month limit on assistance. Thereafter, 43.5 any cash assistance received by a minor caregiver who is 43.6 complying with the requirements of sections 256J.14 and 256J.54, 43.7 if applicable, does not count towards the 60-month limit on 43.8 assistance. 43.9 (c) Any diversionary assistance or emergency assistance 43.10 received prior to July 1, 2003, does not count toward the 43.11 60-month limit. 43.12 (d) Any cash assistance received by an 18- or 19-year-old 43.13 caregiver who is complying withthe requirements ofan 43.14 employment plan that includes an education option under section 43.15 256J.54 does not count toward the 60-month limit. 43.16 (e) Payments provided to meet short-term emergency needs 43.17 under section 256J.626 and diversionary work program benefits 43.18 provided under section 256J.95 do not count toward the 60-month 43.19 time limit. 43.20 Sec. 53. Minnesota Statutes 2002, section 256J.42, 43.21 subdivision 6, is amended to read: 43.22 Subd. 6. [CASE REVIEW.] (a) Within 180 days, but not less 43.23 than 60 days, before the end of the participant's 60th month on 43.24 assistance, the county agency or job counselor must review the 43.25 participant's case to determine if the employment plan is still 43.26 appropriate or if the participant is exempt under section 43.27 256J.56 from the employment and training services component, and 43.28 attempt to meet with the participant face-to-face. 43.29 (b) During the face-to-face meeting, a county agency or the 43.30 job counselor must: 43.31 (1) inform the participant how many months of counted 43.32 assistance the participant has accrued and when the participant 43.33 is expected to reach the 60th month; 43.34 (2) explain the hardship extension criteria under section 43.35 256J.425 and what the participant should do if the participant 43.36 thinks a hardship extension applies; 44.1 (3) identify other resources that may be available to the 44.2 participant to meet the needs of the family; and 44.3 (4) inform the participant of the right to appeal the case 44.4 closure under section 256J.40. 44.5 (c) If a face-to-face meeting is not possible, the county 44.6 agency must send the participant a notice of adverse action as 44.7 provided in section 256J.31, subdivisions 4 and 5. 44.8 (d) Before a participant's case is closed under this 44.9 section, the county must ensure that: 44.10 (1) the case has been reviewed by the job counselor's 44.11 supervisor or the review team designatedinby thecounty's44.12approved local service unit plancounty to determine if the 44.13 criteria for a hardship extension, if requested, were applied 44.14 appropriately; and 44.15 (2) the county agency or the job counselor attempted to 44.16 meet with the participant face-to-face. 44.17 Sec. 54. Minnesota Statutes 2002, section 256J.425, 44.18 subdivision 1, is amended to read: 44.19 Subdivision 1. [ELIGIBILITY.] (a) To be eligible for a 44.20 hardship extension, a participant in an assistance unit subject 44.21 to the time limit under section 256J.42, subdivision 1,in which44.22any participant has received 60 counted months of assistance,44.23 must be in compliance in the participant's 60th counted month 44.24the participant is applying for the extension. For purposes of 44.25 determining eligibility for a hardship extension, a participant 44.26 is in compliance in any month that the participant has not been 44.27 sanctioned. 44.28 (b) If one participant in a two-parent assistance unit is 44.29 determined to be ineligible for a hardship extension, the county 44.30 shall give the assistance unit the option of disqualifying the 44.31 ineligible participant from MFIP. In that case, the assistance 44.32 unit shall be treated as a one-parent assistance unit and the 44.33 assistance unit's MFIP grant shall be calculated using the 44.34 shared household standard under section 256J.08, subdivision 82a. 44.35 Sec. 55. Minnesota Statutes 2002, section 256J.425, 44.36 subdivision 1a, is amended to read: 45.1 Subd. 1a. [REVIEW.] If a county grants a hardship 45.2 extension under this section, a county agency shall review the 45.3 case every six or 12 months, whichever is appropriate based on 45.4 the participant's circumstances and the extension 45.5 category. More frequent reviews shall be required if 45.6 eligibility for an extension is based on a condition that is 45.7 subject to change in less than six months. 45.8 Sec. 56. Minnesota Statutes 2002, section 256J.425, 45.9 subdivision 2, is amended to read: 45.10 Subd. 2. [ILL OR INCAPACITATED.] (a) An assistance unit 45.11 subject to the time limit in section 256J.42, subdivision 1,in45.12which any participant has received 60 counted months of45.13assistance,is eligible to receive months of assistance under a 45.14 hardship extension if the participant who reached the time limit 45.15 belongs to any of the following groups: 45.16 (1) participants who are suffering froma professionally45.17certifiedan illness, injury, or incapacity which has been 45.18 certified by a qualified professional when the illness, injury, 45.19 or incapacity is expected to continue for more than 30 days 45.20 andwhichprevents the person from obtaining or retaining 45.21 employmentand who are following. These participants must 45.22 follow the treatment recommendations of thehealth care provider45.23 qualified professional certifying the illness, injury, or 45.24 incapacity; 45.25 (2) participants whose presence in the home is required as 45.26 a caregiver because ofa professionally certifiedthe illness or 45.27 incapacity of another member in the assistance unit, a relative 45.28 in the household, or a foster child in the householdandwhen 45.29 the illness or incapacity and the need for the participant's 45.30 presence in the home has been certified by a qualified 45.31 professional and is expected to continue for more than 30 days; 45.32 or 45.33 (3) caregivers with a child or an adult in the household 45.34 who meets the disability or medical criteria for home care 45.35 services under section 256B.0627, subdivision 1, paragraph 45.36(c)(f), or a home and community-based waiver services program 46.1 under chapter 256B, or meets the criteria for severe emotional 46.2 disturbance under section 245.4871, subdivision 6, or for 46.3 serious and persistent mental illness under section 245.462, 46.4 subdivision 20, paragraph (c). Caregivers in this category are 46.5 presumed to be prevented from obtaining or retaining employment. 46.6 (b) An assistance unit receiving assistance under a 46.7 hardship extension under this subdivision may continue to 46.8 receive assistance as long as the participant meets the criteria 46.9 in paragraph (a), clause (1), (2), or (3). 46.10 Sec. 57. Minnesota Statutes 2002, section 256J.425, 46.11 subdivision 3, is amended to read: 46.12 Subd. 3. [HARD-TO-EMPLOY PARTICIPANTS.] An assistance unit 46.13 subject to the time limit in section 256J.42, subdivision 1,in46.14which any participant has received 60 counted months of46.15assistance,is eligible to receive months of assistance under a 46.16 hardship extension if the participant who reached the time limit 46.17 belongs to any of the following groups: 46.18 (1) a person who is diagnosed by a licensed physician, 46.19 psychological practitioner, or other qualified professional, as 46.20 mentally retarded or mentally ill, and that condition prevents 46.21 the person from obtaining or retaining unsubsidized employment; 46.22 (2) a person who: 46.23 (i) has been assessed by a vocational specialist or the 46.24 county agency to be unemployable for purposes of this 46.25 subdivision; or 46.26 (ii) has an IQ below 80 who has been assessed by a 46.27 vocational specialist or a county agency to be employable, but 46.28 not at a level that makes the participant eligible for an 46.29 extension under subdivision 4or,. The determination of IQ 46.30 level must be made by a qualified professional. In the case of 46.31 a non-English-speaking personfor whom it is not possible to46.32provide a determination due to language barriers or absence of46.33culturally appropriate assessment tools, is determined by a46.34qualified professional to have an IQ below 80. A person is46.35considered employable if positions of employment in the local46.36labor market exist, regardless of the current availability of47.1openings for those positions, that the person is capable of47.2performing: (A) the determination must be made by a qualified 47.3 professional with experience conducting culturally appropriate 47.4 assessments, whenever possible; (B) the county may accept 47.5 reports that identify an IQ range as opposed to a specific 47.6 score; (C) these reports must include a statement of confidence 47.7 in the results; 47.8 (3) a person who is determined bythe county agencya 47.9 qualified professional to be learning disabledor, and the 47.10 disability severely limits the person's ability to obtain, 47.11 perform, or maintain suitable employment. For purposes of the 47.12 initial approval of a learning disability extension, the 47.13 determination must have been made or confirmed within the 47.14 previous 12 months. In the case of a non-English-speaking 47.15 personfor whom it is not possible to provide a medical47.16diagnosis due to language barriers or absence of culturally47.17appropriate assessment tools, is determined by a qualified47.18professional to have a learning disability. If a rehabilitation47.19plan for the person is developed or approved by the county47.20agency, the plan must be incorporated into the employment plan.47.21However, a rehabilitation plan does not replace the requirement47.22to develop and comply with an employment plan under section47.23256J.52. For purposes of this section, "learning disabled"47.24means the applicant or recipient has a disorder in one or more47.25of the psychological processes involved in perceiving,47.26understanding, or using concepts through verbal language or47.27nonverbal means. The disability must severely limit the47.28applicant or recipient in obtaining, performing, or maintaining47.29suitable employment. Learning disabled does not include47.30learning problems that are primarily the result of visual,47.31hearing, or motor handicaps; mental retardation; emotional47.32disturbance; or due to environmental, cultural, or economic47.33disadvantage: (i) the determination must be made by a qualified 47.34 professional with experience conducting culturally appropriate 47.35 assessments, whenever possible; and (ii) these reports must 47.36 include a statement of confidence in the results. If a 48.1 rehabilitation plan for a participant extended as learning 48.2 disabled is developed or approved by the county agency, the plan 48.3 must be incorporated into the employment plan. However, a 48.4 rehabilitation plan does not replace the requirement to develop 48.5 and comply with an employment plan under section 256J.521; or 48.6 (4) a person whois a victim ofhas been granted a family 48.7 violenceas defined in section 256J.49, subdivision 2waiver, 48.8 and who isparticipating incomplying with analternative48.9 employment plan under section256J.49256J.521, subdivision1a48.10 3. 48.11 Sec. 58. Minnesota Statutes 2002, section 256J.425, 48.12 subdivision 4, is amended to read: 48.13 Subd. 4. [EMPLOYED PARTICIPANTS.] (a) An assistance unit 48.14 subject to the time limit under section 256J.42, subdivision 1, 48.15in which any participant has received 60 months of assistance,48.16 is eligible to receive assistance under a hardship extension if 48.17 the participant who reached the time limit belongs to: 48.18 (1) a one-parent assistance unit in which the participant 48.19 is participating in work activities for at least 30 hours per 48.20 week, of which an average of at least 25 hours per week every 48.21 month are spent participating in employment; 48.22 (2) a two-parent assistance unit in which the participants 48.23 are participating in work activities for at least 55 hours per 48.24 week, of which an average of at least 45 hours per week every 48.25 month are spent participating in employment; or 48.26 (3) an assistance unit in which a participant is 48.27 participating in employment for fewer hours than those specified 48.28 in clause (1), and the participant submits verification from a 48.29health care providerqualified professional, in a form 48.30 acceptable to the commissioner, stating that the number of hours 48.31 the participant may work is limited due to illness or 48.32 disability, as long as the participant is participating in 48.33 employment for at least the number of hours specified by 48.34 thehealth care providerqualified professional. The 48.35 participant must be following the treatment recommendations of 48.36 thehealth care providerqualified professional providing the 49.1 verification. The commissioner shall develop a form to be 49.2 completed and signed by thehealth care providerqualified 49.3 professional, documenting the diagnosis and any additional 49.4 information necessary to document the functional limitations of 49.5 the participant that limit work hours. If the participant is 49.6 part of a two-parent assistance unit, the other parent must be 49.7 treated as a one-parent assistance unit for purposes of meeting 49.8 the work requirements under this subdivision. 49.9 (b) For purposes of this section, employment means: 49.10 (1) unsubsidized employment under section 256J.49, 49.11 subdivision 13, clause (1); 49.12 (2) subsidized employment under section 256J.49, 49.13 subdivision 13, clause (2); 49.14 (3) on-the-job training under section 256J.49, subdivision 49.15 13, clause(4)(2); 49.16 (4) an apprenticeship under section 256J.49, subdivision 49.17 13, clause(19)(1); 49.18 (5) supported work. For purposes of this section,49.19"supported work" means services supporting a participant on the49.20job which include, but are not limited to, supervision, job49.21coaching, and subsidized wagesunder section 256J.49, 49.22 subdivision 13, clause (2); 49.23 (6) a combination of clauses (1) to (5); or 49.24 (7) child care under section 256J.49, subdivision 13, 49.25 clause(25)(7), if it is in combination with paid employment. 49.26 (c) If a participant is complying with a child protection 49.27 plan under chapter 260C, the number of hours required under the 49.28 child protection plan count toward the number of hours required 49.29 under this subdivision. 49.30 (d) The county shall provide the opportunity for subsidized 49.31 employment to participants needing that type of employment 49.32 within available appropriations. 49.33 (e) To be eligible for a hardship extension for employed 49.34 participants under this subdivision, a participantin a49.35one-parent assistance unit or both parents in a two-parent49.36assistance unitmust be in compliance for at least ten out of 50.1 the 12 months immediately preceding the participant's 61st month 50.2 on assistance.If only one parent in a two-parent assistance50.3unit fails to be in compliance ten out of the 12 months50.4immediately preceding the participant's 61st month, the county50.5shall give the assistance unit the option of disqualifying the50.6noncompliant parent. If the noncompliant participant is50.7disqualified, the assistance unit must be treated as a50.8one-parent assistance unit for the purposes of meeting the work50.9requirements under this subdivision and the assistance unit's50.10MFIP grant shall be calculated using the shared household50.11standard under section 256J.08, subdivision 82a.50.12 (f) The employment plan developed under section256J.5250.13 256J.521, subdivision52, for participants under this 50.14 subdivision must contain the number of hours specified in 50.15 paragraph (a) related to employment and work activities. The 50.16 job counselor and the participant must sign the employment plan 50.17 to indicate agreement between the job counselor and the 50.18 participant on the contents of the plan. 50.19 (g) Participants who fail to meet the requirements in 50.20 paragraph (a), without good cause under section 256J.57, shall 50.21 be sanctioned or permanently disqualified under subdivision 6. 50.22 Good cause may only be granted for that portion of the month for 50.23 which the good cause reason applies. Participants must meet all 50.24 remaining requirements in the approved employment plan or be 50.25 subject to sanction or permanent disqualification. 50.26 (h) If the noncompliance with an employment plan is due to 50.27 the involuntary loss of employment, the participant is exempt 50.28 from the hourly employment requirement under this subdivision 50.29 for one month. Participants must meet all remaining 50.30 requirements in the approved employment plan or be subject to 50.31 sanction or permanent disqualification. This exemption is 50.32 available toone-parent assistance unitsa participant two times 50.33 in a 12-month period, and two-parent assistance units, two times50.34per parent in a 12-month period. 50.35(i) This subdivision expires on June 30, 2004.50.36 Sec. 59. Minnesota Statutes 2002, section 256J.425, 51.1 subdivision 6, is amended to read: 51.2 Subd. 6. [SANCTIONS FOR EXTENDED CASES.] (a) If one or 51.3 both participants in an assistance unit receiving assistance 51.4 under subdivision 3 or 4 are not in compliance with the 51.5 employment and training service requirements in sections256J.5251.6 256J.521 to256J.55256J.57, the sanctions under this 51.7 subdivision apply. For a first occurrence of noncompliance, an 51.8 assistance unit must be sanctioned under section 256J.46, 51.9 subdivision 1, paragraph(d)(c), clause (1). For a second or 51.10 third occurrence of noncompliance, the assistance unit must be 51.11 sanctioned under section 256J.46, subdivision 1, 51.12 paragraph(d)(c), clause (2). For a fourth occurrence of 51.13 noncompliance, the assistance unit is disqualified from MFIP. 51.14 If a participant is determined to be out of compliance, the 51.15 participant may claim a good cause exception under section 51.16 256J.57, however, the participant may not claim an exemption 51.17 under section 256J.56. 51.18 (b) If both participants in a two-parent assistance unit 51.19 are out of compliance at the same time, it is considered one 51.20 occurrence of noncompliance. 51.21 Sec. 60. Minnesota Statutes 2002, section 256J.425, 51.22 subdivision 7, is amended to read: 51.23 Subd. 7. [STATUS OF DISQUALIFIED PARTICIPANTS.] (a) An 51.24 assistance unit that is disqualified under subdivision 6, 51.25 paragraph (a), may be approved for MFIP if the participant 51.26 complies with MFIP program requirements and demonstrates 51.27 compliance for up to one month. No assistance shall be paid 51.28 during this period. 51.29 (b) An assistance unit that is disqualified under 51.30 subdivision 6, paragraph (a), and that reapplies under paragraph 51.31 (a) is subject to sanction under section 256J.46, subdivision 1, 51.32 paragraph(d)(c), clause (1), for a first occurrence of 51.33 noncompliance. A subsequent occurrence of noncompliance results 51.34 in a permanent disqualification. 51.35 (c) If one participant in a two-parent assistance unit 51.36 receiving assistance under a hardship extension under 52.1 subdivision 3 or 4 is determined to be out of compliance with 52.2 the employment and training services requirements under sections 52.3256J.52256J.521 to256J.55256J.57, the county shall give the 52.4 assistance unit the option of disqualifying the noncompliant 52.5 participant from MFIP. In that case, the assistance unit shall 52.6 be treated as a one-parent assistance unit for the purposes of 52.7 meeting the work requirements under subdivision 4 and the 52.8 assistance unit's MFIP grant shall be calculated using the 52.9 shared household standard under section 256J.08, subdivision 52.10 82a. An applicant who is disqualified from receiving assistance 52.11 under this paragraph may reapply under paragraph (a). If a 52.12 participant is disqualified from MFIP under this subdivision a 52.13 second time, the participant is permanently disqualified from 52.14 MFIP. 52.15 (d) Prior to a disqualification under this subdivision, a 52.16 county agency must review the participant's case to determine if 52.17 the employment plan is still appropriate and attempt to meet 52.18 with the participant face-to-face. If a face-to-face meeting is 52.19 not conducted, the county agency must send the participant a 52.20 notice of adverse action as provided in section 256J.31. During 52.21 the face-to-face meeting, the county agency must: 52.22 (1) determine whether the continued noncompliance can be 52.23 explained and mitigated by providing a needed preemployment 52.24 activity, as defined in section 256J.49, subdivision 13, clause 52.25(16), or services under a local intervention grant for52.26self-sufficiency under section 256J.625(9); 52.27 (2) determine whether the participant qualifies for a good 52.28 cause exception under section 256J.57; 52.29 (3) inform the participant of the family violence waiver 52.30 criteria and make appropriate referrals if the waiver is 52.31 requested; 52.32 (4) inform the participant of the participant's sanction 52.33 status and explain the consequences of continuing noncompliance; 52.34(4)(5) identify other resources that may be available to 52.35 the participant to meet the needs of the family; and 52.36(5)(6) inform the participant of the right to appeal under 53.1 section 256J.40. 53.2 Sec. 61. Minnesota Statutes 2002, section 256J.45, 53.3 subdivision 2, is amended to read: 53.4 Subd. 2. [GENERAL INFORMATION.] The MFIP orientation must 53.5 consist of a presentation that informs caregivers of: 53.6 (1) the necessity to obtain immediate employment; 53.7 (2) the work incentives under MFIP, including the 53.8 availability of the federal earned income tax credit and the 53.9 Minnesota working family tax credit; 53.10 (3) the requirement to comply with the employment plan and 53.11 other requirements of the employment and training services 53.12 component of MFIP, including a description of the range of work 53.13 and training activities that are allowable under MFIP to meet 53.14 the individual needs of participants; 53.15 (4) the consequences for failing to comply with the 53.16 employment plan and other program requirements, and that the 53.17 county agency may not impose a sanction when failure to comply 53.18 is due to the unavailability of child care or other 53.19 circumstances where the participant has good cause under 53.20 subdivision 3; 53.21 (5) the rights, responsibilities, and obligations of 53.22 participants; 53.23 (6) the types and locations of child care services 53.24 available through the county agency; 53.25 (7) the availability and the benefits of the early 53.26 childhood health and developmental screening under sections 53.27 121A.16 to 121A.19; 123B.02, subdivision 16; and 123B.10; 53.28 (8) the caregiver's eligibility for transition year child 53.29 care assistance under section 119B.05; 53.30 (9)the caregiver's eligibility for extended medical53.31assistance when the caregiver loses eligibility for MFIP due to53.32increased earnings or increased child or spousal supportthe 53.33 availability of all health care programs, including transitional 53.34 medical assistance; 53.35 (10) the caregiver's option to choose an employment and 53.36 training provider and information about each provider, including 54.1 but not limited to, services offered, program components, job 54.2 placement rates, job placement wages, and job retention rates; 54.3 (11) the caregiver's option to request approval of an 54.4 education and training plan according to section256J.5254.5 256J.53; 54.6 (12) the work study programs available under the higher 54.7 education system; and 54.8 (13)effective October 1, 2001,information about the 54.9 60-month time limitexemption and waivers of regular employment54.10and training requirements for family violence victimsexemptions 54.11 under the family violence waiver and referral information about 54.12 shelters and programs for victims of family violence. 54.13 Sec. 62. Minnesota Statutes 2002, section 256J.46, 54.14 subdivision 1, is amended to read: 54.15 Subdivision 1. [PARTICIPANTS NOT COMPLYING WITH PROGRAM 54.16 REQUIREMENTS.] (a) A participant who fails without good 54.17 cause under section 256J.57 to comply with the requirements of 54.18 this chapter, and who is not subject to a sanction under 54.19 subdivision 2, shall be subject to a sanction as provided in 54.20 this subdivision. Prior to the imposition of a sanction, a 54.21 county agency shall provide a notice of intent to sanction under 54.22 section 256J.57, subdivision 2, and, when applicable, a notice 54.23 of adverse action as provided in section 256J.31. 54.24 (b)A participant who fails to comply with an alternative54.25employment plan must have the plan reviewed by a person trained54.26in domestic violence and a job counselor or the county agency to54.27determine if components of the alternative employment plan are54.28still appropriate. If the activities are no longer appropriate,54.29the plan must be revised with a person trained in domestic54.30violence and approved by a job counselor or the county agency.54.31A participant who fails to comply with a plan that is determined54.32not to need revision will lose their exemption and be required54.33to comply with regular employment services activities.54.34(c)A sanction under this subdivision becomes effective the 54.35 month following the month in which a required notice is given. 54.36 A sanction must not be imposed when a participant comes into 55.1 compliance with the requirements for orientation under section 55.2 256J.45or third-party liability for medical services under55.3section 256J.30, subdivision 10,prior to the effective date of 55.4 the sanction. A sanction must not be imposed when a participant 55.5 comes into compliance with the requirements for employment and 55.6 training services under sections256J.49256J.515 to 55.7256J.55256J.57 ten days prior to the effective date of the 55.8 sanction. For purposes of this subdivision, each month that a 55.9 participant fails to comply with a requirement of this chapter 55.10 shall be considered a separate occurrence of noncompliance.A55.11participant who has had one or more sanctions imposed must55.12remain in compliance with the provisions of this chapter for six55.13months in order for a subsequent occurrence of noncompliance to55.14be considered a first occurrence.If both participants in a 55.15 two-parent assistance unit are out of compliance at the same 55.16 time, it is considered one occurrence of noncompliance. 55.17(d)(c) Sanctions for noncompliance shall be imposed as 55.18 follows: 55.19 (1) For the first occurrence of noncompliance by a 55.20 participant in an assistance unit, the assistance unit's grant 55.21 shall be reduced by ten percent of the MFIP standard of need for 55.22 an assistance unit of the same size with the residual grant paid 55.23 to the participant. The reduction in the grant amount must be 55.24 in effect for a minimum of one month and shall be removed in the 55.25 month following the month that the participant returns to 55.26 compliance. 55.27 (2) For a secondor subsequent, third, fourth, fifth, or 55.28 sixth occurrence of noncompliance by a participant in an 55.29 assistance unit,or when each of the participants in a55.30two-parent assistance unit have a first occurrence of55.31noncompliance at the same time,the assistance unit's shelter 55.32 costs shall be vendor paid up to the amount of the cash portion 55.33 of the MFIP grant for which the assistance unit is eligible. At 55.34 county option, the assistance unit's utilities may also be 55.35 vendor paid up to the amount of the cash portion of the MFIP 55.36 grant remaining after vendor payment of the assistance unit's 56.1 shelter costs. The residual amount of the grant after vendor 56.2 payment, if any, must be reduced by an amount equal to 30 56.3 percent of the MFIP standard of need for an assistance unit of 56.4 the same size before the residual grant is paid to the 56.5 assistance unit. The reduction in the grant amount must be in 56.6 effect for a minimum of one month and shall be removed in the 56.7 month following the month that the participant in a one-parent 56.8 assistance unit returns to compliance. In a two-parent 56.9 assistance unit, the grant reduction must be in effect for a 56.10 minimum of one month and shall be removed in the month following 56.11 the month both participants return to compliance. The vendor 56.12 payment of shelter costs and, if applicable, utilities shall be 56.13 removed six months after the month in which the participant or 56.14 participants return to compliance. If an assistance unit is 56.15 sanctioned under this clause, the participant's case file must 56.16 be reviewedas required under paragraph (e)to determine if the 56.17 employment plan is still appropriate. 56.18(e) When a sanction under paragraph (d), clause (2), is in56.19effect(d) For a seventh occurrence of noncompliance by a 56.20 participant in an assistance unit, or when the participants in a 56.21 two-parent assistance unit have a total of seven occurrences of 56.22 noncompliance, the county agency shall close the MFIP assistance 56.23 unit's financial assistance case, both the cash and food 56.24 portions. The case must remain closed for a minimum of one full 56.25 month. Closure under this paragraph does not make a participant 56.26 automatically ineligible for food support, if otherwise eligible. 56.27 Before the case is closed, the county agency must review the 56.28 participant's case to determine if the employment plan is still 56.29 appropriate and attempt to meet with the participant 56.30 face-to-face. The participant may bring an advocate to the 56.31 face-to-face meeting. If a face-to-face meeting is not 56.32 conducted, the county agency must send the participant a written 56.33 notice that includes the information required under clause (1). 56.34 (1) During the face-to-face meeting, the county agency must: 56.35 (i) determine whether the continued noncompliance can be 56.36 explained and mitigated by providing a needed preemployment 57.1 activity, as defined in section 256J.49, subdivision 13, clause 57.2(16), or services under a local intervention grant for57.3self-sufficiency under section 256J.625(9); 57.4 (ii) determine whether the participant qualifies for a good 57.5 cause exception under section 256J.57, or if the sanction is for 57.6 noncooperation with child support requirements, determine if the 57.7 participant qualifies for a good cause exemption under section 57.8 256.741, subdivision 10; 57.9 (iii) determine whether the participant qualifies for an 57.10 exemption under section 256J.56 or the work activities in the 57.11 employment plan are appropriate based on the criteria in section 57.12 256J.521, subdivision 2 or 3; 57.13 (iv)determine whether the participant qualifies for an57.14exemption from regular employment services requirements for57.15victims of family violence under section 256J.52, subdivision57.166determine whether the participant qualifies for the family 57.17 violence waiver; 57.18 (v) inform the participant of the participant's sanction 57.19 status and explain the consequences of continuing noncompliance; 57.20 (vi) identify other resources that may be available to the 57.21 participant to meet the needs of the family; and 57.22 (vii) inform the participant of the right to appeal under 57.23 section 256J.40. 57.24 (2) If the lack of an identified activity or service can 57.25 explain the noncompliance, the county must work with the 57.26 participant to provide the identified activity, and the county57.27must restore the participant's grant amount to the full amount57.28for which the assistance unit is eligible. The grant must be57.29restored retroactively to the first day of the month in which57.30the participant was found to lack preemployment activities or to57.31qualify for an exemption under section 256J.56, a good cause57.32exception under section 256J.57, or an exemption for victims of57.33family violence under section 256J.52, subdivision 6. 57.34 (3)If the participant is found to qualify for a good cause57.35exception or an exemption, the county must restore the57.36participant's grant to the full amount for which the assistance58.1unit is eligible.The grant must be restored to the full amount 58.2 for which the assistance unit is eligible retroactively to the 58.3 first day of the month in which the participant was found to 58.4 lack preemployment activities or to qualify for an exemption 58.5 under section 256J.56, a family violence waiver, or for a good 58.6 cause exemption under section 256.741, subdivision 10, or 58.7 256J.57. 58.8 (e) For the purpose of applying sanctions under this 58.9 section, only occurrences of noncompliance that occur after the 58.10 effective date of this section shall be considered. If the 58.11 participant is in 30 percent sanction in the month this section 58.12 takes effect, that month counts as the first occurrence for 58.13 purposes of applying the sanctions under this section, but the 58.14 sanction shall remain at 30 percent for that month. 58.15 (f) An assistance unit whose case is closed under paragraph 58.16 (d) or (g), or under an approved county option sanction plan 58.17 under section 256J.462 in effect June 30, 2003, or a county 58.18 pilot project under Laws 2000, chapter 488, article 10, section 58.19 29, in effect June 30, 2003, may reapply for MFIP and shall be 58.20 eligible if the participant complies with MFIP program 58.21 requirements and demonstrates compliance for up to one month. 58.22 No assistance shall be paid during this period. 58.23 (g) An assistance unit whose case has been closed for 58.24 noncompliance, that reapplies under paragraph (f) is subject to 58.25 sanction under paragraph (c), clause (2), for a first occurrence 58.26 of noncompliance. Any subsequent occurrence of noncompliance 58.27 shall result in case closure under paragraph (d). 58.28 Sec. 63. Minnesota Statutes 2002, section 256J.46, 58.29 subdivision 2, is amended to read: 58.30 Subd. 2. [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 58.31 REQUIREMENTS.] The grant of an MFIP caregiver who refuses to 58.32 cooperate, as determined by the child support enforcement 58.33 agency, with support requirements under section 256.741, shall 58.34 be subject to sanction as specified in this subdivision and 58.35 subdivision 1. For a first occurrence of noncooperation, the 58.36 assistance unit's grant must be reduced by2530 percent of the 59.1 applicable MFIP standard of need. Subsequent occurrences of 59.2 noncooperation shall be subject to sanction under subdivision 1, 59.3 paragraphs (c), clause (2), and (d). The residual amount of the 59.4 grant, if any, must be paid to the caregiver. A sanction under 59.5 this subdivision becomes effective the first month following the 59.6 month in which a required notice is given. A sanction must not 59.7 be imposed when a caregiver comes into compliance with the 59.8 requirements under section 256.741 prior to the effective date 59.9 of the sanction. The sanction shall be removed in the month 59.10 following the month that the caregiver cooperates with the 59.11 support requirements. Each month that an MFIP caregiver fails 59.12 to comply with the requirements of section 256.741 must be 59.13 considered a separate occurrence of noncompliance for the 59.14 purpose of applying sanctions under subdivision 1, paragraphs 59.15 (c), clause (2), and (d).An MFIP caregiver who has had one or59.16more sanctions imposed must remain in compliance with the59.17requirements of section 256.741 for six months in order for a59.18subsequent sanction to be considered a first occurrence.59.19 Sec. 64. Minnesota Statutes 2002, section 256J.46, 59.20 subdivision 2a, is amended to read: 59.21 Subd. 2a. [DUAL SANCTIONS.] (a) Notwithstanding the 59.22 provisions of subdivisions 1 and 2, for a participant subject to 59.23 a sanction for refusal to comply with child support requirements 59.24 under subdivision 2 and subject to a concurrent sanction for 59.25 refusal to cooperate with other program requirements under 59.26 subdivision 1, sanctions shall be imposed in the manner 59.27 prescribed in this subdivision. 59.28A participant who has had one or more sanctions imposed59.29under this subdivision must remain in compliance with the59.30provisions of this chapter for six months in order for a59.31subsequent occurrence of noncompliance to be considered a first59.32occurrence.Any vendor payment of shelter costs or utilities 59.33 under this subdivision must remain in effect for six months 59.34 after the month in which the participant is no longer subject to 59.35 sanction under subdivision 1. 59.36 (b) If the participant was subject to sanction for: 60.1 (i) noncompliance under subdivision 1 before being subject 60.2 to sanction for noncooperation under subdivision 2; or 60.3 (ii) noncooperation under subdivision 2 before being 60.4 subject to sanction for noncompliance under subdivision 1, the 60.5 participant is considered to have a second occurrence of 60.6 noncompliance and shall be sanctioned as provided in subdivision 60.7 1, paragraph(d)(c), clause (2). Each subsequent occurrence of 60.8 noncompliance shall be considered one additional occurrence and 60.9 shall be subject to the applicable level of sanction under 60.10 subdivision 1, paragraph (d), or section 256J.462. The 60.11 requirement that the county conduct a review as specified in 60.12 subdivision 1, paragraph(e)(d), remains in effect. 60.13 (c) A participant who first becomes subject to sanction 60.14 under both subdivisions 1 and 2 in the same month is subject to 60.15 sanction as follows: 60.16 (i) in the first month of noncompliance and noncooperation, 60.17 the participant's grant must be reduced by2530 percent of the 60.18 applicable MFIP standard of need, with any residual amount paid 60.19 to the participant; 60.20 (ii) in the second and subsequent months of noncompliance 60.21 and noncooperation, the participant shall be subject to the 60.22 applicable level of sanction under subdivision 1, paragraph (d),60.23or section 256J.462. 60.24 The requirement that the county conduct a review as 60.25 specified in subdivision 1, paragraph(e)(d), remains in effect. 60.26 (d) A participant remains subject to sanction under 60.27 subdivision 2 if the participant: 60.28 (i) returns to compliance and is no longer subject to 60.29 sanctionunder subdivision 1 or section 256J.462for 60.30 noncompliance with section 256J.45 or sections 256J.515 to 60.31 256J.57; or 60.32 (ii) has the sanctionunder subdivision 1, paragraph (d),60.33or section 256J.462for noncompliance with section 256J.45 or 60.34 sections 256J.515 to 256J.57 removed upon completion of the 60.35 review under subdivision 1, paragraph (e). 60.36 A participant remains subject to the applicable level of 61.1 sanction under subdivision 1, paragraph (d), or section 256J.46261.2 if the participant cooperates and is no longer subject to 61.3 sanction under subdivision 2. 61.4 Sec. 65. Minnesota Statutes 2002, section 256J.49, 61.5 subdivision 4, is amended to read: 61.6 Subd. 4. [EMPLOYMENT AND TRAINING SERVICE PROVIDER.] 61.7 "Employment and training service provider" means: 61.8 (1) a public, private, or nonprofit employment and training 61.9 agency certified by the commissioner of economic security under 61.10 sections 268.0122, subdivision 3, and 268.871, subdivision 1, or 61.11 is approved under section 256J.51 and is included in the county 61.12planservice agreement submitted under section256J.50256J.626, 61.13 subdivision74; 61.14 (2) a public, private, or nonprofit agency that is not 61.15 certified by the commissioner under clause (1), but with which a 61.16 county has contracted to provide employment and training 61.17 services and which is included in the county'splanservice 61.18 agreement submitted under section256J.50256J.626, 61.19 subdivision74; or 61.20 (3) a county agency, if the county has opted to provide 61.21 employment and training services and the county has indicated 61.22 that fact in theplanservice agreement submitted under section 61.23256J.50256J.626, subdivision74. 61.24 Notwithstanding section 268.871, an employment and training 61.25 services provider meeting this definition may deliver employment 61.26 and training services under this chapter. 61.27 Sec. 66. Minnesota Statutes 2002, section 256J.49, 61.28 subdivision 5, is amended to read: 61.29 Subd. 5. [EMPLOYMENT PLAN.] "Employment plan" means a plan 61.30 developed by the job counselor and the participant which 61.31 identifies the participant's most direct path to unsubsidized 61.32 employment, lists the specific steps that the caregiver will 61.33 take on that path, and includes a timetable for the completion 61.34 of each step. The plan should also identify any subsequent 61.35 steps that support long-term economic stability. For 61.36 participants who request and qualify for a family violence 62.1 waiver, an employment plan must be developed by the job 62.2 counselor, the participant, and a person trained in domestic 62.3 violence and follow the employment plan provisions in section 62.4 256J.521, subdivision 3. 62.5 Sec. 67. Minnesota Statutes 2002, section 256J.49, is 62.6 amended by adding a subdivision to read: 62.7 Subd. 6a. [FUNCTIONAL WORK LITERACY.] "Functional work 62.8 literacy" means an intensive English as a second language 62.9 program that is work focused and offers at least 20 hours of 62.10 class time per week. 62.11 Sec. 68. Minnesota Statutes 2002, section 256J.49, 62.12 subdivision 9, is amended to read: 62.13 Subd. 9. [PARTICIPANT.] "Participant" means a recipient of 62.14 MFIP assistance who participates or is required to participate 62.15 in employment and training services under sections 256J.515 to 62.16 256J.57 and 256J.95. 62.17 Sec. 69. Minnesota Statutes 2002, section 256J.49, is 62.18 amended by adding a subdivision to read: 62.19 Subd. 12a. [SUPPORTED WORK.] "Supported work" means a 62.20 subsidized or unsubsidized work experience placement with a 62.21 public or private sector employer, which may include services 62.22 such as individualized supervision and job coaching to support 62.23 the participant on the job. 62.24 Sec. 70. Minnesota Statutes 2002, section 256J.49, 62.25 subdivision 13, is amended to read: 62.26 Subd. 13. [WORK ACTIVITY.] "Work activity" means any 62.27 activity in a participant's approved employment plan thatis62.28tied to the participant'sleads to employmentgoal. For 62.29 purposes of the MFIP program,any activity that is included in a62.30participant's approved employment plan meetsthis includes 62.31 activities that meet the definition of work activityas counted62.32 under thefederalparticipationstandardsrequirements of TANF. 62.33 Work activity includes, but is not limited to: 62.34 (1) unsubsidized employment, including work study and paid 62.35 apprenticeships or internships; 62.36 (2) subsidized private sector or public sector employment, 63.1 including grant diversion as specified in section 256J.69, 63.2 on-the-job training as specified in section 256J.66, the 63.3 self-employment investment demonstration program (SEID) as 63.4 specified in section 256J.65, paid work experience, and 63.5 supported work when a wage subsidy is provided; 63.6 (3) unpaid work experience, includingCWEPcommunity 63.7 service, volunteer work, the community work experience program 63.8 as specified in section 256J.67, unpaid apprenticeships or 63.9 internships, andincluding work associated with the refurbishing63.10of publicly assisted housing if sufficient private sector63.11employment is not availablesupported work when a wage subsidy 63.12 is not provided; 63.13 (4)on-the-job training as specified in section 256J.66job 63.14 search including job readiness assistance, job clubs, job 63.15 placement, job-related counseling, and job retention services; 63.16(5) job search, either supervised or unsupervised;63.17(6) job readiness assistance;63.18(7) job clubs, including job search workshops;63.19(8) job placement;63.20(9) job development;63.21(10) job-related counseling;63.22(11) job coaching;63.23(12) job retention services;63.24(13) job-specific training or education;63.25(14) job skills training directly related to employment;63.26(15) the self-employment investment demonstration (SEID),63.27as specified in section 256J.65;63.28(16) preemployment activities, based on availability and63.29resources, such as volunteer work, literacy programs and related63.30activities, citizenship classes, English as a second language63.31(ESL) classes as limited by the provisions of section 256J.52,63.32subdivisions 3, paragraph (d), and 5, paragraph (c), or63.33participation in dislocated worker services, chemical dependency63.34treatment, mental health services, peer group networks,63.35displaced homemaker programs, strength-based resiliency63.36training, parenting education, or other programs designed to64.1help families reach their employment goals and enhance their64.2ability to care for their children;64.3(17) community service programs;64.4(18) vocational educational training or educational64.5programs that can reasonably be expected to lead to employment,64.6as limited by the provisions of section 256J.53;64.7(19) apprenticeships;64.8(20) satisfactory attendance in general educational64.9development diploma classes or an adult diploma program;64.10(21) satisfactory attendance at secondary school, if the64.11participant has not received a high school diploma;64.12(22) adult basic education classes;64.13(23) internships;64.14(24) bilingual employment and training services;64.15(25) providing child care services to a participant who is64.16working in a community service program; and64.17(26) activities included in an alternative employment plan64.18that is developed under section 256J.52, subdivision 6.64.19 (5) job readiness education, including English as a second 64.20 language (ESL) or functional work literacy classes as limited by 64.21 the provisions of section 256J.531, subdivision 2, general 64.22 educational development (GED) course work, high school 64.23 completion, and adult basic education as limited by the 64.24 provisions of section 256J.531, subdivision 1; 64.25 (6) job skills training directly related to employment, 64.26 including education and training that can reasonably be expected 64.27 to lead to employment, as limited by the provisions of section 64.28 256J.53; 64.29 (7) providing child care services to a participant who is 64.30 working in a community service program; 64.31 (8) activities included in the employment plan that is 64.32 developed under section 256J.521, subdivision 3; and 64.33 (9) preemployment activities including chemical and mental 64.34 health assessments, treatment, and services; learning 64.35 disabilities services; child protective services; family 64.36 stabilization services; or other programs designed to enhance 65.1 employability. 65.2 Sec. 71. Minnesota Statutes 2002, section 256J.50, 65.3 subdivision 1, is amended to read: 65.4 Subdivision 1. [EMPLOYMENT AND TRAINING SERVICES COMPONENT 65.5 OF MFIP.] (a)By January 1, 1998,Each county must develop and 65.6implementprovide an employment and training services component 65.7of MFIPwhich is designed to put participants on the most direct 65.8 path to unsubsidized employment. Participation in these 65.9 services is mandatory for all MFIP caregivers, unless the 65.10 caregiver is exempt under section 256J.56. 65.11 (b) A county must provide employment and training services 65.12 under sections 256J.515 to 256J.74 within 30 days after 65.13 thecaregiver's participation becomes mandatory under65.14subdivision 5 or within 30 days of receipt of a request for65.15services from a caregiver who under section 256J.42 is no longer65.16eligible to receive MFIP but whose income is below 120 percent65.17of the federal poverty guidelines for a family of the same65.18size. The request must be made within 12 months of the date the65.19caregivers' MFIP case was closedcaregiver is determined 65.20 eligible for MFIP, or within five days when the caregiver 65.21 participated in the diversionary work program under section 65.22 256J.95 within the past 12 months. 65.23 Sec. 72. Minnesota Statutes 2002, section 256J.50, 65.24 subdivision 8, is amended to read: 65.25 Subd. 8. [COUNTY DUTY TO ENSURE EMPLOYMENT AND TRAINING 65.26 CHOICES FOR PARTICIPANTS.] Each county, or group of counties 65.27 working cooperatively, shall make available to participants the 65.28 choice of at least two employment and training service providers 65.29 as defined under section 256J.49, subdivision 4, except in 65.30 counties utilizing workforce centers that use multiple 65.31 employment and training services, offer multiple services 65.32 options under a collaborative effort and can document that 65.33 participants have choice among employment and training services 65.34 designed to meet specialized needs. The requirements of this 65.35 subdivision do not apply to the diversionary work program under 65.36 section 256J.95. 66.1 Sec. 73. Minnesota Statutes 2002, section 256J.50, 66.2 subdivision 9, is amended to read: 66.3 Subd. 9. [EXCEPTION; FINANCIAL HARDSHIP.] Notwithstanding 66.4 subdivision 8, a county that explains in theplanservice 66.5 agreement required under section 256J.626, subdivision74, that 66.6 the provision of alternative employment and training service 66.7 providers would result in financial hardship for the county is 66.8 not required to make available more than one employment and 66.9 training provider. 66.10 Sec. 74. Minnesota Statutes 2002, section 256J.50, 66.11 subdivision 10, is amended to read: 66.12 Subd. 10. [REQUIRED NOTIFICATION TO VICTIMS OF FAMILY 66.13 VIOLENCE.] (a) County agencies and their contractors must 66.14 provide universal notification to all applicants and recipients 66.15 of MFIP that: 66.16 (1) referrals to counseling and supportive services are 66.17 available for victims of family violence; 66.18 (2) nonpermanent resident battered individuals married to 66.19 United States citizens or permanent residents may be eligible to 66.20 petition for permanent residency under the federal Violence 66.21 Against Women Act, and that referrals to appropriate legal 66.22 services are available; 66.23 (3) victims of family violence are exempt from the 60-month 66.24 limit on assistancewhile the individual isif they are 66.25 complying with anapproved safety plan or, after October 1,66.262001, an alternativeemployment plan, as defined inunder 66.27 section256J.49256J.521, subdivision1a3; and 66.28 (4) victims of family violence may choose to have regular 66.29 work requirements waived while the individual is complying with 66.30 analternativeemployment planas defined inunder section 66.31256J.49256J.521, subdivision1a3. 66.32 (b) If analternativeemployment plan under section 66.33 256J.521, subdivision 3, is denied, the county or a job 66.34 counselor must provide reasons why the plan is not approved and 66.35 document how the denial of the plan does not interfere with the 66.36 safety of the participant or children. 67.1 Notification must be in writing and orally at the time of 67.2 application and recertification, when the individual is referred 67.3 to the title IV-D child support agency, and at the beginning of 67.4 any job training or work placement assistance program. 67.5 Sec. 75. Minnesota Statutes 2002, section 256J.51, 67.6 subdivision 1, is amended to read: 67.7 Subdivision 1. [PROVIDER APPLICATION.] An employment and 67.8 training service provider that is not included in a county's 67.9planservice agreement under section256J.50256J.626, 67.10 subdivision74, because the county has demonstrated financial 67.11 hardship under section 256J.50, subdivision 9of that section, 67.12 may appeal its exclusion to the commissioner of economic 67.13 security under this section. 67.14 Sec. 76. Minnesota Statutes 2002, section 256J.51, 67.15 subdivision 2, is amended to read: 67.16 Subd. 2. [APPEAL; ALTERNATE APPROVAL.] (a) An employment 67.17 and training service provider that is not included by a county 67.18 agency in theplanservice agreement under section 67.19256J.50256J.626, subdivision74, and that meets the criteria 67.20 in paragraph (b), may appeal its exclusion to the commissioner 67.21 of economic security, and may request alternative approval by 67.22 the commissioner of economic security to provide services in the 67.23 county. 67.24 (b) An employment and training services provider that is 67.25 requesting alternative approval must demonstrate to the 67.26 commissioner that the provider meets the standards specified in 67.27 section 268.871, subdivision 1, paragraph (b), except that the 67.28 provider's past experience may be in services and programs 67.29 similar to those specified in section 268.871, subdivision 1, 67.30 paragraph (b). 67.31 Sec. 77. Minnesota Statutes 2002, section 256J.51, 67.32 subdivision 3, is amended to read: 67.33 Subd. 3. [COMMISSIONER'S REVIEW.] (a) The commissioner 67.34 must act on a request for alternative approval under this 67.35 section within 30 days of the receipt of the request. If after 67.36 reviewing the provider's request, and the county'splanservice 68.1 agreement submitted under section256J.50256J.626, 68.2 subdivision74, the commissioner determines that the provider 68.3 meets the criteria under subdivision 2, paragraph (b), and that 68.4 approval of the provider would not cause financial hardship to 68.5 the county, the county must submit a revisedplanservice 68.6 agreement under subdivision 4 that includes the approved 68.7 provider. 68.8 (b) If the commissioner determines that the approval of the 68.9 provider would cause financial hardship to the county, the 68.10 commissioner must notify the provider and the county of this 68.11 determination. The alternate approval process under this 68.12 section shall be closed to other requests for alternate approval 68.13 to provide employment and training services in the county for up 68.14 to 12 months from the date that the commissioner makes a 68.15 determination under this paragraph. 68.16 Sec. 78. Minnesota Statutes 2002, section 256J.51, 68.17 subdivision 4, is amended to read: 68.18 Subd. 4. [REVISEDPLANSERVICE AGREEMENT REQUIRED.] The 68.19 commissioner of economic security must notify the county agency 68.20 when the commissioner grants an alternative approval to an 68.21 employment and training service provider under subdivision 2. 68.22 Upon receipt of the notice, the county agency must submit a 68.23 revisedplanservice agreement under section256J.50256J.626, 68.24 subdivision74, that includes the approved provider. The 68.25 county has 90 days from the receipt of the commissioner's notice 68.26 to submit the revisedplanservice agreement. 68.27 Sec. 79. [256J.521] [ASSESSMENT; EMPLOYMENT PLANS.] 68.28 Subdivision 1. [ASSESSMENTS.] (a) For purposes of MFIP 68.29 employment services, assessment is a continuing process of 68.30 gathering information related to employability for the purpose 68.31 of identifying both participant's strengths and strategies for 68.32 coping with issues that interfere with employment. The job 68.33 counselor must use information from the assessment process to 68.34 develop and update the employment plan under subdivision 2. 68.35 (b) The scope of assessment must cover at least the 68.36 following areas: 69.1 (1) basic information about the participant's ability to 69.2 obtain and retain employment, including: a review of the 69.3 participant's education level; interests, skills, and abilities; 69.4 prior employment or work experience; transferable work skills; 69.5 child care and transportation needs; 69.6 (2) identification of personal and family circumstances 69.7 that impact the participant's ability to obtain and retain 69.8 employment, including: any special needs of the children, the 69.9 level of English proficiency, family violence issues, and any 69.10 involvement with social services or the legal system; 69.11 (3) the results of a mental and chemical health screening 69.12 tool designed by the commissioner and results of the brief 69.13 screening tool for special learning needs. Screening for mental 69.14 and chemical health and special learning needs must be completed 69.15 by participants who are unable to find suitable employment after 69.16 six weeks of job search under subdivision 2, paragraph (b), and 69.17 participants who are determined to have barriers to employment 69.18 under subdivision 2, paragraph (d). Failure to complete the 69.19 screens will result in sanction under section 256J.46; and 69.20 (4) a comprehensive review of participation and progress 69.21 for participants who have received MFIP assistance and have not 69.22 worked in unsubsidized employment during the past 12 months. 69.23 The purpose of the review is to determine the need for 69.24 additional services and supports, including placement in 69.25 subsidized employment or unpaid work experience under section 69.26 256J.49, subdivision 13. 69.27 (c) Information gathered during a caregiver's participation 69.28 in the diversionary work program under section 256J.95 must be 69.29 incorporated into the assessment process. 69.30 (d) The job counselor may require the participant to 69.31 complete a professional chemical use assessment to be performed 69.32 according to the rules adopted under section 254A.03, 69.33 subdivision 3, including provisions in the administrative rules 69.34 which recognize the cultural background of the participant, or a 69.35 professional psychological assessment as a component of the 69.36 assessment process, when the job counselor has a reasonable 70.1 belief, based on objective evidence, that a participant's 70.2 ability to obtain and retain suitable employment is impaired by 70.3 a medical condition. The job counselor may assist the 70.4 participant with arranging services, including child care 70.5 assistance and transportation, necessary to meet needs 70.6 identified by the assessment. Data gathered as part of a 70.7 professional assessment must be classified and disclosed 70.8 according to the provisions in section 13.46. 70.9 Subd. 2. [EMPLOYMENT PLAN; CONTENTS.] (a) Based on the 70.10 assessment under subdivision 1, the job counselor and the 70.11 participant must develop an employment plan that includes 70.12 participation in activities and hours that meet the requirements 70.13 of section 256J.55, subdivision 1. The purpose of the 70.14 employment plan is to identify for each participant the most 70.15 direct path to unsubsidized employment and any subsequent steps 70.16 that support long-term economic stability. The employment plan 70.17 should be developed using the highest level of activity 70.18 appropriate for the participant. Activities must be chosen from 70.19 clauses (1) to (6), which are listed in order of preference. 70.20 The employment plan must also list the specific steps the 70.21 participant will take to obtain employment, including steps 70.22 necessary for the participant to progress from one level of 70.23 activity to another, and a timetable for completion of each 70.24 step. Levels of activity include: 70.25 (1) unsubsidized employment; 70.26 (2) job search; 70.27 (3) subsidized employment or unpaid work experience; 70.28 (4) unsubsidized employment and job readiness education or 70.29 job skills training; 70.30 (5) unsubsidized employment or unpaid work experience, and 70.31 activities related to a family violence waiver or preemployment 70.32 needs; and 70.33 (6) activities related to a family violence waiver or 70.34 preemployment needs. 70.35 (b) Participants who are determined able to work in 70.36 unsubsidized employment must job search at least 30 hours per 71.1 week for up to six weeks, and accept any offer of suitable 71.2 employment. The remaining hours necessary to meet the 71.3 requirements of section 256J.55, subdivision 1, may be met 71.4 through participation in other work activities under section 71.5 256J.49, subdivision 13. The participant's employment plan must 71.6 specify, at a minimum: (1) whether the job search is supervised 71.7 or unsupervised; (2) support services that will be provided; and 71.8 (3) how frequently the participant must report to the job 71.9 counselor. Participants who are unable to find suitable 71.10 employment after six weeks must meet with the job counselor to 71.11 determine whether other activities in paragraph (a) should be 71.12 incorporated into the employment plan. Job search activities 71.13 which are continued after six weeks must be structured and 71.14 supervised. 71.15 (c) Beginning July 1, 2004, activities and hourly 71.16 requirements in the employment plan may be adjusted as necessary 71.17 to accommodate the personal and family circumstances of 71.18 participants identified under section 256J.561, subdivision 2, 71.19 paragraph (d). Participants who no longer meet the provisions 71.20 of section 256J.561, subdivision 2, paragraph (d), must meet 71.21 with the job counselor within ten days of the determination to 71.22 revise the employment plan. 71.23 (d) Participants who are determined to have barriers to 71.24 obtaining or retaining employment that will not be overcome 71.25 during six weeks of job search under paragraph (b) must work 71.26 with the job counselor to develop an employment plan that 71.27 addresses those barriers by incorporating appropriate activities 71.28 from paragraph (a), clauses (1) to (6). The employment plan 71.29 must include enough hours to meet the participation requirements 71.30 in section 256J.55, subdivision 1, unless a compelling reason to 71.31 require fewer hours is noted in the participant's file. 71.32 (e) The job counselor and the participant must sign the 71.33 employment plan to indicate agreement on the contents. Failure 71.34 to develop or comply with activities in the plan, or voluntarily 71.35 quitting suitable employment without good cause, will result in 71.36 the imposition of a sanction under section 256J.46. 72.1 (f) Employment plans must be reviewed at least every three 72.2 months to determine whether activities and hourly requirements 72.3 should be revised. 72.4 Subd. 3. [EMPLOYMENT PLAN; FAMILY VIOLENCE WAIVER.] (a) A 72.5 participant who requests and qualifies for a family violence 72.6 waiver shall develop or revise the employment plan as specified 72.7 in this subdivision with a job counselor or county, and a person 72.8 trained in domestic violence. The revised or new employment 72.9 plan must be approved by the county or the job counselor. The 72.10 plan may address safety, legal, or emotional issues, and other 72.11 demands on the family as a result of the family violence. 72.12 Information in section 256J.515, clauses (1) to (8), must be 72.13 included as part of the development of the plan. 72.14 (b) The primary goal of an employment plan developed under 72.15 this subdivision is to ensure the safety of the caregiver and 72.16 children. To the extent it is consistent with ensuring safety, 72.17 the plan shall also include activities that are designed to lead 72.18 to economic stability. An activity is inconsistent with 72.19 ensuring safety if, in the opinion of a person trained in 72.20 domestic violence, the activity would endanger the safety of the 72.21 participant or children. A plan under this subdivision may not 72.22 automatically include a provision that requires a participant to 72.23 obtain an order for protection or to attend counseling. 72.24 (c) If at any time there is a disagreement over whether the 72.25 activities in the plan are appropriate or the participant is not 72.26 complying with activities in the plan under this subdivision, 72.27 the participant must receive the assistance of a person trained 72.28 in domestic violence to help resolve the disagreement or 72.29 noncompliance with the county or job counselor. If the person 72.30 trained in domestic violence recommends that the activities are 72.31 still appropriate, the county or a job counselor must approve 72.32 the activities in the plan or provide written reasons why 72.33 activities in the plan are not approved and document how denial 72.34 of the activities do not endanger the safety of the participant 72.35 or children. 72.36 Subd. 4. [SELF-EMPLOYMENT.] (a) Self-employment activities 73.1 may be included in an employment plan contingent on the 73.2 development of a business plan which establishes a timetable and 73.3 earning goals that will result in the participant exiting MFIP 73.4 assistance. Business plans must be developed with assistance 73.5 from an individual or organization with expertise in small 73.6 business as approved by the job counselor. 73.7 (b) Participants with an approved plan that includes 73.8 self-employment must meet the participation requirements in 73.9 section 256J.55, subdivision 1. Only hours where the 73.10 participant earns at least minimum wage shall be counted toward 73.11 the requirement. Additional activities and hours necessary to 73.12 meet the participation requirements in section 256J.55, 73.13 subdivision 1, must be included in the employment plan. 73.14 (c) Employment plans which include self-employment 73.15 activities must be reviewed every three months. Participants 73.16 who fail, without good cause, to make satisfactory progress as 73.17 established in the business plan must revise the employment plan 73.18 to replace the self-employment with other approved work 73.19 activities. 73.20 (d) The requirements of this subdivision may be waived for 73.21 participants who are enrolled in the self-employment investment 73.22 demonstration program (SEID) under section 256J.65, and who make 73.23 satisfactory progress as determined by the job counselor and the 73.24 SEID provider. 73.25 Subd. 5. [TRANSITION FROM THE DIVERSIONARY WORK 73.26 PROGRAM.] Participants who become eligible for MFIP assistance 73.27 after completing the diversionary work program under section 73.28 256J.95 must comply with all requirements of subdivisions 1 and 73.29 2. Participants who become eligible for MFIP assistance after 73.30 being determined unable to benefit from the diversionary work 73.31 program must comply with the requirements of subdivisions 1 and 73.32 2, with the exception of subdivision 2, paragraph (b). 73.33 Subd. 6. [LOSS OF EMPLOYMENT.] Participants who are laid 73.34 off, quit with good cause, or are terminated from employment 73.35 through no fault of their own must meet with the job counselor 73.36 within ten working days to ascertain the reason for the job loss 74.1 and to revise the employment plan as necessary to address the 74.2 problem. 74.3 Sec. 80. Minnesota Statutes 2002, section 256J.53, 74.4 subdivision 1, is amended to read: 74.5 Subdivision 1. [LENGTH OF PROGRAM.] (a) In order for a 74.6 post-secondary education or training program to be an approved 74.7 work activity as defined in section 256J.49, subdivision 13, 74.8 clause(18)(6), it must be a program lasting2412 months or 74.9 less, and the participant must meet the requirements of 74.10 subdivisions 2and, 3, and 5. 74.11 (b) The 12 months of allowable postsecondary education or 74.12 training may be used to complete the final 12 months of a longer 74.13 program, provided the program does not exceed the undergraduate 74.14 level. 74.15 (c) All course work must be completed within 18 months of 74.16 enrollment in the program. 74.17 Sec. 81. Minnesota Statutes 2002, section 256J.53, 74.18 subdivision 2, is amended to read: 74.19 Subd. 2. [DOCUMENTATION SUPPORTING PROGRAMAPPROVAL OF 74.20 POSTSECONDARY EDUCATION OR TRAINING.] (a) In order for a 74.21 post-secondary education or training program to be an approved 74.22 activity ina participant'san employment plan, the participant 74.23or the employment and training service providermustprovide74.24documentation that:be working in unsubsidized employment at 74.25 least 25 hours per week. 74.26 (b) Participants seeking approval of a postsecondary 74.27 education or training plan must provide documentation that: 74.28 (1) theparticipant'semploymentplan identifies specific74.29goals thatgoal can only be met with the additional education or 74.30 training; 74.31 (2) there are suitable employment opportunities that 74.32 require the specific education or training in the area in which 74.33 the participant resides or is willing to reside; 74.34 (3) the education or training will result in significantly 74.35 higher wages for the participant than the participant could earn 74.36 without the education or training; 75.1 (4) the participant can meet the requirements for admission 75.2 into the program; and 75.3 (5) there is a reasonable expectation that the participant 75.4 will complete the training program based on such factors as the 75.5 participant's MFIP assessment, previous education, training, and 75.6 work history; current motivation; and changes in previous 75.7 circumstances. 75.8 (c) The hourly unsubsidized employment requirement may be 75.9 reduced for intensive education or training programs lasting 12 75.10 weeks or less when full-time attendance is required. 75.11 (d) Participants with an approved employment plan in place 75.12 on July 1, 2003, which includes more than 12 months of 75.13 postsecondary education or training shall be allowed to complete 75.14 that plan provided that hourly requirements in section 256J.55, 75.15 subdivision 1, and conditions specified in paragraph (b), and 75.16 subdivisions 3 and 5 are met. 75.17 Sec. 82. Minnesota Statutes 2002, section 256J.53, 75.18 subdivision 5, is amended to read: 75.19 Subd. 5. [JOB SEARCH AFTER COMPLETION OF WORK ACTIVITY75.20 REQUIREMENTS AFTER POSTSECONDARY EDUCATION OR TRAINING.]If a75.21participant's employment plan includes a post-secondary75.22educational or training program, the plan must include an75.23anticipated completion date for those activities. At the time75.24the education or training is completed, the participant must75.25participate in job search. If, after three months of job75.26search, the participant does not find a job that is consistent75.27with the participant's employment goal, the participant must75.28accept any offer of suitable employment.Upon completion of an 75.29 approved education or training program, a participant who does 75.30 not meet the participation requirements in section 256J.55, 75.31 subdivision 1, through unsubsidized employment must participate 75.32 in job search. If, after six weeks of job search, the 75.33 participant does not find a full-time job consistent with the 75.34 employment goal, the participant must accept any offer of 75.35 full-time suitable employment, or meet with the job counselor to 75.36 revise the employment plan to include additional work activities 76.1 necessary to meet hourly requirements. 76.2 Sec. 83. [256J.531] [BASIC EDUCATION; ENGLISH AS A SECOND 76.3 LANGUAGE.] 76.4 Subdivision 1. [APPROVAL OF ADULT BASIC EDUCATION.] With 76.5 the exception of classes related to obtaining a general 76.6 educational development credential (GED), a participant must 76.7 have reading or mathematics proficiency below a ninth grade 76.8 level in order for adult basic education classes to be an 76.9 approved work activity. The employment plan must also specify 76.10 that the participant fulfill no more than one-half of the 76.11 participation requirements in section 256J.55, subdivision 1, 76.12 through attending adult basic education or general educational 76.13 development classes. 76.14 Subd. 2. [APPROVAL OF ENGLISH AS A SECOND LANGUAGE.] In 76.15 order for English as a second language (ESL) classes to be an 76.16 approved work activity in an employment plan, a participant must 76.17 be below a spoken language proficiency level of SPL6 or its 76.18 equivalent, as measured by a nationally recognized test. In 76.19 approving ESL as a work activity, the job counselor must give 76.20 preference to enrollment in a functional work literacy program, 76.21 if one is available, over a regular ESL program. A participant 76.22 may not be approved for more than a combined total of 24 months 76.23 of ESL classes while participating in the diversionary work 76.24 program and the employment and training services component of 76.25 MFIP. The employment plan must also specify that the 76.26 participant fulfill no more than one-half of the participation 76.27 requirements in section 256J.55, subdivision 1, through 76.28 attending ESL classes. 76.29 Sec. 84. Minnesota Statutes 2002, section 256J.54, 76.30 subdivision 1, is amended to read: 76.31 Subdivision 1. [ASSESSMENT OF EDUCATIONAL PROGRESS AND 76.32 NEEDS.] (a) The county agency must document the educational 76.33 level of each MFIP caregiver who is under the age of 20 and 76.34 determine if the caregiver has obtained a high school diploma or 76.35 its equivalent. If the caregiver has not obtained a high school 76.36 diploma or its equivalent,and is not exempt from the77.1requirement to attend school under subdivision 5,the county 77.2 agency must complete an individual assessment for the 77.3 caregiver unless the caregiver is exempt from the requirement to 77.4 attend school under subdivision 5 or has chosen to have an 77.5 employment plan under section 256J.521, subdivision 2, as 77.6 allowed in paragraph (b). The assessment must be performed as 77.7 soon as possible but within 30 days of determining MFIP 77.8 eligibility for the caregiver. The assessment must provide an 77.9 initial examination of the caregiver's educational progress and 77.10 needs, literacy level, child care and supportive service needs, 77.11 family circumstances, skills, and work experience. In the case 77.12 of a caregiver under the age of 18, the assessment must also 77.13 consider the results of either the caregiver's or the 77.14 caregiver's minor child's child and teen checkup under Minnesota 77.15 Rules, parts 9505.0275 and 9505.1693 to 9505.1748, if available, 77.16 and the effect of a child's development and educational needs on 77.17 the caregiver's ability to participate in the program. The 77.18 county agency must advise the caregiver that the caregiver's 77.19 first goal must be to complete an appropriateeducational77.20 education option if one is identified for the caregiver through 77.21 the assessment and, in consultation with educational agencies, 77.22 must review the various school completion options with the 77.23 caregiver and assist in selecting the most appropriate option. 77.24 (b) The county agency must give a caregiver, who is age 18 77.25 or 19 and has not obtained a high school diploma or its 77.26 equivalent, the option to choose an employment plan with an 77.27 education option under subdivision 3 or an employment plan under 77.28 section 256J.521, subdivision 2. 77.29 Sec. 85. Minnesota Statutes 2002, section 256J.54, 77.30 subdivision 2, is amended to read: 77.31 Subd. 2. [RESPONSIBILITY FOR ASSESSMENT AND EMPLOYMENT 77.32 PLAN.] For caregivers who are under age 18 without a high school 77.33 diploma or its equivalent, the assessment under subdivision 1 77.34 and the employment plan under subdivision 3 must be completed by 77.35 the social services agency under section 257.33. For caregivers 77.36 who are age 18 or 19 without a high school diploma or its 78.1 equivalent who choose to have an employment plan with an 78.2 education option under subdivision 3, the assessment under 78.3 subdivision 1 and the employment plan under subdivision 3 must 78.4 be completed by the job counselor or, at county option, by the 78.5 social services agency under section 257.33. Upon reaching age 78.6 18 or 19 a caregiver who received social services under section 78.7 257.33 and is without a high school diploma or its equivalent 78.8 has the option to choose whether to continue receiving services 78.9 under the caregiver's plan from the social services agency or to 78.10 utilize an MFIP employment and training service provider. The 78.11 social services agency or the job counselor shall consult with 78.12 representatives of educational agencies that are required to 78.13 assist in developing educational plans under section 124D.331. 78.14 Sec. 86. Minnesota Statutes 2002, section 256J.54, 78.15 subdivision 3, is amended to read: 78.16 Subd. 3. [EDUCATIONALEDUCATION OPTION DEVELOPED.] If the 78.17 job counselor or county social services agency identifies an 78.18 appropriateeducationaleducation option for a minor caregiver 78.19under the age of 20without a high school diploma or its 78.20 equivalent, or a caregiver age 18 or 19 without a high school 78.21 diploma or its equivalent who chooses an employment plan with an 78.22 education option, the job counselor or agency must develop an 78.23 employment plan which reflects the identified option. The plan 78.24 must specify that participation in an educational activity is 78.25 required, what school or educational program is most 78.26 appropriate, the services that will be provided, the activities 78.27 the caregiver will take part in, including child care and 78.28 supportive services, the consequences to the caregiver for 78.29 failing to participate or comply with the specified 78.30 requirements, and the right to appeal any adverse action. The 78.31 employment plan must, to the extent possible, reflect the 78.32 preferences of the caregiver. 78.33 Sec. 87. Minnesota Statutes 2002, section 256J.54, 78.34 subdivision 5, is amended to read: 78.35 Subd. 5. [SCHOOL ATTENDANCE REQUIRED.] (a) Notwithstanding 78.36 the provisions of section 256J.56, minor parents, or 18- or 79.1 19-year-old parents without a high school diploma or its 79.2 equivalent who chooses an employment plan with an education 79.3 option must attend school unless: 79.4 (1) transportation services needed to enable the caregiver 79.5 to attend school are not available; 79.6 (2) appropriate child care services needed to enable the 79.7 caregiver to attend school are not available; 79.8 (3) the caregiver is ill or incapacitated seriously enough 79.9 to prevent attendance at school; or 79.10 (4) the caregiver is needed in the home because of the 79.11 illness or incapacity of another member of the household. This 79.12 includes a caregiver of a child who is younger than six weeks of 79.13 age. 79.14 (b) The caregiver must be enrolled in a secondary school 79.15 and meeting the school's attendance requirements. The county, 79.16 social service agency, or job counselor must verify at least 79.17 once per quarter that the caregiver is meeting the school's 79.18 attendance requirements. An enrolled caregiver is considered to 79.19 be meeting the attendance requirements when the school is not in 79.20 regular session, including during holiday and summer breaks. 79.21 Sec. 88. [256J.545] [FAMILY VIOLENCE WAIVER CRITERIA.] 79.22 (a) In order to qualify for a family violence waiver, an 79.23 individual must provide documentation of past or current family 79.24 violence which may prevent the individual from participating in 79.25 certain employment activities. A claim of family violence must 79.26 be documented by the applicant or participant providing a sworn 79.27 statement which is supported by collateral documentation. 79.28 (b) Collateral documentation may consist of: 79.29 (1) police, government agency, or court records; 79.30 (2) a statement from a battered women's shelter staff with 79.31 knowledge of the circumstances or credible evidence that 79.32 supports the sworn statement; 79.33 (3) a statement from a sexual assault or domestic violence 79.34 advocate with knowledge of the circumstances or credible 79.35 evidence that supports the sworn statement; 79.36 (4) a statement from professionals from whom the applicant 80.1 or recipient has sought assistance for the abuse; or 80.2 (5) a sworn statement from any other individual with 80.3 knowledge of circumstances or credible evidence that supports 80.4 the sworn statement. 80.5 Sec. 89. Minnesota Statutes 2002, section 256J.55, 80.6 subdivision 1, is amended to read: 80.7 Subdivision 1. [COMPLIANCE WITH JOB SEARCH OR EMPLOYMENT80.8PLAN; SUITABLE EMPLOYMENTPARTICIPATION REQUIREMENTS.](a) Each80.9MFIP participant must comply with the terms of the participant's80.10job search support plan or employment plan. When the80.11participant has completed the steps listed in the employment80.12plan, the participant must comply with section 256J.53,80.13subdivision 5, if applicable, and then the participant must not80.14refuse any offer of suitable employment. The participant may80.15choose to accept an offer of suitable employment before the80.16participant has completed the steps of the employment plan.80.17(b) For a participant under the age of 20 who is without a80.18high school diploma or general educational development diploma,80.19the requirement to comply with the terms of the employment plan80.20means the participant must meet the requirements of section80.21256J.54.80.22(c) Failure to develop or comply with a job search support80.23plan or an employment plan, or quitting suitable employment80.24without good cause, shall result in the imposition of a sanction80.25as specified in sections 256J.46 and 256J.57.80.26 (a) All caregivers must participate in employment services 80.27 under sections 256J.515 to 256J.57 concurrent with receipt of 80.28 MFIP assistance. 80.29 (b) Until July 1, 2004, participants who meet the 80.30 requirements of section 256J.56 are exempt from participation 80.31 requirements. 80.32 (c) Participants under paragraph (a) must develop and 80.33 comply with an employment plan under section 256J.521, or 80.34 section 256J.54 in the case of a participant under the age of 20 80.35 who has not obtained a high school diploma or its equivalent. 80.36 (d) With the exception of participants under the age of 20 81.1 who must meet the education requirements of section 256J.54, all 81.2 participants must meet the hourly participation requirements of 81.3 TANF or the hourly requirements listed in clauses (1) to (3), 81.4 whichever is higher. 81.5 (1) In single-parent families with no children under six 81.6 years of age, the job counselor and the caregiver must develop 81.7 an employment plan that includes 30 to 35 hours per week of work 81.8 activities. 81.9 (2) In single-parent families with a child under six years 81.10 of age, the job counselor and the caregiver must develop an 81.11 employment plan that includes 20 to 35 hours per week of work 81.12 activities. 81.13 (3) In two-parent families, the job counselor and the 81.14 caregivers must develop employment plans which result in a 81.15 combined total of at least 55 hours per week of work activities. 81.16 (e) Failure to participate in employment services, 81.17 including the requirement to develop and comply with an 81.18 employment plan, including hourly requirements, without good 81.19 cause under section 256J.57, shall result in the imposition of a 81.20 sanction under section 256J.46. 81.21 Sec. 90. Minnesota Statutes 2002, section 256J.55, 81.22 subdivision 2, is amended to read: 81.23 Subd. 2. [DUTY TO REPORT.] The participant must inform the 81.24 job counselor withinthreeten working days regarding any 81.25 changes related to the participant's employment status. 81.26 Sec. 91. Minnesota Statutes 2002, section 256J.56, is 81.27 amended to read: 81.28 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 81.29 EXEMPTIONS.] 81.30 (a) An MFIP participant is exempt from the requirements of 81.31 sections256J.52256J.515 to256J.55256J.57 if the participant 81.32 belongs to any of the following groups: 81.33 (1) participants who are age 60 or older; 81.34 (2) participants who are suffering from aprofessionally81.35certifiedpermanent or temporary illness, injury, or incapacity 81.36 which has been certified by a qualified professional when the 82.1 illness, injury, or incapacity is expected to continue for more 82.2 than 30 days andwhichprevents the person from obtaining or 82.3 retaining employment. Persons in this category with a temporary 82.4 illness, injury, or incapacity must be reevaluated at least 82.5 quarterly; 82.6 (3) participants whose presence in the home is required as 82.7 a caregiver because ofa professionally certifiedthe illness or 82.8 incapacity of another member in the assistance unit, a relative 82.9 in the household, or a foster child in the householdandwhen 82.10 the illness or incapacity and the need for the participant's 82.11 presence in the home has been certified by a qualified 82.12 professional and is expected to continue for more than 30 days; 82.13 (4) women who are pregnant, if the pregnancy has resulted 82.14 ina professionally certifiedan incapacity that prevents the 82.15 woman from obtaining or retaining employment, and the incapacity 82.16 has been certified by a qualified professional; 82.17 (5) caregivers of a child under the age of one year who 82.18 personally provide full-time care for the child. This exemption 82.19 may be used for only 12 months in a lifetime. In two-parent 82.20 households, only one parent or other relative may qualify for 82.21 this exemption; 82.22 (6) participants experiencing a personal or family crisis 82.23 that makes them incapable of participating in the program, as 82.24 determined by the county agency. If the participant does not 82.25 agree with the county agency's determination, the participant 82.26 may seekprofessionalcertification from a qualified 82.27 professional, as defined in section 256J.08, that the 82.28 participant is incapable of participating in the program. 82.29 Persons in this exemption category must be reevaluated 82.30 every 60 days. A personal or family crisis related to family 82.31 violence, as determined by the county or a job counselor with 82.32 the assistance of a person trained in domestic violence, should 82.33 not result in an exemption, but should be addressed through the 82.34 development or revision of analternativeemployment plan under 82.35 section256J.52256J.521, subdivision63; or 82.36 (7) caregivers with a child or an adult in the household 83.1 who meets the disability or medical criteria for home care 83.2 services under section 256B.0627, subdivision 1, 83.3 paragraph(c)(f), or a home and community-based waiver services 83.4 program under chapter 256B, or meets the criteria for severe 83.5 emotional disturbance under section 245.4871, subdivision 6, or 83.6 for serious and persistent mental illness under section 245.462, 83.7 subdivision 20, paragraph (c). Caregivers in this exemption 83.8 category are presumed to be prevented from obtaining or 83.9 retaining employment. 83.10 A caregiver who is exempt under clause (5) must enroll in 83.11 and attend an early childhood and family education class, a 83.12 parenting class, or some similar activity, if available, during 83.13 the period of time the caregiver is exempt under this section. 83.14 Notwithstanding section 256J.46, failure to attend the required 83.15 activity shall not result in the imposition of a sanction. 83.16 (b) The county agency must provide employment and training 83.17 services to MFIP participants who are exempt under this section, 83.18 but who volunteer to participate. Exempt volunteers may request 83.19 approval for any work activity under section 256J.49, 83.20 subdivision 13. The hourly participation requirements for 83.21 nonexempt participants under section256J.50256J.55, 83.22 subdivision51, do not apply to exempt participants who 83.23 volunteer to participate. 83.24 (c) This section expires on June 30, 2004. 83.25 Sec. 92. [256J.561] [UNIVERSAL PARTICIPATION REQUIRED.] 83.26 Subdivision 1. [IMPLEMENTATION OF UNIVERSAL PARTICIPATION 83.27 REQUIREMENTS.] (a) All caregivers whose applications were 83.28 received July 1, 2004, or after, are immediately subject to the 83.29 requirements in subdivision 2. 83.30 (b) For all MFIP participants who were exempt from 83.31 participating in employment services under section 256J.56 as of 83.32 June 30, 2004, between July 1, 2004, and June 30, 2005, the 83.33 county, as part of the participant's recertification under 83.34 section 256J.32, subdivision 6, shall determine whether a new 83.35 employment plan is required to meet the requirements in 83.36 subdivision 2. Counties shall notify each participant who is in 84.1 need of an employment plan that the participant must meet with a 84.2 job counselor within ten days to develop an employment plan. 84.3 Until a participant's employment plan is developed, the 84.4 participant shall be considered in compliance with the 84.5 participation requirements in this section if the participant 84.6 continues to meet the criteria for an exemption under section 84.7 256J.56 as in effect on June 30, 2004, and is cooperating in the 84.8 development of the new plan. 84.9 Subd. 2. [PARTICIPATION REQUIREMENTS.] (a) All MFIP 84.10 caregivers, except caregivers who meet the criteria in 84.11 subdivision 3, must participate in employment services. Except 84.12 as specified in paragraphs (b) to (d), the employment plan must 84.13 meet the requirements of section 256J.521, subdivision 2, 84.14 contain allowable work activities, as defined in section 84.15 256J.49, subdivision 13, and, include at a minimum, the number 84.16 of participation hours required under section 256J.55, 84.17 subdivision 1. 84.18 (b) Minor caregivers and caregivers who are less than age 84.19 20 who have not completed high school or obtained a GED are 84.20 required to comply with section 256J.54. 84.21 (c) A participant who has a family violence waiver shall 84.22 develop and comply with an employment plan under section 84.23 256J.521, subdivision 3. 84.24 (d) As specified in section 256J.521, subdivision 2, 84.25 paragraph (c), a participant who meets any one of the following 84.26 criteria may work with the job counselor to develop an 84.27 employment plan that contains less than the number of 84.28 participation hours under section 256J.55, subdivision 1. 84.29 Employment plans for participants covered under this paragraph 84.30 must be tailored to recognize the special circumstances of 84.31 caregivers and families including limitations due to illness or 84.32 disability and caregiving needs: 84.33 (1) a participant who is age 60 or older; 84.34 (2) a participant who has been diagnosed by a qualified 84.35 professional as suffering from an illness or incapacity that is 84.36 expected to last for 30 days or more, including a pregnant 85.1 participant who is determined to be unable to obtain or retain 85.2 employment due to the pregnancy; or 85.3 (3) a participant who is determined by a qualified 85.4 professional as being needed in the home to care for an ill or 85.5 incapacitated family member, including caregivers with a child 85.6 or an adult in the household who meets the disability or medical 85.7 criteria for home care services under section 256B.0627, 85.8 subdivision 1, paragraph (f), or a home and community-based 85.9 waiver services program under chapter 256B, or meets the 85.10 criteria for severe emotional disturbance under section 85.11 245.4871, subdivision 6, or for serious and persistent mental 85.12 illness under section 245.462, subdivision 20, paragraph (c). 85.13 (e) For participants covered under paragraphs (c) and (d), 85.14 the county shall review the participant's employment services 85.15 status every three months to determine whether conditions have 85.16 changed. When it is determined that the participant's status is 85.17 no longer covered under paragraph (c) or (d), the county shall 85.18 notify the participant that a new or revised employment plan is 85.19 needed. The participant and job counselor shall meet within ten 85.20 days of the determination to revise the employment plan. 85.21 Subd. 3. [CHILD UNDER 12 WEEKS OF AGE.] (a) A participant 85.22 who has a natural born child who is less than 12 weeks of age 85.23 who meets the criteria in clauses (1) and (2) is not required to 85.24 participate in employment services until the child reaches 12 85.25 weeks of age. To be eligible for this provision, the following 85.26 conditions must be met: 85.27 (1) the child must have been born within ten months of the 85.28 caregiver's application for the diversionary work program or 85.29 MFIP; and 85.30 (2) the assistance unit must not have already used this 85.31 provision or the previously allowed child under age one 85.32 exemption. However, an assistance unit that has an approved 85.33 child under age one exemption at the time this provision becomes 85.34 effective may continue to use that exemption until the child 85.35 reaches one year of age. 85.36 (b) The provision in paragraph (a) ends the first full 86.1 month after the child reaches 12 weeks of age. This provision 86.2 is available only once in a caregiver's lifetime. In a 86.3 two-parent household, only one parent shall be allowed to use 86.4 this provision. The participant and job counselor must meet 86.5 within ten days after the child reaches 12 weeks of age to 86.6 revise the participant's employment plan. 86.7 [EFFECTIVE DATE.] This section is effective July 1, 2004. 86.8 Sec. 93. Minnesota Statutes 2002, section 256J.57, is 86.9 amended to read: 86.10 256J.57 [GOOD CAUSE; FAILURE TO COMPLY; NOTICE; 86.11 CONCILIATION CONFERENCE.] 86.12 Subdivision 1. [GOOD CAUSE FOR FAILURE TO COMPLY.] The 86.13 county agency shall not impose the sanction under section 86.14 256J.46 if it determines that the participant has good cause for 86.15 failing to comply with the requirements of sections256J.5286.16 256J.515 to256J.55256J.57. Good cause exists when: 86.17 (1) appropriate child care is not available; 86.18 (2) the job does not meet the definition of suitable 86.19 employment; 86.20 (3) the participant is ill or injured; 86.21 (4) a member of the assistance unit, a relative in the 86.22 household, or a foster child in the household is ill and needs 86.23 care by the participant that prevents the participant from 86.24 complying with thejob search support plan oremployment plan; 86.25 (5) the parental caregiver is unable to secure necessary 86.26 transportation; 86.27 (6) the parental caregiver is in an emergency situation 86.28 that prevents compliance with thejob search support plan or86.29 employment plan; 86.30 (7) the schedule of compliance with thejob search support86.31plan oremployment plan conflicts with judicial proceedings; 86.32 (8) a mandatory MFIP meeting is scheduled during a time 86.33 that conflicts with a judicial proceeding or a meeting related 86.34 to a juvenile court matter, or a participant's work schedule; 86.35 (9) the parental caregiver is already participating in 86.36 acceptable work activities; 87.1 (10) the employment plan requires an educational program 87.2 for a caregiver under age 20, but the educational program is not 87.3 available; 87.4 (11) activities identified in thejob search support plan87.5oremployment plan are not available; 87.6 (12) the parental caregiver is willing to accept suitable 87.7 employment, but suitable employment is not available; or 87.8 (13) the parental caregiver documents other verifiable 87.9 impediments to compliance with thejob search support plan or87.10 employment plan beyond the parental caregiver's control. 87.11 The job counselor shall work with the participant to 87.12 reschedule mandatory meetings for individuals who fall under 87.13 clauses (1), (3), (4), (5), (6), (7), and (8). 87.14 Subd. 2. [NOTICE OF INTENT TO SANCTION.] (a) When a 87.15 participant fails without good cause to comply with the 87.16 requirements of sections256J.52256J.515 to256J.55256J.57, 87.17 the job counselor or the county agency must provide a notice of 87.18 intent to sanction to the participant specifying the program 87.19 requirements that were not complied with, informing the 87.20 participant that the county agency will impose the sanctions 87.21 specified in section 256J.46, and informing the participant of 87.22 the opportunity to request a conciliation conference as 87.23 specified in paragraph (b). The notice must also state that the 87.24 participant's continuing noncompliance with the specified 87.25 requirements will result in additional sanctions under section 87.26 256J.46, without the need for additional notices or conciliation 87.27 conferences under this subdivision. The notice, written in 87.28 English, must include the department of human services language 87.29 block, and must be sent to every applicable participant. If the 87.30 participant does not request a conciliation conference within 87.31 ten calendar days of the mailing of the notice of intent to 87.32 sanction, the job counselor must notify the county agency that 87.33 the assistance payment should be reduced. The countymust then87.34send a notice of adverse action to the participant informing the87.35participant of the sanction that will be imposed, the reasons87.36for the sanction, the effective date of the sanction, and the88.1participant's right to have a fair hearing under section 256J.40.88.2 shall combine the information required in this notice with the 88.3 information required in a notice of adverse action under section 88.4 256J.31, subdivision 4. 88.5 (b) The participant may request a conciliation conference 88.6 by sending a written request, by making a telephone request, or 88.7 by making an in-person request. The request must be received 88.8 within ten calendar days of the date the county agency mailed 88.9 the ten-day notice of intent to sanction. If a timely request 88.10 for a conciliation is received, the county agency's service 88.11 provider must conduct the conference within five days of the 88.12 request. The job counselor's supervisor, or a designee of the 88.13 supervisor, must review the outcome of the conciliation 88.14 conference. If the conciliation conference resolves the 88.15 noncompliance, the job counselor must promptly inform the county 88.16 agency and request withdrawal of the sanction notice. 88.17 (c) Upon receiving a sanction notice, the participant may 88.18 request a fair hearing under section 256J.40, without exercising 88.19 the option of a conciliation conference. In such cases, the 88.20 county agency shall not require the participant to engage in a 88.21 conciliation conference prior to the fair hearing. 88.22 (d) If the participant requests a fair hearing or a 88.23 conciliation conference, sanctions will not be imposed until 88.24 there is a determination of noncompliance. Sanctions must be 88.25 imposed as provided in section 256J.46. 88.26 Sec. 94. Minnesota Statutes 2002, section 256J.62, 88.27 subdivision 9, is amended to read: 88.28 Subd. 9. [CONTINUATION OF CERTAIN SERVICES.] Only if 88.29 services were approved as part of an employment plan prior to 88.30 June 30, 2003, at the request of the participant, the county may 88.31 continue to provide case management, counseling, or other 88.32 support services to a participant: 88.33(a)(1) who has achieved the employment goal; or 88.34(b)(2) who under section 256J.42 is no longer eligible to 88.35 receive MFIP but whose income is below 115 percent of the 88.36 federal poverty guidelines for a family of the same size. 89.1 These services may be provided for up to 12 months 89.2 following termination of the participant's eligibility for MFIP. 89.3 Sec. 95. [256J.626] [MFIP CONSOLIDATED FUND.] 89.4 Subdivision 1. [CONSOLIDATED FUND.] The consolidated fund 89.5 is established to support counties and tribes in meeting their 89.6 duties under this chapter. Counties and tribes must use funds 89.7 from the consolidated fund to develop programs and services that 89.8 are designed to improve participant outcomes as measured in 89.9 section 256J.751, subdivision 2. Counties may use the funds for 89.10 any allowable expenditures under subdivision 2. Tribes may use 89.11 the funds for any allowable expenditures under subdivision 2, 89.12 except those in clauses (1) and (6). 89.13 Subd. 2. [ALLOWABLE EXPENDITURES.] (a) The commissioner 89.14 must restrict expenditures under the consolidated fund to 89.15 benefits and services allowed under title IV-A of the federal 89.16 Social Security Act. Allowable expenditures under the 89.17 consolidated fund may include, but are not limited to: 89.18 (1) short-term, nonrecurring shelter and utility needs that 89.19 are excluded from the definition of assistance under Code of 89.20 Federal Regulations, title 45, section 260.31, for families who 89.21 meet the residency requirement in section 256J.12, subdivisions 89.22 1 and 1a. Payments under this subdivision are not considered 89.23 TANF cash assistance and are not counted towards the 60-month 89.24 time limit; 89.25 (2) transportation needed to obtain or retain employment or 89.26 to participate in other approved work activities; 89.27 (3) direct and administrative costs of staff to deliver 89.28 employment services for MFIP or the diversionary work program, 89.29 to administer financial assistance, and to provide specialized 89.30 services intended to assist hard-to-employ participants to 89.31 transition to work; 89.32 (4) costs of education and training including functional 89.33 work literacy and English as a second language; 89.34 (5) cost of work supports including tools, clothing, boots, 89.35 and other work-related expenses; 89.36 (6) county administrative expenses as defined in Code of 90.1 Federal Regulations, title 45, section 260(b); 90.2 (7) services to parenting and pregnant teens; 90.3 (8) supported work; 90.4 (9) wage subsidies; 90.5 (10) child care needed for MFIP or diversionary work 90.6 program participants to participate in social services; 90.7 (11) child care to ensure that families leaving MFIP or 90.8 diversionary work program will continue to receive child care 90.9 assistance from the time the family no longer qualifies for 90.10 transition year child care until an opening occurs under the 90.11 basic sliding fee child care program; and 90.12 (12) services to help noncustodial parents who live in 90.13 Minnesota and have minor children receiving MFIP or DWP 90.14 assistance, but do not live in the same household as the child, 90.15 obtain or retain employment. 90.16 (b) Administrative costs that are not matched with county 90.17 funds as provided in subdivision 8 may not exceed 7.5 percent of 90.18 a county's or 15 percent of a tribe's reimbursement under this 90.19 section. The commissioner shall define administrative costs for 90.20 purposes of this subdivision. 90.21 Subd. 3. [ELIGIBILITY FOR SERVICES.] Families with a minor 90.22 child, a pregnant woman, or a noncustodial parent of a minor 90.23 child receiving assistance, with incomes below 200 percent of 90.24 the federal poverty guideline for a family of the applicable 90.25 size, are eligible for services funded under the consolidated 90.26 fund. Counties and tribes must give priority to families 90.27 currently receiving MFIP or diversionary work program, and 90.28 families at risk of receiving MFIP or diversionary work program. 90.29 Subd. 4. [COUNTY AND TRIBAL BIENNIAL SERVICE 90.30 AGREEMENTS.] (a) Effective January 1, 2004, and each two-year 90.31 period thereafter, each county and tribe must have in place an 90.32 approved biennial service agreement related to the services and 90.33 programs in this chapter. Counties may collaborate to develop 90.34 multicounty, multitribal, or regional service agreements. 90.35 (b) The service agreements will be completed in a form 90.36 prescribed by the commissioner. The agreement must include: 91.1 (1) a statement of the needs of the service population and 91.2 strengths and resources in the community; 91.3 (2) numerical goals for participant outcomes measures to be 91.4 accomplished during the biennial period. The commissioner may 91.5 identify outcomes from section 256J.751, subdivision 2, as core 91.6 outcomes for all counties and tribes; 91.7 (3) strategies the county or tribe will pursue to achieve 91.8 the outcome targets. Strategies must include specification of 91.9 how funds under this section will be used and may include 91.10 community partnerships that will be established or strengthened; 91.11 and 91.12 (4) other items prescribed by the commissioner in 91.13 consultation with counties and tribes. 91.14 (c) The commissioner shall provide each county and tribe 91.15 with information needed to complete an agreement, including: 91.16 (1) information on MFIP cases in the county or tribe; (2) 91.17 comparisons with the rest of the state; (3) baseline performance 91.18 on outcome measures; and (4) promising program practices. 91.19 (d) The service agreement must be submitted to the 91.20 commissioner by October 15, 2003, and October 15 of each second 91.21 year thereafter. The county or tribe must allow a period of not 91.22 less than 30 days prior to the submission of the agreement to 91.23 solicit comments from the public on the contents of the 91.24 agreement. 91.25 (e) The commissioner must, within 60 days of receiving each 91.26 county or tribal service agreement, inform the county or tribe 91.27 if the service agreement is approved. If the service agreement 91.28 is not approved, the commissioner must inform the county or 91.29 tribe of any revisions needed prior to approval. 91.30 (f) The service agreement in this subdivision supersedes 91.31 the plan requirements of section 268.88. 91.32 Subd. 5. [INNOVATION PROJECTS.] Beginning January 1, 2005, 91.33 no more than $3,000,000 of the funds annually appropriated to 91.34 the commissioner for use in the consolidated fund shall be 91.35 available to the commissioner for projects testing innovative 91.36 approaches to improving outcomes for MFIP participants, and 92.1 persons at risk of receiving MFIP as detailed in subdivision 3. 92.2 Projects shall be targeted to geographic areas with poor 92.3 outcomes as specified in section 256J.751, subdivision 5, or to 92.4 subgroups within the MFIP case load who are experiencing poor 92.5 outcomes. 92.6 Subd. 6. [BASE ALLOCATION TO COUNTIES AND TRIBES.] (a) For 92.7 purposes of this section, the following terms have the meanings 92.8 given them: 92.9 (1) "2002 historic spending base" means the commissioner's 92.10 determination of the sum of the reimbursement related to fiscal 92.11 year 2002 of county or tribal agency expenditures for the base 92.12 programs listed in clause (4), items (i) to (iv), and earnings 92.13 related to calendar year 2002 in the base program listed in 92.14 clause (4), item (v), and the amount of spending in fiscal year 92.15 2002 in the base program listed in clause (4), item (vi), issued 92.16 to or on behalf of persons residing in the county or tribal 92.17 service delivery area. 92.18 (2) "Initial allocation" means the amount potentially 92.19 available to each county or tribe based on the formula in 92.20 paragraphs (b) to (d). 92.21 (3) "Final allocation" means the amount available to each 92.22 county or tribe based on the formula in paragraphs (b) to (d), 92.23 after adjustment by subdivision 7. 92.24 (4) "Base programs" means the: 92.25 (i) MFIP employment and training services under section 92.26 256J.62, subdivision 1, in effect June 30, 2002; 92.27 (ii) bilingual employment and training services to refugees 92.28 under section 256J.62, subdivision 6, in effect June 30, 2002; 92.29 (iii) work literacy language programs under section 92.30 256J.62, subdivision 7, in effect June 30, 2002; 92.31 (iv) supported work program authorized in Laws 2001, First 92.32 Special Session chapter 9, article 17, section 2, in effect June 92.33 30, 2002; 92.34 (v) administrative aid program under section 256J.76 in 92.35 effect December 31, 2002; and 92.36 (vi) emergency assistance program under section 256J.48 in 93.1 effect June 30, 2002. 93.2 (b)(1) Beginning July 1, 2003, the commissioner shall 93.3 determine the initial allocation of funds available under this 93.4 section according to clause (2). 93.5 (2)(i) Ninety percent of the funds available for the period 93.6 beginning July 1, 2003, and ending December 31, 2004, shall be 93.7 allocated to each county or tribe in proportion to the county's 93.8 or tribe's share of the statewide 2002 historic spending base; 93.9 (ii) the remaining funds for the period beginning July 1, 93.10 2003, and ending December 31, 2004, shall be allocated to each 93.11 county or tribe in proportion to the average number of MFIP 93.12 cases: 93.13 (A) the average number of cases must be based upon counts 93.14 of MFIP or tribal TANF cases as of March 31, June 30, September 93.15 30, and December 31 using the most recent available data, less 93.16 the number of child only cases. Two-parent cases, with the 93.17 exception of those with a caregiver age 60 or over, will be 93.18 multiplied by a factor of two; 93.19 (B) the MFIP or tribal TANF case count for each eligible 93.20 tribal provider shall be based upon the number of MFIP or tribal 93.21 TANF cases with participating adults who are enrolled in, or are 93.22 eligible for enrollment in, the tribe; and to be counted, the 93.23 case must be an active MFIP case, and the case members must 93.24 reside within the tribal program's service delivery area; 93.25 (C) the MFIP or tribal TANF case count for each eligible 93.26 tribal provider shall be further adjusted by multiplying the 93.27 count by the proportion of base program spending in paragraph 93.28 (a), clause (4), item (i), compared to paragraph (a), clause 93.29 (4), items (i) to (vi); and 93.30 (D) to prevent duplicate counts, MFIP or tribal TANF cases 93.31 counted for determining allocations to tribal providers in 93.32 clause (C) shall be removed from the case counts of the 93.33 respective counties where they reside. 93.34 (c)(1) Beginning January 1, 2005, the commissioner shall 93.35 determine the initial allocation of funds to be made available 93.36 under this section according to clause (2). 94.1 (2)(i) Seventy percent of the funds available for the 94.2 calendar year shall be allocated to each county or tribe in 94.3 proportion to the county's or tribe's share of the statewide 94.4 2002 historic spending base; 94.5 (ii) the remaining funds shall be allocated to each county 94.6 or tribe in proportion to the sum of the average number of MFIP 94.7 cases and the average monthly count of diversionary work program 94.8 cases. The commissioner shall determine the count of MFIP and 94.9 diversionary work program cases according to subitems (A) to (C): 94.10 (A) the average number of cases must be based upon counts 94.11 of MFIP, tribal TANF, or diversionary work program cases as of 94.12 March 31, June 30, September 30, and December 31 using the most 94.13 recent available data, less the number of child only cases. 94.14 Two-parent cases, with the exception of those with a caregiver 94.15 age 60 or over, will be multiplied by a factor of two; 94.16 (B) the case count for each eligible tribal provider shall 94.17 be based upon the number of MFIP, tribal TANF, or diversionary 94.18 work program cases with participating adults who are enrolled 94.19 in, or are eligible for enrollment in, the tribe; and to be 94.20 counted, the case must be an active MFIP or diversionary work 94.21 program case, and the case members must reside within the tribal 94.22 program's service delivery area; 94.23 (C) the MFIP or tribal TANF case count, including 94.24 diversionary work program cases, for each eligible tribal 94.25 provider shall be further adjusted by multiplying the count by 94.26 the proportion of base program spending in paragraph (a), clause 94.27 (4), item (i), compared to paragraph (a), clause (4), items (i) 94.28 to (vi); and 94.29 (D) to prevent duplicate counts, MFIP, tribal TANF, or 94.30 diversionary work program cases counted for determining 94.31 allocations to tribal providers under clause (C) shall be 94.32 removed from the case counts of the respective counties where 94.33 they reside. 94.34 (d)(1) Beginning January 1, 2006, and effective January 1 94.35 of each subsequent year, the commissioner shall determine the 94.36 initial allocation of funds available under this section 95.1 according to clause (2). 95.2 (2)(i) Fifty percent of the funds available for the 95.3 calendar year shall be allocated to each county or tribe in 95.4 proportion to the county's or tribe's share of the statewide 95.5 2002 historic spending base; 95.6 (ii) the remaining funds shall be allocated to each county 95.7 or tribe in proportion to the sum of the average number of MFIP 95.8 cases and the average monthly count of diversionary work program 95.9 cases. The commissioner shall determine the count of MFIP and 95.10 diversionary work program cases according to subitems (A) to (C): 95.11 (A) the average number of cases must be based upon counts 95.12 of MFIP, tribal TANF, or diversionary work program cases as of 95.13 March 31, June 30, September 30, and December 31 using the most 95.14 recent available data, less the number of child only cases. 95.15 Two-parent cases, with the exception of those with a caregiver 95.16 age 60 or over, will be multiplied by a factor of two; 95.17 (B) the case count for each eligible tribal provider shall 95.18 be based upon the number of MFIP, tribal TANF, or diversionary 95.19 work program cases with participating adults who are enrolled 95.20 in, or are eligible for, enrollment in the tribe; and to be 95.21 counted, the case must be an active MFIP or diversionary work 95.22 program case, and the case members must reside within the tribal 95.23 program's service delivery area; 95.24 (C) the MFIP or tribal TANF case count, including 95.25 diversionary work program cases, for each eligible tribal 95.26 provider shall be further adjusted by multiplying the count by 95.27 the proportion of base program spending in paragraph (a), clause 95.28 (4), item (i), compared to paragraph (a), clause (4), items (i) 95.29 to (vi); and 95.30 (D) to prevent duplicate counts, MFIP, tribal TANF, or 95.31 diversionary work program cases counted for determining 95.32 allocations to tribal providers in clause (C) shall be removed 95.33 from the case counts of the respective counties where they 95.34 reside. 95.35 (e) Before November 30, 2003, a county or tribe may ask for 95.36 a review of the commissioner's determination of the historic 96.1 base spending when the county or tribe believes the 2002 96.2 information was inaccurate or incomplete. By January 1, 2004, 96.3 the commissioner must adjust that county's or tribe's base when 96.4 the commissioner has determined that inaccurate or incomplete 96.5 information was used to develop that base. The commissioner 96.6 shall adjust each county's or tribe's initial allocation under 96.7 paragraph (c) and final allocation under subdivision 7 to 96.8 reflect the base change. 96.9 (f) Effective January 1, 2005, and effective January 1 of 96.10 each succeeding year, counties and tribes will have their final 96.11 allocations adjusted based on the performance provisions of 96.12 subdivision 7. 96.13 Subd. 7. [PERFORMANCE BASE FUNDS.] (a) Beginning with 96.14 allocations for calendar year 2005, each county and tribe will 96.15 be allocated 95 percent of their initial allocation. Counties 96.16 and tribes will be allocated additional funds based on 96.17 performance as follows: 96.18 (1) a county or tribe that achieves a 50 percent rate or 96.19 higher on the MFIP participation rate under section 256J.751, 96.20 subdivision 2, clause (8), as averaged across the four quarterly 96.21 measurements for the most recent year for which the measurements 96.22 are available, will receive an additional allocation equal to 96.23 2.5 percent of its initial allocation; and 96.24 (2) a county or tribe that performs above the top of its 96.25 range of expected performance on the three-year self-support 96.26 index under section 256J.751, subdivision 2, clause (7), in both 96.27 measurements in the preceding year will receive an additional 96.28 allocation equal to five percent of its initial allocation; or 96.29 (3) a county or tribe that performs within its range of 96.30 expected performance on the three-year self-support index under 96.31 section 256J.751, subdivision 2, clause (7), in both 96.32 measurements in the preceding year, or above the top of its 96.33 range of expected performance in one measurement and within its 96.34 expected range of performance in the other measurement, will 96.35 receive an additional allocation equal to 2.5 percent of its 96.36 initial allocation. 97.1 (b) Funds remaining unallocated after the performance-based 97.2 allocations in paragraph (a) are available to the commissioner 97.3 for innovation projects under subdivision 5. 97.4 (c)(1) If available funds are insufficient to meet county 97.5 and tribal allocations under paragraph (a), the commissioner may 97.6 make available for allocation funds that are unobligated and 97.7 available from the innovation projects through the end of the 97.8 current biennium. 97.9 (2) If after the application of clause (1) funds remain 97.10 insufficient to meet county and tribal allocations under 97.11 paragraph (a), the commissioner must proportionally reduce the 97.12 allocation of each county and tribe with respect to their 97.13 maximum allocation available under paragraph (a). 97.14 Subd. 8. [REPORTING REQUIREMENT AND REIMBURSEMENT.] (a) 97.15 The commissioner shall specify requirements for reporting 97.16 according to section 256.01, subdivision 2, clause (17). Each 97.17 county or tribe shall be reimbursed for eligible expenditures up 97.18 to the limit of its allocation and subject to availability of 97.19 funds. 97.20 (b) Reimbursements for county administrative-related 97.21 expenditures determined through the income maintenance random 97.22 moment time study shall be reimbursed at a rate of 50 percent of 97.23 eligible expenditures. 97.24 (c) The commissioner of human services shall review county 97.25 and tribal agency expenditures of the MFIP consolidated fund as 97.26 appropriate and may reallocate unencumbered or unexpended money 97.27 appropriated under this section to those county and tribal 97.28 agencies that can demonstrate a need for additional money. 97.29 Subd. 9. [REPORT.] The commissioner shall, in consultation 97.30 with counties and tribes: 97.31 (1) determine how performance-based allocations under 97.32 subdivision 7, paragraph (a), clauses (2) and (3), will be 97.33 allocated to groupings of counties and tribes when groupings are 97.34 used to measure expected performance ranges for the self-support 97.35 index under section 256J.751, subdivision 2, clause (7); and 97.36 (2) determine how performance-based allocations under 98.1 subdivision 7, paragraph (a), clauses (2) and (3), will be 98.2 allocated to tribes. 98.3 The commissioner shall report to the legislature on the formulas 98.4 developed in clauses (1) and (2) by January 1, 2004. 98.5 Sec. 96. Minnesota Statutes 2002, section 256J.645, 98.6 subdivision 3, is amended to read: 98.7 Subd. 3. [FUNDING.] If the commissioner and an Indian 98.8 tribe are parties to an agreement under this subdivision, the 98.9 agreement shall annually provide to the Indian tribe the funding 98.10 allocated in section256J.62, subdivisions 1 and 2a256J.626. 98.11 Sec. 97. Minnesota Statutes 2002, section 256J.66, 98.12 subdivision 2, is amended to read: 98.13 Subd. 2. [TRAINING AND PLACEMENT.] (a) County agencies 98.14 shall limit the length of training based on the complexity of 98.15 the job and the caregiver's previous experience and training. 98.16 Placement in an on-the-job training position with an employer is 98.17 for the purpose of training and employment with the same 98.18 employer who has agreed to retain the person upon satisfactory 98.19 completion of training. 98.20 (b) Placement of any participant in an on-the-job training 98.21 position must be compatible with the participant's assessment 98.22 and employment plan under section256J.52256J.521. 98.23 Sec. 98. Minnesota Statutes 2002, section 256J.67, 98.24 subdivision 1, is amended to read: 98.25 Subdivision 1. [ESTABLISHING THE COMMUNITY WORK EXPERIENCE 98.26 PROGRAM.] To the extent of available resources, each county 98.27 agency may establish and operate a work experience component for 98.28 MFIP caregivers who are participating in employment and training 98.29 services. This option for county agencies supersedes the 98.30 requirement in section 402(a)(1)(B)(iv) of the Social Security 98.31 Act that caregivers who have received assistance for two months 98.32 and who are not exempt from work requirements must participate 98.33 in a work experience program. The purpose of the work 98.34 experience component is to enhance the caregiver's employability 98.35 and self-sufficiency and to provide meaningful, productive work 98.36 activities. The county shall use this program for an individual 99.1 after exhausting all other unsubsidized employment 99.2 opportunities.The county agency shall not require a caregiver99.3to participate in the community work experience program unless99.4the caregiver has been given an opportunity to participate in99.5other work activities.99.6 Sec. 99. Minnesota Statutes 2002, section 256J.67, 99.7 subdivision 3, is amended to read: 99.8 Subd. 3. [EMPLOYMENT OPTIONS.] (a) Work sites developed 99.9 under this section are limited to projects that serve a useful 99.10 public service such as: health, social service, environmental 99.11 protection, education, urban and rural development and 99.12 redevelopment, welfare, recreation, public facilities, public 99.13 safety, community service, services to aged or disabled 99.14 citizens, and child care. To the extent possible, the prior 99.15 training, skills, and experience of a caregiver must be 99.16 considered in making appropriate work experience assignments. 99.17 (b) Structured, supervised volunteer work with an agency or 99.18 organization, which is monitored by the county service provider, 99.19 may, with the approval of the county agency, be used as a work 99.20 experience placement. 99.21 (c) As a condition of placing a caregiver in a program 99.22 under this section, the county agency shall first provide the 99.23 caregiver the opportunity:99.24(1)for placement in suitablesubsidized orunsubsidized 99.25 employment through participation in a job search; or99.26(2) for placement in suitable employment through99.27participation in on-the-job training, if such employment is99.28available. 99.29 Sec. 100. Minnesota Statutes 2002, section 256J.69, 99.30 subdivision 2, is amended to read: 99.31 Subd. 2. [TRAINING AND PLACEMENT.] (a) County agencies 99.32 shall limit the length of training to nine months. Placement in 99.33 a grant diversion training position with an employer is for the 99.34 purpose of training and employment with the same employer who 99.35 has agreed to retain the person upon satisfactory completion of 99.36 training. 100.1 (b) Placement of any participant in a grant diversion 100.2 subsidized training position must be compatible with the 100.3 assessment and employment plan or employability development plan 100.4 established for the recipient under section256J.52 or 256K.03,100.5subdivision 8256J.521. 100.6 Sec. 101. Minnesota Statutes 2002, section 256J.75, 100.7 subdivision 3, is amended to read: 100.8 Subd. 3. [RESPONSIBILITY FOR INCORRECT ASSISTANCE 100.9 PAYMENTS.] A county of residence, when different from the county 100.10 of financial responsibility, will be charged by the commissioner 100.11 for the value of incorrect assistance paymentsand medical100.12assistancepaid to or on behalf of a person who was not eligible 100.13 to receive that amount. Incorrect payments include payments to 100.14 an ineligible person or family resulting from decisions, 100.15 failures to act, miscalculations, or overdue recertification. 100.16 However, financial responsibility does not accrue for a county 100.17 when the recertification is overdue at the time the referral is 100.18 received by the county of residence or when the county of 100.19 financial responsibility does not act on the recommendation of 100.20 the county of residence.When federal or state law requires100.21that medical assistance continue after assistance ends, this100.22subdivision also governs financial responsibility for the100.23extended medical assistance.100.24 Sec. 102. Minnesota Statutes 2002, section 256J.751, 100.25 subdivision 1, is amended to read: 100.26 Subdivision 1. [QUARTERLYMONTHLY COUNTY CASELOAD REPORT.] 100.27 The commissioner shall reportquarterlymonthly to each county 100.28onthecounty's performance on the following measuresfollowing 100.29 caseload information: 100.30(1) number of cases receiving only the food portion of100.31assistance;100.32(2) number of child-only cases;100.33(3) number of minor caregivers;100.34(4) number of cases that are exempt from the 60-month time100.35limit by the exemption category under section 256J.42;100.36(5) number of participants who are exempt from employment101.1and training services requirements by the exemption category101.2under section 256J.56;101.3(6) number of assistance units receiving assistance under a101.4hardship extension under section 256J.425;101.5(7) number of participants and number of months spent in101.6each level of sanction under section 256J.46, subdivision 1;101.7(8) number of MFIP cases that have left assistance;101.8(9) federal participation requirements as specified in101.9title 1 of Public Law Number 104-193;101.10(10) median placement wage rate; and101.11(11) of each county's total MFIP caseload less the number101.12of cases in clauses (1) to (6):101.13(i) number of one-parent cases;101.14(ii) number of two-parent cases;101.15(iii) percent of one-parent cases that are working more101.16than 20 hours per week;101.17(iv) percent of two-parent cases that are working more than101.1820 hours per week; and101.19(v) percent of cases that have received more than 36 months101.20of assistance.101.21 (1) total number of cases receiving MFIP, and subtotals of 101.22 cases with one eligible parent, two eligible parents, and an 101.23 eligible caregiver who is not a parent; 101.24 (2) total number of child only assistance cases; 101.25 (3) total number of eligible adults and children receiving 101.26 an MFIP grant, and subtotals for cases with one eligible parent, 101.27 two eligible parents, an eligible caregiver who is not a parent, 101.28 and child only cases; 101.29 (4) number of cases with an exemption from the 60-month 101.30 time limit based on a family violence waiver; 101.31 (5) number of MFIP cases with work hours, and subtotals for 101.32 cases with one eligible parent, two eligible parents, and an 101.33 eligible caregiver who is not a parent; 101.34 (6) number of employed MFIP cases, and subtotals for cases 101.35 with one eligible parent, two eligible parents, and an eligible 101.36 caregiver who is not a parent; 102.1 (7) average monthly gross earnings, and averages for 102.2 subgroups of cases with one eligible parent, two eligible 102.3 parents, and an eligible caregiver who is not a parent; 102.4 (8) number of employed cases receiving only the food 102.5 portion of assistance; 102.6 (9) number of parents or caregivers exempt from work 102.7 activity requirements, with subtotals for each exemption type; 102.8 and 102.9 (10) number of cases with a sanction, with subtotals by 102.10 level of sanction for cases with one eligible parent, two 102.11 eligible parents, and an eligible caregiver who is not a parent. 102.12 Sec. 103. Minnesota Statutes 2002, section 256J.751, 102.13 subdivision 2, is amended to read: 102.14 Subd. 2. [QUARTERLY COMPARISON REPORT.] The commissioner 102.15 shall report quarterly to all counties on each county's 102.16 performance on the following measures: 102.17 (1) percent of MFIP caseload working in paid employment; 102.18 (2) percent of MFIP caseload receiving only the food 102.19 portion of assistance; 102.20 (3) number of MFIP cases that have left assistance; 102.21 (4) federal participation requirements as specified in 102.22 Title 1 of Public LawNumber104-193; 102.23 (5) median placement wage rate;and102.24 (6) caseload by months of TANF assistance; 102.25 (7) percent of MFIP cases off cash assistance or working 30 102.26 or more hours per week at one-year, two-year, and three-year 102.27 follow-up points from a base line quarter. This measure is 102.28 called the self-support index. Twice annually, the commissioner 102.29 shall report an expected range of performance for each county, 102.30 county grouping, and tribe on the self-support index. The 102.31 expected range shall be derived by a statistical methodology 102.32 developed by the commissioner in consultation with the counties 102.33 and tribes. The statistical methodology shall control 102.34 differences across counties in economic conditions and 102.35 demographics of the MFIP case load; and 102.36 (8) the MFIP work participation rate, defined as the 103.1 participation requirements specified in title 1 of Public Law 103.2 104-193 applied to all MFIP cases except child only cases and 103.3 cases exempt under section 256J.56. 103.4 Sec. 104. Minnesota Statutes 2002, section 256J.751, 103.5 subdivision 5, is amended to read: 103.6 Subd. 5. [FAILURE TO MEET FEDERAL PERFORMANCE STANDARDS.] 103.7 (a) If sanctions occur for failure to meet the performance 103.8 standards specified in title 1 of Public LawNumber104-193 of 103.9 the Personal Responsibility and Work Opportunity Act of 1996, 103.10 the state shall pay 88 percent of the sanction. The remaining 103.11 12 percent of the sanction will be paid by the counties. The 103.12 county portion of the sanction will be distributed across all 103.13 counties in proportion to each county's percentage of the MFIP 103.14 average monthly caseload during the period for which the 103.15 sanction was applied. 103.16 (b) If a county fails to meet the performance standards 103.17 specified in title 1 of Public LawNumber104-193 of the 103.18 Personal Responsibility and Work Opportunity Act of 1996 for any 103.19 year, the commissioner shall work with counties to organize a 103.20 joint state-county technical assistance team to work with the 103.21 county. The commissioner shall coordinate any technical 103.22 assistance with other departments and agencies including the 103.23 departments of economic security and children, families, and 103.24 learning as necessary to achieve the purpose of this paragraph. 103.25 (c) For state performance measures, a low-performing county 103.26 is one that: 103.27 (1) performs below the bottom of their expected range for 103.28 the measure in subdivision 2, clause (7), in both measurements 103.29 during the year; or 103.30 (2) performs below 40 percent for the measure in 103.31 subdivision 2, clause (8), as averaged across the four quarterly 103.32 measurements for the year, or the ten counties with the lowest 103.33 rates if more than ten are below 40 percent. 103.34 (d) Low-performing counties under paragraph (c) must engage 103.35 in corrective action planning as defined by the commissioner. 103.36 The commissioner may coordinate technical assistance as 104.1 specified in paragraph (b) for low-performing counties under 104.2 paragraph (c). 104.3 Sec. 105. [256J.95] [DIVERSIONARY WORK PROGRAM.] 104.4 Subdivision 1. [ESTABLISHING A DIVERSIONARY WORK PROGRAM 104.5 (DWP).] (a) The Personal Responsibility and Work Opportunity 104.6 Reconciliation Act of 1996, Public Law 104-193, establishes 104.7 block grants to states for temporary assistance for needy 104.8 families (TANF). TANF provisions allow states to use TANF 104.9 dollars for nonrecurrent, short-term diversionary benefits. The 104.10 diversionary work program established on July 1, 2003, is 104.11 Minnesota's TANF program to provide short-term diversionary 104.12 benefits to eligible recipients of the diversionary work program. 104.13 (b) The goal of the diversionary work program is to provide 104.14 short-term, necessary services and supports to families which 104.15 will lead to unsubsidized employment, increase economic 104.16 stability, and reduce the risk of those families needing longer 104.17 term assistance, under the Minnesota family investment program 104.18 (MFIP). 104.19 (c) When a family unit meets the eligibility criteria in 104.20 this section, the family must receive a diversionary work 104.21 program grant and is not eligible for MFIP. 104.22 (d) A family unit is eligible for the diversionary work 104.23 program for a maximum of four months only once in a 12-month 104.24 period. The 12-month period begins at the date of application 104.25 or the date eligibility is met, whichever is later. During the 104.26 four-month period, family maintenance needs as defined in 104.27 subdivision 2, shall be vendor paid, up to the cash portion of 104.28 the MFIP standard of need for the same size household. To the 104.29 extent there is a balance available between the amount paid for 104.30 family maintenance needs and the cash portion of the 104.31 transitional standard, a personal needs allowance of up to $70 104.32 per DWP recipient in the family unit shall be issued. The 104.33 personal needs allowance payment plus the family maintenance 104.34 needs shall not exceed the cash portion of the MFIP standard of 104.35 need. Counties may provide supportive and other allowable 104.36 services funded by the MFIP consolidated fund under section 105.1 256J.626 to eligible participants during the four-month 105.2 diversionary period. 105.3 Subd. 2. [DEFINITIONS.] The terms used in this section 105.4 have the following meanings. 105.5 (a) "Diversionary Work Program (DWP)" means the program 105.6 established under this section. 105.7 (b) "Employment plan" means a plan developed by the job 105.8 counselor and the participant which identifies the participant's 105.9 most direct path to unsubsidized employment, lists the specific 105.10 steps that the caregiver will take on that path, and includes a 105.11 timetable for the completion of each step. For participants who 105.12 request and qualify for a family violence waiver in section 105.13 256J.521, subdivision 3, an employment plan must be developed by 105.14 the job counselor, the participant and a person trained in 105.15 domestic violence and follow the employment plan provisions in 105.16 section 256J.521, subdivision 3. Employment plans under this 105.17 section shall be written for a period of time not to exceed four 105.18 months. 105.19 (c) "Employment services" means programs, activities, and 105.20 services in this section that are designed to assist 105.21 participants in obtaining and retaining employment. 105.22 (d) "Family maintenance needs" means current housing costs 105.23 including rent, manufactured home lot rental costs, or monthly 105.24 principal, interest, insurance premiums, and property taxes due 105.25 for mortgages or contracts for deed, association fees required 105.26 for homeownership, utility costs for current month expenses of 105.27 gas and electric, garbage, water and sewer, and a flat rate of 105.28 $35 for telephone services. 105.29 (e) "Family unit" means a group of people applying for or 105.30 receiving DWP benefits together. For the purposes of 105.31 determining eligibility for this program, the unit includes the 105.32 relationships in section 256J.24, subdivisions 2 and 4. 105.33 (f) "Minnesota family investment program (MFIP)" means the 105.34 assistance program as defined in section 256J.08, subdivision 57. 105.35 (g) "Personal needs allowance" means an allowance of up to 105.36 $70 per month per DWP unit member to pay for expenses such as 106.1 household products and personal products. 106.2 (h) "Work activities" means allowable work activities as 106.3 defined in section 256J.49, subdivision 13. 106.4 Subd. 3. [ELIGIBILITY FOR DIVERSIONARY WORK PROGRAM.] (a) 106.5 Except for the categories of family units listed below, all 106.6 family units who apply for cash benefits and who meet MFIP 106.7 eligibility as required in sections 256J.11 to 256J.15 are 106.8 eligible and must participate in the diversionary work program. 106.9 Family units that are not eligible for the diversionary work 106.10 program include: 106.11 (1) child only cases; 106.12 (2) a single-parent family unit that includes a child under 106.13 12 weeks of age. A parent is eligible for this exception once 106.14 in a parent's lifetime and is not eligible if the parent has 106.15 already used the previously allowed child under age one 106.16 exemption from MFIP employment services; 106.17 (3) a minor parent without a high school diploma or its 106.18 equivalent; 106.19 (4) a caregiver 18 or 19 years of age without a high school 106.20 diploma or its equivalent who chooses to have an employment plan 106.21 with an education option; 106.22 (5) a caregiver age 60 or over; 106.23 (6) family units with a parent who received DWP benefits 106.24 within a 12-month period as defined in subdivision 1, paragraph 106.25 (d); and 106.26 (7) family units with a parent who received MFIP within the 106.27 past 12 months. 106.28 (b) A two-parent family must participate in DWP unless both 106.29 parents meet the criteria for an exception under paragraph (a), 106.30 clauses (1) through (5), or the family unit includes a parent 106.31 who meets the criteria in paragraph (a), clause (6) or (7). 106.32 Subd. 4. [COOPERATION WITH PROGRAM REQUIREMENTS.] (a) To 106.33 be eligible for DWP, an applicant must comply with the 106.34 requirements of paragraphs (b) to (d). 106.35 (b) Applicants and participants must cooperate with the 106.36 requirements of the child support enforcement program, but will 107.1 not be charged a fee under section 518.551, subdivision 7. 107.2 (c) The applicant must provide each member of the family 107.3 unit's social security number to the county agency. This 107.4 requirement is satisfied when each member of the family unit 107.5 cooperates with the procedures for verification of numbers, 107.6 issuance of duplicate cards, and issuance of new numbers which 107.7 have been established jointly between the Social Security 107.8 Administration and the commissioner. 107.9 (d) Before DWP benefits can be issued to a family unit, the 107.10 caregiver must, in conjunction with a job counselor, develop and 107.11 sign an employment plan. In two-parent family units, both 107.12 parents must develop and sign employment plans before benefits 107.13 can be issued. Food support and health care benefits are not 107.14 contingent on the requirement for a signed employment plan. 107.15 Subd. 5. [SUBMITTING APPLICATION FORM.] The eligibility 107.16 date for the diversionary work program begins with the date the 107.17 signed combined application form (CAF) is received by the county 107.18 agency or the date diversionary work program eligibility 107.19 criteria are met, whichever is later. The county agency must 107.20 inform the applicant that any delay in submitting the 107.21 application will reduce the benefits paid for the month of 107.22 application. The county agency must inform a person that an 107.23 application may be submitted before the person has an interview 107.24 appointment. Upon receipt of a signed application, the county 107.25 agency must stamp the date of receipt on the face of the 107.26 application. The applicant may withdraw the application at any 107.27 time prior to approval by giving written or oral notice to the 107.28 county agency. The county agency must follow the notice 107.29 requirements in section 256J.09, subdivision 3, when issuing a 107.30 notice confirming the withdrawal. 107.31 Subd. 6. [INITIAL SCREENING OF APPLICATIONS.] Upon receipt 107.32 of the application, the county agency must determine if the 107.33 applicant may be eligible for other benefits as required in 107.34 sections 256J.09, subdivision 3a, and 256J.28, subdivisions 1 107.35 and 5. The county must also follow the provisions in section 107.36 256J.09, subdivision 3b, clause (2). 108.1 Subd. 7. [PROGRAM AND PROCESSING STANDARDS.] (a) The 108.2 interview to determine financial eligibility for the 108.3 diversionary work program must be conducted within five working 108.4 days of the receipt of the cash application form. During the 108.5 intake interview the financial worker must discuss: 108.6 (1) the goals, requirements, and services of the 108.7 diversionary work program; 108.8 (2) the availability of child care assistance. If child 108.9 care is needed, the worker must obtain a completed application 108.10 for child care from the applicant before the interview is 108.11 terminated. The same day the application for child care is 108.12 received, the application must be forwarded to the appropriate 108.13 child care worker. For purposes of eligibility for child care 108.14 assistance under chapter 119B, DWP participants shall be 108.15 eligible for the same benefits as MFIP recipients; and 108.16 (3) if the applicant has not requested food support and 108.17 health care assistance on the application, the county agency 108.18 shall, during the interview process, talk with the applicant 108.19 about the availability of these benefits. 108.20 (b) The county shall follow section 256J.74, subdivision 2, 108.21 paragraph (b), clauses (1) and (2), when an applicant or a 108.22 recipient of DWP has a person who is a member of more than one 108.23 assistance unit in a given payment month. 108.24 (c) If within 30 days the county agency cannot determine 108.25 eligibility for the diversionary work program, the county must 108.26 deny the application and inform the applicant of the decision 108.27 according to the notice provisions in section 256J.31. A family 108.28 unit is eligible for a fair hearing under section 256J.40. 108.29 Subd. 8. [VERIFICATION REQUIREMENTS.] (a) A county agency 108.30 must only require verification of information necessary to 108.31 determine DWP eligibility and the amount of the payment. The 108.32 applicant or participant must document the information required 108.33 or authorize the county agency to verify the information. The 108.34 applicant or participant has the burden of providing documentary 108.35 evidence to verify eligibility. The county agency shall assist 108.36 the applicant or participant in obtaining required documents 109.1 when the applicant or participant is unable to do so. 109.2 (b) A county agency must not request information about an 109.3 applicant or participant that is not a matter of public record 109.4 from a source other than county agencies, the department of 109.5 human services, or the United States Department of Health and 109.6 Human Services without the person's prior written consent. An 109.7 applicant's signature on an application form constitutes consent 109.8 for contact with the sources specified on the application. A 109.9 county agency may use a single consent form to contact a group 109.10 of similar sources, but the sources to be contacted must be 109.11 identified by the county agency prior to requesting an 109.12 applicant's consent. 109.13 (c) Factors to be verified shall follow section 256J.32, 109.14 subdivision 4. Except for personal needs, family maintenance 109.15 needs must be verified before the expense can be allowed in the 109.16 calculation of the DWP grant. 109.17 Subd. 9. [PROPERTY AND INCOME LIMITATIONS.] The asset 109.18 limits and exclusions in section 256J.20, apply to applicants 109.19 and recipients of DWP. All payments, unless excluded in section 109.20 256J.21, must be counted as income to determine eligibility for 109.21 the diversionary work program. The county shall treat income as 109.22 outlined in section 256J.37, except for subdivision 3a. The 109.23 initial income test and the disregards in section 256J.21, 109.24 subdivision 3, shall be followed for determining eligibility for 109.25 the diversionary work program. 109.26 Subd. 10. [DIVERSIONARY WORK PROGRAM GRANT.] (a) The 109.27 amount of cash benefits that a family unit is eligible for under 109.28 the diversionary work program is based on the number of persons 109.29 in the family unit, the family maintenance needs, personal needs 109.30 allowance, and countable income. The county agency shall 109.31 evaluate the income of the family unit that is requesting 109.32 payments under the diversionary work program. Countable income 109.33 means gross earned and unearned income not excluded or 109.34 disregarded under MFIP. The same disregards for earned income 109.35 that are allowed under MFIP are allowed for the diversionary 109.36 work program. 110.1 (b) The DWP grant is based on the family maintenance needs 110.2 for which the DWP family unit is responsible plus a personal 110.3 needs allowance. Housing and utilities, except for telephone 110.4 service, shall be vendor paid. Unless otherwise stated in this 110.5 section, actual housing and utility expenses shall be used when 110.6 determining the amount of the DWP grant. 110.7 (c) The maximum monthly benefit amount available under the 110.8 diversionary work program is the difference between the family 110.9 unit's family maintenance needs under paragraph (b) and the 110.10 family unit's countable income not to exceed the cash portion of 110.11 the MFIP standard of need as defined in section 256J.08, 110.12 subdivision 55a, for the family unit's size. The family wage 110.13 level as defined in section 256J.08, subdivision 35, shall be 110.14 used when determining the amount of countable income for working 110.15 members. 110.16 (d) Once the county has determined a grant amount, the DWP 110.17 grant amount will not be decreased if the determination is based 110.18 on the best information available at the time of approval and 110.19 shall not be decreased because of any additional income to the 110.20 family unit. The grant can be increased if a participant later 110.21 verifies an increase in family maintenance needs or family unit 110.22 size. The minimum cash benefit amount, if income and asset 110.23 tests are met, is $10. Benefits of $10 shall not be vendor paid. 110.24 (e) When all criteria are met, including the development of 110.25 an employment plan as described in subdivision 14 and 110.26 eligibility exists for the month of application, the amount of 110.27 benefits for the diversionary work program retroactive to the 110.28 date of application is as specified in section 256J.35, 110.29 paragraph (a). 110.30 (f) Any month during the four-month DWP period that a 110.31 person receives a DWP benefit directly or through a vendor 110.32 payment made on the person's behalf, that person is ineligible 110.33 for MFIP or any other TANF cash assistance program except for 110.34 benefits defined in section 256J.626, subdivision 2, clause (1). 110.35 If during the four-month period a family unit that receives 110.36 DWP benefits moves to a county that has not established a 111.1 diversionary work program, the family unit may be eligible for 111.2 MFIP the month following the last month of the issuance of the 111.3 DWP benefit. 111.4 Subd. 11. [UNIVERSAL PARTICIPATION REQUIRED.] (a) All DWP 111.5 caregivers, except caregivers who meet the criteria in paragraph 111.6 (d), are required to participate in DWP employment services. 111.7 Except as specified in paragraphs (b) and (c), employment plans 111.8 under DWP must, at a minimum, meet the requirements in section 111.9 256J.55, subdivision 1. 111.10 (b) A caregiver who is a member of a two-parent family that 111.11 is required to participate in DWP who would otherwise be 111.12 ineligible for DWP under subdivision 3 may be allowed to develop 111.13 an employment plan under section 256J.521, subdivision 2, 111.14 paragraph (c), that may contain alternate activities and reduced 111.15 hours. 111.16 (c) A participant who has a family violence waiver shall be 111.17 allowed to develop an employment plan under section 256J.521, 111.18 subdivision 3. 111.19 (d) One parent in a two-parent family unit that has a 111.20 natural born child under 12 weeks of age is not required to have 111.21 an employment plan until the child reaches 12 weeks of age 111.22 unless the family unit has already used the exclusion under 111.23 section 256J.561, subdivision 2, or the previously allowed child 111.24 under age one exemption under section 256J.56, paragraph (a), 111.25 clause (5). 111.26 (e) The provision in paragraph (d) ends the first full 111.27 month after the child reaches 12 weeks of age. This provision 111.28 is allowable only once in a caregiver's lifetime. In a 111.29 two-parent household, only one parent shall be allowed to use 111.30 this category. 111.31 (f) The participant and job counselor must meet within ten 111.32 working days after the child reaches 12 weeks of age to revise 111.33 the participant's employment plan. The employment plan for a 111.34 family unit that has a child under 12 weeks of age that has 111.35 already used the exclusion in section 256J.561 or the previously 111.36 allowed child under age one exemption under section 256J.56, 112.1 paragraph (a), clause (5), must be tailored to recognize the 112.2 caregiving needs of the parent. 112.3 Subd. 12. [CONVERSION OR REFERRAL TO MFIP.] (a) If at any 112.4 time during the DWP application process or during the four-month 112.5 DWP eligibility period, it is determined that a participant is 112.6 unlikely to benefit from the diversionary work program, the 112.7 county shall convert or refer the participant to MFIP as 112.8 specified in paragraph (d). Participants who are determined to 112.9 be unlikely to benefit from the diversionary work program must 112.10 develop and sign an employment plan. Participants who meet the 112.11 criteria in paragraph (b) shall be considered to be unlikely to 112.12 benefit from DWP, provided the necessary documentation is 112.13 available to support the determination. 112.14 (b) A participant who: 112.15 (1) has been determined by a qualified professional as 112.16 being unable to obtain or retain employment due to an illness, 112.17 injury, or incapacity that is expected to last at least 60 days; 112.18 (2) is determined by a qualified professional as being 112.19 needed in the home to care for a family member, or a relative in 112.20 the household, or a foster child, due to an illness, injury, or 112.21 incapacity that is expected to last at least 60 days; 112.22 (3) is determined by a qualified professional as being 112.23 needed in the home to care for a child meeting the special 112.24 medical criteria in section 256J.425, subdivision 2, clause (3); 112.25 (4) is pregnant and is determined by a qualified 112.26 professional as being unable to obtain or retain employment due 112.27 to the pregnancy; and 112.28 (5) has applied for SSI or RSDI. 112.29 (c) In a two-parent family unit, both parents must be 112.30 determined to be unlikely to benefit from the diversionary work 112.31 program before the family unit can be converted or referred to 112.32 MFIP. 112.33 (d) A participant who is determined to be unlikely to 112.34 benefit from the diversionary work program shall be converted to 112.35 MFIP and, if the determination was made within 30 days of the 112.36 initial application for benefits, a new combined application 113.1 form will not be required. A participant who is determined to 113.2 be unlikely to benefit from the diversionary work program shall 113.3 be referred to MFIP and, if the determination is made more than 113.4 30 days after the initial application, the participant must 113.5 submit a new combined application form. The county agency shall 113.6 process the combined application form by the first of the 113.7 following month to ensure that no gap in benefits is due to 113.8 delayed action by the county agency. In processing the combined 113.9 application form, the county must follow section 256J.32, 113.10 subdivision 1, except that the county agency shall not require 113.11 additional verification of the information in the case file from 113.12 the DWP application unless the information in the case file is 113.13 inaccurate, questionable, or no longer current. 113.14 Subd. 13. [IMMEDIATE REFERRAL TO EMPLOYMENT SERVICES.] 113.15 Within one working day of determination that the applicant is 113.16 eligible for the diversionary work program, but before benefits 113.17 are issued to or on behalf of the family unit, the county shall 113.18 refer all caregivers to employment services. The referral to 113.19 the DWP employment services must be in writing and must contain 113.20 the following information: 113.21 (1) notification that, as part of the application process, 113.22 applicants are required to develop an employment plan or the DWP 113.23 application will be denied; 113.24 (2) the employment services provider name and phone number; 113.25 (3) the date, time, and location of the scheduled 113.26 employment services interview; 113.27 (4) the immediate availability of supportive services, 113.28 including, but not limited to, child care, transportation, and 113.29 other work-related aid; and 113.30 (5) the rights, responsibilities, and obligations of 113.31 participants in the program, including, but not limited to, the 113.32 grounds for good cause, the consequences of refusing or failing 113.33 to participate fully with program requirements, and the appeal 113.34 process. 113.35 Subd. 14. [EMPLOYMENT PLAN; DWP BENEFITS.] As soon as 113.36 possible, but no later than ten working days of being notified 114.1 that a participant is financially eligible for the diversionary 114.2 work program, the employment services provider shall provide the 114.3 participant with an opportunity to meet to develop an initial 114.4 employment plan. Once the initial employment plan has been 114.5 developed and signed by the participant and the job counselor, 114.6 the employment services provider shall notify the county within 114.7 one working day that the employment plan has been signed. The 114.8 county shall issue DWP benefits within one working day after 114.9 receiving notice that the employment plan has been signed. 114.10 Subd. 15. [LIMITATIONS ON CERTAIN WORK ACTIVITIES.] (a) 114.11 Except as specified in paragraphs (b) to (d), employment 114.12 activities listed in section 256J.49, subdivision 13, are 114.13 allowable under the diversionary work program. 114.14 (b) Work activities under section 256J.49, subdivision 13, 114.15 clause (5), shall be allowable only when in combination with 114.16 approved work activities under section 256J.49, subdivision 13, 114.17 clauses (1) to (4), and shall be limited to no more than 114.18 one-half of the hours required in the employment plan. 114.19 (c) In order for an English as a second language (ESL) 114.20 class to be an approved work activity, a participant must: 114.21 (1) be below a spoken language proficiency level of SPL6 or 114.22 its equivalent, as measured by a nationally recognized test; and 114.23 (2) not have been enrolled in ESL for more than 24 months 114.24 while previously participating in MFIP or DWP. A participant 114.25 who has been enrolled in ESL for 20 or more months may be 114.26 approved for ESL until the participant has received 24 total 114.27 months. 114.28 (d) Work activities under section 256J.49, subdivision 13, 114.29 clause (6), shall be allowable only when the training or 114.30 education program will be completed within the four-month DWP 114.31 period. Training or education programs that will not be 114.32 completed within the four-month DWP period shall not be approved. 114.33 Subd. 16. [FAILURE TO COMPLY WITH REQUIREMENTS.] A family 114.34 unit that includes a participant who fails to comply with DWP 114.35 employment service or child support enforcement requirements, 114.36 without good cause as defined in sections 256.741 and 256J.57, 115.1 shall be disqualified from the diversionary work program. The 115.2 county shall provide written notice as specified in section 115.3 256J.31 to the participant prior to disqualifying the family 115.4 unit due to noncompliance with employment service or child 115.5 support. The disqualification does not apply to food support or 115.6 health care benefits. 115.7 Subd. 17. [GOOD CAUSE FOR NOT COMPLYING WITH 115.8 REQUIREMENTS.] A participant who fails to comply with the 115.9 requirements of the diversionary work program may claim good 115.10 cause for reasons listed in sections 256.741 and 256J.57, 115.11 subdivision 1, clauses (1) to (13). The county shall not impose 115.12 a disqualification if good cause exists. 115.13 Subd. 18. [REINSTATEMENT FOLLOWING DISQUALIFICATION.] A 115.14 participant who has been disqualified from the diversionary work 115.15 program due to noncompliance with employment services may regain 115.16 eligibility for the diversionary work program by complying with 115.17 program requirements. A participant who has been disqualified 115.18 from the diversionary work program due to noncooperation with 115.19 child support enforcement requirements may regain eligibility by 115.20 complying with child support requirements under section 115.21 256J.741. Once a participant has been reinstated, the county 115.22 shall issue prorated benefits for the remaining portion of the 115.23 month. A family unit that has been disqualified from the 115.24 diversionary work program due to noncompliance shall not be 115.25 eligible for MFIP or any other TANF cash program during the 115.26 period of time the participant remains noncompliant. In a 115.27 two-parent family, both parents must be in compliance before the 115.28 family unit can regain eligibility for benefits. 115.29 Subd. 19. [RECOVERY OF OVERPAYMENTS.] When an overpayment 115.30 or an ATM error is determined, the overpayment shall be recouped 115.31 or recovered as specified in section 256J.38. 115.32 Subd. 20. [IMPLEMENTATION OF DWP.] Counties may establish 115.33 a diversionary work program according to this section any time 115.34 on or after July 1, 2003. Prior to establishing a diversionary 115.35 work program, the county must notify the commissioner. All 115.36 counties must implement the provisions of this section no later 116.1 than July 1, 2004. 116.2 Sec. 106. Minnesota Statutes 2002, section 261.063, is 116.3 amended to read: 116.4 261.063 [TAX LEVY FOR SOCIAL SERVICES; BOARD DUTY; 116.5 PENALTY.] 116.6 (a) The board of county commissioners of each county shall 116.7 annually levy taxes and fix a rate sufficient to produce the 116.8 full amount required for poor relief, general assistance, 116.9 Minnesota family investment program, diversionary work program, 116.10 county share of county and state supplemental aid to 116.11 supplemental security income applicants or recipients, and any 116.12 other social security measures wherein there is now or may 116.13 hereafter be county participation, sufficient to produce the 116.14 full amount necessary for each such item, including 116.15 administrative expenses, for the ensuing year, within the time 116.16 fixed by law in addition to all other tax levies and tax rates, 116.17 however fixed or determined, and any commissioner who shall fail 116.18 to comply herewith shall be guilty of a gross misdemeanor and 116.19 shall be immediately removed from office by the governor. For 116.20 the purposes of this paragraph, "poor relief" means county 116.21 services provided under sections 261.035, 261.04,and 261.21 to 116.22 261.231. 116.23 (b) Nothing within the provisions of this section shall be 116.24 construed as requiring a county agency to provide income support 116.25 or cash assistance to needy persons when they are no longer 116.26 eligible for assistance under general assistance,the Minnesota116.27family investment programchapter 256J, or Minnesota 116.28 supplemental aid. 116.29 Sec. 107. Minnesota Statutes 2002, section 393.07, 116.30 subdivision 10, is amended to read: 116.31 Subd. 10. [FEDERAL FOOD STAMP PROGRAM AND THE MATERNAL AND 116.32 CHILD NUTRITION ACT.] (a) The local social services agency shall 116.33 establish and administer the food stamp or support program 116.34 according to rules of the commissioner of human services, the 116.35 supervision of the commissioner as specified in section 256.01, 116.36 and all federal laws and regulations. The commissioner of human 117.1 services shall monitor food stamp or support program delivery on 117.2 an ongoing basis to ensure that each county complies with 117.3 federal laws and regulations. Program requirements to be 117.4 monitored include, but are not limited to, number of 117.5 applications, number of approvals, number of cases pending, 117.6 length of time required to process each application and deliver 117.7 benefits, number of applicants eligible for expedited issuance, 117.8 length of time required to process and deliver expedited 117.9 issuance, number of terminations and reasons for terminations, 117.10 client profiles by age, household composition and income level 117.11 and sources, and the use of phone certification and home 117.12 visits. The commissioner shall determine the county-by-county 117.13 and statewide participation rate. 117.14 (b) On July 1 of each year, the commissioner of human 117.15 services shall determine a statewide and county-by-county food 117.16 stamp program participation rate. The commissioner may 117.17 designate a different agency to administer the food stamp 117.18 program in a county if the agency administering the program 117.19 fails to increase the food stamp program participation rate 117.20 among families or eligible individuals, or comply with all 117.21 federal laws and regulations governing the food stamp program. 117.22 The commissioner shall review agency performance annually to 117.23 determine compliance with this paragraph. 117.24 (c) A person who commits any of the following acts has 117.25 violated section 256.98 or 609.821, or both, and is subject to 117.26 both the criminal and civil penalties provided under those 117.27 sections: 117.28 (1) obtains or attempts to obtain, or aids or abets any 117.29 person to obtain by means of a willful statement or 117.30 misrepresentation, or intentional concealment of a material 117.31 fact, food stamps or vouchers issued according to sections 117.32 145.891 to 145.897 to which the person is not entitled or in an 117.33 amount greater than that to which that person is entitled or 117.34 which specify nutritional supplements to which that person is 117.35 not entitled; or 117.36 (2) presents or causes to be presented, coupons or vouchers 118.1 issued according to sections 145.891 to 145.897 for payment or 118.2 redemption knowing them to have been received, transferred or 118.3 used in a manner contrary to existing state or federal law; or 118.4 (3) willfully uses, possesses, or transfers food stamp 118.5 coupons, authorization to purchase cards or vouchers issued 118.6 according to sections 145.891 to 145.897 in any manner contrary 118.7 to existing state or federal law, rules, or regulations; or 118.8 (4) buys or sells food stamp coupons, authorization to 118.9 purchase cards, other assistance transaction devices, vouchers 118.10 issued according to sections 145.891 to 145.897, or any food 118.11 obtained through the redemption of vouchers issued according to 118.12 sections 145.891 to 145.897 for cash or consideration other than 118.13 eligible food. 118.14 (d) A peace officer or welfare fraud investigator may 118.15 confiscate food stamps, authorization to purchase cards, or 118.16 other assistance transaction devices found in the possession of 118.17 any person who is neither a recipient of the food stamp program 118.18 nor otherwise authorized to possess and use such materials. 118.19 Confiscated property shall be disposed of as the commissioner 118.20 may direct and consistent with state and federal food stamp 118.21 law. The confiscated property must be retained for a period of 118.22 not less than 30 days to allow any affected person to appeal the 118.23 confiscation under section 256.045. 118.24 (e) Food stamp overpayment claims which are due in whole or 118.25 in part to client error shall be established by the county 118.26 agency for a period of six years from the date of any resultant 118.27 overpayment. 118.28 (f) With regard to the federal tax revenue offset program 118.29 only, recovery incentives authorized by the federal food and 118.30 consumer service shall be retained at the rate of 50 percent by 118.31 the state agency and 50 percent by the certifying county agency. 118.32 (g) A peace officer, welfare fraud investigator, federal 118.33 law enforcement official, or the commissioner of health may 118.34 confiscate vouchers found in the possession of any person who is 118.35 neither issued vouchers under sections 145.891 to 145.897, nor 118.36 otherwise authorized to possess and use such vouchers. 119.1 Confiscated property shall be disposed of as the commissioner of 119.2 health may direct and consistent with state and federal law. 119.3 The confiscated property must be retained for a period of not 119.4 less than 30 days. 119.5 (h) The commissioner of human services shall seek a waiver 119.6 from the United States Department of Agriculture to allow the 119.7 state to specify foods that may and may not be purchased in 119.8 Minnesota with benefits funded by the federal Food Stamp Program. 119.9 Sec. 108. Laws 1997, chapter 203, article 9, section 21, 119.10 as amended by Laws 1998, chapter 407, article 6, section 111, 119.11 Laws 2000, chapter 488, article 10, section 28, and Laws 2001, 119.12 First Special Session chapter 9, article 10, section 62, is 119.13 amended to read: 119.14 Sec. 21. [INELIGIBILITY FOR STATE FUNDED PROGRAMS.] 119.15 (a) Effective on the date specified, the following persons 119.16 will be ineligible for general assistance and general assistance 119.17 medical care under Minnesota Statutes, chapter 256D, group 119.18 residential housing under Minnesota Statutes, chapter 256I, and 119.19 MFIP assistance under Minnesota Statutes, chapter 256J, funded 119.20 with state money: 119.21 (1) Beginning July 1, 2002, persons who are terminated from 119.22 or denied Supplemental Security Income due to the 1996 changes 119.23 in the federal law making persons whose alcohol or drug 119.24 addiction is a material factor contributing to the person's 119.25 disability ineligible for Supplemental Security Income, and are 119.26 eligible for general assistance under Minnesota Statutes, 119.27 section 256D.05, subdivision 1, paragraph (a), clause (15), 119.28 general assistance medical care under Minnesota Statutes, 119.29 chapter 256D, or group residential housing under Minnesota 119.30 Statutes, chapter 256I; and 119.31 (2) Beginning July 1, 2002, legal noncitizens who are 119.32 ineligible for Supplemental Security Income due to the 1996 119.33 changes in federal law making certain noncitizens ineligible for 119.34 these programs due to their noncitizen status; and 119.35 (3) Beginning July 1,20032007, legal noncitizens who are 119.36 eligible for MFIP assistance, either the cash assistance portion 120.1 or the food assistance portion, funded entirely with state money. 120.2 (b) State money that remains unspent due to changes in 120.3 federal law enacted after May 12, 1997, that reduce state 120.4 spending for legal noncitizens or for persons whose alcohol or 120.5 drug addiction is a material factor contributing to the person's 120.6 disability, or enacted after February 1, 1998, that reduce state 120.7 spending for food benefits for legal noncitizens shall not 120.8 cancel and shall be deposited in the TANF reserve account. 120.9 Sec. 109. [REVISOR'S INSTRUCTION.] 120.10 (a) In the next publication of Minnesota Statutes, the 120.11 revisor of statutes shall codify section 108 of this act. 120.12 (b) Wherever "food stamp" or "food stamps" appears in 120.13 Minnesota Statutes and Rules, the revisor of statutes shall 120.14 insert "food support" or "or food support" except for instances 120.15 where federal code or federal law is referenced. 120.16 (c) For sections in Minnesota Statutes and Minnesota Rules 120.17 affected by the repealed sections in this article, the revisor 120.18 shall delete internal cross-references where appropriate and 120.19 make changes necessary to correct the punctuation, grammar, or 120.20 structure of the remaining text and preserve its meaning. 120.21 Sec. 110. [REPEALER.] 120.22 (a) Minnesota Statutes 2002, sections 256J.02, subdivision 120.23 3; 256J.08, subdivisions 28 and 70; 256J.24, subdivision 8; 120.24 256J.30, subdivision 10; 256J.462; 256J.47; 256J.48; 256J.49, 120.25 subdivisions 1a, 2, 6, and 7; 256J.50, subdivisions 2, 3, 3a, 5, 120.26 and 7; 256J.52; 256J.62, subdivisions 1, 2a, 4, 6, 7, and 8; 120.27 256J.625; 256J.655; 256J.74, subdivision 3; 256J.751, 120.28 subdivisions 3 and 4; 256J.76; and 256K.30, are repealed. 120.29 (b) Laws 2000, chapter 488, article 10, section 29, is 120.30 repealed. 120.31 ARTICLE 2 120.32 HEALTH CARE 120.33 Section 1. Minnesota Statutes 2002, section 16A.724, is 120.34 amended to read: 120.35 16A.724 [HEALTH CARE ACCESS FUND.] 120.36 A health care access fund is created in the state 121.1 treasury. The fund is a direct appropriated special revenue 121.2 fund. The commissioner shall deposit to the credit of the fund 121.3 money made available to the fund. Notwithstanding section 121.4 11A.20, after June 30, 1997, all investment income and all 121.5 investment losses attributable to the investment of the health 121.6 care access fund not currently needed shall be credited to the 121.7 health care access fund. The health care access fund shall 121.8 sunset on June 30, 2005, and all remaining funds shall be 121.9 deposited in the general fund. Beginning July 1, 2005, all 121.10 activities which would otherwise receive funding from the health 121.11 care access fund shall be funded out of the general fund. 121.12 Sec. 2. Minnesota Statutes 2002, section 256.01, 121.13 subdivision 2, is amended to read: 121.14 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 121.15 section 241.021, subdivision 2, the commissioner of human 121.16 services shall: 121.17 (1) Administer and supervise all forms of public assistance 121.18 provided for by state law and other welfare activities or 121.19 services as are vested in the commissioner. Administration and 121.20 supervision of human services activities or services includes, 121.21 but is not limited to, assuring timely and accurate distribution 121.22 of benefits, completeness of service, and quality program 121.23 management. In addition to administering and supervising human 121.24 services activities vested by law in the department, the 121.25 commissioner shall have the authority to: 121.26 (a) require county agency participation in training and 121.27 technical assistance programs to promote compliance with 121.28 statutes, rules, federal laws, regulations, and policies 121.29 governing human services; 121.30 (b) monitor, on an ongoing basis, the performance of county 121.31 agencies in the operation and administration of human services, 121.32 enforce compliance with statutes, rules, federal laws, 121.33 regulations, and policies governing welfare services and promote 121.34 excellence of administration and program operation; 121.35 (c) develop a quality control program or other monitoring 121.36 program to review county performance and accuracy of benefit 122.1 determinations; 122.2 (d) require county agencies to make an adjustment to the 122.3 public assistance benefits issued to any individual consistent 122.4 with federal law and regulation and state law and rule and to 122.5 issue or recover benefits as appropriate; 122.6 (e) delay or deny payment of all or part of the state and 122.7 federal share of benefits and administrative reimbursement 122.8 according to the procedures set forth in section 256.017; 122.9 (f) make contracts with and grants to public and private 122.10 agencies and organizations, both profit and nonprofit, and 122.11 individuals, using appropriated funds; and 122.12 (g) enter into contractual agreements with federally 122.13 recognized Indian tribes with a reservation in Minnesota to the 122.14 extent necessary for the tribe to operate a federally approved 122.15 family assistance program or any other program under the 122.16 supervision of the commissioner. The commissioner shall consult 122.17 with the affected county or counties in the contractual 122.18 agreement negotiations, if the county or counties wish to be 122.19 included, in order to avoid the duplication of county and tribal 122.20 assistance program services. The commissioner may establish 122.21 necessary accounts for the purposes of receiving and disbursing 122.22 funds as necessary for the operation of the programs. 122.23 (2) Inform county agencies, on a timely basis, of changes 122.24 in statute, rule, federal law, regulation, and policy necessary 122.25 to county agency administration of the programs. 122.26 (3) Administer and supervise all child welfare activities; 122.27 promote the enforcement of laws protecting handicapped, 122.28 dependent, neglected and delinquent children, and children born 122.29 to mothers who were not married to the children's fathers at the 122.30 times of the conception nor at the births of the children; 122.31 license and supervise child-caring and child-placing agencies 122.32 and institutions; supervise the care of children in boarding and 122.33 foster homes or in private institutions; and generally perform 122.34 all functions relating to the field of child welfare now vested 122.35 in the state board of control. 122.36 (4) Administer and supervise all noninstitutional service 123.1 to handicapped persons, including those who are visually 123.2 impaired, hearing impaired, or physically impaired or otherwise 123.3 handicapped. The commissioner may provide and contract for the 123.4 care and treatment of qualified indigent children in facilities 123.5 other than those located and available at state hospitals when 123.6 it is not feasible to provide the service in state hospitals. 123.7 (5) Assist and actively cooperate with other departments, 123.8 agencies and institutions, local, state, and federal, by 123.9 performing services in conformity with the purposes of Laws 123.10 1939, chapter 431. 123.11 (6) Act as the agent of and cooperate with the federal 123.12 government in matters of mutual concern relative to and in 123.13 conformity with the provisions of Laws 1939, chapter 431, 123.14 including the administration of any federal funds granted to the 123.15 state to aid in the performance of any functions of the 123.16 commissioner as specified in Laws 1939, chapter 431, and 123.17 including the promulgation of rules making uniformly available 123.18 medical care benefits to all recipients of public assistance, at 123.19 such times as the federal government increases its participation 123.20 in assistance expenditures for medical care to recipients of 123.21 public assistance, the cost thereof to be borne in the same 123.22 proportion as are grants of aid to said recipients. 123.23 (7) Establish and maintain any administrative units 123.24 reasonably necessary for the performance of administrative 123.25 functions common to all divisions of the department. 123.26 (8) Act as designated guardian of both the estate and the 123.27 person of all the wards of the state of Minnesota, whether by 123.28 operation of law or by an order of court, without any further 123.29 act or proceeding whatever, except as to persons committed as 123.30 mentally retarded. For children under the guardianship of the 123.31 commissioner whose interests would be best served by adoptive 123.32 placement, the commissioner may contract with a licensed 123.33 child-placing agency or a Minnesota tribal social services 123.34 agency to provide adoption services. A contract with a licensed 123.35 child-placing agency must be designed to supplement existing 123.36 county efforts and may not replace existing county programs, 124.1 unless the replacement is agreed to by the county board and the 124.2 appropriate exclusive bargaining representative or the 124.3 commissioner has evidence that child placements of the county 124.4 continue to be substantially below that of other counties. 124.5 Funds encumbered and obligated under an agreement for a specific 124.6 child shall remain available until the terms of the agreement 124.7 are fulfilled or the agreement is terminated. 124.8 (9) Act as coordinating referral and informational center 124.9 on requests for service for newly arrived immigrants coming to 124.10 Minnesota. 124.11 (10) The specific enumeration of powers and duties as 124.12 hereinabove set forth shall in no way be construed to be a 124.13 limitation upon the general transfer of powers herein contained. 124.14 (11) Establish county, regional, or statewide schedules of 124.15 maximum fees and charges which may be paid by county agencies 124.16 for medical, dental, surgical, hospital, nursing and nursing 124.17 home care and medicine and medical supplies under all programs 124.18 of medical care provided by the state and for congregate living 124.19 care under the income maintenance programs. 124.20 (12) Have the authority to conduct and administer 124.21 experimental projects to test methods and procedures of 124.22 administering assistance and services to recipients or potential 124.23 recipients of public welfare. To carry out such experimental 124.24 projects, it is further provided that the commissioner of human 124.25 services is authorized to waive the enforcement of existing 124.26 specific statutory program requirements, rules, and standards in 124.27 one or more counties. The order establishing the waiver shall 124.28 provide alternative methods and procedures of administration, 124.29 shall not be in conflict with the basic purposes, coverage, or 124.30 benefits provided by law, and in no event shall the duration of 124.31 a project exceed four years. It is further provided that no 124.32 order establishing an experimental project as authorized by the 124.33 provisions of this section shall become effective until the 124.34 following conditions have been met: 124.35 (a) The secretary of health and human services of the 124.36 United States has agreed, for the same project, to waive state 125.1 plan requirements relative to statewide uniformity. 125.2 (b) A comprehensive plan, including estimated project 125.3 costs, shall be approved by the legislative advisory commission 125.4 and filed with the commissioner of administration. 125.5 (13) According to federal requirements, establish 125.6 procedures to be followed by local welfare boards in creating 125.7 citizen advisory committees, including procedures for selection 125.8 of committee members. 125.9 (14) Allocate federal fiscal disallowances or sanctions 125.10 which are based on quality control error rates for the aid to 125.11 families with dependent children program formerly codified in 125.12 sections 256.72 to 256.87, medical assistance, or food stamp 125.13 program in the following manner: 125.14 (a) One-half of the total amount of the disallowance shall 125.15 be borne by the county boards responsible for administering the 125.16 programs. For the medical assistance and the AFDC program 125.17 formerly codified in sections 256.72 to 256.87, disallowances 125.18 shall be shared by each county board in the same proportion as 125.19 that county's expenditures for the sanctioned program are to the 125.20 total of all counties' expenditures for the AFDC program 125.21 formerly codified in sections 256.72 to 256.87, and medical 125.22 assistance programs. For the food stamp program, sanctions 125.23 shall be shared by each county board, with 50 percent of the 125.24 sanction being distributed to each county in the same proportion 125.25 as that county's administrative costs for food stamps are to the 125.26 total of all food stamp administrative costs for all counties, 125.27 and 50 percent of the sanctions being distributed to each county 125.28 in the same proportion as that county's value of food stamp 125.29 benefits issued are to the total of all benefits issued for all 125.30 counties. Each county shall pay its share of the disallowance 125.31 to the state of Minnesota. When a county fails to pay the 125.32 amount due hereunder, the commissioner may deduct the amount 125.33 from reimbursement otherwise due the county, or the attorney 125.34 general, upon the request of the commissioner, may institute 125.35 civil action to recover the amount due. 125.36 (b) Notwithstanding the provisions of paragraph (a), if the 126.1 disallowance results from knowing noncompliance by one or more 126.2 counties with a specific program instruction, and that knowing 126.3 noncompliance is a matter of official county board record, the 126.4 commissioner may require payment or recover from the county or 126.5 counties, in the manner prescribed in paragraph (a), an amount 126.6 equal to the portion of the total disallowance which resulted 126.7 from the noncompliance, and may distribute the balance of the 126.8 disallowance according to paragraph (a). 126.9 (15) Develop and implement special projects that maximize 126.10 reimbursements and result in the recovery of money to the 126.11 state. For the purpose of recovering state money, the 126.12 commissioner may enter into contracts with third parties. Any 126.13 recoveries that result from projects or contracts entered into 126.14 under this paragraph shall be deposited in the state treasury 126.15 and credited to a special account until the balance in the 126.16 account reaches $1,000,000. When the balance in the account 126.17 exceeds $1,000,000, the excess shall be transferred and credited 126.18 to the general fund. All money in the account is appropriated 126.19 to the commissioner for the purposes of this paragraph. 126.20 (16) Have the authority to make direct payments to 126.21 facilities providing shelter to women and their children 126.22 according to section 256D.05, subdivision 3. Upon the written 126.23 request of a shelter facility that has been denied payments 126.24 under section 256D.05, subdivision 3, the commissioner shall 126.25 review all relevant evidence and make a determination within 30 126.26 days of the request for review regarding issuance of direct 126.27 payments to the shelter facility. Failure to act within 30 days 126.28 shall be considered a determination not to issue direct payments. 126.29 (17) Have the authority to establish and enforce the 126.30 following county reporting requirements: 126.31 (a) The commissioner shall establish fiscal and statistical 126.32 reporting requirements necessary to account for the expenditure 126.33 of funds allocated to counties for human services programs. 126.34 When establishing financial and statistical reporting 126.35 requirements, the commissioner shall evaluate all reports, in 126.36 consultation with the counties, to determine if the reports can 127.1 be simplified or the number of reports can be reduced. 127.2 (b) The county board shall submit monthly or quarterly 127.3 reports to the department as required by the commissioner. 127.4 Monthly reports are due no later than 15 working days after the 127.5 end of the month. Quarterly reports are due no later than 30 127.6 calendar days after the end of the quarter, unless the 127.7 commissioner determines that the deadline must be shortened to 127.8 20 calendar days to avoid jeopardizing compliance with federal 127.9 deadlines or risking a loss of federal funding. Only reports 127.10 that are complete, legible, and in the required format shall be 127.11 accepted by the commissioner. 127.12 (c) If the required reports are not received by the 127.13 deadlines established in clause (b), the commissioner may delay 127.14 payments and withhold funds from the county board until the next 127.15 reporting period. When the report is needed to account for the 127.16 use of federal funds and the late report results in a reduction 127.17 in federal funding, the commissioner shall withhold from the 127.18 county boards with late reports an amount equal to the reduction 127.19 in federal funding until full federal funding is received. 127.20 (d) A county board that submits reports that are late, 127.21 illegible, incomplete, or not in the required format for two out 127.22 of three consecutive reporting periods is considered 127.23 noncompliant. When a county board is found to be noncompliant, 127.24 the commissioner shall notify the county board of the reason the 127.25 county board is considered noncompliant and request that the 127.26 county board develop a corrective action plan stating how the 127.27 county board plans to correct the problem. The corrective 127.28 action plan must be submitted to the commissioner within 45 days 127.29 after the date the county board received notice of noncompliance. 127.30 (e) The final deadline for fiscal reports or amendments to 127.31 fiscal reports is one year after the date the report was 127.32 originally due. If the commissioner does not receive a report 127.33 by the final deadline, the county board forfeits the funding 127.34 associated with the report for that reporting period and the 127.35 county board must repay any funds associated with the report 127.36 received for that reporting period. 128.1 (f) The commissioner may not delay payments, withhold 128.2 funds, or require repayment under paragraph (c) or (e) if the 128.3 county demonstrates that the commissioner failed to provide 128.4 appropriate forms, guidelines, and technical assistance to 128.5 enable the county to comply with the requirements. If the 128.6 county board disagrees with an action taken by the commissioner 128.7 under paragraph (c) or (e), the county board may appeal the 128.8 action according to sections 14.57 to 14.69. 128.9 (g) Counties subject to withholding of funds under 128.10 paragraph (c) or forfeiture or repayment of funds under 128.11 paragraph (e) shall not reduce or withhold benefits or services 128.12 to clients to cover costs incurred due to actions taken by the 128.13 commissioner under paragraph (c) or (e). 128.14 (18) Allocate federal fiscal disallowances or sanctions for 128.15 audit exceptions when federal fiscal disallowances or sanctions 128.16 are based on a statewide random sample for the foster care 128.17 program under title IV-E of the Social Security Act, United 128.18 States Code, title 42, in direct proportion to each county's 128.19 title IV-E foster care maintenance claim for that period. 128.20 (19) Be responsible for ensuring the detection, prevention, 128.21 investigation, and resolution of fraudulent activities or 128.22 behavior by applicants, recipients, and other participants in 128.23 the human services programs administered by the department. 128.24 (20) Require county agencies to identify overpayments, 128.25 establish claims, and utilize all available and cost-beneficial 128.26 methodologies to collect and recover these overpayments in the 128.27 human services programs administered by the department. 128.28 (21) Have the authority to administer a drug rebate program 128.29 for drugs purchased pursuant to the prescription drug program 128.30 established under section 256.955 after the beneficiary's 128.31 satisfaction of any deductible established in the program. The 128.32 commissioner shall require a rebate agreement from all 128.33 manufacturers of covered drugs as defined in section 256B.0625, 128.34 subdivision 13. Rebate agreements for prescription drugs 128.35 delivered on or after July 1, 2002, must include rebates for 128.36 individuals covered under the prescription drug program who are 129.1 under 65 years of age. For each drug, the amount of the rebate 129.2 shall be equal to thebasicrebate as defined for purposes of 129.3 the federal rebate program in United States Code, title 42, 129.4 section 1396r-8(c)(1).This basic rebate shall be applied to129.5single-source and multiple-source drugs.The manufacturers must 129.6 provide full payment within 30 days of receipt of the state 129.7 invoice for the rebate within the terms and conditions used for 129.8 the federal rebate program established pursuant to section 1927 129.9 of title XIX of the Social Security Act. The manufacturers must 129.10 provide the commissioner with any information necessary to 129.11 verify the rebate determined per drug. The rebate program shall 129.12 utilize the terms and conditions used for the federal rebate 129.13 program established pursuant to section 1927 of title XIX of the 129.14 Social Security Act. 129.15 (22) Have the authority to administer the federal drug 129.16 rebate program for drugs purchased under the medical assistance 129.17 program as allowed by section 1927 of title XIX of the Social 129.18 Security Act and according to the terms and conditions of 129.19 section 1927. Rebates shall be collected for all drugs that 129.20 have been dispensed or administered in an outpatient setting and 129.21 that are from manufacturers who have signed a rebate agreement 129.22 with the United States Department of Health and Human Services. 129.23 (23) Have the authority to administer a supplemental drug 129.24 rebate program for drugs purchased under the medical assistance 129.25 program. The commissioner may enter into supplemental rebate 129.26 contracts with pharmaceutical manufacturers and may require 129.27 prior authorization for drugs that are from manufacturers that 129.28 have not signed a supplemental rebate contract. Prior 129.29 authorization of drugs shall be subject to the provisions of 129.30 section 256B.0625, subdivision 13. 129.31 (24) Operate the department's communication systems account 129.32 established in Laws 1993, First Special Session chapter 1, 129.33 article 1, section 2, subdivision 2, to manage shared 129.34 communication costs necessary for the operation of the programs 129.35 the commissioner supervises. A communications account may also 129.36 be established for each regional treatment center which operates 130.1 communications systems. Each account must be used to manage 130.2 shared communication costs necessary for the operations of the 130.3 programs the commissioner supervises. The commissioner may 130.4 distribute the costs of operating and maintaining communication 130.5 systems to participants in a manner that reflects actual usage. 130.6 Costs may include acquisition, licensing, insurance, 130.7 maintenance, repair, staff time and other costs as determined by 130.8 the commissioner. Nonprofit organizations and state, county, 130.9 and local government agencies involved in the operation of 130.10 programs the commissioner supervises may participate in the use 130.11 of the department's communications technology and share in the 130.12 cost of operation. The commissioner may accept on behalf of the 130.13 state any gift, bequest, devise or personal property of any 130.14 kind, or money tendered to the state for any lawful purpose 130.15 pertaining to the communication activities of the department. 130.16 Any money received for this purpose must be deposited in the 130.17 department's communication systems accounts. Money collected by 130.18 the commissioner for the use of communication systems must be 130.19 deposited in the state communication systems account and is 130.20 appropriated to the commissioner for purposes of this section. 130.21 (25) Receive any federal matching money that is made 130.22 available through the medical assistance program for the 130.23 consumer satisfaction survey. Any federal money received for 130.24 the survey is appropriated to the commissioner for this 130.25 purpose. The commissioner may expend the federal money received 130.26 for the consumer satisfaction survey in either year of the 130.27 biennium. 130.28 (26) Incorporate cost reimbursement claims from First Call 130.29 Minnesota and Greater Twin Cities United Way into the federal 130.30 cost reimbursement claiming processes of the department 130.31 according to federal law, rule, and regulations. Any 130.32 reimbursement received is appropriated to the commissioner and 130.33 shall be disbursed to First Call Minnesota and Greater Twin 130.34 Cities United Way according to normal department payment 130.35 schedules. 130.36 (27) Develop recommended standards for foster care homes 131.1 that address the components of specialized therapeutic services 131.2 to be provided by foster care homes with those services. 131.3 Sec. 3. Minnesota Statutes 2002, section 256.046, 131.4 subdivision 1, is amended to read: 131.5 Subdivision 1. [HEARING AUTHORITY.] A local agency must 131.6 initiate an administrative fraud disqualification hearing for 131.7 individuals accused of wrongfully obtaining assistance or 131.8 intentional program violations, in lieu of a criminal action 131.9 when it has not been pursued, in the aid to families with 131.10 dependent children program formerly codified in sections 256.72 131.11 to 256.87, MFIP, child care assistance programs, general 131.12 assistance, family general assistance program formerly codified 131.13 in section 256D.05, subdivision 1, clause (15), Minnesota 131.14 supplemental aid,medical care, orfood stamp programs, general 131.15 assistance medical care, MinnesotaCare for adults without 131.16 children, and upon federal approval, all categories of medical 131.17 assistance and remaining categories of MinnesotaCare except for 131.18 children through age 18. The hearing is subject to the 131.19 requirements of section 256.045 and the requirements in Code of 131.20 Federal Regulations, title 7, section 273.16, for the food stamp 131.21 program and title 45, section 235.112, as of September 30, 1995, 131.22 for the cash grant and medical care programs. 131.23 Sec. 4. [256.954] [PRESCRIPTION DRUG DISCOUNT PROGRAM.] 131.24 Subdivision 1. [ESTABLISHMENT; ADMINISTRATION.] The 131.25 commissioner of human services shall establish and administer 131.26 the prescription drug discount program, effective July 1, 2005. 131.27 Subd. 2. [COMMISSIONER'S AUTHORITY.] The commissioner 131.28 shall administer a drug rebate program for drugs purchased 131.29 according to the prescription drug discount program. The 131.30 commissioner shall require a rebate agreement from all 131.31 manufacturers of covered drugs as defined in section 256B.0625, 131.32 subdivision 13. For each drug, the amount of the rebate shall 131.33 be equal to the rebate as defined for purposes of the federal 131.34 rebate program in United States Code, title 42, section 131.35 1396r-8. The rebate program shall utilize the terms and 131.36 conditions used for the federal rebate program established 132.1 according to section 1927 of title XIX of the federal Social 132.2 Security Act. 132.3 Subd. 3. [DEFINITIONS.] For the purpose of this section, 132.4 the following terms have the meanings given them: 132.5 (a) "Commissioner" means the commissioner of human services. 132.6 (b) "Manufacturer" means a manufacturer as defined in 132.7 section 151.44, paragraph (c). 132.8 (c) "Covered prescription drug" means a prescription drug 132.9 as defined in section 151.44, paragraph (d), that is covered 132.10 under medical assistance as described in section 256B.0625, 132.11 subdivision 13, and that is provided by a manufacturer that has 132.12 a fully executed rebate agreement with the commissioner under 132.13 this section and complies with that agreement. Multisource 132.14 drugs for which there are three or more drug products are not 132.15 subject to the requirements of this section. This exemption 132.16 does not apply to innovator multisource drugs. Covered 132.17 prescription drug does not include the drug commonly referred to 132.18 as RU486, nor any other drug used to chemically induce an 132.19 abortion, and these drugs shall not be made available under this 132.20 program nor be allowed on any preferred drug list adopted or 132.21 implemented by the state. 132.22 (d) "Health carrier" means an insurance company licensed 132.23 under chapter 60A to offer, sell, or issue an individual or 132.24 group policy of accident and sickness insurance as defined in 132.25 section 62A.01; a nonprofit health service plan corporation 132.26 operating under chapter 62C; a health maintenance organization 132.27 operating under chapter 62D; a joint self-insurance employee 132.28 health plan operating under chapter 62H; a community integrated 132.29 systems network licensed under chapter 62N; a fraternal benefit 132.30 society operating under chapter 64B; a city, county, school 132.31 district, or other political subdivision providing self-insured 132.32 health coverage under section 461.617 or sections 471.98 to 132.33 471.982; and a self-funded health plan under the Employee 132.34 Retirement Income Security Act of 1974, as amended. 132.35 (e) "Participating pharmacy" means a pharmacy as defined in 132.36 section 151.01, subdivision 2, that agrees to participate in the 133.1 prescription drug discount program. 133.2 (f) "Enrolled individual" means a person who is eligible 133.3 for the program under subdivision 4 and has enrolled in the 133.4 program according to subdivision 5. 133.5 Subd. 4. [ELIGIBLE PERSONS.] To be eligible for the 133.6 program, an applicant must: 133.7 (1) be a permanent resident of Minnesota as defined in 133.8 section 256L.09, subdivision 4; 133.9 (2) not be enrolled in medical assistance, general 133.10 assistance medical care, MinnesotaCare, or the prescription drug 133.11 program under section 256.955; 133.12 (3) not be enrolled in and have currently available 133.13 prescription drug coverage under a health plan offered by a 133.14 health carrier; 133.15 (4) not be enrolled in and have currently available 133.16 prescription drug coverage under a Medicare supplement plan, as 133.17 defined in sections 62A.31 to 62A.44, or policies, contracts, or 133.18 certificates that supplement Medicare issued by health 133.19 maintenance organizations or those policies, contracts, or 133.20 certificates governed by section 1833 or 1876 of the federal 133.21 Social Security Act, United States Code, title 42, section 1395, 133.22 et. seq., as amended; and 133.23 (5) have a gross household income that does not exceed 250 133.24 percent of the federal poverty guidelines. 133.25 Subd. 5. [APPLICATION PROCEDURE.] (a) Applications and 133.26 information on the program must be made available at county 133.27 social services agencies, health care provider offices, and 133.28 agencies and organizations serving senior citizens. Individuals 133.29 shall submit applications and any information specified by the 133.30 commissioner as being necessary to verify eligibility directly 133.31 to the commissioner. The commissioner shall determine an 133.32 applicant's eligibility for the program within 30 days from the 133.33 date the application is received. Eligibility begins the month 133.34 after approval. 133.35 (b) The commissioner shall develop an application form that 133.36 does not exceed one page in length and requires information 134.1 necessary to determine eligibility for the program. 134.2 Subd. 6. [PARTICIPATING PHARMACY.] According to a valid 134.3 prescription, a participating pharmacy must sell a covered 134.4 prescription drug to an enrolled individual at the pharmacy's 134.5 usual and customary retail price, minus an amount that is equal 134.6 to the rebate amount described in subdivision 8, plus the amount 134.7 of any administrative fee and switch fee established by the 134.8 commissioner under subdivision 10. Each participating pharmacy 134.9 shall provide the commissioner with all information necessary to 134.10 administer the program, including, but not limited to, 134.11 information on prescription drug sales to enrolled individuals 134.12 and usual and customary retail prices. 134.13 Subd. 7. [NOTIFICATION OF REBATE AMOUNT.] The commissioner 134.14 shall notify each drug manufacturer, each calendar quarter or 134.15 according to a schedule to be established by the commissioner, 134.16 of the amount of the rebate owed on the prescription drugs sold 134.17 by participating pharmacies to enrolled individuals. 134.18 Subd. 8. [PROVISION OF REBATE.] To the extent that a 134.19 manufacturer's prescription drugs are prescribed to a citizen of 134.20 this state, the manufacturer must provide a rebate equal to the 134.21 rebate provided under the medical assistance program for any 134.22 prescription drug distributed by the manufacturer that is 134.23 purchased by an enrolled individual at a participating 134.24 pharmacy. The manufacturer must provide full payment within 30 134.25 days of receipt of the state invoice for the rebate, or 134.26 according to a schedule to be established by the commissioner. 134.27 The commissioner shall deposit all rebates received into the 134.28 Minnesota prescription drug dedicated fund established under 134.29 this section. The manufacturer must provide the commissioner 134.30 with any information necessary to verify the rebate determined 134.31 per drug. 134.32 Subd. 9. [PAYMENT TO PHARMACIES.] The commissioner shall 134.33 distribute on a biweekly basis an amount that is equal to an 134.34 estimate of the rebate amount described in subdivision 8 to each 134.35 participating pharmacy based on the prescription drugs sold by 134.36 that pharmacy to enrolled individuals, minus the amount of the 135.1 administrative fee established by the commissioner under 135.2 subdivision 10. 135.3 Subd. 10. [ADMINISTRATIVE FEE; SWITCH FEE.] The 135.4 commissioner shall establish a reasonable administrative fee 135.5 that covers the commissioner's expenses for enrollment, 135.6 processing claims, repaying the appropriation from the health 135.7 care access fund over a seven-year period, and distributing 135.8 rebates under this program. The commissioner shall establish a 135.9 reasonable switch fee that covers expenses incurred by 135.10 pharmacies in formatting for electronic submission claims for 135.11 prescription drugs sold to enrolled individuals. 135.12 Subd. 11. [DEDICATED FUND; CREATION; USE OF FUND.] (a) The 135.13 Minnesota prescription drug dedicated fund is established as an 135.14 account in the state treasury. The commissioner of finance 135.15 shall credit to the dedicated fund all rebates paid under 135.16 subdivision 8, any federal funds received for the program, and 135.17 any appropriations or allocations designated for the fund. The 135.18 commissioner of finance shall ensure that fund money is invested 135.19 under section 11A.25. All money earned by the fund must be 135.20 credited to the fund. The fund shall earn a proportionate share 135.21 of the total state annual investment income. 135.22 (b) Money in the fund is appropriated to the commissioner 135.23 of human services to reimburse participating pharmacies for 135.24 prescription drug discounts provided to enrolled individuals 135.25 under this section, to reimburse the commissioner of human 135.26 services for costs related to enrollment, processing claims, 135.27 distributing rebates, and for other reasonable administrative 135.28 costs related to administration of the prescription drug 135.29 discount program, and to repay the appropriation provided for 135.30 this section. The commissioner must administer the program so 135.31 that the costs total no more than funds appropriated plus the 135.32 drug rebate proceeds. 135.33 Subd. 12. [EXPIRATION.] This section expires upon the 135.34 effective date of an expanded prescription drug benefit under 135.35 Medicare. 135.36 Sec. 5. Minnesota Statutes 2002, section 256.955, 136.1 subdivision 2a, is amended to read: 136.2 Subd. 2a. [ELIGIBILITY.] An individual satisfying the 136.3 following requirements and the requirements described in 136.4 subdivision 2, paragraph (d), is eligible for the prescription 136.5 drug program: 136.6 (1) is at least 65 years of age or older; and 136.7 (2) is eligible as a qualified Medicare beneficiary 136.8 according to section 256B.057, subdivision 3,or 3a,or 3b,136.9clause (1),or is eligible under section 256B.057, subdivision 136.10 3,or 3a,or 3b, clause (1),and is also eligible for medical 136.11 assistance or general assistance medical care with a spenddown 136.12 as defined in section 256B.056, subdivision 5. 136.13 Sec. 6. Minnesota Statutes 2002, section 256.955, 136.14 subdivision 3, is amended to read: 136.15 Subd. 3. [PRESCRIPTION DRUG COVERAGE.] Coverage under the 136.16 program shall be limited to those prescription drugs that: 136.17 (1) are covered under the medical assistance program as 136.18 described in section 256B.0625, subdivision 13;and136.19 (2) are provided by manufacturers that have fully executed 136.20 senior drug rebate agreements with the commissioner and comply 136.21 with such agreements; and 136.22 (3) for a specific enrollee, are not covered under an 136.23 assistance program offered by a pharmaceutical manufacturer, as 136.24 determined by the board on aging under section 256.975, 136.25 subdivision 9, except that this shall not apply to qualified 136.26 individuals under this section who are also eligible for medical 136.27 assistance with a spenddown as described in subdivision 2a, 136.28 clause (2), and subdivision 2b, clause (2). 136.29 [EFFECTIVE DATE.] This section is effective 90 days after 136.30 implementation by the board of aging of the prescription drug 136.31 assistance program under section 256.975, subdivision 9. 136.32 Sec. 7. Minnesota Statutes 2002, section 256.955, is 136.33 amended by adding a subdivision to read: 136.34 Subd. 4a. [REFERRALS TO PRESCRIPTION DRUG ASSISTANCE 136.35 PROGRAM.] County social service agencies, in coordination with 136.36 the commissioner and the Minnesota board on aging, shall refer 137.1 individuals applying to the prescription drug program, or 137.2 enrolled in the prescription drug program, to the prescription 137.3 drug assistance program for all required prescription drugs that 137.4 the board on aging determines, under section 256.975, 137.5 subdivision 9, are covered under an assistance program offered 137.6 by a pharmaceutical manufacturer. Applicants and enrollees 137.7 referred to the prescription drug assistance program remain 137.8 eligible for coverage under the prescription drug program of all 137.9 prescription drugs covered under subdivision 3. The board on 137.10 aging shall phase-in participation of enrollees, over a period 137.11 of 90 days, after implementation of the program under section 137.12 256.975, subdivision 9. This subdivision does not apply to 137.13 individuals who are also eligible for medical assistance with a 137.14 spenddown as defined in section 256B.056, subdivision 5. 137.15 [EFFECTIVE DATE.] This section is effective 90 days after 137.16 implementation by the board of aging of the prescription drug 137.17 assistance program under section 256.975, subdivision 9. 137.18 Sec. 8. Minnesota Statutes 2002, section 256.955, is 137.19 amended by adding a subdivision to read: 137.20 Subd. 10. [EXPIRATION.] This section expires upon the 137.21 effective date of an expanded prescription drug benefit under 137.22 Medicare. 137.23 Sec. 9. Minnesota Statutes 2002, section 256.969, 137.24 subdivision 2b, is amended to read: 137.25 Subd. 2b. [OPERATING PAYMENT RATES.] In determining 137.26 operating payment rates for admissions occurring on or after the 137.27 rate year beginning January 1, 1991, and every two years after, 137.28 or more frequently as determined by the commissioner, the 137.29 commissioner shall obtain operating data from an updated base 137.30 year and establish operating payment rates per admission for 137.31 each hospital based on the cost-finding methods and allowable 137.32 costs of the Medicare program in effect during the base year. 137.33 Rates under the general assistance medical care, medical 137.34 assistance, and MinnesotaCare programs shall not be rebased to 137.35 more current data on January 1, 1997, and January 1, 2005. The 137.36 base year operating payment rate per admission is standardized 138.1 by the case mix index and adjusted by the hospital cost index, 138.2 relative values, and disproportionate population adjustment. 138.3 The cost and charge data used to establish operating rates shall 138.4 only reflect inpatient services covered by medical assistance 138.5 and shall not include property cost information and costs 138.6 recognized in outlier payments. 138.7 Sec. 10. Minnesota Statutes 2002, section 256.969, 138.8 subdivision 3a, is amended to read: 138.9 Subd. 3a. [PAYMENTS.] (a) Acute care hospital billings 138.10 under the medical assistance program must not be submitted until 138.11 the recipient is discharged. However, the commissioner shall 138.12 establish monthly interim payments for inpatient hospitals that 138.13 have individual patient lengths of stay over 30 days regardless 138.14 of diagnostic category. Except as provided in section 256.9693, 138.15 medical assistance reimbursement for treatment of mental illness 138.16 shall be reimbursed based on diagnostic classifications. 138.17 Individual hospital payments established under this section and 138.18 sections 256.9685, 256.9686, and 256.9695, in addition to third 138.19 party and recipient liability, for discharges occurring during 138.20 the rate year shall not exceed, in aggregate, the charges for 138.21 the medical assistance covered inpatient services paid for the 138.22 same period of time to the hospital. This payment limitation 138.23 shall be calculated separately for medical assistance and 138.24 general assistance medical care services. The limitation on 138.25 general assistance medical care shall be effective for 138.26 admissions occurring on or after July 1, 1991. Services that 138.27 have rates established under subdivision 11 or 12, must be 138.28 limited separately from other services. After consulting with 138.29 the affected hospitals, the commissioner may consider related 138.30 hospitals one entity and may merge the payment rates while 138.31 maintaining separate provider numbers. The operating and 138.32 property base rates per admission or per day shall be derived 138.33 from the best Medicare and claims data available when rates are 138.34 established. The commissioner shall determine the best Medicare 138.35 and claims data, taking into consideration variables of recency 138.36 of the data, audit disposition, settlement status, and the 139.1 ability to set rates in a timely manner. The commissioner shall 139.2 notify hospitals of payment rates by December 1 of the year 139.3 preceding the rate year. The rate setting data must reflect the 139.4 admissions data used to establish relative values. Base year 139.5 changes from 1981 to the base year established for the rate year 139.6 beginning January 1, 1991, and for subsequent rate years, shall 139.7 not be limited to the limits ending June 30, 1987, on the 139.8 maximum rate of increase under subdivision 1. The commissioner 139.9 may adjust base year cost, relative value, and case mix index 139.10 data to exclude the costs of services that have been 139.11 discontinued by the October 1 of the year preceding the rate 139.12 year or that are paid separately from inpatient services. 139.13 Inpatient stays that encompass portions of two or more rate 139.14 years shall have payments established based on payment rates in 139.15 effect at the time of admission unless the date of admission 139.16 preceded the rate year in effect by six months or more. In this 139.17 case, operating payment rates for services rendered during the 139.18 rate year in effect and established based on the date of 139.19 admission shall be adjusted to the rate year in effect by the 139.20 hospital cost index. 139.21 (b) For fee-for-service admissions occurring on or after 139.22 July 1, 2002, the total payment, before third-party liability 139.23 and spenddown, made to hospitals for inpatient services is 139.24 reduced by .5 percent from the current statutory rates. 139.25 (c) In addition to the reduction in paragraph (b), the 139.26 total payment for fee-for-service admissions occurring on or 139.27 after July 1, 2003, made to hospitals for inpatient services 139.28 before third-party liability and spenddown, is reduced 2.5 139.29 percent from the current statutory rates. Mental health 139.30 services within diagnosis related groups 424 to 432, and 139.31 facilities defined under subdivision 16 are excluded from this 139.32 paragraph. 139.33 Sec. 11. Minnesota Statutes 2002, section 256.975, is 139.34 amended by adding a subdivision to read: 139.35 Subd. 9. [PRESCRIPTION DRUG ASSISTANCE.] (a) The Minnesota 139.36 board on aging shall establish and administer a prescription 140.1 drug assistance program to assist individuals in accessing 140.2 programs offered by pharmaceutical manufacturers that provide 140.3 free or discounted prescription drugs or provide coverage for 140.4 prescription drugs. The board shall use computer software 140.5 programs to link individuals with the pharmaceutical assistance 140.6 programs most appropriate for the individual. The board shall 140.7 make information on the prescription drug assistance program 140.8 available to interested individuals and health care providers 140.9 and shall coordinate the program with the statewide information 140.10 and assistance services provided through the Senior LinkAge Line 140.11 under subdivision 7. 140.12 (b) The board shall work with the commissioner and county 140.13 social service agencies to coordinate the enrollment of 140.14 individuals who are referred to the prescription drug assistance 140.15 program from the prescription drug program, as required under 140.16 section 256.955, subdivision 4a. 140.17 Sec. 12. Minnesota Statutes 2002, section 256.98, 140.18 subdivision 3, is amended to read: 140.19 Subd. 3. [AMOUNT OF ASSISTANCE INCORRECTLY PAID.] The 140.20 amount of the assistance incorrectly paid under this section is: 140.21 (a) the difference between the amount of assistance 140.22 actually received on the basis of misrepresented or concealed 140.23 facts and the amount to which the recipient would have been 140.24 entitled had the specific concealment or misrepresentation not 140.25 occurred. Unless required by law, rule, or regulation, earned 140.26 income disregards shall not be applied to earnings not reported 140.27 by the recipient; or 140.28 (b) equal to all payments for health care services, 140.29 including capitation payments made to a health plan, made on 140.30 behalf of a person enrolled in MinnesotaCare, medical 140.31 assistance, or general assistance medical care, for which the 140.32 person was not entitled due to the concealment or 140.33 misrepresentation of facts. 140.34 Sec. 13. Minnesota Statutes 2002, section 256.98, 140.35 subdivision 4, is amended to read: 140.36 Subd. 4. [RECOVERY OF ASSISTANCE.] The amount of 141.1 assistance determined to have been incorrectly paid is 141.2 recoverable from: 141.3 (1) the recipient or the recipient's estate by the county 141.4 or the state as a debt due the county or the state or both; and 141.5 (2) any person found to have taken independent action to 141.6 establish eligibility for, conspired with, or aided and abetted, 141.7 any recipient of public assistance found to have been 141.8 incorrectly paid. 141.9 The obligations established under this subdivision shall be 141.10 joint and several and shall extend to all cases involving client 141.11 error as well as cases involving wrongfully obtained assistance. 141.12 MinnesotaCare participants who have been found to have 141.13 wrongfully obtained assistance as described in subdivision 1, 141.14 but who otherwise remain eligible for the program, may agree to 141.15 have their MinnesotaCare premiums increased by an amount equal 141.16 to ten percent of their premiums or $10 per month, whichever is 141.17 greater, until the debt is satisfied. 141.18 Sec. 14. Minnesota Statutes 2002, section 256.98, 141.19 subdivision 8, is amended to read: 141.20 Subd. 8. [DISQUALIFICATION FROM PROGRAM.] (a) Any person 141.21 found to be guilty of wrongfully obtaining assistance by a 141.22 federal or state court or by an administrative hearing 141.23 determination, or waiver thereof, through a disqualification 141.24 consent agreement, or as part of any approved diversion plan 141.25 under section 401.065, or any court-ordered stay which carries 141.26 with it any probationary or other conditions, in the Minnesota 141.27 family investment program, the food stamp program, the general 141.28 assistance program, the group residential housing program, or 141.29 the Minnesota supplemental aid program shall be disqualified 141.30 from that program. In addition, any person disqualified from 141.31 the Minnesota family investment program shall also be 141.32 disqualified from the food stamp program. The needs of that 141.33 individual shall not be taken into consideration in determining 141.34 the grant level for that assistance unit: 141.35 (1) for one year after the first offense; 141.36 (2) for two years after the second offense; and 142.1 (3) permanently after the third or subsequent offense. 142.2 The period of program disqualification shall begin on the 142.3 date stipulated on the advance notice of disqualification 142.4 without possibility of postponement for administrative stay or 142.5 administrative hearing and shall continue through completion 142.6 unless and until the findings upon which the sanctions were 142.7 imposed are reversed by a court of competent jurisdiction. The 142.8 period for which sanctions are imposed is not subject to 142.9 review. The sanctions provided under this subdivision are in 142.10 addition to, and not in substitution for, any other sanctions 142.11 that may be provided for by law for the offense involved. A 142.12 disqualification established through hearing or waiver shall 142.13 result in the disqualification period beginning immediately 142.14 unless the person has become otherwise ineligible for 142.15 assistance. If the person is ineligible for assistance, the 142.16 disqualification period begins when the person again meets the 142.17 eligibility criteria of the program from which they were 142.18 disqualified and makes application for that program. 142.19 (b) A family receiving assistance through child care 142.20 assistance programs under chapter 119B with a family member who 142.21 is found to be guilty of wrongfully obtaining child care 142.22 assistance by a federal court, state court, or an administrative 142.23 hearing determination or waiver, through a disqualification 142.24 consent agreement, as part of an approved diversion plan under 142.25 section 401.065, or a court-ordered stay with probationary or 142.26 other conditions, is disqualified from child care assistance 142.27 programs. The disqualifications must be for periods of three 142.28 months, six months, and two years for the first, second, and 142.29 third offenses respectively. Subsequent violations must result 142.30 in permanent disqualification. During the disqualification 142.31 period, disqualification from any child care program must extend 142.32 to all child care programs and must be immediately applied. 142.33 (c) Any person found to be guilty of wrongfully obtaining 142.34 general assistance medical care, MinnesotaCare for adults 142.35 without children, and upon federal approval, all categories of 142.36 medical assistance and remaining categories of MinnesotaCare, 143.1 except for children through age 18, by a federal or state court 143.2 or by an administrative hearing determination, or waiver 143.3 thereof, through a disqualification consent agreement, or as 143.4 part of any approved diversion plan under section 401.065, or 143.5 any court-ordered stay which carries with it any probationary or 143.6 other conditions, is disqualified from that program. The period 143.7 of disqualification is one year after the first offense, two 143.8 years after the second offense, and permanently after the third 143.9 or subsequent offense. The period of program disqualification 143.10 shall begin on the date stipulated on the advance notice of 143.11 disqualification without possibility of postponement for 143.12 administrative stay or administrative hearing and shall continue 143.13 through completion unless and until the findings upon which the 143.14 sanctions were imposed are reversed by a court of competent 143.15 jurisdiction. The period for which sanctions are imposed is not 143.16 subject to review. The sanctions provided under this 143.17 subdivision are in addition to, and not in substitution for, any 143.18 other sanctions that may be provided for by law for the offense 143.19 involved. 143.20 Sec. 15. Minnesota Statutes 2002, section 256B.055, is 143.21 amended by adding a subdivision to read: 143.22 Subd. 13. [RESIDENTS OF INSTITUTIONS FOR MENTAL DISEASES.] 143.23 Beginning October 1, 2003, persons who would be eligible for 143.24 medical assistance under this chapter but for residing in a 143.25 facility that is determined by the commissioner or the federal 143.26 Centers for Medicare and Medicaid Services to be an institution 143.27 for mental diseases are eligible for medical assistance without 143.28 federal financial participation, except that coverage shall not 143.29 include payment for a nursing facility determined to be an 143.30 institution for mental diseases. 143.31 Sec. 16. Minnesota Statutes 2002, section 256B.056, 143.32 subdivision 1a, is amended to read: 143.33 Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless 143.34 specifically required by state law or rule or federal law or 143.35 regulation, the methodologies used in counting income and assets 143.36 to determine eligibility for medical assistance for persons 144.1 whose eligibility category is based on blindness, disability, or 144.2 age of 65 or more years, the methodologies for the supplemental 144.3 security income program shall be used. Increases in benefits 144.4 under title II of the Social Security Act shall not be counted 144.5 as income for purposes of this subdivision until July 1 of each 144.6 year. Effective upon federal approval, for children eligible 144.7 under section 256B.055, subdivision 12, or for home and 144.8 community-based waiver services whose eligibility for medical 144.9 assistance is determined without regard to parental income, 144.10 child support payments, including any payments made by an 144.11 obligor in satisfaction of or in addition to a temporary or 144.12 permanent order for child support, and social security payments 144.13 are not counted as income. For families and children, which 144.14 includes all other eligibility categories, the methodologies 144.15 under the state's AFDC plan in effect as of July 16, 1996, as 144.16 required by the Personal Responsibility and Work Opportunity 144.17 Reconciliation Act of 1996 (PRWORA), Public LawNumber104-193, 144.18 shall be used, except that effectiveJuly 1, 2002, the $90 and144.19$30 and one-third earned income disregards shall not apply and144.20the disregard specified in subdivision 1c shall applyOctober 1, 144.21 2003, the earned income disregards and deductions are limited to 144.22 those in subdivision 1c. For these purposes, a "methodology" 144.23 does not include an asset or income standard, or accounting 144.24 method, or method of determining effective dates. 144.25 Sec. 17. Minnesota Statutes 2002, section 256B.056, 144.26 subdivision 1c, is amended to read: 144.27 Subd. 1c. [FAMILIES WITH CHILDREN INCOME METHODOLOGY.] 144.28 (a)(1) For children ages one to five whose eligibility is 144.29 determined under section 256B.057, subdivision 2, 21 percent of 144.30 countable earned income shall be disregarded for up to four 144.31 months. This clause expires July 1, 2003. 144.32 (2) For children ages one through 18 whose eligibility is 144.33 determined under section 256B.057, subdivision 2, the following 144.34 deductions shall be applied to income counted toward the child's 144.35 eligibility as allowed under the state's AFDC plan in effect as 144.36 of July 16, 1996: $90 work expense, dependent care, and child 145.1 support paid under court order. This clause is effective 145.2 October 1, 2003. 145.3 (b) For families with children whose eligibility is 145.4 determined using the standard specified in section 256B.056, 145.5 subdivision 4, paragraph (c), 17 percent of countable earned 145.6 income shall be disregarded for up to four months and the 145.7 following deductions shall be applied to each individual's 145.8 income counted toward eligibility as allowed under the state's 145.9 AFDC plan in effect as of July 16, 1996: dependent care and 145.10 child support paid under court order. 145.11 (c) If the four month disregard in paragraph (b) has been 145.12 applied to the wage earner's income for four months, the 145.13 disregard shall not be applied again until the wage earner's 145.14 income has not been considered in determining medical assistance 145.15 eligibility for 12 consecutive months. 145.16 [EFFECTIVE DATE.] The amendments to paragraphs (b) and (c) 145.17 are effective July 1, 2003. 145.18 Sec. 18. Minnesota Statutes 2002, section 256B.057, 145.19 subdivision 1, is amended to read: 145.20 Subdivision 1. [PREGNANT WOMEN AND INFANTS.] (a) An infant 145.21 less than one year of ageor a pregnant woman who has written145.22verification of a positive pregnancy test from a physician or145.23licensed registered nurse,is eligible for medical assistance if 145.24 countable family income is equal to or less than 275 percent of 145.25 the federal poverty guideline for the same family size. A 145.26 pregnant woman who has written verification of a positive 145.27 pregnancy test from a physician or licensed registered nurse is 145.28 eligible for medical assistance if countable family income is 145.29 equal to or less than 200 percent of the federal poverty 145.30 guideline for the same family size. For purposes of this 145.31 subdivision, "countable family income" means the amount of 145.32 income considered available using the methodology of the AFDC 145.33 program under the state's AFDC plan as of July 16, 1996, as 145.34 required by the Personal Responsibility and Work Opportunity 145.35 Reconciliation Act of 1996 (PRWORA), Public LawNumber104-193, 145.36 except for the earned income disregard and employment deductions. 146.1 (b) An amount equal to the amount of earned income 146.2 exceeding 275 percent of the federal poverty guideline, up to a 146.3 maximum of the amount by which the combined total of 185 percent 146.4 of the federal poverty guideline plus the earned income 146.5 disregards and deductions of the AFDC program under the state's 146.6 AFDC plan as of July 16, 1996, as required by the Personal 146.7 Responsibility and Work Opportunity Reconciliation Act of 1996 146.8 (PRWORA), Public LawNumber104-193, exceeds 275 percent of the 146.9 federal poverty guideline will be deducted for pregnant women 146.10 and infants less than one year of age. This paragraph expires 146.11 July 1, 2003. 146.12 (c) Dependent care and child support paid under court order 146.13 shall be deducted from the countable income of pregnant women. 146.14(b)(d) An infant born on or after January 1, 1991, to a 146.15 woman who was eligible for and receiving medical assistance on 146.16 the date of the child's birth shall continue to be eligible for 146.17 medical assistance without redetermination until the child's 146.18 first birthday, as long as the child remains in the woman's 146.19 household. 146.20 [EFFECTIVE DATE.] This section is effective February 1, 146.21 2004, or upon federal approval, whichever is later, except where 146.22 a different date is specified in the text. 146.23 Sec. 19. Minnesota Statutes 2002, section 256B.057, 146.24 subdivision 2, is amended to read: 146.25 Subd. 2. [CHILDREN.] Except as specified in subdivision 146.26 1b, effectiveJuly 1, 2002October 1, 2003, a child one through 146.27 18 years of age in a family whose countable income is no greater 146.28 than170150 percent of the federal poverty guidelines for the 146.29 same family size, is eligible for medical assistance. 146.30 Sec. 20. Minnesota Statutes 2002, section 256B.057, 146.31 subdivision 3b, is amended to read: 146.32 Subd. 3b. [QUALIFYING INDIVIDUALS.] Beginning July 1, 146.33 1998,to the extent of the federal allocation to Minnesota146.34 contingent upon federal funding, a person who would otherwise be 146.35 eligible as a qualified Medicare beneficiary under subdivision 146.36 3, except that the person's income is in excess of the limit, is 147.1 eligible as a qualifying individual according to the following 147.2 criteria: 147.3 (1) if the person's income is greater than 120 percent, but 147.4 less than 135 percent of the official federal poverty guidelines 147.5 for the applicable family size, the person is eligible for 147.6 medical assistance reimbursement of Medicare Part B premiums; or 147.7 (2) if the person's income is equal to or greater than 135 147.8 percent but less than 175 percent of the official federal 147.9 poverty guidelines for the applicable family size, the person is 147.10 eligible for medical assistance reimbursement of that portion of 147.11 the Medicare Part B premium attributable to an increase in Part 147.12 B expenditures which resulted from the shift of home care 147.13 services from Medicare Part A to Medicare Part B under Public 147.14 LawNumber105-33, section 4732, the Balanced Budget Act of 1997. 147.15 The commissioner shall limit enrollment of qualifying 147.16 individuals under this subdivision according to the requirements 147.17 of Public LawNumber105-33, section 4732. 147.18 [EFFECTIVE DATE.] This section is effective July 1, 2003. 147.19 Sec. 21. Minnesota Statutes 2002, section 256B.057, 147.20 subdivision 9, is amended to read: 147.21 Subd. 9. [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 147.22 assistance may be paid for a person who is employed and who: 147.23 (1) meets the definition of disabled under the supplemental 147.24 security income program; 147.25 (2) is at least 16 but less than 65 years of age; 147.26 (3) meets the asset limits in paragraph (b); and 147.27 (4) effective November 1, 2003, pays a premium, if147.28required,and other obligations under paragraph(c)(d). 147.29 Any spousal income or assets shall be disregarded for purposes 147.30 of eligibility and premium determinations. 147.31 After the month of enrollment, a person enrolled in medical 147.32 assistance under this subdivision who: 147.33 (1) is temporarily unable to work and without receipt of 147.34 earned income due to a medical condition, as verified by a 147.35 physician, may retain eligibility for up to four calendar 147.36 months; or 148.1 (2) effective January 1, 2004, loses employment for reasons 148.2 not attributable to the enrollee, may retain eligibility for up 148.3 to four consecutive months after the month of job loss. To 148.4 receive a four-month extension, enrollees must verify the 148.5 medical condition or provide notification of job loss. All 148.6 other eligibility requirements must be met and the enrollee must 148.7 pay all calculated premium costs for continued eligibility. 148.8 (b) For purposes of determining eligibility under this 148.9 subdivision, a person's assets must not exceed $20,000, 148.10 excluding: 148.11 (1) all assets excluded under section 256B.056; 148.12 (2) retirement accounts, including individual accounts, 148.13 401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 148.14 (3) medical expense accounts set up through the person's 148.15 employer. 148.16 (c)(1) Effective January 1, 2004, for purposes of 148.17 eligibility, there will be a $65 earned income disregard. To be 148.18 eligible, a person applying for medical assistance under this 148.19 subdivision must have earned income above the disregard level. 148.20 (2) Effective January 1, 2004, to be considered earned 148.21 income, Medicare, social security, and applicable state and 148.22 federal income taxes must be withheld. To be eligible, a person 148.23 must document earned income tax withholding. 148.24 (d)(1) A person whose earned and unearned income is equal 148.25 to or greater than 100 percent of federal poverty guidelines for 148.26 the applicable family size must pay a premium to be eligible for 148.27 medical assistance under this subdivision. The premium shall be 148.28 based on the person's gross earned and unearned income and the 148.29 applicable family size using a sliding fee scale established by 148.30 the commissioner, which begins at one percent of income at 100 148.31 percent of the federal poverty guidelines and increases to 7.5 148.32 percent of income for those with incomes at or above 300 percent 148.33 of the federal poverty guidelines. Annual adjustments in the 148.34 premium schedule based upon changes in the federal poverty 148.35 guidelines shall be effective for premiums due in July of each 148.36 year. 149.1 (2) Effective January 1, 2004, all enrollees must pay a 149.2 premium to be eligible for medical assistance under this 149.3 subdivision. An enrollee shall pay the greater of a $35 premium 149.4 or the premium calculated in clause (1). 149.5 (3) Effective November 1, 2003, all enrollees who receive 149.6 unearned income must pay one-half of one percent of unearned 149.7 income in addition to the premium amount. 149.8 (4) Effective November 1, 2003, for enrollees whose income 149.9 does not exceed 150 percent of the federal poverty guidelines 149.10 and who are also enrolled in Medicare, the commissioner must 149.11 reimburse the enrollee for Medicare Part B premiums under 149.12 section 256B.0625, subdivision 15, paragraph (a). 149.13(d)(e) A person's eligibility and premium shall be 149.14 determined by the local county agency. Premiums must be paid to 149.15 the commissioner. All premiums are dedicated to the 149.16 commissioner. 149.17(e)(f) Any required premium shall be determined at 149.18 application and redeterminedannually at recertificationat the 149.19 enrollee's six-month income review or when a change in income or 149.20familyhousehold sizeoccursis reported. Enrollees must report 149.21 any change in income or household size within ten days of when 149.22 the change occurs. A decreased premium resulting from a 149.23 reported change in income or household size shall be effective 149.24 the first day of the next available billing month after the 149.25 change is reported. Except for changes occurring from annual 149.26 cost-of-living increases or verification of income under section 149.27 256B.061, paragraph (b), a change resulting in an increased 149.28 premium shall not affect the premium amount until the next 149.29 six-month review. 149.30(f)(g) Premium payment is due upon notification from the 149.31 commissioner of the premium amount required. Premiums may be 149.32 paid in installments at the discretion of the commissioner. 149.33(g)(h) Nonpayment of the premium shall result in denial or 149.34 termination of medical assistance unless the person demonstrates 149.35 good cause for nonpayment. Good cause exists if the 149.36 requirements specified in Minnesota Rules, part 9506.0040, 150.1 subpart 7, items B to D, are met. Except when an installment 150.2 agreement is accepted by the commissioner, all persons 150.3 disenrolled for nonpayment of a premium must pay any past due 150.4 premiums as well as current premiums due prior to being 150.5 reenrolled. Nonpayment shall include payment with a returned, 150.6 refused, or dishonored instrument. The commissioner may require 150.7 a guaranteed form of payment as the only means to replace a 150.8 returned, refused, or dishonored instrument. 150.9 [EFFECTIVE DATE.] This section is effective November 1, 150.10 2003, except the amendments to Minnesota Statutes 2002, section 150.11 256B.057, subdivision 9, paragraphs (e) and (g), are effective 150.12 July 1, 2003. 150.13 Sec. 22. Minnesota Statutes 2002, section 256B.057, 150.14 subdivision 10, is amended to read: 150.15 Subd. 10. [CERTAIN PERSONS NEEDING TREATMENT FOR BREAST OR 150.16 CERVICAL CANCER.] (a) Medical assistance may be paid for a 150.17 person who: 150.18 (1) has been screened for breast or cervical cancer by the 150.19 Minnesota breast and cervical cancer control program, and 150.20 program funds have been used to pay for the person's screening; 150.21 (2) according to the person's treating health professional, 150.22 needs treatment, including diagnostic services necessary to 150.23 determine the extent and proper course of treatment, for breast 150.24 or cervical cancer, including precancerous conditions and early 150.25 stage cancer; 150.26 (3) meets the income eligibility guidelines for the 150.27 Minnesota breast and cervical cancer control program; 150.28 (4) is under age 65; 150.29 (5) is not otherwise eligible for medical assistance under 150.30 United States Code, title 42, section 1396(a)(10)(A)(i); and 150.31 (6) is not otherwise covered under creditable coverage, as 150.32 defined under United States Code, title 42, section 150.33300gg(c)1396a(aa). 150.34 (b) Medical assistance provided for an eligible person 150.35 under this subdivision shall be limited to services provided 150.36 during the period that the person receives treatment for breast 151.1 or cervical cancer. 151.2 (c) A person meeting the criteria in paragraph (a) is 151.3 eligible for medical assistance without meeting the eligibility 151.4 criteria relating to income and assets in section 256B.056, 151.5 subdivisions 1a to 5b. 151.6 Sec. 23. Minnesota Statutes 2002, section 256B.0595, 151.7 subdivision 1, is amended to read: 151.8 Subdivision 1. [PROHIBITED TRANSFERS.] (a) For transfers 151.9 of assets made on or before August 10, 1993, if a person or the 151.10 person's spouse has given away, sold, or disposed of, for less 151.11 than fair market value, any asset or interest therein, except 151.12 assets other than the homestead that are excluded under the 151.13 supplemental security program, within 30 months before or any 151.14 time after the date of institutionalization if the person has 151.15 been determined eligible for medical assistance, or within 30 151.16 months before or any time after the date of the first approved 151.17 application for medical assistance if the person has not yet 151.18 been determined eligible for medical assistance, the person is 151.19 ineligible for long-term care services for the period of time 151.20 determined under subdivision 2. 151.21 (b) Effective for transfers made after August 10, 1993, a 151.22 person, a person's spouse, or any person, court, or 151.23 administrative body with legal authority to act in place of, on 151.24 behalf of, at the direction of, or upon the request of the 151.25 person or person's spouse, may not give away, sell, or dispose 151.26 of, for less than fair market value, any asset or interest 151.27 therein, except assets other than the homestead that are 151.28 excluded under the supplemental security income program, for the 151.29 purpose of establishing or maintaining medical assistance 151.30 eligibility. This applies to all transfers, including those 151.31 made by a community spouse after the month in which the 151.32 institutionalized spouse is determined eligible for medical 151.33 assistance. For purposes of determining eligibility for 151.34 long-term care services, any transfer of such assets within 36 151.35 months before or any time after an institutionalized person 151.36 applies for medical assistance, or 36 months before or any time 152.1 after a medical assistance recipient becomes institutionalized, 152.2 for less than fair market value may be considered. Any such 152.3 transfer is presumed to have been made for the purpose of 152.4 establishing or maintaining medical assistance eligibility and 152.5 the person is ineligible for long-term care services for the 152.6 period of time determined under subdivision 2, unless the person 152.7 furnishes convincing evidence to establish that the transaction 152.8 was exclusively for another purpose, or unless the transfer is 152.9 permitted under subdivision 3 or 4. Notwithstanding the 152.10 provisions of this paragraph, in the case of payments from a 152.11 trust or portions of a trust that are considered transfers of 152.12 assets under federal law, any transfers made within 60 months 152.13 before or any time after an institutionalized person applies for 152.14 medical assistance and within 60 months before or any time after 152.15 a medical assistance recipient becomes institutionalized, may be 152.16 considered. 152.17 (c) This section applies to transfers, for less than fair 152.18 market value, of income or assets, including assets that are 152.19 considered income in the month received, such as inheritances, 152.20 court settlements, and retroactive benefit payments or income to 152.21 which the person or the person's spouse is entitled but does not 152.22 receive due to action by the person, the person's spouse, or any 152.23 person, court, or administrative body with legal authority to 152.24 act in place of, on behalf of, at the direction of, or upon the 152.25 request of the person or the person's spouse. 152.26 (d) This section applies to payments for care or personal 152.27 services provided by a relative, unless the compensation was 152.28 stipulated in a notarized, written agreement which was in 152.29 existence when the service was performed, the care or services 152.30 directly benefited the person, and the payments made represented 152.31 reasonable compensation for the care or services provided. A 152.32 notarized written agreement is not required if payment for the 152.33 services was made within 60 days after the service was provided. 152.34 (e) This section applies to the portion of any asset or 152.35 interest that a person, a person's spouse, or any person, court, 152.36 or administrative body with legal authority to act in place of, 153.1 on behalf of, at the direction of, or upon the request of the 153.2 person or the person's spouse, transfers to any annuity that 153.3 exceeds the value of the benefit likely to be returned to the 153.4 person or spouse while alive, based on estimated life expectancy 153.5 using the life expectancy tables employed by the supplemental 153.6 security income program to determine the value of an agreement 153.7 for services for life. The commissioner may adopt rules 153.8 reducing life expectancies based on the need for long-term 153.9 care. This section applies to an annuity described in this 153.10 paragraph purchased on or after March 1, 2002, that: 153.11 (1) is not purchased from an insurance company or financial 153.12 institution that is subject to licensing or regulation by the 153.13 Minnesota department of commerce or a similar regulatory agency 153.14 of another state; 153.15 (2) does not pay out principal and interest in equal 153.16 monthly installments; or 153.17 (3) does not begin payment at the earliest possible date 153.18 after annuitization. 153.19 (f) For purposes of this section, long-term care services 153.20 include services in a nursing facility, services that are 153.21 eligible for payment according to section 256B.0625, subdivision 153.22 2, because they are provided in a swing bed, intermediate care 153.23 facility for persons with mental retardation, and home and 153.24 community-based services provided pursuant to sections 153.25 256B.0915, 256B.092, and 256B.49. For purposes of this 153.26 subdivision and subdivisions 2, 3, and 4, "institutionalized 153.27 person" includes a person who is an inpatient in a nursing 153.28 facility or in a swing bed, or intermediate care facility for 153.29 persons with mental retardation or who is receiving home and 153.30 community-based services under sections 256B.0915, 256B.092, and 153.31 256B.49. 153.32 [EFFECTIVE DATE.] This section is effective July 1, 2003. 153.33 Sec. 24. Minnesota Statutes 2002, section 256B.0595, is 153.34 amended by adding a subdivision to read: 153.35 Subd. 1b. [PROHIBITED TRANSFERS.] (a) Notwithstanding any 153.36 contrary provisions of this section, this subdivision applies to 154.1 transfers involving recipients of medical assistance that are 154.2 made on or after July 1, 2003, and to all transfers involving 154.3 persons who apply for medical assistance on or after July 1, 154.4 2003, if the transfer occurred within 72 months before the 154.5 person applies for medical assistance, except that this 154.6 subdivision does not apply to transfers made prior to July 1, 154.7 2003. A person, a person's spouse, or any person, court, or 154.8 administrative body with legal authority to act in place of, on 154.9 behalf of, at the direction of, or upon the request of the 154.10 person or the person's spouse, may not give away, sell, dispose 154.11 of, or reduce ownership or control of any income, asset, or 154.12 interest therein for less than fair market value for the purpose 154.13 of establishing or maintaining medical assistance eligibility. 154.14 This applies to all transfers, including those made by a 154.15 community spouse after the month in which the institutionalized 154.16 spouse is determined eligible for medical assistance. For 154.17 purposes of determining eligibility for medical assistance 154.18 services, any transfer of such income or assets for less than 154.19 fair market value within 72 months before or any time after a 154.20 person applies for medical assistance may be considered. Any 154.21 such transfer is presumed to have been made for the purpose of 154.22 establishing or maintaining medical assistance eligibility, and 154.23 the person is ineligible for medical assistance services for the 154.24 period of time determined under subdivision 2b, unless the 154.25 person furnishes convincing evidence to establish that the 154.26 transaction was exclusively for another purpose or unless the 154.27 transfer is permitted under subdivision 3b or 4b. 154.28 (b) This section applies to transfers to trusts. The 154.29 commissioner shall determine valid trust purposes under this 154.30 section. Assets placed into a trust that is not for a valid 154.31 purpose shall always be considered available for the purposes of 154.32 medical assistance eligibility, regardless of when the trust is 154.33 established. 154.34 (c) This section applies to transfers of income or assets 154.35 for less than fair market value, including assets that are 154.36 considered income in the month received, such as inheritances, 155.1 court settlements, and retroactive benefit payments or income to 155.2 which the person or the person's spouse is entitled but does not 155.3 receive due to action by the person, the person's spouse, or any 155.4 person, court, or administrative body with legal authority to 155.5 act in place of, on behalf of, at the direction of, or upon the 155.6 request of the person or the person's spouse. 155.7 (d) This section applies to payments for care or personal 155.8 services provided by a relative, unless the compensation was 155.9 stipulated in a notarized written agreement that was in 155.10 existence when the service was performed, the care or services 155.11 directly benefited the person, and the payments made represented 155.12 reasonable compensation for the care or services provided. A 155.13 notarized written agreement is not required if payment for the 155.14 services was made within 60 days after the service was provided. 155.15 (e) This section applies to the portion of any income, 155.16 asset, or interest therein that a person, a person's spouse, or 155.17 any person, court, or administrative body with legal authority 155.18 to act in place of, on behalf of, at the direction of, or upon 155.19 the request of the person or the person's spouse, transfers to 155.20 any annuity that exceeds the value of the benefit likely to be 155.21 returned to the person or the person's spouse while alive, based 155.22 on estimated life expectancy, using the life expectancy tables 155.23 employed by the supplemental security income program, or based 155.24 on a shorter life expectancy if the annuitant had a medical 155.25 condition that would shorten the annuitant's life expectancy and 155.26 that was diagnosed before funds were placed into the annuity. 155.27 The agency may request and receive a physician's statement to 155.28 determine if the annuitant had a diagnosed medical condition 155.29 that would shorten the annuitant's life expectancy. If so, the 155.30 agency shall determine the expected value of the benefits based 155.31 upon the physician's statement instead of using a life 155.32 expectancy table. This section applies to an annuity described 155.33 in this paragraph purchased on or after March 1, 2002, that: 155.34 (1) is not purchased from an insurance company or financial 155.35 institution that is subject to licensing or regulation by the 155.36 Minnesota department of commerce or a similar regulatory agency 156.1 of another state; 156.2 (2) does not pay out principal and interest in equal 156.3 monthly installments; or 156.4 (3) does not begin payment at the earliest possible date 156.5 after annuitization. 156.6 (f) Transfers under this section shall affect 156.7 determinations of eligibility for all medical assistance 156.8 services or long-term care services, whichever receives federal 156.9 approval. 156.10 [EFFECTIVE DATE.] (a) This section is effective July 1, 156.11 2003, to the extent permitted by federal law. If any provision 156.12 of this section is prohibited by federal law, the provision 156.13 shall become effective when federal law is changed to permit its 156.14 application or a waiver is received. The commissioner of human 156.15 services shall notify the revisor of statutes when federal law 156.16 is enacted or a waiver or other federal approval is received and 156.17 publish a notice in the State Register. The commissioner must 156.18 include the notice in the first State Register published after 156.19 the effective date of the federal changes. 156.20 (b) If, by July 1, 2003, any provision of this section is 156.21 not effective because of prohibitions in federal law, the 156.22 commissioner of human services shall apply to the federal 156.23 government by August 1, 2003, for a waiver of those prohibitions 156.24 or other federal authority, and that provision shall become 156.25 effective upon receipt of a federal waiver or other federal 156.26 approval, notification to the revisor of statutes, and 156.27 publication of a notice in the State Register to that effect. 156.28 In applying for federal approval to extend the lookback period, 156.29 the commissioner shall seek the longest lookback period the 156.30 federal government will approve, not to exceed 72 months. 156.31 Sec. 25. Minnesota Statutes 2002, section 256B.0595, 156.32 subdivision 2, is amended to read: 156.33 Subd. 2. [PERIOD OF INELIGIBILITY.] (a) For any 156.34 uncompensated transfer occurring on or before August 10, 1993, 156.35 the number of months of ineligibility for long-term care 156.36 services shall be the lesser of 30 months, or the uncompensated 157.1 transfer amount divided by the average medical assistance rate 157.2 for nursing facility services in the state in effect on the date 157.3 of application. The amount used to calculate the average 157.4 medical assistance payment rate shall be adjusted each July 1 to 157.5 reflect payment rates for the previous calendar year. The 157.6 period of ineligibility begins with the month in which the 157.7 assets were transferred. If the transfer was not reported to 157.8 the local agency at the time of application, and the applicant 157.9 received long-term care services during what would have been the 157.10 period of ineligibility if the transfer had been reported, a 157.11 cause of action exists against the transferee for the cost of 157.12 long-term care services provided during the period of 157.13 ineligibility, or for the uncompensated amount of the transfer, 157.14 whichever is less. The action may be brought by the state or 157.15 the local agency responsible for providing medical assistance 157.16 under chapter 256G. The uncompensated transfer amount is the 157.17 fair market value of the asset at the time it was given away, 157.18 sold, or disposed of, less the amount of compensation received. 157.19 (b) For uncompensated transfers made after August 10, 1993, 157.20 the number of months of ineligibility for long-term care 157.21 services shall be the total uncompensated value of the resources 157.22 transferred divided by the average medical assistance rate for 157.23 nursing facility services in the state in effect on the date of 157.24 application. The amount used to calculate the average medical 157.25 assistance payment rate shall be adjusted each July 1 to reflect 157.26 payment rates for the previous calendar year. The period of 157.27 ineligibility begins with the first day of the month after the 157.28 month in which the assets were transferred except that if one or 157.29 more uncompensated transfers are made during a period of 157.30 ineligibility, the total assets transferred during the 157.31 ineligibility period shall be combined and a penalty period 157.32 calculated to begininon the first day of the month after the 157.33 month in which the first uncompensated transfer was made. If 157.34 the transfer was not reported to the local agencyat the time of157.35application, and the applicant received medical assistance 157.36 services during what would have been the period of ineligibility 158.1 if the transfer had been reported, a cause of action exists 158.2 against the transferee for the cost of medical assistance 158.3 services provided during the period of ineligibility, or for the 158.4 uncompensated amount of the transfer, whichever is less. The 158.5 action may be brought by the state or the local agency 158.6 responsible for providing medical assistance under chapter 158.7 256G. The uncompensated transfer amount is the fair market 158.8 value of the asset at the time it was given away, sold, or 158.9 disposed of, less the amount of compensation received. 158.10 Effective for transfers made on or after March 1, 1996, 158.11 involving persons who apply for medical assistance on or after 158.12 April 13, 1996, no cause of action exists for a transfer unless: 158.13 (1) the transferee knew or should have known that the 158.14 transfer was being made by a person who was a resident of a 158.15 long-term care facility or was receiving that level of care in 158.16 the community at the time of the transfer; 158.17 (2) the transferee knew or should have known that the 158.18 transfer was being made to assist the person to qualify for or 158.19 retain medical assistance eligibility; or 158.20 (3) the transferee actively solicited the transfer with 158.21 intent to assist the person to qualify for or retain eligibility 158.22 for medical assistance. 158.23 (c) If a calculation of a penalty period results in a 158.24 partial month, payments for long-term care services shall be 158.25 reduced in an amount equal to the fraction, except that in 158.26 calculating the value of uncompensated transfers, if the total 158.27 value of all uncompensated transfers made in a month not 158.28 included in an existing penalty period does not exceed $200, 158.29 then such transfers shall be disregarded for each month prior to 158.30 the month of application for or during receipt of medical 158.31 assistance. 158.32 [EFFECTIVE DATE.] Paragraph (b) of this section is 158.33 effective July 1, 2003. 158.34 Sec. 26. Minnesota Statutes 2002, section 256B.0595, is 158.35 amended by adding a subdivision to read: 158.36 Subd. 2b. [PERIOD OF INELIGIBILITY.] (a) Notwithstanding 159.1 any contrary provisions of this section, this subdivision 159.2 applies to transfers, including transfers to trusts, involving 159.3 recipients of medical assistance that are made on or after July 159.4 1, 2003, and to all transfers involving persons who apply for 159.5 medical assistance on or after July 1, 2003, regardless of when 159.6 the transfer occurred, except that this subdivision does not 159.7 apply to transfers made prior to July 1, 2003. For any 159.8 uncompensated transfer occurring within 72 months prior to the 159.9 date of application, at any time after application, or while 159.10 eligible, the number of months of cumulative ineligibility for 159.11 medical assistance services shall be the total uncompensated 159.12 value of the assets and income transferred divided by the 159.13 statewide average per-person nursing facility payment made by 159.14 the state in effect at the time a penalty for a transfer is 159.15 determined. The amount used to calculate the average per-person 159.16 nursing facility payment shall be adjusted each July 1 to 159.17 reflect average payments for the previous calendar year. For 159.18 applicants, the period of ineligibility begins with the month in 159.19 which the person applied for medical assistance and satisfied 159.20 all other requirements for eligibility, or the first month the 159.21 local agency becomes aware of the transfer and can give proper 159.22 notice, if later. For recipients, the period of ineligibility 159.23 begins in the first month after the month the agency becomes 159.24 aware of the transfer and can give proper notice, except that 159.25 penalty periods for transfers made during a period of 159.26 ineligibility as determined under this section shall begin in 159.27 the month following the existing period of ineligibility. If 159.28 the transfer was not reported to the local agency, and the 159.29 applicant received medical assistance services during what would 159.30 have been the period of ineligibility if the transfer had been 159.31 reported, a cause of action exists against the transferee for 159.32 the cost of medical assistance services provided during the 159.33 period of ineligibility or for the uncompensated amount of the 159.34 transfer that was not recovered from the transferor through the 159.35 implementation of a penalty period under this subdivision, 159.36 whichever is less. Recovery shall include the costs incurred 160.1 due to the action. The action may be brought by the state or 160.2 the local agency responsible for providing medical assistance 160.3 under chapter 256B. The uncompensated transfer amount is the 160.4 fair market value of the asset at the time it was given away, 160.5 sold, or disposed of, less the amount of compensation received. 160.6 No cause of action exists for a transfer unless: 160.7 (1) the transferee knew or should have known that the 160.8 transfer was being made by a person who was a resident of a 160.9 long-term care facility or was receiving that level of care in 160.10 the community at the time of the transfer; 160.11 (2) the transferee knew or should have known that the 160.12 transfer was being made to assist the person to qualify for or 160.13 retain medical assistance eligibility; or 160.14 (3) the transferee actively solicited the transfer with 160.15 intent to assist the person to qualify for or retain eligibility 160.16 for medical assistance. 160.17 (b) If a calculation of a penalty period results in a 160.18 partial month, payments for medical assistance services shall be 160.19 reduced in an amount equal to the fraction, except that in 160.20 calculating the value of uncompensated transfers, if the total 160.21 value of all uncompensated transfers made in a month not 160.22 included in an existing penalty period does not exceed $200, 160.23 then such transfers shall be disregarded for each month prior to 160.24 the month of application for or during receipt of medical 160.25 assistance. 160.26 (c) Ineligibility under this section shall apply to medical 160.27 assistance services or long-term care services, whichever 160.28 receives federal approval. 160.29 [EFFECTIVE DATE.] (a) This section is effective July 1, 160.30 2003, to the extent permitted by federal law. If any provision 160.31 of this section is prohibited by federal law, the provision 160.32 shall become effective when federal law is changed to permit its 160.33 application or a waiver is received. The commissioner of human 160.34 services shall notify the revisor of statutes when federal law 160.35 is enacted or a waiver or other federal approval is received and 160.36 publish a notice in the State Register. The commissioner must 161.1 include the notice in the first State Register published after 161.2 the effective date of the federal changes. 161.3 (b) If, by July 1, 2003, any provision of this section is 161.4 not effective because of prohibitions in federal law, the 161.5 commissioner of human services shall apply to the federal 161.6 government by August 1, 2003, for a waiver of those prohibitions 161.7 or other federal authority, and that provision shall become 161.8 effective upon receipt of a federal waiver or other federal 161.9 approval, notification to the revisor of statutes, and 161.10 publication of a notice in the State Register to that effect. 161.11 In applying for federal approval to extend the lookback period, 161.12 the commissioner shall seek the longest lookback period the 161.13 federal government will approve, not to exceed 72 months. 161.14 Sec. 27. Minnesota Statutes 2002, section 256B.0595, is 161.15 amended by adding a subdivision to read: 161.16 Subd. 3b. [HOMESTEAD EXCEPTION TO TRANSFER 161.17 PROHIBITION.] (a) This subdivision applies to transfers 161.18 involving recipients of medical assistance that are made on or 161.19 after July 1, 2003, and to all transfers involving persons who 161.20 apply for medical assistance on or after July 1, 2003, 161.21 regardless of when the transfer occurred, except that this 161.22 subdivision does not apply to transfers made prior to July 1, 161.23 2003. A person is not ineligible for medical assistance 161.24 services due to a transfer of assets for less than fair market 161.25 value as described in subdivision 1b, if the asset transferred 161.26 was a homestead, and: 161.27 (1) a satisfactory showing is made that the individual 161.28 intended to dispose of the homestead at fair market value or for 161.29 other valuable consideration; or 161.30 (2) the local agency grants a waiver of a penalty resulting 161.31 from a transfer for less than fair market value because denial 161.32 of eligibility would cause undue hardship for the individual and 161.33 there exists an imminent threat to the individual's health and 161.34 well-being. Whenever an applicant or recipient is denied 161.35 eligibility because of a transfer for less than fair market 161.36 value, the local agency shall notify the applicant or recipient 162.1 that the applicant or recipient may request a waiver of the 162.2 penalty if the denial of eligibility will cause undue hardship. 162.3 In evaluating a waiver, the local agency shall take into account 162.4 whether the individual was the victim of financial exploitation, 162.5 whether the individual has made reasonable efforts to recover 162.6 the transferred property or resource, and other factors relevant 162.7 to a determination of hardship. If the local agency does not 162.8 approve a hardship waiver, the local agency shall issue a 162.9 written notice to the individual stating the reasons for the 162.10 denial and the process for appealing the local agency's decision. 162.11 (b) When a waiver is granted under paragraph (a), clause 162.12 (2), a cause of action exists against the person to whom the 162.13 homestead was transferred for that portion of medical assistance 162.14 services granted within 72 months of the date the transferor 162.15 applied for medical assistance and satisfied all other 162.16 requirements for eligibility or the amount of the uncompensated 162.17 transfer, whichever is less, together with the costs incurred 162.18 due to the action. The action shall be brought by the state 162.19 unless the state delegates this responsibility to the local 162.20 agency responsible for providing medical assistance under 162.21 chapter 256B. 162.22 [EFFECTIVE DATE.] (a) This section is effective July 1, 162.23 2003, to the extent permitted by federal law. If any provision 162.24 of this section is prohibited by federal law, the provision 162.25 shall become effective when federal law is changed to permit its 162.26 application or a waiver is received. The commissioner of human 162.27 services shall notify the revisor of statutes when federal law 162.28 is enacted or a waiver or other federal approval is received and 162.29 publish a notice in the State Register. The commissioner must 162.30 include the notice in the first State Register published after 162.31 the effective date of the federal changes. 162.32 (b) If, by July 1, 2003, any provision of this section is 162.33 not effective because of prohibitions in federal law, the 162.34 commissioner of human services shall apply to the federal 162.35 government by August 1, 2003, for a waiver of those prohibitions 162.36 or other federal authority, and that provision shall become 163.1 effective upon receipt of a federal waiver or other federal 163.2 approval, notification to the revisor of statutes, and 163.3 publication of a notice in the State Register to that effect. 163.4 In applying for federal approval to extend the lookback period, 163.5 the commissioner shall seek the longest lookback period the 163.6 federal government will approve, not to exceed 72 months. 163.7 Sec. 28. Minnesota Statutes 2002, section 256B.0595, is 163.8 amended by adding a subdivision to read: 163.9 Subd. 4b. [OTHER EXCEPTIONS TO TRANSFER PROHIBITION.] (a) 163.10 This subdivision applies to transfers involving recipients of 163.11 medical assistance that are made on or after July 1, 2003, and 163.12 to all transfers involving persons who apply for medical 163.13 assistance on or after July 1, 2003, regardless of when the 163.14 transfer occurred, except that this subdivision does not apply 163.15 to transfers made prior to July 1, 2003. A person or a person's 163.16 spouse who made a transfer prohibited by subdivision 1b is not 163.17 ineligible for medical assistance services if one of the 163.18 following conditions applies: 163.19 (1) the assets or income were transferred to the 163.20 individual's spouse or to another for the sole benefit of the 163.21 spouse, except that after eligibility is established and the 163.22 assets have been divided between the spouses as part of the 163.23 asset allowance under section 256B.059, no further transfers 163.24 between spouses may be made; 163.25 (2) the institutionalized spouse, prior to being 163.26 institutionalized, transferred assets or income to a spouse, 163.27 provided that the spouse to whom the assets or income were 163.28 transferred does not then transfer those assets or income to 163.29 another person for less than fair market value. At the time 163.30 when one spouse is institutionalized, assets must be allocated 163.31 between the spouses as provided under section 256B.059; 163.32 (3) the assets or income were transferred to a trust for 163.33 the sole benefit of the individual's child who is blind or 163.34 permanently and totally disabled as determined in the 163.35 supplemental security income program and the trust reverts to 163.36 the state upon the disabled child's death to the extent the 164.1 medical assistance has paid for services for the grantor or 164.2 beneficiary of the trust. This clause applies to a trust 164.3 established after the commissioner publishes a notice in the 164.4 State Register that the commissioner has been authorized to 164.5 implement this clause due to a change in federal law or the 164.6 approval of a federal waiver; 164.7 (4) a satisfactory showing is made that the individual 164.8 intended to dispose of the assets or income either at fair 164.9 market value or for other valuable consideration; or 164.10 (5) the local agency determines that denial of eligibility 164.11 for medical assistance services would cause undue hardship and 164.12 grants a waiver of a penalty resulting from a transfer for less 164.13 than fair market value because there exists an imminent threat 164.14 to the individual's health and well-being. Whenever an 164.15 applicant or recipient is denied eligibility because of a 164.16 transfer for less than fair market value, the local agency shall 164.17 notify the applicant or recipient that the applicant or 164.18 recipient may request a waiver of the penalty if the denial of 164.19 eligibility will cause undue hardship. In evaluating a waiver, 164.20 the local agency shall take into account whether the individual 164.21 was the victim of financial exploitation, whether the individual 164.22 has made reasonable efforts to recover the transferred property 164.23 or resource, and other factors relevant to a determination of 164.24 hardship. If the local agency does not approve a hardship 164.25 waiver, the local agency shall issue a written notice to the 164.26 individual stating the reasons for the denial and the process 164.27 for appealing the local agency's decision. When a waiver is 164.28 granted, a cause of action exists against the person to whom the 164.29 assets were transferred for that portion of medical assistance 164.30 services granted within 72 months of the date the transferor 164.31 applied for medical assistance and satisfied all other 164.32 requirements for eligibility, or the amount of the uncompensated 164.33 transfer, whichever is less, together with the costs incurred 164.34 due to the action. The action shall be brought by the state 164.35 unless the state delegates this responsibility to the local 164.36 agency responsible for providing medical assistance under this 165.1 chapter. 165.2 [EFFECTIVE DATE.] (a) This section is effective July 1, 165.3 2003, to the extent permitted by federal law. If any provision 165.4 of this section is prohibited by federal law, the provision 165.5 shall become effective when federal law is changed to permit its 165.6 application or a waiver is received. The commissioner of human 165.7 services shall notify the revisor of statutes when federal law 165.8 is enacted or a waiver or other federal approval is received and 165.9 publish a notice in the State Register. The commissioner must 165.10 include the notice in the first State Register published after 165.11 the effective date of the federal changes. 165.12 (b) If, by July 1, 2003, any provision of this section is 165.13 not effective because of prohibitions in federal law, the 165.14 commissioner of human services shall apply to the federal 165.15 government by August 1, 2003, for a waiver of those prohibitions 165.16 or other federal authority, and that provision shall become 165.17 effective upon receipt of a federal waiver or other federal 165.18 approval, notification to the revisor of statutes, and 165.19 publication of a notice in the State Register to that effect. 165.20 In applying for federal approval to extend the lookback period, 165.21 the commissioner shall seek the longest lookback period the 165.22 federal government will approve, not to exceed 72 months. 165.23 Sec. 29. Minnesota Statutes 2002, section 256B.06, 165.24 subdivision 4, is amended to read: 165.25 Subd. 4. [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for 165.26 medical assistance is limited to citizens of the United States, 165.27 qualified noncitizens as defined in this subdivision, and other 165.28 persons residing lawfully in the United States. 165.29 (b) "Qualified noncitizen" means a person who meets one of 165.30 the following immigration criteria: 165.31 (1) admitted for lawful permanent residence according to 165.32 United States Code, title 8; 165.33 (2) admitted to the United States as a refugee according to 165.34 United States Code, title 8, section 1157; 165.35 (3) granted asylum according to United States Code, title 165.36 8, section 1158; 166.1 (4) granted withholding of deportation according to United 166.2 States Code, title 8, section 1253(h); 166.3 (5) paroled for a period of at least one year according to 166.4 United States Code, title 8, section 1182(d)(5); 166.5 (6) granted conditional entrant status according to United 166.6 States Code, title 8, section 1153(a)(7); 166.7 (7) determined to be a battered noncitizen by the United 166.8 States Attorney General according to the Illegal Immigration 166.9 Reform and Immigrant Responsibility Act of 1996, title V of the 166.10 Omnibus Consolidated Appropriations Bill, Public Law Number 166.11 104-200; 166.12 (8) is a child of a noncitizen determined to be a battered 166.13 noncitizen by the United States Attorney General according to 166.14 the Illegal Immigration Reform and Immigrant Responsibility Act 166.15 of 1996, title V, of the Omnibus Consolidated Appropriations 166.16 Bill, Public Law Number 104-200; or 166.17 (9) determined to be a Cuban or Haitian entrant as defined 166.18 in section 501(e) of Public Law Number 96-422, the Refugee 166.19 Education Assistance Act of 1980. 166.20 (c) All qualified noncitizens who were residing in the 166.21 United States before August 22, 1996, who otherwise meet the 166.22 eligibility requirements of chapter 256B, are eligible for 166.23 medical assistance with federal financial participation. 166.24 (d) All qualified noncitizens who entered the United States 166.25 on or after August 22, 1996, and who otherwise meet the 166.26 eligibility requirements of chapter 256B, are eligible for 166.27 medical assistance with federal financial participation through 166.28 November 30, 1996. 166.29 Beginning December 1, 1996, qualified noncitizens who 166.30 entered the United States on or after August 22, 1996, and who 166.31 otherwise meet the eligibility requirements of chapter 256B are 166.32 eligible for medical assistance with federal participation for 166.33 five years if they meet one of the following criteria: 166.34 (i) refugees admitted to the United States according to 166.35 United States Code, title 8, section 1157; 166.36 (ii) persons granted asylum according to United States 167.1 Code, title 8, section 1158; 167.2 (iii) persons granted withholding of deportation according 167.3 to United States Code, title 8, section 1253(h); 167.4 (iv) veterans of the United States Armed Forces with an 167.5 honorable discharge for a reason other than noncitizen status, 167.6 their spouses and unmarried minor dependent children; or 167.7 (v) persons on active duty in the United States Armed 167.8 Forces, other than for training, their spouses and unmarried 167.9 minor dependent children. 167.10 Beginning December 1, 1996, qualified noncitizens who do 167.11 not meet one of the criteria in items (i) to (v) are eligible 167.12 for medical assistance without federal financial participation 167.13 as described in paragraph(j)(i). 167.14 (e) Noncitizens who are not qualified noncitizens as 167.15 defined in paragraph (b), who are lawfully residing in the 167.16 United States and who otherwise meet the eligibility 167.17 requirements of chapter 256B, are eligible for medical 167.18 assistance under clauses (1) to (3). These individuals must 167.19 cooperate with the Immigration and Naturalization Service to 167.20 pursue any applicable immigration status, including citizenship, 167.21 that would qualify them for medical assistance with federal 167.22 financial participation. 167.23 (1) Persons who were medical assistance recipients on 167.24 August 22, 1996, are eligible for medical assistance with 167.25 federal financial participation through December 31, 1996. 167.26 (2) Beginning January 1, 1997, persons described in clause 167.27 (1) are eligible for medical assistance without federal 167.28 financial participation as described in paragraph(j)(i). 167.29 (3) Beginning December 1, 1996, persons residing in the 167.30 United States prior to August 22, 1996, who were not receiving 167.31 medical assistance and persons who arrived on or after August 167.32 22, 1996, are eligible for medical assistance without federal 167.33 financial participation as described in paragraph(j)(i). 167.34 (f) Nonimmigrants who otherwise meet the eligibility 167.35 requirements of chapter 256B are eligible for the benefits as 167.36 provided in paragraphs (g)to (i)and (h). For purposes of this 168.1 subdivision, a "nonimmigrant" is a person in one of the classes 168.2 listed in United States Code, title 8, section 1101(a)(15). 168.3 (g) Payment shall also be made for care and services that 168.4 are furnished to noncitizens, regardless of immigration status, 168.5 who otherwise meet the eligibility requirements of chapter 256B, 168.6 if such care and services are necessary for the treatment of an 168.7 emergency medical condition, except for organ transplants and 168.8 related care and services and routine prenatal care. 168.9 (h) For purposes of this subdivision, the term "emergency 168.10 medical condition" means a medical condition that meets the 168.11 requirements of United States Code, title 42, section 1396b(v). 168.12 (i)Pregnant noncitizens who are undocumented or168.13nonimmigrants, who otherwise meet the eligibility requirements168.14of chapter 256B, are eligible for medical assistance payment168.15without federal financial participation for care and services168.16through the period of pregnancy, and 60 days postpartum, except168.17for labor and delivery.168.18(j)Qualified noncitizens as described in paragraph (d), 168.19 and all other noncitizens lawfully residing in the United States 168.20 as described in paragraph (e), who are ineligible for medical 168.21 assistance with federal financial participation and who 168.22 otherwise meet the eligibility requirements of chapter 256B and 168.23 of this paragraph, are eligible for medical assistance without 168.24 federal financial participation. Qualified noncitizens as 168.25 described in paragraph (d) are only eligible for medical 168.26 assistance without federal financial participation for five 168.27 years from their date of entry into the United States. 168.28(k) The commissioner shall submit to the legislature by168.29December 31, 1998, a report on the number of recipients and cost168.30of coverage of care and services made according to paragraphs168.31(i) and (j).168.32 (j) Beginning October 1, 2003, persons who are receiving 168.33 care and rehabilitation services from a nonprofit center 168.34 established to serve victims of torture and are otherwise 168.35 ineligible for medical assistance under chapter 256B or general 168.36 assistance medical care under section 256D.03 are eligible for 169.1 medical assistance without federal financial participation. 169.2 These individuals are eligible only for the period during which 169.3 they are receiving services from the center. Individuals 169.4 eligible under this clause shall not be required to participate 169.5 in prepaid medical assistance. 169.6 [EFFECTIVE DATE.] This section is effective July 1, 2003, 169.7 except where a different date is specified in the text. 169.8 Sec. 30. Minnesota Statutes 2002, section 256B.061, is 169.9 amended to read: 169.10 256B.061 [ELIGIBILITY; RETROACTIVE EFFECT; RESTRICTIONS.] 169.11(a)If any individual has been determined to be eligible 169.12 for medical assistance, it will be made available for care and 169.13 services included under the plan and furnished in or after the 169.14 third month before the month in which the individual made 169.15 application for such assistance, if such individual was, or upon 169.16 application would have been, eligible for medical assistance at 169.17 the time the care and services were furnished. The commissioner 169.18 may limit, restrict, or suspend the eligibility of an individual 169.19 for up to one year upon that individual's conviction of a 169.20 criminal offense related to application for or receipt of 169.21 medical assistance benefits. 169.22(b) On the basis of information provided on the completed169.23application, an applicant who meets the following criteria shall169.24be determined eligible beginning in the month of application:169.25(1) whose gross income is less than 90 percent of the169.26applicable income standard;169.27(2) whose total liquid assets are less than 90 percent of169.28the asset limit;169.29(3) does not reside in a long-term care facility; and169.30(4) meets all other eligibility requirements.169.31The applicant must provide all required verifications within 30169.32days' notice of the eligibility determination or eligibility169.33shall be terminated.169.34 [EFFECTIVE DATE.] This section is effective July 1, 2003. 169.35 Sec. 31. Minnesota Statutes 2002, section 256B.0625, 169.36 subdivision 5a, is amended to read: 170.1 Subd. 5a. [INTENSIVE EARLY INTERVENTION BEHAVIOR THERAPY 170.2 SERVICES FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS.](a)170.3 [COVERAGE.] Medical assistance covers home-based intensive early 170.4 intervention behavior therapy for children with autism spectrum 170.5 disorders, effective July 1, 2007. Children with autism 170.6 spectrum disorder, and their custodial parents or foster 170.7 parents, may access other covered services to treat autism 170.8 spectrum disorder, and are not required to receive intensive 170.9 early intervention behavior therapy services under this 170.10 subdivision. Intensive early intervention behavior therapy does 170.11 not include coverage for services to treat developmental 170.12 disorders of language, early onset psychosis, Rett's disorder, 170.13 selective mutism, social anxiety disorder, stereotypic movement 170.14 disorder, dementia, obsessive compulsive disorder, schizoid 170.15 personality disorder, avoidant personality disorder, or reactive 170.16 attachment disorder. If a child with autism spectrum disorder 170.17 is diagnosed to have one or more of these conditions, intensive 170.18 early intervention behavior therapy includes coverage only for 170.19 services necessary to treat the autism spectrum disorder. 170.20(b)Subd. 5b. [PURPOSE OF INTENSIVE EARLY INTERVENTION 170.21 BEHAVIOR THERAPY SERVICES (IEIBTS).] The purpose of IEIBTS is to 170.22 improve the child's behavioral functioning, to prevent 170.23 development of challenging behaviors, to eliminate autistic 170.24 behaviors, to reduce the risk of out-of-home placement, and to 170.25 establish independent typical functioning in language and social 170.26 behavior. The procedures used to accomplish these goals are 170.27 based upon research in applied behavior analysis. 170.28(c)Subd. 5c. [ELIGIBLE CHILDREN.] A child is eligible to 170.29 initiate IEIBTS if, the child meets the additional eligibility 170.30 criteria in paragraph (d) and in a diagnostic assessment by a 170.31 mental health professional who is not under the employ of the 170.32 service provider, the child: 170.33 (1) is found to have an autism spectrum disorder; 170.34 (2) has a current IQ of either untestable, or at least 30; 170.35 (3) if nonverbal, initiated behavior therapy by 42 months 170.36 of age; 171.1 (4) if verbal, initiated behavior therapy by 48 months of 171.2 age; or 171.3 (5) if having an IQ of at least 50, initiated behavior 171.4 therapy by 84 months of age. 171.5 To continue after six-month individualized treatment plan (ITP) 171.6 reviews, at least one of the child's custodial parents or foster 171.7 parents must participate in an average of at least five hours of 171.8 documented behavior therapy per week for six months, and 171.9 consistently implement behavior therapy recommendations 24 hours 171.10 a day. To continue after six-month individualized treatment 171.11 plan (ITP) reviews, the child must show documented progress 171.12 toward mastery of six-month benchmark behavior objectives. The 171.13 maximum number of months during which services may be billed is 171.14 54, or up to the month of August in the first year in which the 171.15 child completes first grade, whichever comes last. If 171.16 significant progress towards treatment goals has not been 171.17 achieved after 24 months of treatment, treatment must be 171.18 discontinued. 171.19(d)Subd. 5d. [ADDITIONAL ELIGIBILITY CRITERIA.] A child 171.20 is eligible to initiate IEIBTS if: 171.21 (1) in medical and diagnostic assessments by medical and 171.22 mental health professionals, it is determined that the child 171.23 does not have severe or profound mental retardation; 171.24 (2) an accurate assessment of the child's hearing has been 171.25 performed, including audiometry if the brain stem auditory 171.26 evokes response; 171.27 (3) a blood lead test has been performed prior to 171.28 initiation of treatment; and 171.29 (4) an EEG or neurologic evaluation is done, prior to 171.30 initiation of treatment, if the child has a history of staring 171.31 spells or developmental regression. 171.32(e)Subd. 5e. [COVERED SERVICES.] The focus of IEIBTS must 171.33 be to treat the principal diagnostic features of the autism 171.34 spectrum disorder. All IEIBTS must be delivered by a team of 171.35 practitioners under the consistent supervision of a single 171.36 clinical supervisor. A mental health professional must develop 172.1 the ITP for IEIBTS. The ITP must include six-month benchmark 172.2 behavior objectives. All behavior therapy must be based upon 172.3 research in applied behavior analysis, with an emphasis upon 172.4 positive reinforcement of carefully task-analyzed skills for 172.5 optimum rates of progress. All behavior therapy must be 172.6 consistently applied and generalized throughout the 24-hour day 172.7 and seven-day week by all of the child's regular care 172.8 providers. When placing the child in school activities, a 172.9 majority of the peers must have no mental health diagnosis, and 172.10 the child must have sufficient social skills to succeed with 80 172.11 percent of the school activities. Reactive consequences, such 172.12 as redirection, correction, positive practice, or time-out, must 172.13 be used only when necessary to improve the child's success when 172.14 proactive procedures alone have not been effective. IEIBTS must 172.15 be delivered by a team of behavior therapy practitioners who are 172.16 employed under the direction of the same agency. The team may 172.17 deliver up to 200 billable hours per year of direct clinical 172.18 supervisor services, up to 700 billable hours per year of senior 172.19 behavior therapist services, and up to 1,800 billable hours per 172.20 year of direct behavior therapist services. A one-hour clinical 172.21 review meeting for the child, parents, and staff must be 172.22 scheduled 50 weeks a year, at which behavior therapy is reviewed 172.23 and planned. At least one-quarter of the annual clinical 172.24 supervisor billable hours shall consist of on-site clinical 172.25 meeting time. At least one-half of the annual senior behavior 172.26 therapist billable hours shall consist of direct services to the 172.27 child or parents. All of the behavioral therapist billable 172.28 hours shall consist of direct on-site services to the child or 172.29 parents. None of the senior behavior therapist billable hours 172.30 or behavior therapist billable hours shall consist of clinical 172.31 meeting time. If there is any regression of the autistic 172.32 spectrum disorder after 12 months of therapy, a neurologic 172.33 consultation must be performed. 172.34(f)Subd. 5f. [PROVIDER QUALIFICATIONS.] The provider 172.35 agency must be capable of delivering consistent applied behavior 172.36 analysis (ABA) based behavior therapy in the home. The site 173.1 director of the agency must be a mental health professional and 173.2 a board certified behavior analyst certified by the behavior 173.3 analyst certification board. Each clinical supervisor must be a 173.4 certified associate behavior analyst certified by the behavior 173.5 analyst certification board or have equivalent experience in 173.6 applied behavior analysis. 173.7(g)Subd. 5g. [SUPERVISION REQUIREMENTS.] (1) Each 173.8 behavior therapist practitioner must be continuously supervised 173.9 while in the home until the practitioner has mastered 173.10 competencies for independent practice. Each behavior therapist 173.11 must have mastered three credits of academic content and 173.12 practice in an applied behavior analysis sequence at an 173.13 accredited university before providing more than 12 months of 173.14 therapy. A college degree or minimum hours of experience are 173.15 not required. Each behavior therapist must continue training 173.16 through weekly direct observation by the senior behavior 173.17 therapist, through demonstrated performance in clinical meetings 173.18 with the clinical supervisor, and annual training in applied 173.19 behavior analysis. 173.20 (2) Each senior behavior therapist practitioner must have 173.21 mastered the senior behavior therapy competencies, completed one 173.22 year of practice as a behavior therapist, and six months of 173.23 co-therapy training with another senior behavior therapist or 173.24 have an equivalent amount of experience in applied behavior 173.25 analysis. Each senior behavior therapist must have mastered 12 173.26 credits of academic content and practice in an applied behavior 173.27 analysis sequence at an accredited university before providing 173.28 more than 12 months of senior behavior therapy. Each senior 173.29 behavior therapist must continue training through demonstrated 173.30 performance in clinical meetings with the clinical supervisor, 173.31 and annual training in applied behavior analysis. 173.32 (3) Each clinical supervisor practitioner must have 173.33 mastered the clinical supervisor and family consultation 173.34 competencies, completed two years of practice as a senior 173.35 behavior therapist and one year of co-therapy training with 173.36 another clinical supervisor, or equivalent experience in applied 174.1 behavior analysis. Each clinical supervisor must continue 174.2 training through annual training in applied behavior analysis. 174.3(h)Subd. 5h. [PLACE OF SERVICE.] IEIBTS are provided 174.4 primarily in the child's home and community. Services may be 174.5 provided in the child's natural school or preschool classroom, 174.6 home of a relative, natural recreational setting, or day care. 174.7(i)Subd. 5i. [PRIOR AUTHORIZATION REQUIREMENTS.] Prior 174.8 authorization shall be required for services provided after 200 174.9 hours of clinical supervisor, 700 hours of senior behavior 174.10 therapist, or 1,800 hours of behavior therapist services per 174.11 year. 174.12(j)Subd. 5j. [PAYMENT RATES.] The following payment rates 174.13 apply: 174.14 (1) for an IEIBTS clinical supervisor practitioner under 174.15 supervision of a mental health professional, the lower of the 174.16 submitted charge or $67 per hour unit; 174.17 (2) for an IEIBTS senior behavior therapist practitioner 174.18 under supervision of a mental health professional, the lower of 174.19 the submitted charge or $37 per hour unit; or 174.20 (3) for an IEIBTS behavior therapist practitioner under 174.21 supervision of a mental health professional, the lower of the 174.22 submitted charge or $27 per hour unit. 174.23 An IEIBTS practitioner may receive payment for travel time which 174.24 exceeds 50 minutes one-way. The maximum payment allowed will be 174.25 $0.51 per minute for up to a maximum of 300 hours per year. 174.26 For any week during which the above charges are made to 174.27 medical assistance, payments for the following services are 174.28 excluded: supervising mental health professional hours and 174.29 personal care attendant, home-based mental health, 174.30 family-community support, or mental health behavioral aide hours. 174.31(k)Subd. 5k. [REPORT.] The commissioner shall collect 174.32 evidence of the effectiveness of intensive early intervention 174.33 behavior therapy services and present a report to the 174.34 legislature by July 1,20062010. 174.35 Sec. 32. Minnesota Statutes 2002, section 256B.0625, 174.36 subdivision 9, is amended to read: 175.1 Subd. 9. [DENTAL SERVICES.] (a) Medical assistance covers 175.2 dental services. Dental services include, with prior 175.3 authorization, fixed bridges that are cost-effective for persons 175.4 who cannot use removable dentures because of their medical 175.5 condition. 175.6 (b) Coverage of dental services for adults age 21 and over 175.7 who are not pregnant is subject to a $500 annual benefit limit 175.8 and covered services are limited to: 175.9 (1) diagnostic and preventative services; 175.10 (2) basic restorative services; and 175.11 (3) emergency services. 175.12 Emergency services, dentures, and extractions related to 175.13 dentures are not included in the $500 annual benefit limit. 175.14 Sec. 33. Minnesota Statutes 2002, section 256B.0625, 175.15 subdivision 13, is amended to read: 175.16 Subd. 13. [DRUGS.] (a) Medical assistance covers drugs, 175.17 except for fertility drugs when specifically used to enhance 175.18 fertility, if prescribed by a licensed practitioner and 175.19 dispensed by a licensed pharmacist, by a physician enrolled in 175.20 the medical assistance program as a dispensing physician, or by 175.21 a physician or a nurse practitioner employed by or under 175.22 contract with a community health board as defined in section 175.23 145A.02, subdivision 5, for the purposes of communicable disease 175.24 control. 175.25 (b) The dispensed quantity of a prescription drug must not 175.26 exceed a 34-day supply, unless authorized by the commissioner. 175.27 (c) Medical assistance covers the following 175.28 over-the-counter drugs when prescribed by a licensed 175.29 practitioner or by a licensed pharmacist who meets standards 175.30 established by the commissioner, in consultation with the board 175.31 of pharmacy: antacids, acetaminophen, family planning products, 175.32 aspirin, insulin, products for the treatment of lice, vitamins 175.33 for adults with documented vitamin deficiencies, vitamins for 175.34 children under the age of seven and pregnant or nursing women, 175.35 and any other over-the-counter drug identified by the 175.36 commissioner, in consultation with the pharmaceutical and 176.1 therapeutics committee, as necessary, appropriate, and 176.2 cost-effective for the treatment of certain specified chronic 176.3 diseases, conditions, or disorders, and this determination shall 176.4 not be subject to the requirements of chapter 14. A pharmacist 176.5 may prescribe over-the-counter medications as provided under 176.6 this paragraph for purposes of receiving reimbursement under 176.7 Medicaid. When prescribing over-the-counter drugs under this 176.8 paragraph, licensed pharmacists must consult with the recipient 176.9 to determine necessity, provide drug counseling, review drug 176.10 therapy for potential adverse interactions, and make referrals 176.11 as needed to other health care professionals. 176.12 (d) The commissioner may contract with a pharmacy benefit 176.13 administrator or pharmacy benefit manager to administer the 176.14 medical assistance prescription drug benefit in compliance with 176.15 subdivisions 13 to 13h. Any contract must require that the 176.16 entity under contract make transparent and transfer to the state 176.17 all direct and indirect payments received from pharmaceutical 176.18 manufacturers. For purposes of this paragraph, a "pharmacy 176.19 benefit administrator or pharmacy benefit manager" means an 176.20 entity under contract to process and adjudicate claims, disburse 176.21 payments to pharmacy providers, channel communication of 176.22 eligibility and coverage information to beneficiaries and 176.23 pharmacy providers, provide information and computer support to 176.24 enable pharmacy providers to conduct drug utilization review, 176.25 conduct activities to control fraud, abuse, and waste, and 176.26 negotiate and collect payments from participating pharmaceutical 176.27 manufacturers. 176.28 Subd. 13c. [LIMITS ON NUMBER OF BRAND NAME 176.29 PRESCRIPTIONS.] (a) Medical assistance outpatient prescription 176.30 drug coverage for brand name drugs may be limited to the 176.31 dispensing of four brand name drug products per recipient per 176.32 month. Antiretroviral agents and brand name drugs dispensed to 176.33 recipients under 18 years of age are exempt from this 176.34 restriction. For purposes of this subdivision, "brand name 176.35 drugs" means single source and innovator multiple source drugs. 176.36 The commissioner may, through prior authorization, allow 177.1 exceptions to the limitation on the dispensing of brand name 177.2 drugs, based on the treatment needs of a recipient. 177.3 Subd. 13d. [PHARMACEUTICAL AND THERAPEUTICS COMMITTEE.] (a) 177.4 The commissioner, after receiving recommendations from 177.5 professional medical associations and professionalpharmacist177.6 pharmacy associations, and consumer groups, shall designate a 177.7formulary committee to advise the commissioner on the names of177.8drugs for which payment is made, recommend a system for177.9reimbursing providers on a set fee or charge basis rather than177.10the present system, and develop methods encouraging use of177.11generic drugs when they are less expensive and equally effective177.12as trademark drugspharmaceutical and therapeutics committee to 177.13 develop and assist the commissioner in implementing a medical 177.14 assistance preferred drug list, to review and recommend to the 177.15 commissioner drugs which require prior authorization, and to 177.16 carry out duties as described in subdivisions 13 to 13h and in 177.17 section 151.21, subdivision 8. The committee shall meet at 177.18 least quarterly. The commissioner may designate the Medicaid 177.19 drug utilization review board as the committee established under 177.20 this subdivision. Committee members shall serve three-year 177.21 terms and may be reappointed. 177.22 (b) Theformularypharmaceutical and therapeutics committee 177.23 shall consist ofnine members, four of whom shall be physicians177.24who are not employed by the department of human services, and a177.25majority of whose practice is for persons paying privately or177.26through health insurance, three of whom shall be pharmacists who177.27are not employed by the department of human services, and a177.28majority of whose practice is for persons paying privately or177.29through health insurance, a consumer representative, and a177.30nursing home representative. Committee members shall serve177.31three-year terms and shall serve without compensation. Members177.32may be reappointed oncethe following nine members: at least 177.33 three but no more than four licensed physicians actively engaged 177.34 in the practice of medicine in Minnesota; at least three 177.35 licensed pharmacists actively engaged in the practice of 177.36 pharmacy in Minnesota; and one consumer representative; the 178.1 remainder to be made up of health care professionals who are 178.2 licensed in their field and have recognized knowledge in the 178.3 clinically appropriate prescribing, dispensing, and monitoring 178.4 of covered outpatient drugs. An honorarium of $100 per meeting 178.5 and reimbursement for mileage shall be paid to each committee 178.6 member in attendance. 178.7 Subd. 13e. [DRUG FORMULARY.](b)The commissioner shall 178.8 establish a drug formulary. Its establishment and publication 178.9 shall not be subject to the requirements of the Administrative 178.10 Procedure Act, but theformularypharmaceutical and therapeutics 178.11 committee shall review and comment on the formulary contents. 178.12 The formulary shall not include: 178.13(i)(1) drugs or products for which there is no federal 178.14 funding; 178.15(ii)(2) over-the-counter drugs, exceptfor antacids,178.16acetaminophen, family planning products, aspirin, insulin,178.17products for the treatment of lice, vitamins for adults with178.18documented vitamin deficiencies, vitamins for children under the178.19age of seven and pregnant or nursing women, and any other178.20over-the-counter drug identified by the commissioner, in178.21consultation with the drug formulary committee, as necessary,178.22appropriate, and cost-effective for the treatment of certain178.23specified chronic diseases, conditions or disorders, and this178.24determination shall not be subject to the requirements of178.25chapter 14as provided in subdivision 13; 178.26(iii) anorectics, except that medically necessary178.27anorectics shall be covered for a recipient previously diagnosed178.28as having pickwickian syndrome and currently diagnosed as having178.29diabetes and being morbidly obese(3) drugs used for weight 178.30 loss; 178.31(iv)(4) drugs for which medical value has not been 178.32 established; and 178.33(v)(5) drugs from manufacturers who have not signed a 178.34 rebate agreement with the Department of Health and Human 178.35 Services pursuant to section 1927 of title XIX of the Social 178.36 Security Act. 179.1The commissioner shall publish conditions for prohibiting179.2payment for specific drugs after considering the formulary179.3committee's recommendations. An honorarium of $100 per meeting179.4and reimbursement for mileage shall be paid to each committee179.5member in attendance.179.6 Subd. 13f. [PAYMENT RATES.](c)(a) The basis for 179.7 determining the amount of payment shall be the lower of the 179.8 actual acquisition costs of the drugs plus a fixed dispensing 179.9 fee; the maximum allowable cost set by the federal government or 179.10 by the commissioner plus the fixed dispensing fee; or the usual 179.11 and customary price charged to the public. The amount of 179.12 payment basis must be reduced to reflect all discount amounts 179.13 applied to the charge by any provider/insurer agreement or 179.14 contract for submitted charges to medical assistance programs. 179.15 The net submitted charge may not be greater than the patient 179.16 liability for the service. The pharmacy dispensing fee shall be 179.17 $3.65, except that the dispensing fee for intravenous solutions 179.18 which must be compounded by the pharmacist shall be $8 per bag, 179.19 $14 per bag for cancer chemotherapy products, and $30 per bag 179.20 for total parenteral nutritional products dispensed in one liter 179.21 quantities, or $44 per bag for total parenteral nutritional 179.22 products dispensed in quantities greater than one liter. Actual 179.23 acquisition cost includes quantity and other special discounts 179.24 except time and cash discounts. The actual acquisition cost of 179.25 a drug shall be estimated by the commissioner, at average 179.26 wholesale price minusnine11.5 percent, except that where a 179.27 drug has had its wholesale price reduced as a result of the 179.28 actions of the National Association of Medicaid Fraud Control 179.29 Units, the estimated actual acquisition cost shall be the 179.30 reduced average wholesale price, without thenine11.5 percent 179.31 deduction. The maximum allowable cost of a multisource drug may 179.32 be set by the commissioner and it shall be comparable to, but no 179.33 higher than, the maximum amount paid by other third-party payors 179.34 in this state who have maximum allowable cost programs.The179.35commissioner shall set maximum allowable costs for multisource179.36drugs that are not on the federal upper limit list as described180.1in United States Code, title 42, chapter 7, section 1396r-8(e),180.2the Social Security Act, and Code of Federal Regulations, title180.342, part 447, section 447.332.Establishment of the amount of 180.4 payment for drugs shall not be subject to the requirements of 180.5 the Administrative Procedure Act. 180.6 (b) An additional dispensing fee of $.30 may be added to 180.7 the dispensing fee paid to pharmacists for legend drug 180.8 prescriptions dispensed to residents of long-term care 180.9 facilities when a unit dose blister card system, approved by the 180.10 department, is used. Under this type of dispensing system, the 180.11 pharmacist must dispense a 30-day supply of drug. The National 180.12 Drug Code (NDC) from the drug container used to fill the blister 180.13 card must be identified on the claim to the department. The 180.14 unit dose blister card containing the drug must meet the 180.15 packaging standards set forth in Minnesota Rules, part 180.16 6800.2700, that govern the return of unused drugs to the 180.17 pharmacy for reuse. The pharmacy provider will be required to 180.18 credit the department for the actual acquisition cost of all 180.19 unused drugs that are eligible for reuse. Over-the-counter 180.20 medications must be dispensed in the manufacturer's unopened 180.21 package. The commissioner may permit the drug clozapine to be 180.22 dispensed in a quantity that is less than a 30-day supply. 180.23 (c) Whenever a generically equivalent product is available, 180.24 payment shall be on the basis of the actual acquisition cost of 180.25 the generic drug, unless the prescriber specifically indicates 180.26 "dispense as written - brand necessary" on the prescription as 180.27 required by section 151.21, subdivision 2. 180.28 (d)For purposes of this subdivision, "multisource drugs"180.29means covered outpatient drugs, excluding innovator multisource180.30drugs for which there are two or more drug products, which:180.31(1) are related as therapeutically equivalent under the180.32Food and Drug Administration's most recent publication of180.33"Approved Drug Products with Therapeutic Equivalence180.34Evaluations";180.35(2) are pharmaceutically equivalent and bioequivalent as180.36determined by the Food and Drug Administration; and181.1(3) are sold or marketed in Minnesota.181.2"Innovator multisource drug" means a multisource drug that was181.3originally marketed under an original new drug application181.4approved by the Food and Drug Administration.181.5 (e) The basis for determining the amount of payment for 181.6 drugs administered in an outpatient setting shall be the lower 181.7 of the usual and customary cost submitted by the provider, the 181.8 average wholesale price minus five percent, or the maximum 181.9 allowable cost set by the federal government under United States 181.10 Code, title 42, chapter 7, section 1396r-8(e), and Code of 181.11 Federal Regulations, title 42, section 447.332, or by the 181.12 commissioner under paragraphs (a) to (c). 181.13 Subd. 13g. [PRIOR AUTHORIZATION.] (a) Theformulary181.14 pharmaceutical and therapeutics committee shall review and 181.15 recommend drugs which require prior authorization. The 181.16 pharmaceutical and therapeutics committee shall establish 181.17 general criteria to be used for the prior authorization of 181.18 brand-name drugs for which generically equivalent drugs are 181.19 available, but the committee is not required to review each 181.20 brand-name drug for which a generically equivalent drug is 181.21 available. Theformularycommittee may recommend drugs for 181.22 prior authorization directly to the commissioner, as long as 181.23 opportunity for public input is provided.Prior authorization181.24may be requested by the commissioner based on medical and181.25clinical criteria and on cost before certain drugs are eligible181.26for payment. Before a drug may be considered for prior181.27authorization at the request of the commissioner:181.28(1) the drug formulary committee must develop criteria to181.29be used for identifying drugs; the development of these criteria181.30is not subject to the requirements of chapter 14, but the181.31formulary committee shall provide opportunity for public input181.32in developing criteria;181.33(2) the drug formulary committee must hold a public forum181.34and receive public comment for an additional 15 days;181.35(3) the drug formulary committee must consider data from181.36the state Medicaid program if such data is available; and182.1(4) the commissioner must provide information to the182.2formulary committee on the impact that placing the drug on prior182.3authorization will have on the quality of patient care and on182.4program costs, and information regarding whether the drug is182.5subject to clinical abuse or misuse.182.6 Prior authorization may be required by the commissioner 182.7 before certain formulary drugs are eligible for payment. If 182.8 prior authorization of a drug is required by the commissioner, 182.9 the commissioner must provide a 30-day notice period before 182.10 implementing the prior authorization. If a prior authorization 182.11 request is denied by the department, the recipient may appeal 182.12 the denial in accordance with section 256.045. If an appeal is 182.13 filed, the drug must be provided without prior authorization 182.14 until a decision is made on the appeal. 182.15(f) The basis for determining the amount of payment for182.16drugs administered in an outpatient setting shall be the lower182.17of the usual and customary cost submitted by the provider; the182.18average wholesale price minus five percent; or the maximum182.19allowable cost set by the federal government under United States182.20Code, title 42, chapter 7, section 1396r-8(e), and Code of182.21Federal Regulations, title 42, section 447.332, or by the182.22commissioner under paragraph (c).182.23(g)Prior authorization shall not be required or utilized 182.24 for any antipsychotic drug prescribed to an individual before 182.25 July 1, 2003, for the treatment of mental illness where there is 182.26 no generically equivalent drug available unless the commissioner 182.27 determines that prior authorization is necessary for patient 182.28 safety. This paragraph applies to any supplemental drug rebate 182.29 program established or administered by the commissioner. 182.30 (b) Prior authorization shall not be required for 182.31 antipsychotic drugs when used for the treatment of mental 182.32 illness, where there is no generically equivalent drug 182.33 available, and on which the patient has been stabilized. All 182.34 prescriptions for antipsychotic drugs issued after June 30, 182.35 2003, are subject to the preferred drug list established by the 182.36 commissioner. 183.1(h)(c) Prior authorization shall not be required or 183.2 utilized for any antihemophilic factor drug prescribed for the 183.3 treatment of hemophilia and blood disorders where there is no 183.4 generically equivalent drug available unless the commissioner 183.5 determines that prior authorization is necessary for patient 183.6 safety. This paragraph applies to any supplemental drug rebate 183.7 program established or administered by the commissioner. This 183.8 paragraph expires July 1,20032005. 183.9 (d) The commissioner may require prior authorization for 183.10 brand name drugs whenever a generically equivalent product is 183.11 available, even if the prescriber specifically indicates 183.12 "dispense as written-brand necessary" on the prescription as 183.13 required by section 151.21, subdivision 2. 183.14 Subd. 13h. [PREFERRED DRUG LIST.] (a) The commissioner 183.15 shall adopt and implement a preferred drug list by January 1, 183.16 2004. The commissioner may enter into a contract with a vendor 183.17 or one or more states for the purpose of participating in a 183.18 multistate preferred drug list and supplemental rebate program. 183.19 The commissioner shall ensure that any contract meets all 183.20 federal requirements and maximizes federal financial 183.21 participation. The commissioner shall publish the preferred 183.22 drug list annually in the State Register and shall maintain an 183.23 accurate and up-to-date list on the agency Web site. 183.24 (b) The commissioner may add to, delete from, and otherwise 183.25 modify the preferred drug list, after consulting with the 183.26 pharmaceutical and therapeutics committee and appropriate 183.27 medical specialists and providing public notice and the 183.28 opportunity for public comment. 183.29 (c) The commissioner shall adopt and administer the 183.30 preferred drug list as part of the administration of the 183.31 supplemental drug rebate program. Reimbursement for 183.32 prescription drugs not on the preferred drug list may be subject 183.33 to prior authorization, unless the drug manufacturer signs a 183.34 supplemental rebate contract. 183.35 (d) For purposes of this subdivision, "preferred drug list" 183.36 means a list of prescription drugs within designated therapeutic 184.1 classes selected by the commissioner, for which prior 184.2 authorization based on the identity of the drug or class is not 184.3 required. 184.4 (e) The commissioner shall seek any federal waivers or 184.5 approvals necessary to implement this subdivision. 184.6 [EFFECTIVE DATE.] This section is effective July 1, 2003. 184.7 Sec. 34. Minnesota Statutes 2002, section 256B.0625, 184.8 subdivision 17, is amended to read: 184.9 Subd. 17. [TRANSPORTATION COSTS.] (a) Medical assistance 184.10 covers transportation costs incurred solely for obtaining 184.11 emergency medical care or transportation costs incurred by 184.12nonambulatoryeligible persons in obtaining emergency or 184.13 nonemergency medical care when paid directly to an ambulance 184.14 company, common carrier, or other recognized providers of 184.15 transportation services.For the purpose of this subdivision, a184.16person who is incapable of transport by taxicab or bus shall be184.17considered to be nonambulatory.184.18 (b) Medical assistance covers special transportation, as 184.19 defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 184.20 if theprovider receives and maintains a current physician's184.21order by the recipient's attending physician certifying that the184.22 recipient has a physical or mental impairment that would 184.23 prohibit the recipient from safely accessing and using a bus, 184.24 taxi, other commercial transportation, or private automobile. 184.25 The commissioner may use an order by the recipient's attending 184.26 physician to certify that the recipient requires special 184.27 transportation services. Special transportation includes 184.28 driver-assisted service to eligible individuals. 184.29 Driver-assisted service includes passenger pickup at and return 184.30 to the individual's residence or place of business, assistance 184.31 with admittance of the individual to the medical facility, and 184.32 assistance in passenger securement or in securing of wheelchairs 184.33 or stretchers in the vehicle.The commissioner shall establish184.34maximum medical assistance reimbursement rates for special184.35transportation services for persons who need a184.36wheelchair-accessible van or stretcher-accessible vehicle and185.1for those who do not need a wheelchair-accessible van or185.2stretcher-accessible vehicle. The average of these two rates185.3per trip must not exceed $15 for the base rate and $1.40 per185.4mile. Special transportation provided to nonambulatory persons185.5who do not need a wheelchair-accessible van or185.6stretcher-accessible vehicle, may be reimbursed at a lower rate185.7than special transportation provided to persons who need a185.8wheelchair-accessible van or stretcher-accessible185.9vehicle.Special transportation providers must obtain written 185.10 documentation from the health care service provider who is 185.11 serving the recipient being transported, identifying the time 185.12 that the recipient arrived. Special transportation providers 185.13 may not bill for separate base rates for the continuation of a 185.14 trip beyond the original destination. Special transportation 185.15 providers must take recipients to the nearest appropriate health 185.16 care provider, using the most direct route available. The 185.17 maximum medical assistance reimbursement rates for special 185.18 transportation services are: 185.19 (1) $18 for the base rate and $1.40 per mile for services 185.20 to eligible persons who need a wheelchair-accessible van; 185.21 (2) $12 for the base rate and $1.40 per mile for services 185.22 to eligible persons who do not need a wheelchair-accessible van; 185.23 and 185.24 (3) for all trips, a base rate of $36 and $1.40 per mile, 185.25 and an attendant rate of $9 per trip, for eligible persons who 185.26 need a stretcher-accessible vehicle. 185.27 Sec. 35. Minnesota Statutes 2002, section 256B.0625, 185.28 subdivision 18a, is amended to read: 185.29 Subd. 18a. [ACCESS TO MEDICAL SERVICES.] (a) Medical 185.30 assistance reimbursement for meals for persons traveling to 185.31 receive medical care shall be provided only for travel involving 185.32 lodging, and may not exceed $5.50 for breakfast, $6.50 for 185.33 lunch, or $8 for dinner. 185.34 (b) Medical assistance reimbursement for lodging for 185.35 persons traveling to receive medical care shall be provided only 185.36 if the local agency determines that the medical care service is 186.1 not available at a location that does not require lodging, and 186.2 may not exceed $50 per day unless prior authorized by the local 186.3 agency. 186.4 (c) Medical assistance direct mileage reimbursement to the 186.5 eligible person or the eligible person's driver may not exceed 186.6 20 cents per mile. 186.7 (d) Medical assistance covers oral language interpreter 186.8 services when provided by an enrolled health care provider 186.9 during the course of providing a direct, person-to-person 186.10 covered health care service to an enrolled recipient with 186.11 limited English proficiency. 186.12 Sec. 36. [256B.0631] [MEDICAL ASSISTANCE CO-PAYMENTS.] 186.13 Subdivision 1. [CO-PAYMENTS.] (a) Except as provided in 186.14 subdivision 2, the medical assistance benefit plan shall include 186.15 the following co-payments for all recipients, effective for 186.16 services provided on or after October 1, 2003: 186.17 (1) $3 per nonpreventive visit. For purposes of this 186.18 subdivision, a visit means an episode of service which is 186.19 required because of a recipient's symptoms, diagnosis, or 186.20 established illness, and which is delivered in an ambulatory 186.21 setting by a physician or physician ancillary, chiropractor, 186.22 podiatrist, nurse midwife, mental health professional, advanced 186.23 practice nurse, audiologist, optician, or optometrist; 186.24 (2) $3 for eyeglasses; 186.25 (3) $6 for nonemergency visits to a hospital-based 186.26 emergency room; and 186.27 (4) $3 per brand-name drug prescription and $1 per generic 186.28 drug prescription, subject to a $20 per month maximum for 186.29 prescription drug co-payments. No co-payments shall apply to 186.30 antipsychotic drugs when used for the treatment of mental 186.31 illness. 186.32 (b) Recipients of medical assistance are responsible for 186.33 all co-payments in this subdivision. 186.34 Subd. 2. [EXCEPTIONS.] Co-payments shall be subject to the 186.35 following exceptions: 186.36 (1) children under the age of 21; 187.1 (2) pregnant women for services that relate to the 187.2 pregnancy or any other medical condition that may complicate the 187.3 pregnancy; 187.4 (3) recipients expected to reside for at least 30 days in a 187.5 hospital, nursing home, or intermediate care facility for the 187.6 mentally retarded; 187.7 (4) recipients receiving hospice care; 187.8 (5) 100 percent federally funded services provided by an 187.9 Indian health service; 187.10 (6) emergency services; 187.11 (7) family planning services; 187.12 (8) services that are paid by Medicare, resulting in the 187.13 medical assistance program paying for the coinsurance and 187.14 deductible; and 187.15 (9) co-payments that exceed one per day per provider for 187.16 nonpreventive visits, eyeglasses, and nonemergency visits to a 187.17 hospital-based emergency room. 187.18 Subd. 3. [COLLECTION.] The medical assistance 187.19 reimbursement to the provider shall be reduced by the amount of 187.20 the co-payment, except that reimbursement for prescription drugs 187.21 shall not be reduced once a recipient has reached the $20 per 187.22 month maximum for prescription drug co-payments. The provider 187.23 collects the co-payment from the recipient. Providers may not 187.24 deny services to recipients who are unable to pay the 187.25 co-payment, except as provided in subdivision 4. 187.26 Subd. 4. [UNCOLLECTED DEBT.] If it is the routine business 187.27 practice of a provider to refuse service to an individual with 187.28 uncollected debt, the provider may include uncollected 187.29 co-payments under this section. A provider must give advance 187.30 notice to a recipient with uncollected debt before services can 187.31 be denied. 187.32 Sec. 37. Minnesota Statutes 2002, section 256B.0635, 187.33 subdivision 1, is amended to read: 187.34 Subdivision 1. [INCREASED EMPLOYMENT.] (a) Until June 30, 187.35 2002, medical assistance may be paid for persons who received 187.36 MFIP or medical assistance for families and children in at least 188.1 three of six months preceding the month in which the person 188.2 became ineligible for MFIP or medical assistance, if the 188.3 ineligibility was due to an increase in hours of employment or 188.4 employment income or due to the loss of an earned income 188.5 disregard. In addition, to receive continued assistance under 188.6 this section, persons who received medical assistance for 188.7 families and children but did not receive MFIP must have had 188.8 income less than or equal to the assistance standard for their 188.9 family size under the state's AFDC plan in effect as of July 16, 188.10 1996, increased by three percent effective July 1, 2000, at the 188.11 time medical assistance eligibility began. A person who is 188.12 eligible for extended medical assistance is entitled to six 188.13 months of assistance without reapplication, unless the 188.14 assistance unit ceases to include a dependent child. For a 188.15 person under 21 years of age, medical assistance may not be 188.16 discontinued within the six-month period of extended eligibility 188.17 until it has been determined that the person is not otherwise 188.18 eligible for medical assistance. Medical assistance may be 188.19 continued for an additional six months if the person meets all 188.20 requirements for the additional six months, according to title 188.21 XIX of the Social Security Act, as amended by section 303 of the 188.22 Family Support Act of 1988, Public LawNumber100-485. 188.23 (b) Beginning July 1, 2002, contingent upon federal 188.24 funding, medical assistance for families and children may be 188.25 paid for persons who were eligible under section 256B.055, 188.26 subdivision 3a, in at least three of six months preceding the 188.27 month in which the person became ineligible under that section 188.28 if the ineligibility was due to an increase in hours of 188.29 employment or employment income or due to the loss of an earned 188.30 income disregard. A person who is eligible for extended medical 188.31 assistance is entitled to six months of assistance without 188.32 reapplication, unless the assistance unit ceases to include a 188.33 dependent child, except medical assistance may not be 188.34 discontinued for that dependent child under 21 years of age 188.35 within the six-month period of extended eligibility until it has 188.36 been determined that the person is not otherwise eligible for 189.1 medical assistance. Medical assistance may be continued for an 189.2 additional six months if the person meets all requirements for 189.3 the additional six months, according to title XIX of the Social 189.4 Security Act, as amended by section 303 of the Family Support 189.5 Act of 1988, Public LawNumber100-485. 189.6 [EFFECTIVE DATE.] This section is effective July 1, 2003. 189.7 Sec. 38. Minnesota Statutes 2002, section 256B.0635, 189.8 subdivision 2, is amended to read: 189.9 Subd. 2. [INCREASED CHILD OR SPOUSAL SUPPORT.] (a) Until 189.10 June 30, 2002, medical assistance may be paid for persons who 189.11 received MFIP or medical assistance for families and children in 189.12 at least three of the six months preceding the month in which 189.13 the person became ineligible for MFIP or medical assistance, if 189.14 the ineligibility was the result of the collection of child or 189.15 spousal support under part D of title IV of the Social Security 189.16 Act. In addition, to receive continued assistance under this 189.17 section, persons who received medical assistance for families 189.18 and children but did not receive MFIP must have had income less 189.19 than or equal to the assistance standard for their family size 189.20 under the state's AFDC plan in effect as of July 16, 1996, 189.21 increased by three percent effective July 1, 2000, at the time 189.22 medical assistance eligibility began. A person who is eligible 189.23 for extended medical assistance under this subdivision is 189.24 entitled to four months of assistance without reapplication, 189.25 unless the assistance unit ceases to include a dependent child, 189.26 except medical assistance may not be discontinued for that 189.27 dependent child under 21 years of age within the four-month 189.28 period of extended eligibility until it has been determined that 189.29 the person is not otherwise eligible for medical assistance. 189.30 (b) Beginning July 1, 2002, contingent upon federal 189.31 funding, medical assistance for families and children may be 189.32 paid for persons who were eligible under section 256B.055, 189.33 subdivision 3a, in at least three of the six months preceding 189.34 the month in which the person became ineligible under that 189.35 section if the ineligibility was the result of the collection of 189.36 child or spousal support under part D of title IV of the Social 190.1 Security Act. A person who is eligible for extended medical 190.2 assistance under this subdivision is entitled to four months of 190.3 assistance without reapplication, unless the assistance unit 190.4 ceases to include a dependent child, except medical assistance 190.5 may not be discontinued for that dependent child under 21 years 190.6 of age within the four-month period of extended eligibility 190.7 until it has been determined that the person is not otherwise 190.8 eligible for medical assistance. 190.9 [EFFECTIVE DATE.] This section is effective July 1, 2003. 190.10 Sec. 39. Minnesota Statutes 2002, section 256B.15, 190.11 subdivision 1, is amended to read: 190.12 Subdivision 1. [POLICY, APPLICABILITY, PURPOSE, AND 190.13 CONSTRUCTION; DEFINITION.] (a) It is the policy of this state 190.14 that individuals or couples, either or both of whom participate 190.15 in the medical assistance program, use their own assets to pay 190.16 their share of the total cost of their care during or after 190.17 their enrollment in the program according to applicable federal 190.18 law and the laws of this state. The following provisions apply: 190.19 (1) subdivisions 1c to 1k shall not apply to claims arising 190.20 under this section which are presented under section 525.313; 190.21 (2) the provisions of subdivisions 1c to 1k expanding the 190.22 interests included in an estate for purposes of recovery under 190.23 this section give effect to the provisions of United States 190.24 Code, title 42, section 1396p, governing recoveries, but do not 190.25 give rise to any express or implied liens in favor of any other 190.26 parties not named in these provisions; 190.27 (3) the continuation of a recipient's life estate or joint 190.28 tenancy interest in real property after the recipient's death 190.29 for the purpose of recovering medical assistance under this 190.30 section modifies common law principles holding that these 190.31 interests terminate on the death of the holder; 190.32 (4) all laws, rules, and regulations governing or involved 190.33 with a recovery of medical assistance shall be liberally 190.34 construed to accomplish their intended purposes; 190.35 (5) a deceased recipient's life estate and joint tenancy 190.36 interests continued under this section shall be owned by the 191.1 remaindermen or surviving joint tenants as their interests may 191.2 appear on the date of the recipient's death. They shall not be 191.3 merged into the remainder interest or the interests of the 191.4 surviving joint tenants by reason of ownership. They shall be 191.5 subject to the provisions of this section. Any conveyance, 191.6 transfer, sale, assignment, or encumbrance by a remainderman, a 191.7 surviving joint tenant, or their heirs, successors, and assigns 191.8 shall be deemed to include all of their interest in the deceased 191.9 recipient's life estate or joint tenancy interest continued 191.10 under this section; and 191.11 (6) the provisions of subdivisions 1c to 1k continuing a 191.12 recipient's joint tenancy interests in real property after the 191.13 recipient's death do not apply to a homestead owned of record, 191.14 on the date the recipient dies, by the recipient and the 191.15 recipient's spouse as joint tenants with a right of survivorship. 191.16 (b) For purposes of this section, "medical assistance" 191.17 includes the medical assistance program under this chapter and 191.18 the general assistance medical care program under chapter 256D, 191.19 but does not include the alternative care program for nonmedical 191.20 assistance recipients under section 256B.0913, subdivision 4. 191.21 [EFFECTIVE DATE.] This section is effective August 1, 2003, 191.22 and applies to estates of decedents who die on or after that 191.23 date. 191.24 Sec. 40. Minnesota Statutes 2002, section 256B.15, 191.25 subdivision 1a, is amended to read: 191.26 Subd. 1a. [ESTATES SUBJECT TO CLAIMS.] If a person 191.27 receives any medical assistance hereunder, on the person's 191.28 death, if single, or on the death of the survivor of a married 191.29 couple, either or both of whom received medical assistance, or 191.30 as otherwise provided for in this section, the total amount paid 191.31 for medical assistance rendered for the person and spouse shall 191.32 be filed as a claim against the estate of the person or the 191.33 estate of the surviving spouse in the court having jurisdiction 191.34 to probate the estate or to issue a decree of descent according 191.35 to sections 525.31 to 525.313. 191.36 A claim shall be filed if medical assistance was rendered 192.1 for either or both persons under one of the following 192.2 circumstances: 192.3 (a) the person was over 55 years of age, and received 192.4 services under this chapter, excluding alternative care; 192.5 (b) the person resided in a medical institution for six 192.6 months or longer, received services under this chapter excluding 192.7 alternative care, and, at the time of institutionalization or 192.8 application for medical assistance, whichever is later, the 192.9 person could not have reasonably been expected to be discharged 192.10 and returned home, as certified in writing by the person's 192.11 treating physician. For purposes of this section only, a 192.12 "medical institution" means a skilled nursing facility, 192.13 intermediate care facility, intermediate care facility for 192.14 persons with mental retardation, nursing facility, or inpatient 192.15 hospital; or 192.16 (c) the person received general assistance medical care 192.17 services under chapter 256D. 192.18 The claim shall be considered an expense of the last 192.19 illness of the decedent for the purpose of section 524.3-805. 192.20 Any statute of limitations that purports to limit any county 192.21 agency or the state agency, or both, to recover for medical 192.22 assistance granted hereunder shall not apply to any claim made 192.23 hereunder for reimbursement for any medical assistance granted 192.24 hereunder. Notice of the claim shall be given to all heirs and 192.25 devisees of the decedent whose identity can be ascertained with 192.26 reasonable diligence. The notice must include procedures and 192.27 instructions for making an application for a hardship waiver 192.28 under subdivision 5; time frames for submitting an application 192.29 and determination; and information regarding appeal rights and 192.30 procedures. Counties are entitled to one-half of the nonfederal 192.31 share of medical assistance collections from estates that are 192.32 directly attributable to county effort. 192.33 [EFFECTIVE DATE.] This section is effective August 1, 2003, 192.34 and applies to the estates of decedents who die on and after 192.35 that date. 192.36 Sec. 41. Minnesota Statutes 2002, section 256B.15, is 193.1 amended by adding a subdivision to read: 193.2 Subd. 1c. [NOTICE OF POTENTIAL CLAIM.] (a) A state agency 193.3 with a claim or potential claim under this section may file a 193.4 notice of potential claim under this subdivision anytime before 193.5 or within one year after a medical assistance recipient dies. 193.6 The claimant shall be the state agency. A notice filed prior to 193.7 the recipient's death shall not take effect and shall not be 193.8 effective as notice until the recipient dies. A notice filed 193.9 after a recipient dies shall be effective from the time of 193.10 filing. 193.11 (b) The notice of claim shall be filed or recorded in the 193.12 real estate records in the office of the county recorder or 193.13 registrar of titles for each county in which any part of the 193.14 property is located. The recorder shall accept the notice for 193.15 recording or filing. The registrar of titles shall accept the 193.16 notice for filing if the recipient has a recorded interest in 193.17 the property. The registrar of titles shall not carry forward 193.18 to a new certificate of title any notice filed more than one 193.19 year from the date of the recipient's death. 193.20 (c) The notice must be dated, state the name of the 193.21 claimant, the medical assistance recipient's name and social 193.22 security number if filed before their death and their date of 193.23 death if filed after they die, the name and date of death of any 193.24 predeceased spouse of the medical assistance recipient for whom 193.25 a claim may exist, a statement that the claimant may have a 193.26 claim arising under this section, generally identify the 193.27 recipient's interest in the property, contain a legal 193.28 description for the property and whether it is abstract or 193.29 registered property, a statement of when the notice becomes 193.30 effective and the effect of the notice, be signed by an 193.31 authorized representative of the state agency, and may include 193.32 such other contents as the state agency may deem appropriate. 193.33 [EFFECTIVE DATE.] This section is effective August 1, 2003, 193.34 and applies to the estates of decedents who die on or after that 193.35 date. 193.36 Sec. 42. Minnesota Statutes 2002, section 256B.15, is 194.1 amended by adding a subdivision to read: 194.2 Subd. 1d. [EFFECT OF NOTICE.] From the time it takes 194.3 effect, the notice shall be notice to remaindermen, joint 194.4 tenants, or to anyone else owning or acquiring an interest in or 194.5 encumbrance against the property described in the notice that 194.6 the medical assistance recipient's life estate, joint tenancy, 194.7 or other interests in the real estate described in the notice: 194.8 (1) shall, in the case of life estate and joint tenancy 194.9 interests, continue to exist for purposes of this section, and 194.10 be subject to liens and claims as provided in this section; 194.11 (2) shall be subject to a lien in favor of the claimant 194.12 effective upon the death of the recipient and dealt with as 194.13 provided in this section; 194.14 (3) may be included in the recipient's estate, as defined 194.15 in this section; and 194.16 (4) may be subject to administration and all other 194.17 provisions of chapter 524 and may be sold, assigned, 194.18 transferred, or encumbered free and clear of their interest or 194.19 encumbrance to satisfy claims under this section. 194.20 [EFFECTIVE DATE.] This section is effective August 1, 2003, 194.21 and applies to the estates of decedents who die on or after that 194.22 date. 194.23 Sec. 43. Minnesota Statutes 2002, section 256B.15, is 194.24 amended by adding a subdivision to read: 194.25 Subd. 1e. [FULL OR PARTIAL RELEASE OF NOTICE.] (a) The 194.26 claimant may fully or partially release the notice and the lien 194.27 arising out of the notice of record in the real estate records 194.28 where the notice is filed or recorded at any time. The claimant 194.29 may give a full or partial release to extinguish any life 194.30 estates or joint tenancy interests which are or may be continued 194.31 under this section or whose existence or nonexistence may create 194.32 a cloud on the title to real property at any time whether or not 194.33 a notice has been filed. The recorder or registrar of titles 194.34 shall accept the release for recording or filing. If the 194.35 release is a partial release, it must include a legal 194.36 description of the property being released. 195.1 (b) At any time, the claimant may, at the claimant's 195.2 discretion, wholly or partially release, subordinate, modify, or 195.3 amend the recorded notice and the lien arising out of the notice. 195.4 [EFFECTIVE DATE.] This section is effective August 1, 2003, 195.5 and applies to the estates of decedents who die on or after that 195.6 date. 195.7 Sec. 44. Minnesota Statutes 2002, section 256B.15, is 195.8 amended by adding a subdivision to read: 195.9 Subd. 1f. [AGENCY LIEN.] (a) The notice shall constitute a 195.10 lien in favor of the department of human services against the 195.11 recipient's interests in the real estate it describes for a 195.12 period of 20 years from the date of filing or the date of the 195.13 recipient's death, whichever is later. Notwithstanding any law 195.14 or rule to the contrary, a recipient's life estate and joint 195.15 tenancy interests shall not end upon the recipient's death but 195.16 shall continue according to subdivisions 1h, 1i, and 1j. The 195.17 amount of the lien shall be equal to the total amount of the 195.18 claims that could be presented in the recipient's estate under 195.19 this section. 195.20 (b) If no estate has been opened for the deceased 195.21 recipient, any holder of an interest in the property may apply 195.22 to the lien holder for a statement of the amount of the lien or 195.23 for a full or partial release of the lien. The application 195.24 shall include the applicant's name, current mailing address, 195.25 current home and work telephone numbers, and a description of 195.26 their interest in the property, a legal description of the 195.27 recipient's interest in the property, and the deceased 195.28 recipient's name, date of birth, and social security number. 195.29 The lien holder shall send the applicant by certified mail, 195.30 return receipt requested, a written statement showing the amount 195.31 of the lien, whether the lien holder is willing to release the 195.32 lien and under what conditions, and inform them of the right to 195.33 a hearing under section 256.045. The lien holder shall have the 195.34 discretion to compromise and settle the lien upon any terms and 195.35 conditions the lien holder deems appropriate. 195.36 (c) Any holder of an interest in property subject to the 196.1 lien has a right to request a hearing under section 256.045 to 196.2 determine the validity, extent, or amount of the lien. The 196.3 request must be in writing, and must include the names, current 196.4 addresses, and home and business telephone numbers for all other 196.5 parties holding an interest in the property. A request for a 196.6 hearing by any holder of an interest in the property shall be 196.7 deemed to be a request for a hearing by all parties owning 196.8 interests in the property. Notice of the hearing shall be given 196.9 to the lien holder, the party filing the appeal, and all of the 196.10 other holders of interests in the property at the addresses 196.11 listed in the appeal by certified mail, return receipt 196.12 requested, or by ordinary mail. Any owner of an interest in the 196.13 property to whom notice of the hearing is mailed shall be deemed 196.14 to have waived any and all claims or defenses in respect to the 196.15 lien unless they appear and assert any claims or defenses at the 196.16 hearing. 196.17 (d) If the claim the lien secures could be filed under 196.18 subdivision 1h, the lien holder may collect, compromise, settle, 196.19 or release the lien upon any terms and conditions it deems 196.20 appropriate. If the claim the lien secures could be filed under 196.21 subdivision 1i or 1j, the lien may be adjusted or enforced to 196.22 the same extent had it been filed under subdivisions 1i and 1j, 196.23 and the provisions of subdivisions 1i, clause (f), and lj, 196.24 clause (d), shall apply to voluntary payment, settlement, or 196.25 satisfaction of the lien. 196.26 (e) If no probate proceedings have been commenced for the 196.27 recipient as of the date the lien holder executes a release of 196.28 the lien on a recipient's life estate or joint tenancy interest, 196.29 created for purposes of this section, the release shall 196.30 terminate the life estate or joint tenancy interest created 196.31 under this section as of the date it is recorded or filed to the 196.32 extent of the release. If the claimant executes a release for 196.33 purposes of extinguishing a life estate or a joint tenancy 196.34 interest created under this section to remove a cloud on title 196.35 to real property, the release shall have the effect of 196.36 extinguishing any life estate or joint tenancy interests in the 197.1 property it describes which may have been continued by reason of 197.2 this section retroactive to the date of death of the deceased 197.3 life tenant or joint tenant except as provided for in section 197.4 514.981, subdivision 6. 197.5 (f) If the deceased recipient's estate is probated, a claim 197.6 shall be filed under this section. The amount of the lien shall 197.7 be limited to the amount of the claim as finally allowed. If 197.8 the claim the lien secures is filed under subdivision 1h, the 197.9 lien may be released in full after any allowance of the claim 197.10 becomes final or according to any agreement to settle and 197.11 satisfy the claim. The release shall release the lien but shall 197.12 not extinguish or terminate the interest being released. If the 197.13 claim the lien secures is filed under subdivision 1i or 1j, the 197.14 lien shall be released after the lien under subdivision 1i or 1j 197.15 is filed or recorded, or settled according to any agreement to 197.16 settle and satisfy the claim. The release shall not extinguish 197.17 or terminate the interest being released. If the claim is 197.18 finally disallowed in full, the claimant shall release the 197.19 claimant's lien at the claimant's expense. 197.20 [EFFECTIVE DATE.] This section takes effect on August 1, 197.21 2003, and applies to the estates of decedents who die on or 197.22 after that date. 197.23 Sec. 45. Minnesota Statutes 2002, section 256B.15, is 197.24 amended by adding a subdivision to read: 197.25 Subd. 1g. [ESTATE PROPERTY.] Notwithstanding any law or 197.26 rule to the contrary, if a claim is presented under this 197.27 section, interests or the proceeds of interests in real property 197.28 a decedent owned as a life tenant or a joint tenant with a right 197.29 of survivorship shall be part of the decedent's estate, subject 197.30 to administration, and shall be dealt with as provided in this 197.31 section. 197.32 [EFFECTIVE DATE.] This section takes effect on August 1, 197.33 2003, and applies to the estates of decedents who die on or 197.34 after that date. 197.35 Sec. 46. Minnesota Statutes 2002, section 256B.15, is 197.36 amended by adding a subdivision to read: 198.1 Subd. 1h. [ESTATES OF SPECIFIC PERSONS RECEIVING MEDICAL 198.2 ASSISTANCE.] (a) For purposes of this section, paragraphs (b) to 198.3 (k) apply if a person received medical assistance for which a 198.4 claim may be filed under this section and died single, or the 198.5 surviving spouse of the couple and was not survived by any of 198.6 the persons described in subdivisions 3 and 4. 198.7 (b) For purposes of this section, the person's estate 198.8 consists of: (1) their probate estate; (2) all of the person's 198.9 interests or proceeds of those interests in real property the 198.10 person owned as a life tenant or as a joint tenant with a right 198.11 of survivorship at the time of the person's death; (3) all of 198.12 the person's interests or proceeds of those interests in 198.13 securities the person owned in beneficiary form as provided 198.14 under sections 524.6-301 to 524.6-311 at the time of the 198.15 person's death, to the extent they become part of the probate 198.16 estate under section 524.6-307; and (4) all of the person's 198.17 interests in joint accounts, multiple party accounts, and pay on 198.18 death accounts, or the proceeds of those accounts, as provided 198.19 under sections 524.6-201 to 524.6-214 at the time of the 198.20 person's death to the extent they become part of the probate 198.21 estate under section 524.6-207. Notwithstanding any law or rule 198.22 to the contrary, a state or county agency with a claim under 198.23 this section shall be a creditor under section 524.6-307. 198.24 (c) Notwithstanding any law or rule to the contrary, the 198.25 person's life estate or joint tenancy interest in real property 198.26 not subject to a medical assistance lien under sections 514.980 198.27 to 514.985 on the date of the person's death shall not end upon 198.28 the person's death and shall continue as provided in this 198.29 subdivision. The life estate in the person's estate shall be 198.30 that portion of the interest in the real property subject to the 198.31 life estate that is equal to the life estate percentage factor 198.32 for the life estate as listed in the Life Estate Mortality Table 198.33 of the health care program's manual for a person who was the age 198.34 of the medical assistance recipient on the date of the person's 198.35 death. The joint tenancy interest in real property in the 198.36 estate shall be equal to the fractional interest the person 199.1 would have owned in the jointly held interest in the property 199.2 had they and the other owners held title to the property as 199.3 tenants in common on the date the person died. 199.4 (d) The court upon its own motion, or upon motion by the 199.5 personal representative or any interested party, may enter an 199.6 order directing the remaindermen or surviving joint tenants and 199.7 their spouses, if any, to sign all documents, take all actions, 199.8 and otherwise fully cooperate with the personal representative 199.9 and the court to liquidate the decedent's life estate or joint 199.10 tenancy interests in the estate and deliver the cash or the 199.11 proceeds of those interests to the personal representative and 199.12 provide for any legal and equitable sanctions as the court deems 199.13 appropriate to enforce and carry out the order, including an 199.14 award of reasonable attorney fees. 199.15 (e) The personal representative may make, execute, and 199.16 deliver any conveyances or other documents necessary to convey 199.17 the decedent's life estate or joint tenancy interest in the 199.18 estate that are necessary to liquidate and reduce to cash the 199.19 decedent's interest or for any other purposes. 199.20 (f) Subject to administration, all costs, including 199.21 reasonable attorney fees, directly and immediately related to 199.22 liquidating the decedent's life estate or joint tenancy interest 199.23 in the decedent's estate, shall be paid from the gross proceeds 199.24 of the liquidation allocable to the decedent's interest and the 199.25 net proceeds shall be turned over to the personal representative 199.26 and applied to payment of the claim presented under this section. 199.27 (g) The personal representative shall bring a motion in the 199.28 district court in which the estate is being probated to compel 199.29 the remaindermen or surviving joint tenants to account for and 199.30 deliver to the personal representative all or any part of the 199.31 proceeds of any sale, mortgage, transfer, conveyance, or any 199.32 disposition of real property allocable to the decedent's life 199.33 estate or joint tenancy interest in the decedent's estate, and 199.34 do everything necessary to liquidate and reduce to cash the 199.35 decedent's interest and turn the proceeds of the sale or other 199.36 disposition over to the personal representative. The court may 200.1 grant any legal or equitable relief including, but not limited 200.2 to, ordering a partition of real estate under chapter 558 200.3 necessary to make the value of the decedent's life estate or 200.4 joint tenancy interest available to the estate for payment of a 200.5 claim under this section. 200.6 (h) Subject to administration, the personal representative 200.7 shall use all of the cash or proceeds of interests to pay an 200.8 allowable claim under this section. The remaindermen or 200.9 surviving joint tenants and their spouses, if any, may enter 200.10 into a written agreement with the personal representative or the 200.11 claimant to settle and satisfy obligations imposed at any time 200.12 before or after a claim is filed. 200.13 (i) The personal representative may provide any or all of 200.14 the other owners, remaindermen, or surviving joint tenants with 200.15 an affidavit terminating the decedent's estate's interest in 200.16 real property the decedent owned as a life tenant or as a joint 200.17 tenant with others, if the personal representative determines 200.18 that neither the decedent nor any of the decedent's predeceased 200.19 spouses received any medical assistance for which a claim could 200.20 be filed under this section, or if the personal representative 200.21 has filed an affidavit with the court that the estate has other 200.22 assets sufficient to pay a claim, as presented, or if there is a 200.23 written agreement under paragraph (h), or if the claim, as 200.24 allowed, has been paid in full or to the full extent of the 200.25 assets the estate has available to pay it. The affidavit may be 200.26 recorded in the office of the county recorder or filed in the 200.27 office of the registrar of titles for the county in which the 200.28 real property is located. Except as provided in section 200.29 514.981, subdivision 6, when recorded or filed, the affidavit 200.30 shall terminate the decedent's interest in real estate the 200.31 decedent owned as a life tenant or a joint tenant with others. 200.32 The affidavit shall: (1) be signed by the personal 200.33 representative; (2) identify the decedent and the interest being 200.34 terminated; (3) give recording information sufficient to 200.35 identify the instrument that created the interest in real 200.36 property being terminated; (4) legally describe the affected 201.1 real property; (5) state that the personal representative has 201.2 determined that neither the decedent nor any of the decedent's 201.3 predeceased spouses received any medical assistance for which a 201.4 claim could be filed under this section; (6) state that the 201.5 decedent's estate has other assets sufficient to pay the claim, 201.6 as presented, or that there is a written agreement between the 201.7 personal representative and the claimant and the other owners or 201.8 remaindermen or other joint tenants to satisfy the obligations 201.9 imposed under this subdivision; and (7) state that the affidavit 201.10 is being given to terminate the estate's interest under this 201.11 subdivision, and any other contents as may be appropriate. 201.12 The recorder or registrar of titles shall accept the affidavit 201.13 for recording or filing. The affidavit shall be effective as 201.14 provided in this section and shall constitute notice even if it 201.15 does not include recording information sufficient to identify 201.16 the instrument creating the interest it terminates. The 201.17 affidavit shall be conclusive evidence of the stated facts. 201.18 (j) The holder of a lien arising under subdivision 1c shall 201.19 release the lien at the holder's expense against an interest 201.20 terminated under paragraph (h) to the extent of the termination. 201.21 (k) If a lien arising under subdivision 1c is not released 201.22 under paragraph (j), prior to closing the estate, the personal 201.23 representative shall deed the interest subject to the lien to 201.24 the remaindermen or surviving joint tenants as their interests 201.25 may appear. Upon recording or filing, the deed shall work a 201.26 merger of the recipient's life estate or joint tenancy interest, 201.27 subject to the lien, into the remainder interest or interest the 201.28 decedent and others owned jointly. The lien shall attach to and 201.29 run with the property to the extent of the decedent's interest 201.30 at the time of the decedent's death. 201.31 [EFFECTIVE DATE.] This section takes effect on August 1, 201.32 2003, and applies to the estates of decedents who die on or 201.33 after that date. 201.34 Sec. 47. Minnesota Statutes 2002, section 256B.15, is 201.35 amended by adding a subdivision to read: 201.36 Subd. 1i. [ESTATES OF PERSONS RECEIVING MEDICAL ASSISTANCE 202.1 AND SURVIVED BY OTHERS.] (a) For purposes of this subdivision, 202.2 the person's estate consists of the person's probate estate and 202.3 all of the person's interests in real property the person owned 202.4 as a life tenant or a joint tenant at the time of the person's 202.5 death. 202.6 (b) Notwithstanding any law or rule to the contrary, this 202.7 subdivision applies if a person received medical assistance for 202.8 which a claim could be filed under this section but for the fact 202.9 the person was survived by a spouse or by a person listed in 202.10 subdivision 3, or if subdivision 4 applies to a claim arising 202.11 under this section. 202.12 (c) The person's life estate or joint tenancy interests in 202.13 real property not subject to a medical assistance lien under 202.14 sections 514.980 to 514.985 on the date of the person's death 202.15 shall not end upon death and shall continue as provided in this 202.16 subdivision. The life estate in the estate shall be the portion 202.17 of the interest in the property subject to the life estate that 202.18 is equal to the life estate percentage factor for the life 202.19 estate as listed in the Life Estate Mortality Table of the 202.20 health care program's manual for a person who was the age of the 202.21 medical assistance recipient on the date of the person's death. 202.22 The joint tenancy interest in the estate shall be equal to the 202.23 fractional interest the medical assistance recipient would have 202.24 owned in the jointly held interest in the property had they and 202.25 the other owners held title to the property as tenants in common 202.26 on the date the medical assistance recipient died. 202.27 (d) The county agency shall file a claim in the estate 202.28 under this section on behalf of the claimant who shall be the 202.29 commissioner of human services, notwithstanding that the 202.30 decedent is survived by a spouse or a person listed in 202.31 subdivision 3. The claim, as allowed, shall not be paid by the 202.32 estate and shall be disposed of as provided in this paragraph. 202.33 The personal representative or the court shall make, execute, 202.34 and deliver a lien in favor of the claimant on the decedent's 202.35 interest in real property in the estate in the amount of the 202.36 allowed claim on forms provided by the commissioner to the 203.1 county agency filing the lien. The lien shall bear interest as 203.2 provided under section 524.3-806, shall attach to the property 203.3 it describes upon filing or recording, and shall remain a lien 203.4 on the real property it describes for a period of 20 years from 203.5 the date it is filed or recorded. The lien shall be a 203.6 disposition of the claim sufficient to permit the estate to 203.7 close. 203.8 (e) The state or county agency shall file or record the 203.9 lien in the office of the county recorder or registrar of titles 203.10 for each county in which any of the real property is located. 203.11 The recorder or registrar of titles shall accept the lien for 203.12 filing or recording. All recording or filing fees shall be paid 203.13 by the department of human services. The recorder or registrar 203.14 of titles shall mail the recorded lien to the department of 203.15 human services. The lien need not be attested, certified, or 203.16 acknowledged as a condition of recording or filing. Upon 203.17 recording or filing of a lien against a life estate or a joint 203.18 tenancy interest, the interest subject to the lien shall merge 203.19 into the remainder interest or the interest the recipient and 203.20 others owned jointly. The lien shall attach to and run with the 203.21 property to the extent of the decedent's interest in the 203.22 property at the time of the decedent's death as determined under 203.23 this section. 203.24 (f) The department shall make no adjustment or recovery 203.25 under the lien until after the decedent's spouse, if any, has 203.26 died, and only at a time when the decedent has no surviving 203.27 child described in subdivision 3. The estate, any owner of an 203.28 interest in the property which is or may be subject to the lien, 203.29 or any other interested party, may voluntarily pay off, settle, 203.30 or otherwise satisfy the claim secured or to be secured by the 203.31 lien at any time before or after the lien is filed or recorded. 203.32 Such payoffs, settlements, and satisfactions shall be deemed to 203.33 be voluntary repayments of past medical assistance payments for 203.34 the benefit of the deceased recipient, and neither the process 203.35 of settling the claim, the payment of the claim, or the 203.36 acceptance of a payment shall constitute an adjustment or 204.1 recovery that is prohibited under this subdivision. 204.2 (g) The lien under this subdivision may be enforced or 204.3 foreclosed in the manner provided by law for the enforcement of 204.4 judgment liens against real estate or by a foreclosure by action 204.5 under chapter 581. When the lien is paid, satisfied, or 204.6 otherwise discharged, the state or county agency shall prepare 204.7 and file a release of lien at its own expense. No action to 204.8 foreclose the lien shall be commenced unless the lien holder has 204.9 first given 30 days' prior written notice to pay the lien to the 204.10 owners and parties in possession of the property subject to the 204.11 lien. The notice shall: (1) include the name, address, and 204.12 telephone number of the lien holder; (2) describe the lien; (3) 204.13 give the amount of the lien; (4) inform the owner or party in 204.14 possession that payment of the lien in full must be made to the 204.15 lien holder within 30 days after service of the notice or the 204.16 lien holder may begin proceedings to foreclose the lien; and (5) 204.17 be served by personal service, certified mail, return receipt 204.18 requested, ordinary first class mail, or by publishing it once 204.19 in a newspaper of general circulation in the county in which any 204.20 part of the property is located. Service of the notice shall be 204.21 complete upon mailing or publication. 204.22 [EFFECTIVE DATE.] This section takes effect August 1, 2003, 204.23 and applies to estates of decedents who die on or after that 204.24 date. 204.25 Sec. 48. Minnesota Statutes 2002, section 256B.15, is 204.26 amended by adding a subdivision to read: 204.27 Subd. 1j. [CLAIMS IN ESTATES OF DECEDENTS SURVIVED BY 204.28 OTHER SURVIVORS.] For purposes of this subdivision, the 204.29 provisions in subdivision 1i, paragraphs (a) to (c) apply. 204.30 (a) If payment of a claim filed under this section is 204.31 limited as provided in subdivision 4, and if the estate does not 204.32 have other assets sufficient to pay the claim in full, as 204.33 allowed, the personal representative or the court shall make, 204.34 execute, and deliver a lien on the property in the estate that 204.35 is exempt from the claim under subdivision 4 in favor of the 204.36 commissioner of human services on forms provided by the 205.1 commissioner to the county agency filing the claim. If the 205.2 estate pays a claim filed under this section in full from other 205.3 assets of the estate, no lien shall be filed against the 205.4 property described in subdivision 4. 205.5 (b) The lien shall be in an amount equal to the unpaid 205.6 balance of the allowed claim under this section remaining after 205.7 the estate has applied all other available assets of the estate 205.8 to pay the claim. The property exempt under subdivision 4 shall 205.9 not be sold, assigned, transferred, conveyed, encumbered, or 205.10 distributed until after the personal representative has 205.11 determined the estate has other assets sufficient to pay the 205.12 allowed claim in full, or until after the lien has been filed or 205.13 recorded. The lien shall bear interest as provided under 205.14 section 524.3-806, shall attach to the property it describes 205.15 upon filing or recording, and shall remain a lien on the real 205.16 property it describes for a period of 20 years from the date it 205.17 is filed or recorded. The lien shall be a disposition of the 205.18 claim sufficient to permit the estate to close. 205.19 (c) The state or county agency shall file or record the 205.20 lien in the office of the county recorder or registrar of titles 205.21 in each county in which any of the real property is located. 205.22 The department shall pay the filing fees. The lien need not be 205.23 attested, certified, or acknowledged as a condition of recording 205.24 or filing. The recorder or registrar of titles shall accept the 205.25 lien for filing or recording. 205.26 (d) The commissioner shall make no adjustment or recovery 205.27 under the lien until none of the persons listed in subdivision 4 205.28 are residing on the property or until the property is sold or 205.29 transferred. The estate or any owner of an interest in the 205.30 property that is or may be subject to the lien, or any other 205.31 interested party, may voluntarily pay off, settle, or otherwise 205.32 satisfy the claim secured or to be secured by the lien at any 205.33 time before or after the lien is filed or recorded. The 205.34 payoffs, settlements, and satisfactions shall be deemed to be 205.35 voluntary repayments of past medical assistance payments for the 205.36 benefit of the deceased recipient and neither the process of 206.1 settling the claim, the payment of the claim, or acceptance of a 206.2 payment shall constitute an adjustment or recovery that is 206.3 prohibited under this subdivision. 206.4 (e) A lien under this subdivision may be enforced or 206.5 foreclosed in the manner provided for by law for the enforcement 206.6 of judgment liens against real estate or by a foreclosure by 206.7 action under chapter 581. When the lien has been paid, 206.8 satisfied, or otherwise discharged, the claimant shall prepare 206.9 and file a release of lien at the claimant's expense. No action 206.10 to foreclose the lien shall be commenced unless the lien holder 206.11 has first given 30 days prior written notice to pay the lien to 206.12 the record owners of the property and the parties in possession 206.13 of the property subject to the lien. The notice shall: (1) 206.14 include the name, address, and telephone number of the lien 206.15 holder; (2) describe the lien; (3) give the amount of the lien; 206.16 (4) inform the owner or party in possession that payment of the 206.17 lien in full must be made to the lien holder within 30 days 206.18 after service of the notice or the lien holder may begin 206.19 proceedings to foreclose the lien; and (5) be served by personal 206.20 service, certified mail, return receipt requested, ordinary 206.21 first class mail, or by publishing it once in a newspaper of 206.22 general circulation in the county in which any part of the 206.23 property is located. Service shall be complete upon mailing or 206.24 publication. 206.25 (f) Upon filing or recording of a lien against a life 206.26 estate or joint tenancy interest under this subdivision, the 206.27 interest subject to the lien shall merge into the remainder 206.28 interest or the interest the decedent and others owned jointly, 206.29 effective on the date of recording and filing. The lien shall 206.30 attach to and run with the property to the extent of the 206.31 decedent's interest in the property at the time of the 206.32 decedent's death as determined under this section. 206.33 (g)(1) An affidavit may be provided by a personal 206.34 representative stating the personal representative has 206.35 determined in good faith that a decedent survived by a spouse or 206.36 a person listed in subdivision 3, or by a person listed in 207.1 subdivision 4, or the decedent's predeceased spouse did not 207.2 receive any medical assistance giving rise to a claim under this 207.3 section, or that the real property described in subdivision 4 is 207.4 not needed to pay in full a claim arising under this section. 207.5 (2) The affidavit shall: (i) describe the property and the 207.6 interest being extinguished; (ii) name the decedent and give the 207.7 date of death; (iii) state the facts listed in clause (1); (iv) 207.8 state that the affidavit is being filed to terminate the life 207.9 estate or joint tenancy interest created under this subdivision; 207.10 (v) be signed by the personal representative; and (vi) contain 207.11 any other information that the affiant deems appropriate. 207.12 (3) Except as provided in section 514.981, subdivision 6, 207.13 when the affidavit is filed or recorded, the life estate or 207.14 joint tenancy interest in real property that the affidavit 207.15 describes shall be terminated effective as of the date of filing 207.16 or recording. The termination shall be final and may not be set 207.17 aside for any reason. 207.18 [EFFECTIVE DATE.] This section takes effect on August 1, 207.19 2003, and applies to the estates of decedents who die on or 207.20 after that date. 207.21 Sec. 49. Minnesota Statutes 2002, section 256B.15, is 207.22 amended by adding a subdivision to read: 207.23 Subd. 1k. [FILING.] Any notice, lien, release, or other 207.24 document filed under subdivisions 1c to 1l, and any lien, 207.25 release of lien, or other documents relating to a lien filed 207.26 under subdivisions 1h, 1i, and 1j must be filed or recorded in 207.27 the office of the county recorder or registrar of titles, as 207.28 appropriate, in the county where the affected real property is 207.29 located. Notwithstanding section 386.77, the state or county 207.30 agency shall pay any applicable filing fee. An attestation, 207.31 certification, or acknowledgment is not required as a condition 207.32 of filing. If the property described in the filing is 207.33 registered property, the registrar of titles shall record the 207.34 filing on the certificate of title for each parcel of property 207.35 described in the filing. If the property described in the 207.36 filing is abstract property, the recorder shall file and index 208.1 the property in the county's grantor-grantee indexes and any 208.2 tract indexes the county maintains for each parcel of property 208.3 described in the filing. The recorder or registrar of titles 208.4 shall return the filed document to the party filing it at no 208.5 cost. If the party making the filing provides a duplicate copy 208.6 of the filing, the recorder or registrar of titles shall show 208.7 the recording or filing data on the copy and return it to the 208.8 party at no extra cost. 208.9 [EFFECTIVE DATE.] This section takes effect on August 1, 208.10 2003, and applies to the estates of decedents who die on or 208.11 after that date. 208.12 Sec. 50. Minnesota Statutes 2002, section 256B.15, 208.13 subdivision 3, is amended to read: 208.14 Subd. 3. [SURVIVING SPOUSE, MINOR, BLIND, OR DISABLED 208.15 CHILDREN.] If a decedentwhois survived by a spouse, or was 208.16 single,orwho wasthe surviving spouse of a married couple,and 208.17 is survived by a child who is under age 21 or blind or 208.18 permanently and totally disabled according to the supplemental 208.19 security income program criteria,noa claim shall be filed 208.20 against the estate according to this section. 208.21 [EFFECTIVE DATE.] This section is effective August 1, 2003, 208.22 and applies to decedents who die on or after that date. 208.23 Sec. 51. Minnesota Statutes 2002, section 256B.15, 208.24 subdivision 4, is amended to read: 208.25 Subd. 4. [OTHER SURVIVORS.] If the decedent who was single 208.26 or the surviving spouse of a married couple is survived by one 208.27 of the following persons, a claim exists against the estate in 208.28 an amount not to exceed the value of the nonhomestead property 208.29 included in the estate and the personal representative shall 208.30 make, execute, and deliver to the county agency a lien against 208.31 the homestead property in the estate for any unpaid balance of 208.32 the claim to the claimant as provided under this section: 208.33 (a) a sibling who resided in the decedent medical 208.34 assistance recipient's home at least one year before the 208.35 decedent's institutionalization and continuously since the date 208.36 of institutionalization; or 209.1 (b) a son or daughter or a grandchild who resided in the 209.2 decedent medical assistance recipient's home for at least two 209.3 years immediately before the parent's or grandparent's 209.4 institutionalization and continuously since the date of 209.5 institutionalization, and who establishes by a preponderance of 209.6 the evidence having provided care to the parent or grandparent 209.7 who received medical assistance, that the care was provided 209.8 before institutionalization, and that the care permitted the 209.9 parent or grandparent to reside at home rather than in an 209.10 institution. 209.11 [EFFECTIVE DATE.] This section is effective August 1, 2003, 209.12 and applies to decedents who die on or after that date. 209.13 Sec. 52. Minnesota Statutes 2002, section 256B.195, 209.14 subdivision 4, is amended to read: 209.15 Subd. 4. [ADJUSTMENTS PERMITTED.] (a) The commissioner may 209.16 adjust the intergovernmental transfers under subdivision 2 and 209.17 the payments under subdivision 3,and payments and transfers209.18under subdivision 5,based on the commissioner's determination 209.19 of Medicare upper payment limits, hospital-specific charge 209.20 limits, and hospital-specific limitations on disproportionate 209.21 share payments. Any adjustments must be made on a proportional 209.22 basis. If participation by a particular hospital under this 209.23 section is limited, the commissioner shall adjust the payments 209.24 that relate to that hospital under subdivisions 2,and 3, and 5209.25 on a proportional basis in order to allow the hospital to 209.26 participate under this section to the fullest extent possible 209.27 and shall increase other payments under subdivisions 2,and 3,209.28and 5to the extent allowable to maintain the overall level of 209.29 payments under this section. The commissioner may make 209.30 adjustments under this subdivision only after consultation with 209.31 the counties and hospitals identified in subdivisions 2 and 3,209.32and, if subdivision 5 receives federal approval, with the209.33hospital and educational institution identified in subdivision 5. 209.34 (b) The ratio of medical assistance payments specified in 209.35 subdivision 3 to the intergovernmental transfers specified in 209.36 subdivision 2 shall not be reduced except as provided under 210.1 paragraph (a). 210.2 Sec. 53. Minnesota Statutes 2002, section 256B.195, 210.3 subdivision 5, is amended to read: 210.4 Subd. 5. [INCLUSION OF FAIRVIEW UNIVERSITY MEDICAL 210.5 CENTER.] (a) Upon federal approval of theinclusion of Fairview210.6University Medical Center in the nonstate government210.7categorypayments in paragraph (b), the commissioner shall 210.8 establish an intergovernmental transfer with the University of 210.9 Minnesota in an amount determined by the commissioner based on 210.10 theincrease in theamount of Medicare upper payment limitdue210.11solely to the inclusion of Fairview University Medical Center as210.12a nonstate government hospital and limitedavailable for 210.13 nongovernment hospitals, adjusted by hospital-specific charge 210.14 limits and the amount available under the hospital-specific 210.15 disproportionate share limit. 210.16 (b) The commissioner shall increase payments for medical 210.17 assistance admissions at Fairview University Medical Center by 210.18 71 percent of the transfer plus any federal matching payments on 210.19 that amount, to increase payments for medical assistance 210.20 admissions and to recognize higher medical assistance costs in 210.21 institutions that provide high levels of charity care. From 210.22 this payment, Fairview University Medical Center shall pay to 210.23 the University of Minnesota the cost of the transfer, on the 210.24 same day the payment is received. Eighteen percent of the 210.25 transfer plus any federal matching payments shall be used as 210.26 specified in subdivision 3, paragraph (b), clause (1). Payments 210.27 under section 256.969, subdivision 26, may be increased above 210.28 the 90 percent level specified in that subdivision within the 210.29 limits of additional funding available under this subdivision. 210.30 Eleven percent of the transfer shall be used to increase the 210.31 grants under section 145.9268. 210.32 Sec. 54. Minnesota Statutes 2002, section 256B.31, is 210.33 amended to read: 210.34 256B.31 [CONTINUED HOSPITAL CARE FOR LONG-TERM POLIO 210.35 PATIENT.] 210.36 A medical assistance recipient who has been a polio patient 211.1 in an acute care hospital for a period of not less than 25 211.2 consecutive years is eligible to continue receiving hospital 211.3 care, whether or not the care is medically necessary for 211.4 purposes of federal reimbursement. The cost of continued 211.5 hospital care not reimbursable by the federal government must be 211.6 paid with state money allocated for the medical assistance 211.7 program. The rate paid to the hospital is therate per day211.8established using Medicare principles for the hospital's fiscal211.9year ending December 31, 1981, adjusted each year by the annual211.10hospital cost index established under section 256.969,211.11subdivision 1, or by other limits in effect at the time of the211.12adjustmentaverage inpatient routine rate per day for non-MFIP 211.13 eligibles, excluding rehabilitation and neonate admissions but 211.14 including property, for hospitals located outside of a 211.15 metropolitan statistical area, as defined by the United States 211.16 Census Bureau. This section does not prohibit a voluntary move 211.17 to another living arrangement by a recipient whose care is 211.18 reimbursed under this section. 211.19 Sec. 55. Minnesota Statutes 2002, section 256B.32, 211.20 subdivision 1, is amended to read: 211.21 Subdivision 1. [FACILITY FEE PAYMENT.] (a) The 211.22 commissioner shall establish a facility fee payment mechanism 211.23 that will pay a facility fee to all enrolled outpatient 211.24 hospitals for each emergency room or outpatient clinic visit 211.25 provided on or after July 1, 1989. This payment mechanism may 211.26 not result in an overall increase in outpatient payment rates. 211.27 This section does not apply to federally mandated maximum 211.28 payment limits, department approved program packages, or 211.29 services billed using a nonoutpatient hospital provider number. 211.30 (b) For fee-for-service services provided on or after July 211.31 1, 2002, the total payment, before third-party liability and 211.32 spenddown, made to hospitals for outpatient hospital facility 211.33 services is reduced by .5 percent from the current statutory 211.34 rates. 211.35 (c) In addition to the reduction in paragraph (b), the 211.36 total payment for fee-for-service services provided on or after 212.1 July 1, 2003, made to hospitals for outpatient hospital facility 212.2 services before third-party liability and spenddown, is reduced 212.3 2.5 percent from the current statutory rates. Facilities 212.4 defined under section 256.969, subdivision 16, are excluded from 212.5 this paragraph. 212.6 Sec. 56. Minnesota Statutes 2002, section 256B.69, 212.7 subdivision 2, is amended to read: 212.8 Subd. 2. [DEFINITIONS.] For the purposes of this section, 212.9 the following terms have the meanings given. 212.10 (a) "Commissioner" means the commissioner of human services. 212.11 For the remainder of this section, the commissioner's 212.12 responsibilities for methods and policies for implementing the 212.13 project will be proposed by the project advisory committees and 212.14 approved by the commissioner. 212.15 (b) "Demonstration provider" means a health maintenance 212.16 organization, community integrated service network, or 212.17 accountable provider network authorized and operating under 212.18 chapter 62D, 62N, or 62T that participates in the demonstration 212.19 project according to criteria, standards, methods, and other 212.20 requirements established for the project and approved by the 212.21 commissioner. For purposes of this section, a county board, or 212.22 group of county boards operating under a joint powers agreement, 212.23 is considered a demonstration provider if the county or group of 212.24 county boards meets the requirements of section 256B.692. 212.25 Notwithstanding the above, Itasca county may continue to 212.26 participate as a demonstration provider until July 1, 2004. 212.27 (c) "Eligible individuals" means those persons eligible for 212.28 medical assistance benefits as defined in sections 256B.055, 212.29 256B.056, and 256B.06. 212.30 (d) "Limitation of choice" means suspending freedom of 212.31 choice while allowing eligible individuals to choose among the 212.32 demonstration providers. 212.33(e) This paragraph supersedes paragraph (c) as long as the212.34Minnesota health care reform waiver remains in effect. When the212.35waiver expires, this paragraph expires and the commissioner of212.36human services shall publish a notice in the State Register and213.1notify the revisor of statutes. "Eligible individuals" means213.2those persons eligible for medical assistance benefits as213.3defined in sections 256B.055, 256B.056, and 256B.06.213.4Notwithstanding sections 256B.055, 256B.056, and 256B.06, an213.5individual who becomes ineligible for the program because of213.6failure to submit income reports or recertification forms in a213.7timely manner, shall remain enrolled in the prepaid health plan213.8and shall remain eligible to receive medical assistance coverage213.9through the last day of the month following the month in which213.10the enrollee became ineligible for the medical assistance213.11program.213.12 [EFFECTIVE DATE.] This section is effective July 1, 2003. 213.13 Sec. 57. Minnesota Statutes 2002, section 256B.69, 213.14 subdivision 4, is amended to read: 213.15 Subd. 4. [LIMITATION OF CHOICE.] (a) The commissioner 213.16 shall develop criteria to determine when limitation of choice 213.17 may be implemented in the experimental counties. The criteria 213.18 shall ensure that all eligible individuals in the county have 213.19 continuing access to the full range of medical assistance 213.20 services as specified in subdivision 6. 213.21 (b) The commissioner shall exempt the following persons 213.22 from participation in the project, in addition to those who do 213.23 not meet the criteria for limitation of choice: 213.24 (1) persons eligible for medical assistance according to 213.25 section 256B.055, subdivision 1; 213.26 (2) persons eligible for medical assistance due to 213.27 blindness or disability as determined by the social security 213.28 administration or the state medical review team, unless: 213.29 (i) they are 65 years of age or older; or 213.30 (ii) they reside in Itasca county or they reside in a 213.31 county in which the commissioner conducts a pilot project under 213.32 a waiver granted pursuant to section 1115 of the Social Security 213.33 Act; 213.34 (3) recipients who currently have private coverage through 213.35 a health maintenance organization; 213.36 (4) recipients who are eligible for medical assistance by 214.1 spending down excess income for medical expenses other than the 214.2 nursing facility per diem expense; 214.3 (5) recipients who receive benefits under the Refugee 214.4 Assistance Program, established under United States Code, title 214.5 8, section 1522(e); 214.6 (6) children who are both determined to be severely 214.7 emotionally disturbed and receiving case management services 214.8 according to section 256B.0625, subdivision 20; 214.9 (7) adults who are both determined to be seriously and 214.10 persistently mentally ill and received case management services 214.11 according to section 256B.0625, subdivision 20;and214.12 (8) persons eligible for medical assistance according to 214.13 section 256B.057, subdivision 10; and 214.14 (9) persons with access to cost-effective 214.15 employer-sponsored private health insurance or persons enrolled 214.16 in an individual health plan determined to be cost-effective 214.17 according to section 256B.0625, subdivision 15. 214.18 Children under age 21 who are in foster placement may enroll in 214.19 the project on an elective basis. Individuals excluded under 214.20 clauses (6) and (7) may choose to enroll on an elective basis. 214.21 (c) The commissioner may allow persons with a one-month 214.22 spenddown who are otherwise eligible to enroll to voluntarily 214.23 enroll or remain enrolled, if they elect to prepay their monthly 214.24 spenddown to the state. 214.25 (d) The commissioner may require those individuals to 214.26 enroll in the prepaid medical assistance program who otherwise 214.27 would have been excluded under paragraph (b), clauses (1), (3), 214.28 and (8), and under Minnesota Rules, part 9500.1452, subpart 2, 214.29 items H, K, and L. 214.30 (e) Before limitation of choice is implemented, eligible 214.31 individuals shall be notified and after notification, shall be 214.32 allowed to choose only among demonstration providers. The 214.33 commissioner may assign an individual with private coverage 214.34 through a health maintenance organization, to the same health 214.35 maintenance organization for medical assistance coverage, if the 214.36 health maintenance organization is under contract for medical 215.1 assistance in the individual's county of residence. After 215.2 initially choosing a provider, the recipient is allowed to 215.3 change that choice only at specified times as allowed by the 215.4 commissioner. If a demonstration provider ends participation in 215.5 the project for any reason, a recipient enrolled with that 215.6 provider must select a new provider but may change providers 215.7 without cause once more within the first 60 days after 215.8 enrollment with the second provider. 215.9 Sec. 58. Minnesota Statutes 2002, section 256B.69, 215.10 subdivision 5a, is amended to read: 215.11 Subd. 5a. [MANAGED CARE CONTRACTS.] (a) Managed care 215.12 contracts under this section and sections 256L.12 and 256D.03, 215.13 shall be entered into or renewed on a calendar year basis 215.14 beginning January 1, 1996. Managed care contracts which were in 215.15 effect on June 30, 1995, and set to renew on July 1, 1995, shall 215.16 be renewed for the period July 1, 1995 through December 31, 1995 215.17 at the same terms that were in effect on June 30, 1995. 215.18 (b) A prepaid health plan providing covered health services 215.19 for eligible persons pursuant to chapters 256B, 256D, and 256L, 215.20 is responsible for complying with the terms of its contract with 215.21 the commissioner. Requirements applicable to managed care 215.22 programs under chapters 256B, 256D, and 256L, established after 215.23 the effective date of a contract with the commissioner take 215.24 effect when the contract is next issued or renewed. 215.25 (c) Effective for services rendered on or after January 1, 215.26 2003, the commissioner shall withhold five percent of managed 215.27 care plan payments under this section for the prepaid medical 215.28 assistance and general assistance medical care programs pending 215.29 completion of performance targets. Each performance target must 215.30 be quantifiable, objective, measurable, and reasonably 215.31 attainable. Criteria for assessment of each performance target 215.32 must be outlined in writing prior to the contract effective 215.33 date. The withheld funds must be returned no sooner than July 215.34 of the following year if performance targets in the contract are 215.35 achieved. The commissioner may exclude special demonstration 215.36 projects under subdivision 23. A managed care plan may include 216.1 as admitted assets under section 62D.044 any amount withheld 216.2 under this paragraph that is reasonably expected to be returned. 216.3 (d) The commissioner may exempt from paragraph (c) a 216.4 managed care plan that has entered into a managed care contract 216.5 with the commissioner in accordance with this section if the 216.6 contract was the initial contract between the managed care plan 216.7 and the commissioner, and it was entered into after January 1, 216.8 2000. This exemption shall apply for the first five years of 216.9 operation of the managed care plan. 216.10 [EFFECTIVE DATE.] This section is effective for services 216.11 rendered on or after July 1, 2003, except that the amendment to 216.12 paragraph (c) is effective for services rendered on or after 216.13 January 1, 2004. 216.14 Sec. 59. Minnesota Statutes 2002, section 256B.69, 216.15 subdivision 5c, is amended to read: 216.16 Subd. 5c. [MEDICAL EDUCATION AND RESEARCH FUND.] (a) The 216.17 commissioner of human services shall transfer each year to the 216.18 medical education and research fund established under section 216.19 62J.692, the following: 216.20 (1) an amount equal to the reduction in the prepaid medical 216.21 assistance and prepaid general assistance medical care payments 216.22 as specified in this clause. Until January 1, 2002, the county 216.23 medical assistance and general assistance medical care 216.24 capitation base rate prior to plan specific adjustments and 216.25 after the regional rate adjustments under section 256B.69, 216.26 subdivision 5b, is reduced 6.3 percent for Hennepin county, two 216.27 percent for the remaining metropolitan counties, and no 216.28 reduction for nonmetropolitan Minnesota counties; and after 216.29 January 1, 2002, the county medical assistance and general 216.30 assistance medical care capitation base rate prior to plan 216.31 specific adjustments is reduced 6.3 percent for Hennepin county, 216.32 two percent for the remaining metropolitan counties, and 1.6 216.33 percent for nonmetropolitan Minnesota counties. Nursing 216.34 facility and elderly waiver payments and demonstration project 216.35 payments operating under subdivision 23 are excluded from this 216.36 reduction. The amount calculated under this clause shall not be 217.1 adjusted for periods already paid due to subsequent changes to 217.2 the capitation payments; 217.3 (2) beginning July 1,2001, $2,537,0002003, $2,157,000 217.4 from the capitation rates paid under this section plus any 217.5 federal matching funds on this amount; 217.6 (3) beginning July 1, 2002, an additional $12,700,000 from 217.7 the capitation rates paid under this section; and 217.8 (4) beginning July 1, 2003, an additional $4,700,000 from 217.9 the capitation rates paid under this section. 217.10 (b) This subdivision shall be effective upon approval of a 217.11 federal waiver which allows federal financial participation in 217.12 the medical education and research fund. 217.13 (c) Effective July 1, 2003, the amount from general 217.14 assistance medical care under paragraph (a), clause (1), shall 217.15 be transferred to the general fund. 217.16 Sec. 60. Minnesota Statutes 2002, section 256B.69, is 217.17 amended by adding a subdivision to read: 217.18 Subd. 5h. [PAYMENT REDUCTION.] In addition to the 217.19 reduction in subdivision 5g, the total payment made to managed 217.20 care plans under the medical assistance program is reduced 0.5 217.21 percent for services provided on or after October 1, 2003, and 217.22 an additional 0.5 percent for services provided on or after 217.23 January 1, 2004. This provision excludes payments for nursing 217.24 home services, home and community-based waivers, and payments to 217.25 demonstration projects for persons with disabilities. 217.26 Sec. 61. Minnesota Statutes 2002, section 256B.69, is 217.27 amended by adding a subdivision to read: 217.28 Subd. 5i. [ACTUARIAL SOUNDNESS.] All payments made to 217.29 managed care plans under the medical assistance program shall be 217.30 actuarially sound pursuant to Code of Federal Regulations, title 217.31 42, section 438.6. In establishing payment rates for managed 217.32 care plans under the medical assistance program, the 217.33 commissioner must consider, to the extent this information is 217.34 available, verifiable, and actuarially significant: (1) 217.35 individual health plan annual financial performance for public 217.36 programs; and (2) rate relationships and geographic payment 218.1 relativities based on actual health plan experience. The 218.2 commissioner may recover any administrative costs related to 218.3 implementing this subdivision by assessing managed care plans in 218.4 proportion to their share of enrollees in the prepaid medical 218.5 assistance program. 218.6 Sec. 62. Minnesota Statutes 2002, section 256B.75, is 218.7 amended to read: 218.8 256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 218.9 (a) For outpatient hospital facility fee payments for 218.10 services rendered on or after October 1, 1992, the commissioner 218.11 of human services shall pay the lower of (1) submitted charge, 218.12 or (2) 32 percent above the rate in effect on June 30, 1992, 218.13 except for those services for which there is a federal maximum 218.14 allowable payment. Effective for services rendered on or after 218.15 January 1, 2000, payment rates for nonsurgical outpatient 218.16 hospital facility fees and emergency room facility fees shall be 218.17 increased by eight percent over the rates in effect on December 218.18 31, 1999, except for those services for which there is a federal 218.19 maximum allowable payment. Services for which there is a 218.20 federal maximum allowable payment shall be paid at the lower of 218.21 (1) submitted charge, or (2) the federal maximum allowable 218.22 payment. Total aggregate payment for outpatient hospital 218.23 facility fee services shall not exceed the Medicare upper 218.24 limit. If it is determined that a provision of this section 218.25 conflicts with existing or future requirements of the United 218.26 States government with respect to federal financial 218.27 participation in medical assistance, the federal requirements 218.28 prevail. The commissioner may, in the aggregate, prospectively 218.29 reduce payment rates to avoid reduced federal financial 218.30 participation resulting from rates that are in excess of the 218.31 Medicare upper limitations. 218.32 (b) Notwithstanding paragraph (a), payment for outpatient, 218.33 emergency, and ambulatory surgery hospital facility fee services 218.34 for critical access hospitals designated under section 144.1483, 218.35 clause (11), shall be paid on a cost-based payment system that 218.36 is based on the cost-finding methods and allowable costs of the 219.1 Medicare program. 219.2 (c) Effective for services provided on or after July 1, 219.3 2003, rates that are based on the Medicare outpatient 219.4 prospective payment system shall be replaced by a budget neutral 219.5 prospective payment system that is derived using medical 219.6 assistance data. The commissioner shall provide a proposal to 219.7 the 2003 legislature to define and implement this provision. 219.8 (d) For fee-for-service services provided on or after July 219.9 1, 2002, the total payment, before third-party liability and 219.10 spenddown, made to hospitals for outpatient hospital facility 219.11 services is reduced by .5 percent from the current statutory 219.12 rate. 219.13 (e) In addition to the reduction in paragraph (d), the 219.14 total payment for fee-for-service services provided on or after 219.15 July 1, 2003, made to hospitals for outpatient hospital facility 219.16 services before third-party liability and spenddown, is reduced 219.17 2.5 percent from the current statutory rates. Facilities 219.18 defined under section 256.969, subdivision 16, are excluded from 219.19 this paragraph. 219.20 Sec. 63. Minnesota Statutes 2002, section 256B.76, is 219.21 amended to read: 219.22 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 219.23 (a) Effective for services rendered on or after October 1, 219.24 1992, the commissioner shall make payments for physician 219.25 services as follows: 219.26 (1) payment for level one Centers for Medicare and Medicaid 219.27 Services' common procedural coding system codes titled "office 219.28 and other outpatient services," "preventive medicine new and 219.29 established patient," "delivery, antepartum, and postpartum 219.30 care," "critical care," cesarean delivery and pharmacologic 219.31 management provided to psychiatric patients, and level three 219.32 codes for enhanced services for prenatal high risk, shall be 219.33 paid at the lower of (i) submitted charges, or (ii) 25 percent 219.34 above the rate in effect on June 30, 1992. If the rate on any 219.35 procedure code within these categories is different than the 219.36 rate that would have been paid under the methodology in section 220.1 256B.74, subdivision 2, then the larger rate shall be paid; 220.2 (2) payments for all other services shall be paid at the 220.3 lower of (i) submitted charges, or (ii) 15.4 percent above the 220.4 rate in effect on June 30, 1992; 220.5 (3) all physician rates shall be converted from the 50th 220.6 percentile of 1982 to the 50th percentile of 1989, less the 220.7 percent in aggregate necessary to equal the above increases 220.8 except that payment rates for home health agency services shall 220.9 be the rates in effect on September 30, 1992; 220.10 (4) effective for services rendered on or after January 1, 220.11 2000, payment rates for physician and professional services 220.12 shall be increased by three percent over the rates in effect on 220.13 December 31, 1999, except for home health agency and family 220.14 planning agency services; and 220.15 (5) the increases in clause (4) shall be implemented 220.16 January 1, 2000, for managed care. 220.17 (b) Effective for services rendered on or after October 1, 220.18 1992, the commissioner shall make payments for dental services 220.19 as follows: 220.20 (1) dental services shall be paid at the lower of (i) 220.21 submitted charges, or (ii) 25 percent above the rate in effect 220.22 on June 30, 1992; 220.23 (2) dental rates shall be converted from the 50th 220.24 percentile of 1982 to the 50th percentile of 1989, less the 220.25 percent in aggregate necessary to equal the above increases; 220.26 (3) effective for services rendered on or after January 1, 220.27 2000, payment rates for dental services shall be increased by 220.28 three percent over the rates in effect on December 31, 1999; 220.29 (4) the commissioner shall award grants to community 220.30 clinics or other nonprofit community organizations, political 220.31 subdivisions, professional associations, or other organizations 220.32 that demonstrate the ability to provide dental services 220.33 effectively to public program recipients. Grants may be used to 220.34 fund the costs related to coordinating access for recipients, 220.35 developing and implementing patient care criteria, upgrading or 220.36 establishing new facilities, acquiring furnishings or equipment, 221.1 recruiting new providers, or other development costs that will 221.2 improve access to dental care in a region. In awarding grants, 221.3 the commissioner shall give priority to applicants that plan to 221.4 serve areas of the state in which the number of dental providers 221.5 is not currently sufficient to meet the needs of recipients of 221.6 public programs or uninsured individuals. The commissioner 221.7 shall consider the following in awarding the grants: 221.8 (i) potential to successfully increase access to an 221.9 underserved population; 221.10 (ii) the ability to raise matching funds; 221.11 (iii) the long-term viability of the project to improve 221.12 access beyond the period of initial funding; 221.13 (iv) the efficiency in the use of the funding; and 221.14 (v) the experience of the proposers in providing services 221.15 to the target population. 221.16 The commissioner shall monitor the grants and may terminate 221.17 a grant if the grantee does not increase dental access for 221.18 public program recipients. The commissioner shall consider 221.19 grants for the following: 221.20 (i) implementation of new programs or continued expansion 221.21 of current access programs that have demonstrated success in 221.22 providing dental services in underserved areas; 221.23 (ii) a pilot program for utilizing hygienists outside of a 221.24 traditional dental office to provide dental hygiene services; 221.25 and 221.26 (iii) a program that organizes a network of volunteer 221.27 dentists, establishes a system to refer eligible individuals to 221.28 volunteer dentists, and through that network provides donated 221.29 dental care services to public program recipients or uninsured 221.30 individuals; 221.31 (5) beginning October 1, 1999, the payment for tooth 221.32 sealants and fluoride treatments shall be the lower of (i) 221.33 submitted charge, or (ii) 80 percent of median 1997 charges; 221.34 (6) the increases listed in clauses (3) and (5) shall be 221.35 implemented January 1, 2000, for managed care; and 221.36 (7) effective for services provided on or after January 1, 222.1 2002, payment for diagnostic examinations and dental x-rays 222.2 provided to children under age 21 shall be the lower of (i) the 222.3 submitted charge, or (ii) 85 percent of median 1999 charges. 222.4 (c) Effective for dental services rendered on or after 222.5 January 1, 2002, the commissioner may, within the limits of 222.6 available appropriation, increase reimbursements to dentists and 222.7 dental clinics deemed by the commissioner to be critical access 222.8 dental providers. Reimbursement to a critical access dental 222.9 provider may be increased by not more than 50 percent above the 222.10 reimbursement rate that would otherwise be paid to the 222.11 provider. Payments to health plan companies shall be adjusted 222.12 to reflect increased reimbursements to critical access dental 222.13 providers as approved by the commissioner. In determining which 222.14 dentists and dental clinics shall be deemed critical access 222.15 dental providers, the commissioner shall review: 222.16 (1) the utilization rate in the service area in which the 222.17 dentist or dental clinic operates for dental services to 222.18 patients covered by medical assistance, general assistance 222.19 medical care, or MinnesotaCare as their primary source of 222.20 coverage; 222.21 (2) the level of services provided by the dentist or dental 222.22 clinic to patients covered by medical assistance, general 222.23 assistance medical care, or MinnesotaCare as their primary 222.24 source of coverage; and 222.25 (3) whether the level of services provided by the dentist 222.26 or dental clinic is critical to maintaining adequate levels of 222.27 patient access within the service area. 222.28 In the absence of a critical access dental provider in a service 222.29 area, the commissioner may designate a dentist or dental clinic 222.30 as a critical access dental provider if the dentist or dental 222.31 clinic is willing to provide care to patients covered by medical 222.32 assistance, general assistance medical care, or MinnesotaCare at 222.33 a level which significantly increases access to dental care in 222.34 the service area. 222.35 (d) Effective July 1, 2001, the medical assistance rates 222.36 for outpatient mental health services provided by an entity that 223.1 operates: 223.2 (1) a Medicare-certified comprehensive outpatient 223.3 rehabilitation facility; and 223.4 (2) a facility that was certified prior to January 1, 1993, 223.5 with at least 33 percent of the clients receiving rehabilitation 223.6 services in the most recent calendar year who are medical 223.7 assistance recipients, will be increased by 38 percent, when 223.8 those services are provided within the comprehensive outpatient 223.9 rehabilitation facility and provided to residents of nursing 223.10 facilities owned by the entity. 223.11 (e) An entity that operates both a Medicare certified 223.12 comprehensive outpatient rehabilitation facility and a facility 223.13 which was certified prior to January 1, 1993, that is licensed 223.14 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 223.15 whom at least 33 percent of the clients receiving rehabilitation 223.16 services in the most recent calendar year are medical assistance 223.17 recipients, shall be reimbursed by the commissioner for 223.18 rehabilitation services at rates that are 38 percent greater 223.19 than the maximum reimbursement rate allowed under paragraph (a), 223.20 clause (2), when those services are (1) provided within the 223.21 comprehensive outpatient rehabilitation facility and (2) 223.22 provided to residents of nursing facilities owned by the entity. 223.23 (f) Effective for services rendered on or after January 1, 223.24 2007, the commissioner shall make payments for physician and 223.25 professional services based on the Medicare relative value units 223.26 (RVUs). This change shall be budget neutral and the cost of 223.27 implementing RVUs will be incorporated in the established 223.28 conversion factor. 223.29 Sec. 64. Minnesota Statutes 2002, section 256D.03, 223.30 subdivision 3, is amended to read: 223.31 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 223.32 (a) General assistance medical care may be paid for any person 223.33 who is not eligible for medical assistance under chapter 256B, 223.34 including eligibility for medical assistance based on a 223.35 spenddown of excess income according to section 256B.056, 223.36 subdivision 5, or MinnesotaCare as defined in paragraph (b), 224.1 except as provided in paragraph (c);, and: 224.2 (1)who is receiving assistance under section 256D.05,224.3except for families with children who are eligible under224.4Minnesota family investment program (MFIP), who is having a224.5payment made on the person's behalf under sections 256I.01 to224.6256I.06, or who resides in group residential housing as defined224.7in chapter 256I and can meet a spenddown using the cost of224.8remedial services received through group residential housing; or224.9(2)(i)who is a resident of Minnesota; and whose equity in 224.10 assets is not in excess of$1,000 per assistance unit. Exempt224.11assets, the reduction of excess assets, and the waiver of excess224.12assets must conform to the medical assistance program in chapter224.13256B, with the following exception: the maximum amount of224.14undistributed funds in a trust that could be distributed to or224.15on behalf of the beneficiary by the trustee, assuming the full224.16exercise of the trustee's discretion under the terms of the224.17trust, must be applied toward the asset maximumthe limits in 224.18 section 256L.17, subdivision 2; and 224.19(ii)(2) who has gross countable income not in excess of 224.20the assistance standards established in section 256B.056,224.21subdivision 5c, paragraph (b), or whose excess income is spent224.22down to that standard using a six-month budget period. The224.23method for calculating earned income disregards and deductions224.24for a person who resides with a dependent child under age 21224.25shall follow the AFDC income disregard and deductions in effect224.26under the July 16, 1996, AFDC state plan. The earned income and224.27work expense deductions for a person who does not reside with a224.28dependent child under age 21 shall be the same as the method224.29used to determine eligibility for a person under section224.30256D.06, subdivision 1, except the disregard of the first $50 of224.31earned income is not allowed;224.32(3) who would be eligible for medical assistance except224.33that the person resides in a facility that is determined by the224.34commissioner or the federal Centers for Medicare and Medicaid224.35Services to be an institution for mental diseases; or224.36(4) who is ineligible for medical assistance under chapter225.1256B or general assistance medical care under any other225.2provision of this section, and is receiving care and225.3rehabilitation services from a nonprofit center established to225.4serve victims of torture. These individuals are eligible for225.5general assistance medical care only for the period during which225.6they are receiving services from the center. During this period225.7of eligibility, individuals eligible under this clause shall not225.8be required to participate in prepaid general assistance medical225.9care75 percent of the federal poverty guidelines for the family 225.10 size, using a six-month budget period. 225.11 (b)Beginning January 1, 2000,General assistance medical 225.12 care may not be paid for applicants or recipients who meet all 225.13 eligibility requirements of MinnesotaCare as defined in sections 225.14 256L.01 to 256L.16, and are: (i)adults with dependent children 225.15 under 21 whose gross family income is equal to or less than 275 225.16 percent of the federal poverty guidelines; or. 225.17(ii) adults without children with earned income and whose225.18family gross income is between 75 percent of the federal poverty225.19guidelines and the amount set by section 256L.04, subdivision 7,225.20shall be terminated from general assistance medical care upon225.21enrollment in MinnesotaCare. Earned income is deemed available225.22to family members as defined in section 256D.02, subdivision 8.225.23 (c) Forservices rendered on or after July 1, 1997,225.24eligibility is limited to one month prior to application if the225.25person is determined eligible in the prior monthapplications 225.26 received on or after October 1, 2003, eligibility may begin no 225.27 earlier than the date of application. A redetermination of 225.28 eligibility must occur every 12 months. Beginning January 1, 225.29 2000, Minnesota health care program applications completed by 225.30 recipients and applicants who are persons described in paragraph 225.31 (b), may be returned to the county agency to be forwarded to the 225.32 department of human services or sent directly to the department 225.33 of human services for enrollment in MinnesotaCare. If all other 225.34 eligibility requirements of this subdivision are met, 225.35 eligibility for general assistance medical care shall be 225.36 available in any month during which a MinnesotaCare eligibility 226.1 determination and enrollment are pending. Upon notification of 226.2 eligibility for MinnesotaCare, notice of termination for 226.3 eligibility for general assistance medical care shall be sent to 226.4 an applicant or recipient. If all other eligibility 226.5 requirements of this subdivision are met, eligibility for 226.6 general assistance medical care shall be available until 226.7 enrollment in MinnesotaCare subject to the provisions of 226.8 paragraph (e). 226.9 (d) The date of an initial Minnesota health care program 226.10 application necessary to begin a determination of eligibility 226.11 shall be the date the applicant has provided a name, address, 226.12 and social security number, signed and dated, to the county 226.13 agency or the department of human services. If the applicant is 226.14 unable to provide an initial application when health care is 226.15 delivered due to a medical condition or disability, a health 226.16 care provider may act on the person's behalf to complete the 226.17 initial application. The applicant must complete the remainder 226.18 of the application and provide necessary verification before 226.19 eligibility can be determined. The county agency must assist 226.20 the applicant in obtaining verification if necessary.On the226.21basis of information provided on the completed application, an226.22applicant who meets the following criteria shall be determined226.23eligible beginning in the month of application:226.24(1) has gross income less than 90 percent of the applicable226.25income standard;226.26(2) has liquid assets that total within $300 of the asset226.27standard;226.28(3) does not reside in a long-term care facility; and226.29(4) meets all other eligibility requirements.226.30The applicant must provide all required verifications within 30226.31days' notice of the eligibility determination or eligibility226.32shall be terminated.226.33 (e) County agencies are authorized to use all automated 226.34 databases containing information regarding recipients' or 226.35 applicants' income in order to determine eligibility for general 226.36 assistance medical care or MinnesotaCare. Such use shall be 227.1 considered sufficient in order to determine eligibility and 227.2 premium payments by the county agency. 227.3 (f) General assistance medical care is not available for a 227.4 person in a correctional facility unless the person is detained 227.5 by law for less than one year in a county correctional or 227.6 detention facility as a person accused or convicted of a crime, 227.7 or admitted as an inpatient to a hospital on a criminal hold 227.8 order, and the person is a recipient of general assistance 227.9 medical care at the time the person is detained by law or 227.10 admitted on a criminal hold order and as long as the person 227.11 continues to meet other eligibility requirements of this 227.12 subdivision. 227.13 (g) General assistance medical care is not available for 227.14 applicants or recipients who do not cooperate with the county 227.15 agency to meet the requirements of medical assistance.General227.16assistance medical care is limited to payment of emergency227.17services only for applicants or recipients as described in227.18paragraph (b), whose MinnesotaCare coverage is denied or227.19terminated for nonpayment of premiums as required by sections227.20256L.06 and 256L.07.227.21 (h) In determining the amount of assets of an individual, 227.22 there shall be included any asset or interest in an asset, 227.23 including an asset excluded under paragraph (a), that was given 227.24 away, sold, or disposed of for less than fair market value 227.25 within the 60 months preceding application for general 227.26 assistance medical care or during the period of eligibility. 227.27 Any transfer described in this paragraph shall be presumed to 227.28 have been for the purpose of establishing eligibility for 227.29 general assistance medical care, unless the individual furnishes 227.30 convincing evidence to establish that the transaction was 227.31 exclusively for another purpose. For purposes of this 227.32 paragraph, the value of the asset or interest shall be the fair 227.33 market value at the time it was given away, sold, or disposed 227.34 of, less the amount of compensation received. For any 227.35 uncompensated transfer, the number of months of ineligibility, 227.36 including partial months, shall be calculated by dividing the 228.1 uncompensated transfer amount by the average monthly per person 228.2 payment made by the medical assistance program to skilled 228.3 nursing facilities for the previous calendar year. The 228.4 individual shall remain ineligible until this fixed period has 228.5 expired. The period of ineligibility may exceed 30 months, and 228.6 a reapplication for benefits after 30 months from the date of 228.7 the transfer shall not result in eligibility unless and until 228.8 the period of ineligibility has expired. The period of 228.9 ineligibility begins in the month the transfer was reported to 228.10 the county agency, or if the transfer was not reported, the 228.11 month in which the county agency discovered the transfer, 228.12 whichever comes first. For applicants, the period of 228.13 ineligibility begins on the date of the first approved 228.14 application. 228.15 (i) When determining eligibility for any state benefits 228.16 under this subdivision, the income and resources of all 228.17 noncitizens shall be deemed to include their sponsor's income 228.18 and resources as defined in the Personal Responsibility and Work 228.19 Opportunity Reconciliation Act of 1996, title IV, Public Law 228.20 Number 104-193, sections 421 and 422, and subsequently set out 228.21 in federal rules. 228.22 (j)(1) AnUndocumentednoncitizen or a nonimmigrant228.23isnoncitizens and nonimmigrants are ineligible for general 228.24 assistance medical careother than emergency services, except an 228.25 individual eligible under paragraph (a), clause (4), remains 228.26 eligible through September 30, 2003. For purposes of this 228.27 subdivision, a nonimmigrant is an individual in one or more of 228.28 the classes listed in United States Code, title 8, section 228.29 1101(a)(15), and an undocumented noncitizen is an individual who 228.30 resides in the United States without the approval or 228.31 acquiescence of the Immigration and Naturalization Service. 228.32(2) This paragraph does not apply to a child under age 18,228.33to a Cuban or Haitian entrant as defined in Public Law Number228.3496-422, section 501(e)(1) or (2)(a), or to a noncitizen who is228.35aged, blind, or disabled as defined in Code of Federal228.36Regulations, title 42, sections 435.520, 435.530, 435.531,229.1435.540, and 435.541, or effective October 1, 1998, to an229.2individual eligible for general assistance medical care under229.3paragraph (a), clause (4), who cooperates with the Immigration229.4and Naturalization Service to pursue any applicable immigration229.5status, including citizenship, that would qualify the individual229.6for medical assistance with federal financial participation.229.7 (k)For purposes of paragraphs (g) and (j), "emergency229.8services" has the meaning given in Code of Federal Regulations,229.9title 42, section 440.255(b)(1), except that it also means229.10services rendered because of suspected or actual pesticide229.11poisoning.229.12 (l) Notwithstanding any other provision of law, a 229.13 noncitizen who is ineligible for medical assistance due to the 229.14 deeming of a sponsor's income and resources, is ineligible for 229.15 general assistance medical care. 229.16 (m) Effective July 1, 2003, general assistance medical care 229.17 emergency services end. Effective October 1, 2004, the general 229.18 assistance medical care program ends. Persons enrolled in 229.19 general assistance medical care as of September 30, 2004, will 229.20 be converted to MinnesotaCare if they meet all the requirements 229.21 of chapter 256L. 229.22 [EFFECTIVE DATE.] (a) The amendments to paragraphs (a), 229.23 clauses (1) to (4), and (b) and (c), are effective October 1, 229.24 2003. 229.25 (b) The amendments to paragraphs (d), (j), (g), and (k), 229.26 are effective July 1, 2003. 229.27 Sec. 65. Minnesota Statutes 2002, section 256D.03, 229.28 subdivision 4, is amended to read: 229.29 Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 229.30 For a person who is eligible under subdivision 3, paragraph (a), 229.31 clause (3), general assistance medical care covers, except as 229.32 provided in paragraph (c): 229.33 (1) inpatient hospital services; 229.34 (2) outpatient hospital services; 229.35 (3) services provided by Medicare certified rehabilitation 229.36 agencies; 230.1 (4) prescription drugs and other products recommended 230.2 through the process established in section 256B.0625, 230.3 subdivision 13; 230.4 (5) equipment necessary to administer insulin and 230.5 diagnostic supplies and equipment for diabetics to monitor blood 230.6 sugar level; 230.7 (6) eyeglasses and eye examinations provided by a physician 230.8 or optometrist; 230.9 (7) hearing aids; 230.10 (8) prosthetic devices; 230.11 (9) laboratory and X-ray services; 230.12 (10) physician's services; 230.13 (11) medical transportation; 230.14 (12) chiropractic services as covered under the medical 230.15 assistance program; 230.16 (13) podiatric services; 230.17 (14) dental services and dentures, subject to the 230.18 limitations specified in section 256B.0625, subdivision 9, 230.19 except that a 50 percent coinsurance requirement applies to 230.20 basic restorative dental services; 230.21 (15) outpatient services provided by a mental health center 230.22 or clinic that is under contract with the county board and is 230.23 established under section 245.62; 230.24 (16) day treatment services for mental illness provided 230.25 under contract with the county board; 230.26 (17) prescribed medications for persons who have been 230.27 diagnosed as mentally ill as necessary to prevent more 230.28 restrictive institutionalization; 230.29 (18) psychological services, medical supplies and 230.30 equipment, and Medicare premiums, coinsurance and deductible 230.31 payments; 230.32 (19) medical equipment not specifically listed in this 230.33 paragraph when the use of the equipment will prevent the need 230.34 for costlier services that are reimbursable under this 230.35 subdivision; 230.36 (20) services performed by a certified pediatric nurse 231.1 practitioner, a certified family nurse practitioner, a certified 231.2 adult nurse practitioner, a certified obstetric/gynecological 231.3 nurse practitioner, a certified neonatal nurse practitioner, or 231.4 a certified geriatric nurse practitioner in independent 231.5 practice, if (1) the service is otherwise covered under this 231.6 chapter as a physician service, (2) the service provided on an 231.7 inpatient basis is not included as part of the cost for 231.8 inpatient services included in the operating payment rate, and 231.9 (3) the service is within the scope of practice of the nurse 231.10 practitioner's license as a registered nurse, as defined in 231.11 section 148.171; 231.12 (21) services of a certified public health nurse or a 231.13 registered nurse practicing in a public health nursing clinic 231.14 that is a department of, or that operates under the direct 231.15 authority of, a unit of government, if the service is within the 231.16 scope of practice of the public health nurse's license as a 231.17 registered nurse, as defined in section 148.171; and 231.18 (22) telemedicine consultations, to the extent they are 231.19 covered under section 256B.0625, subdivision 3b. 231.20 (b) Except as provided in paragraph (c), for a recipient 231.21 who is eligible under subdivision 3, paragraph (a), clause (1) 231.22 or (2), general assistance medical care covers the services 231.23 listed in paragraph (a) with the exception of special 231.24 transportation services. 231.25 (c) Gender reassignment surgery and related services are 231.26 not covered services under this subdivision unless the 231.27 individual began receiving gender reassignment services prior to 231.28 July 1, 1995. 231.29 (d) In order to contain costs, the commissioner of human 231.30 services shall select vendors of medical care who can provide 231.31 the most economical care consistent with high medical standards 231.32 and shall where possible contract with organizations on a 231.33 prepaid capitation basis to provide these services. The 231.34 commissioner shall consider proposals by counties and vendors 231.35 for prepaid health plans, competitive bidding programs, block 231.36 grants, or other vendor payment mechanisms designed to provide 232.1 services in an economical manner or to control utilization, with 232.2 safeguards to ensure that necessary services are provided. 232.3 Before implementing prepaid programs in counties with a county 232.4 operated or affiliated public teaching hospital or a hospital or 232.5 clinic operated by the University of Minnesota, the commissioner 232.6 shall consider the risks the prepaid program creates for the 232.7 hospital and allow the county or hospital the opportunity to 232.8 participate in the program in a manner that reflects the risk of 232.9 adverse selection and the nature of the patients served by the 232.10 hospital, provided the terms of participation in the program are 232.11 competitive with the terms of other participants considering the 232.12 nature of the population served. Payment for services provided 232.13 pursuant to this subdivision shall be as provided to medical 232.14 assistance vendors of these services under sections 256B.02, 232.15 subdivision 8, and 256B.0625. For payments made during fiscal 232.16 year 1990 and later years, the commissioner shall consult with 232.17 an independent actuary in establishing prepayment rates, but 232.18 shall retain final control over the rate methodology. In 232.19 establishing payment rates for managed care plans under the 232.20 prepaid general assistance medical care program, the 232.21 commissioner must consider, to the extent this information is 232.22 available, verifiable, and actuarially significant: (1) 232.23 individual health plan annual financial performance for public 232.24 programs; and (2) rate relationships and geographic payment 232.25 relativities based on actual health plan experience. The 232.26 commissioner may recover any administrative costs related to 232.27 implementing this requirement, by assessing managed care plans 232.28 in proportion to their share of enrollees in the prepaid general 232.29 assistance medical care program.Notwithstanding the provisions232.30of subdivision 3, an individual who becomes ineligible for232.31general assistance medical care because of failure to submit232.32income reports or recertification forms in a timely manner,232.33shall remain enrolled in the prepaid health plan and shall232.34remain eligible for general assistance medical care coverage232.35through the last day of the month in which the enrollee became232.36ineligible for general assistance medical care.233.1 (e)There shall be no copayment required of any recipient233.2of benefits for any services provided under this subdivision.A 233.3 hospital receiving a reduced payment as a result of this section 233.4 may apply the unpaid balance toward satisfaction of the 233.5 hospital's bad debts. 233.6 (f) Any county may, from its own resources, provide medical 233.7 payments for which state payments are not made. 233.8 (g) Chemical dependency services that are reimbursed under 233.9 chapter 254B must not be reimbursed under general assistance 233.10 medical care. 233.11 (h) The maximum payment for new vendors enrolled in the 233.12 general assistance medical care program after the base year 233.13 shall be determined from the average usual and customary charge 233.14 of the same vendor type enrolled in the base year. 233.15 (i) The conditions of payment for services under this 233.16 subdivision are the same as the conditions specified in rules 233.17 adopted under chapter 256B governing the medical assistance 233.18 program, unless otherwise provided by statute or rule. 233.19 Sec. 66. [256D.031] [GAMC CO-PAYMENTS AND COINSURANCE.] 233.20 Subdivision 1. [CO-PAYMENTS AND COINSURANCE.] (a) Except 233.21 as provided in subdivision 2, the general assistance medical 233.22 care benefit plan under section 256D.03, subdivision 3, shall 233.23 include the following co-payments for all recipients effective 233.24 for services provided on or after October 1, 2003: 233.25 (1) $3 per nonpreventive visit. For purposes of this 233.26 subdivision, a visit means an episode of service which is 233.27 required because of a recipient's symptoms, diagnosis, or 233.28 established illness, and which is delivered in an ambulatory 233.29 setting by a physician or physician ancillary, chiropractor, 233.30 podiatrist, nurse midwife, mental health professional, advanced 233.31 practice nurse, physical therapist, occupational therapist, 233.32 speech therapist, audiologist, optician, or optometrist; 233.33 (2) $25 for eyeglasses; 233.34 (3) $25 for nonemergency visits to a hospital-based 233.35 emergency room; and 233.36 (4) $3 per brand-name drug prescription and $1 per generic 234.1 drug prescription, subject to a $20 per month maximum for 234.2 prescription drug co-payments. No co-payments shall apply to 234.3 antipsychotic drugs when used for the treatment of mental 234.4 illness. 234.5 (b) Recipients of general assistance medical care are 234.6 responsible for all co-payments in this subdivision. 234.7 Subd. 2. [EXCEPTIONS.] Co-payments shall be subject to the 234.8 following exceptions: 234.9 (1) children under the age of 21; 234.10 (2) pregnant women for services that relate to the 234.11 pregnancy or any other medical condition that may complicate the 234.12 pregnancy; 234.13 (3) recipients expected to reside for at least 30 days in a 234.14 hospital, nursing home, or intermediate care facility for the 234.15 mentally retarded; 234.16 (4) recipients receiving hospice care; 234.17 (5) 100 percent federally funded services provided by an 234.18 Indian health service; 234.19 (6) emergency services; 234.20 (7) family planning services; 234.21 (8) services that are paid by Medicare, resulting in the 234.22 general assistance medical care program paying for the 234.23 coinsurance and deductible; and 234.24 (9) co-payments that exceed one per day per provider for 234.25 nonpreventive office visits, eyeglasses, and nonemergency visits 234.26 to a hospital-based emergency room. 234.27 Subd. 3. [COLLECTION.] The general assistance medical care 234.28 reimbursement to the provider shall be reduced by the amount of 234.29 the co-payment, except that reimbursement for prescription drugs 234.30 shall not be reduced once a recipient has reached the $20 per 234.31 month maximum for prescription drug co-payments. The provider 234.32 collects the co-payment from the recipient. Providers may not 234.33 deny services to recipients who are unable to pay the 234.34 co-payment, except as provided in subdivision 4. 234.35 Subd. 4. [UNCOLLECTED DEBT.] If it is the routine business 234.36 practice of a provider to refuse service to an individual with 235.1 uncollected debt, the provider may include uncollected 235.2 co-payments under this section. A provider must give advance 235.3 notice to a recipient with uncollected debt before services can 235.4 be denied. 235.5 Sec. 67. Minnesota Statutes 2002, section 256G.05, 235.6 subdivision 2, is amended to read: 235.7 Subd. 2. [NON-MINNESOTA RESIDENTS.] State residence is not 235.8 required for receiving emergency assistance in the Minnesota 235.9 supplemental aid program. The receipt of emergency assistance 235.10 must not be used as a factor in determining county or state 235.11 residence.Non-Minnesota residents are not eligible for235.12emergency general assistance medical care, except emergency235.13hospital services, and professional services incident to the235.14hospital services, for the treatment of acute trauma resulting235.15from an accident occurring in Minnesota. To be eligible under235.16this subdivision a non-Minnesota resident must verify that they235.17are not eligible for coverage under any other health care235.18program, including coverage from a program in their state of235.19residence.235.20 [EFFECTIVE DATE.] This section is effective July 1, 2003. 235.21 Sec. 68. Minnesota Statutes 2002, section 256L.02, is 235.22 amended by adding a subdivision to read: 235.23 Subd. 3a. [FUNDING SOURCE.] Beginning July 1, 2005, all 235.24 MinnesotaCare obligations shall be funded out of the general 235.25 fund. 235.26 Sec. 69. Minnesota Statutes 2002, section 256L.03, 235.27 subdivision 1, is amended to read: 235.28 Subdivision 1. [COVERED HEALTH SERVICES.] "Covered health 235.29 services" means the health services reimbursed under chapter 235.30 256B, with the exception of inpatient hospital services, special 235.31 education services, private duty nursing services, adult dental 235.32 care services other thanpreventive servicesservices covered 235.33 under section 256B.0625, subdivision 9, paragraph (b), 235.34 orthodontic services, nonemergency medical transportation 235.35 services, personal care assistant and case management services, 235.36 nursing home or intermediate care facilities services, inpatient 236.1 mental health services, and chemical dependency 236.2 services.Effective July 1, 1998, adult dental care for236.3nonpreventive services with the exception of orthodontic236.4services is available to persons who qualify under section236.5256L.04, subdivisions 1 to 7, with family gross income equal to236.6or less than 175 percent of the federal poverty guidelines.236.7 Outpatient mental health services covered under the 236.8 MinnesotaCare program are limited to diagnostic assessments, 236.9 psychological testing, explanation of findings, medication 236.10 management by a physician, day treatment, partial 236.11 hospitalization, and individual, family, and group psychotherapy. 236.12 No public funds shall be used for coverage of abortion 236.13 under MinnesotaCare except where the life of the female would be 236.14 endangered or substantial and irreversible impairment of a major 236.15 bodily function would result if the fetus were carried to term; 236.16 or where the pregnancy is the result of rape or incest. 236.17 Covered health services shall be expanded as provided in 236.18 this section. 236.19 Sec. 70. Minnesota Statutes 2002, section 256L.03, 236.20 subdivision 3, is amended to read: 236.21 Subd. 3. [INPATIENT HOSPITAL SERVICES.] (a) Covered health 236.22 services shall include inpatient hospital services, including 236.23 inpatient hospital mental health services and inpatient hospital 236.24 and residential chemical dependency treatment, subject to those 236.25 limitations necessary to coordinate the provision of these 236.26 services with eligibility under the medical assistance 236.27 spenddown. Prior to July 1, 1997, the inpatient hospital 236.28 benefit for adult enrollees is subject to an annual benefit 236.29 limit of $10,000. The inpatient hospital benefit for adult 236.30 enrollees who qualify under section 256L.04, subdivision 7, or 236.31 who qualify under section 256L.04, subdivisions 1 and 2, with 236.32 family gross income that exceeds 175 percent of the federal 236.33 poverty guidelines and who are not pregnant, is subject to an 236.34 annual limit of $10,000. For services provided on or after 236.35 October 1, 2004, the annual limit of $10,000 does not apply to 236.36 adults who qualify under section 256L.04, subdivision 7, whose 237.1 gross income is at or below 75 percent of the federal poverty 237.2 guidelines. 237.3 (b) Admissions for inpatient hospital services paid for 237.4 under section 256L.11, subdivision 3, must be certified as 237.5 medically necessary in accordance with Minnesota Rules, parts 237.6 9505.0500 to 9505.0540, except as provided in clauses (1) and 237.7 (2): 237.8 (1) all admissions must be certified, except those 237.9 authorized under rules established under section 254A.03, 237.10 subdivision 3, or approved under Medicare; and 237.11 (2) payment under section 256L.11, subdivision 3, shall be 237.12 reduced by five percent for admissions for which certification 237.13 is requested more than 30 days after the day of admission. The 237.14 hospital may not seek payment from the enrollee for the amount 237.15 of the payment reduction under this clause. 237.16 Sec. 71. Minnesota Statutes 2002, section 256L.03, 237.17 subdivision 5, is amended to read: 237.18 Subd. 5. [COPAYMENTS AND COINSURANCE.] (a) Except as 237.19 provided in paragraphs (b) and (c), the MinnesotaCare benefit 237.20 plan shall include the following copayments and coinsurance 237.21 requirements for all enrollees effective for services provided 237.22 on or after October 1, 2003: 237.23 (1) ten percent of the paid charges for inpatient hospital 237.24 services for adult enrollees, subject to an annual inpatient 237.25 out-of-pocket maximum of $1,000 per individual and $3,000 per 237.26 family; 237.27 (2) $3 perprescription for adult enrolleesnonpreventive 237.28 visit. For purposes of this subdivision, a visit means an 237.29 episode of service which is required because of a recipient's 237.30 symptoms, diagnosis, or established illness, and which is 237.31 delivered in an ambulatory setting by a physician or physician 237.32 ancillary, chiropractor, podiatrist, nurse, midwife, mental 237.33 health professional, advanced practice nurse, physical 237.34 therapist, occupational therapist, speech therapist, 237.35 audiologist, optician, or optometrist; 237.36 (3) $25 for eyeglasses for adult enrollees; 238.1 (4) $6 for nonemergency visits to a hospital-based 238.2 emergency room, except that a $25 co-payment applies to parents 238.3 with incomes exceeding 100 percent of the federal poverty 238.4 guidelines for nonemergency visits to a hospital-based emergency 238.5 room;and238.6(4) 50 percent of the fee-for-service rate for adult dental238.7care services other than preventive care services for persons238.8eligible under section 256L.04, subdivisions 1 to 7, with income238.9equal to or less than 175 percent of the federal poverty238.10guidelines(5) $3 per prescription, subject to a $20 per month 238.11 maximum for prescription drug co-payments; and 238.12 (6) basic restorative dental services for adults age 21 and 238.13 over who are not pregnant are subject to a 50 percent 238.14 coinsurance requirement. 238.15 (b) Paragraph (a), clause (1), does not apply to parents 238.16 and relative caretakers of children under the age of 21 in 238.17 households with family income equal to or less than 175 percent 238.18 of the federal poverty guidelines. Paragraph (a), clause (1), 238.19 does not apply to parents and relative caretakers of children 238.20 under the age of 21 in households with family income greater 238.21 than 175 percent of the federal poverty guidelines for inpatient 238.22 hospital admissions occurring on or after January 1, 238.23 2001. Effective for services provided on or after October 1, 238.24 2004, paragraph (a), clause (1), does not apply to single adults 238.25 and households without children whose gross income is at or 238.26 below 75 percent of the federal poverty guidelines. 238.27 (c) Paragraph (a), clauses (1) to(4)(6), do not apply to 238.28pregnant women and children under the age of 21.: 238.29 (1) children under the age of 21; 238.30 (2) pregnant women for services that relate to the 238.31 pregnancy or any other medical condition that may complicate the 238.32 pregnancy; 238.33 (3) enrollees expected to reside for at least 30 days in a 238.34 hospital, nursing home, or intermediate care facility for the 238.35 mentally retarded; 238.36 (4) enrollees receiving hospice care; 239.1 (5) 100 percent federally funded services provided by an 239.2 Indian Health Service; 239.3 (6) emergency services; 239.4 (7) family planning services; and 239.5 (8) co-payments that exceed one per day per provider for 239.6 nonpreventive office visits, eyeglasses, and nonemergency visits 239.7 to a hospital emergency room. 239.8 (d) Adult enrollees with family gross income that exceeds 239.9 175 percent of the federal poverty guidelines and who are not 239.10 pregnant shall be financially responsible for the coinsurance 239.11 amount, if applicable, and amounts which exceed the $10,000 239.12 inpatient hospital benefit limit. 239.13 (e) When a MinnesotaCare enrollee becomes a member of a 239.14 prepaid health plan, or changes from one prepaid health plan to 239.15 another during a calendar year, any charges submitted towards 239.16 the $10,000 annual inpatient benefit limit, and any 239.17 out-of-pocket expenses incurred by the enrollee for inpatient 239.18 services, that were submitted or incurred prior to enrollment, 239.19 or prior to the change in health plans, shall be disregarded. 239.20 (f) Enrollees are responsible for all co-payments and 239.21 coinsurance in this subdivision. 239.22 (g) The MinnesotaCare reimbursement to the provider shall 239.23 be reduced by the amount of the co-payment, except that 239.24 reimbursement for prescription drugs shall not be reduced once a 239.25 recipient has reached the $20 per month maximum for prescription 239.26 drug co-payments. The provider collects the co-payment from the 239.27 enrollee and may not deny services to enrollees who are unable 239.28 to pay the co-payment, except as provided in paragraph (h). 239.29 (h) If it is the routine business practice of a provider to 239.30 refuse service to an individual with uncollected debt, the 239.31 provider may include uncollected co-payments under this 239.32 section. A provider must give advance notice to a recipient 239.33 with uncollected debt before services can be denied. 239.34 Sec. 72. Minnesota Statutes 2002, section 256L.04, 239.35 subdivision 1, is amended to read: 239.36 Subdivision 1. [FAMILIES WITH CHILDREN.] (a) Families with 240.1 children with family income equal to or less than 275 percent of 240.2 the federal poverty guidelines for the applicable family size 240.3 shall be eligible for MinnesotaCare according to this section. 240.4 All other provisions of sections 256L.01 to 256L.18, including 240.5 the insurance-related barriers to enrollment under section 240.6 256L.07, shall apply unless otherwise specified. 240.7 (b) Parents who enroll in the MinnesotaCare program must 240.8 also enroll their childrenand dependent siblings, if the 240.9 childrenand their dependent siblingsare eligible. Children 240.10and dependent siblingsmay be enrolled separately without 240.11 enrollment by parents. However, if one parent in the household 240.12 enrolls, both parents must enroll, unless other insurance is 240.13 available. If one child from a family is enrolled, all children 240.14 must be enrolled, unless other insurance is available. If one 240.15 spouse in a household enrolls, the other spouse in the household 240.16 must also enroll, unless other insurance is available. Families 240.17 cannot choose to enroll only certain uninsured members. 240.18 (c) Beginning February 1, 2004, the dependent sibling 240.19 definition no longer applies to the MinnesotaCare program. 240.20 These persons are no longer counted in the parental household 240.21 and may apply as a separate household. 240.22 (d) Beginning July 1, 2003, parents are not eligible for 240.23 MinnesotaCare if their gross income exceeds $50,000. 240.24 [EFFECTIVE DATE.] This section is effective February 1, 240.25 2004, unless the statutory language specifies a different 240.26 effective date. 240.27 Sec. 73. Minnesota Statutes 2002, section 256L.05, 240.28 subdivision 1, is amended to read: 240.29 Subdivision 1. [APPLICATION AND INFORMATION AVAILABILITY.] 240.30 Applications and other information must be made available to 240.31 provider offices, local human services agencies, school 240.32 districts, public and private elementary schools in which 25 240.33 percent or more of the students receive free or reduced price 240.34 lunches, community health offices, and Women, Infants and 240.35 Children (WIC) program sites. These sites may accept 240.36 applications and forward the forms to the commissioner. 241.1 Otherwise, applicants may apply directly to the commissioner. 241.2 Beginning January 1, 2000, MinnesotaCare enrollment sites will 241.3 be expanded to include local county human services agencies 241.4 which choose to participate. Beginning October 1, 2004, all 241.5 local county human service agencies must accept and process 241.6 applications and renewals for single adults and households 241.7 without children with income at or below 75 percent of the 241.8 federal poverty guidelines who choose to have the county 241.9 administer their case. 241.10 Sec. 74. Minnesota Statutes 2002, section 256L.05, 241.11 subdivision 3, is amended to read: 241.12 Subd. 3. [EFFECTIVE DATE OF COVERAGE.] (a) The effective 241.13 date of coverage is the first day of the month following the 241.14 month in which eligibility is approved and the first premium 241.15 payment has been received. As provided in section 256B.057, 241.16 coverage for newborns is automatic from the date of birth and 241.17 must be coordinated with other health coverage. The effective 241.18 date of coverage for eligible newly adoptive children added to a 241.19 family receiving covered health services is the date of entry 241.20 into the family. The effective date of coverage for other new 241.21 recipients added to the family receiving covered health services 241.22 is the first day of the month following the month in which 241.23 eligibility is approved or at renewal, whichever the family 241.24 receiving covered health services prefers. All eligibility 241.25 criteria must be met by the family at the time the new family 241.26 member is added. The income of the new family member is 241.27 included with the family's gross income and the adjusted premium 241.28 begins in the month the new family member is added. 241.29 (b) The initial premium must be received by the last 241.30 working day of the month for coverage to begin the first day of 241.31 the following month. 241.32 (c) Benefits are not available until the day following 241.33 discharge if an enrollee is hospitalized on the first day of 241.34 coverage. 241.35 (d) Notwithstanding any other law to the contrary, benefits 241.36 under sections 256L.01 to 256L.18 are secondary to a plan of 242.1 insurance or benefit program under which an eligible person may 242.2 have coverage and the commissioner shall use cost avoidance 242.3 techniques to ensure coordination of any other health coverage 242.4 for eligible persons. The commissioner shall identify eligible 242.5 persons who may have coverage or benefits under other plans of 242.6 insurance or who become eligible for medical assistance. 242.7 (e) Notwithstanding paragraphs (a) and (b), effective 242.8 October 1, 2004, coverage begins for single adults and 242.9 households without children with gross family income at or below 242.10 75 percent of the federal poverty guidelines the first day of 242.11 the month following approval. 242.12 (f) Effective October 1, 2004, the date of an initial 242.13 application necessary to begin a determination of eligibility 242.14 for single adults and households without children with gross 242.15 family income at or below 75 percent of the federal poverty 242.16 guidelines shall be the date the applicant has provided a name, 242.17 address, and social security number, signed and dated, to the 242.18 county agency or the department of human services. If the 242.19 applicant is unable to provide an initial application when 242.20 health care is delivered due to a medical condition or 242.21 disability, a health care provider may act on the person's 242.22 behalf to complete the initial application. The applicant must 242.23 complete the remainder of the application and provide necessary 242.24 verification before eligibility can be determined. The county 242.25 agency must assist the applicant in obtaining verification if 242.26 necessary. 242.27 Sec. 75. Minnesota Statutes 2002, section 256L.05, 242.28 subdivision 3a, is amended to read: 242.29 Subd. 3a. [RENEWAL OF ELIGIBILITY.] (a) Beginning January 242.30 1, 1999, an enrollee's eligibility must be renewed every 12 242.31 months. The 12-month period begins in the month after the month 242.32 the application is approved. 242.33 (b) Beginning October 1, 2004, an enrollee's eligibility 242.34 must be renewed every six months. The first six-month period of 242.35 eligibility begins in the month after the month the application 242.36 is approved. Each new period of eligibility must take into 243.1 account any changes in circumstances that impact eligibility and 243.2 premium amount. An enrollee must provide all the information 243.3 needed to redetermine eligibility by the first day of the month 243.4 that ends the eligibility period. The premium for the new 243.5 period of eligibility must be received as provided in section 243.6 256L.06 in order for eligibility to continue. 243.7 Sec. 76. Minnesota Statutes 2002, section 256L.05, 243.8 subdivision 3c, is amended to read: 243.9 Subd. 3c. [RETROACTIVE COVERAGE.] Notwithstanding 243.10 subdivision 3, the effective date of coverage shall be the first 243.11 day of the month following termination from medical assistance 243.12or general assistance medical carefor families and individuals 243.13 who are eligible for MinnesotaCare and who submitted a written 243.14 request for retroactive MinnesotaCare coverage with a completed 243.15 application within 30 days of the mailing of notification of 243.16 termination from medical assistanceor general assistance243.17medical care. The applicant must provide all required 243.18 verifications within 30 days of the written request for 243.19 verification. For retroactive coverage, premiums must be paid 243.20 in full for any retroactive month, current month, and next month 243.21 within 30 days of the premium billing. 243.22 [EFFECTIVE DATE.] This section is effective November 1, 243.23 2004. 243.24 Sec. 77. Minnesota Statutes 2002, section 256L.05, 243.25 subdivision 4, is amended to read: 243.26 Subd. 4. [APPLICATION PROCESSING.] The commissioner of 243.27 human services shall determine an applicant's eligibility for 243.28 MinnesotaCare no more than 30 days from the date that the 243.29 application is received by the department of human services. 243.30 Beginning January 1, 2000, this requirement also applies to 243.31 local county human services agencies that determine eligibility 243.32 for MinnesotaCare.Once annually at application or243.33reenrollment, to prevent processing delays, applicants or243.34enrollees who, from the information provided on the application,243.35appear to meet eligibility requirements shall be enrolled upon243.36timely payment of premiums. The enrollee must provide all244.1required verifications within 30 days of notification of the244.2eligibility determination or coverage from the program shall be244.3terminated. Enrollees who are determined to be ineligible when244.4verifications are provided shall be disenrolled from the program.244.5 [EFFECTIVE DATE.] This section is effective July 1, 2003. 244.6 Sec. 78. Minnesota Statutes 2002, section 256L.06, 244.7 subdivision 3, is amended to read: 244.8 Subd. 3. [COMMISSIONER'S DUTIES AND PAYMENT.] (a) Premiums 244.9 are dedicated to the commissioner for MinnesotaCare. 244.10 (b) The commissioner shall develop and implement procedures 244.11 to: (1) require enrollees to report changes in income; (2) 244.12 adjust sliding scale premium payments, based upon changes in 244.13 enrollee income; and (3) disenroll enrollees from MinnesotaCare 244.14 for failure to pay required premiums. Failure to pay includes 244.15 payment with a dishonored check, a returned automatic bank 244.16 withdrawal, or a refused credit card or debit card payment. The 244.17 commissioner may demand a guaranteed form of payment, including 244.18 a cashier's check or a money order, as the only means to replace 244.19 a dishonored, returned, or refused payment. 244.20 (c) Premiums are calculated on a calendar month basis and 244.21 may be paid on a monthly, quarterly, orannualsemiannual basis, 244.22 with the first payment due upon notice from the commissioner of 244.23 the premium amount required. The commissioner shall inform 244.24 applicants and enrollees of these premium payment options. 244.25 Premium payment is required before enrollment is complete and to 244.26 maintain eligibility in MinnesotaCare. Premium payments 244.27 received before noon are credited the same day. Premium 244.28 payments received after noon are credited on the next working 244.29 day. 244.30 (d) Nonpayment of the premium will result in disenrollment 244.31 from the plan effective for the calendar month for which the 244.32 premium was due. Persons disenrolled for nonpayment or who 244.33 voluntarily terminate coverage from the program may not reenroll 244.34 until four calendar months have elapsed. Persons disenrolled 244.35 for nonpayment who pay all past due premiums as well as current 244.36 premiums due, including premiums due for the period of 245.1 disenrollment, within 20 days of disenrollment, shall be 245.2 reenrolled retroactively to the first day of disenrollment. 245.3 Persons disenrolled for nonpayment or who voluntarily terminate 245.4 coverage from the program may not reenroll for four calendar 245.5 months unless the person demonstrates good cause for 245.6 nonpayment. Good cause does not exist if a person chooses to 245.7 pay other family expenses instead of the premium. The 245.8 commissioner shall define good cause in rule. 245.9 [EFFECTIVE DATE.] This section is effective October 1, 2004. 245.10 Sec. 79. Minnesota Statutes 2002, section 256L.07, 245.11 subdivision 1, is amended to read: 245.12 Subdivision 1. [GENERAL REQUIREMENTS.] (a) Children 245.13 enrolled in the original children's health plan as of September 245.14 30, 1992, children who enrolled in the MinnesotaCare program 245.15 after September 30, 1992, pursuant to Laws 1992, chapter 549, 245.16 article 4, section 17, and children who have family gross 245.17 incomes that are equal to or less than175150 percent of the 245.18 federal poverty guidelines are eligible without meeting the 245.19 requirements of subdivision 2 and the four-month requirement in 245.20 subdivision 3, as long as they maintain continuous coverage in 245.21 the MinnesotaCare program or medical assistance. Children who 245.22 apply for MinnesotaCare on or after the implementation date of 245.23 the employer-subsidized health coverage program as described in 245.24 Laws 1998, chapter 407, article 5, section 45, who have family 245.25 gross incomes that are equal to or less than175150 percent of 245.26 the federal poverty guidelines, must meet the requirements of 245.27 subdivision 2 to be eligible for MinnesotaCare. 245.28 (b) Families enrolled in MinnesotaCare under section 245.29 256L.04, subdivision 1, whose income increases above 275 percent 245.30 of the federal poverty guidelines, are no longer eligible for 245.31 the program and shall be disenrolled by the commissioner. 245.32 Individuals enrolled in MinnesotaCare under section 256L.04, 245.33 subdivision 7, whose income increases above 175 percent of the 245.34 federal poverty guidelines are no longer eligible for the 245.35 program and shall be disenrolled by the commissioner. For 245.36 persons disenrolled under this subdivision, MinnesotaCare 246.1 coverage terminates the last day of the calendar month following 246.2 the month in which the commissioner determines that the income 246.3 of a family or individual exceeds program income limits. 246.4 (c)(1) Notwithstanding paragraph (b),individuals and246.5 families enrolled in MinnesotaCare under section 256L.04, 246.6 subdivision 1, may remain enrolled in MinnesotaCare if ten 246.7 percent of their annual income is less than the annual premium 246.8 for a policy with a $500 deductible available through the 246.9 Minnesota comprehensive health association.Individuals and246.10 Families who are no longer eligible for MinnesotaCare under this 246.11 subdivision shall be given an 18-month notice period from the 246.12 date that ineligibility is determined before 246.13 disenrollment. This clause expires February 1, 2004. 246.14 (2) Effective February 1, 2004, notwithstanding paragraph 246.15 (b), children may remain enrolled in MinnesotaCare if ten 246.16 percent of their annual family income is less than the annual 246.17 premium for a policy with a $500 deductible available through 246.18 the Minnesota comprehensive health association. Children who 246.19 are no longer eligible for MinnesotaCare under this clause shall 246.20 be given a 12-month notice period from the date that 246.21 ineligibility is determined before disenrollment. The premium 246.22 for children remaining eligible under this clause shall be the 246.23 maximum premium determined under section 256L.15, subdivision 2, 246.24 paragraph (b), until July 1, 2005, when the premium shall be 246.25 determined by section 256L.15, subdivision 2, paragraph (c). 246.26 [EFFECTIVE DATE.] The amendments to paragraph (a) are 246.27 effective July 1, 2003. The amendments to paragraph (c), clause 246.28 (1), are effective October 1, 2003. 246.29 Sec. 80. Minnesota Statutes 2002, section 256L.07, 246.30 subdivision 2, is amended to read: 246.31 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 246.32 COVERAGE.] (a) To be eligible, a family or individual must not 246.33 have access to subsidized health coverage through an employer 246.34 and must not have had access to employer-subsidized coverage 246.35 through a current employer for 18 months prior to application or 246.36 reapplication. A family or individual whose employer-subsidized 247.1 coverage is lost due to an employer terminating health care 247.2 coverage as an employee benefit during the previous 18 months is 247.3 not eligible. 247.4 (b) This subdivision does not apply to a family or 247.5 individual who was enrolled in MinnesotaCare within six months 247.6 or less of reapplication and who no longer has 247.7 employer-subsidized coverage due to the employer terminating 247.8 health care coverage as an employee benefit. 247.9 (c) For purposes of this requirement, subsidized health 247.10 coverage means health coverage for which the employer pays at 247.11 least 50 percent of the cost of coverage for the employee or 247.12 dependent, or a higher percentage as specified by the 247.13 commissioner. Children are eligible for employer-subsidized 247.14 coverage through either parent, including the noncustodial 247.15 parent. The commissioner must treat employer contributions to 247.16 Internal Revenue Code Section 125 plans and any other employer 247.17 benefits intended to pay health care costs as qualified employer 247.18 subsidies toward the cost of health coverage for employees for 247.19 purposes of this subdivision. 247.20 (d) Notwithstanding paragraph (c), beginning February 1, 247.21 2004, health coverage for single adults and households without 247.22 children and adults in families with children shall be 247.23 considered to be subsidized health coverage if the employer 247.24 contributes any amount towards the cost of coverage. 247.25 Sec. 81. Minnesota Statutes 2002, section 256L.07, 247.26 subdivision 3, is amended to read: 247.27 Subd. 3. [OTHER HEALTH COVERAGE.] (a) Families and 247.28 individuals enrolled in the MinnesotaCare program must have no 247.29 health coverage while enrolled or for at least four months prior 247.30 to application and renewal. Children enrolled in the original 247.31 children's health plan and children in families with income 247.32 equal to or less than175150 percent of the federal poverty 247.33 guidelines, who have other health insurance, are eligible if the 247.34 coverage: 247.35 (1) lacks two or more of the following: 247.36 (i) basic hospital insurance; 248.1 (ii) medical-surgical insurance; 248.2 (iii) prescription drug coverage; 248.3 (iv) dental coverage; or 248.4 (v) vision coverage; 248.5 (2) requires a deductible of $100 or more per person per 248.6 year; or 248.7 (3) lacks coverage because the child has exceeded the 248.8 maximum coverage for a particular diagnosis or the policy 248.9 excludes a particular diagnosis. 248.10 The commissioner may change this eligibility criterion for 248.11 sliding scale premiums in order to remain within the limits of 248.12 available appropriations. The requirement of no health coverage 248.13 does not apply to newborns. 248.14 (b) Medical assistance, general assistance medical care, 248.15 and the Civilian Health and Medical Program of the Uniformed 248.16 Service, CHAMPUS, or other coverage provided under United States 248.17 Code, title 10, subtitle A, part II, chapter 55, are not 248.18 considered insurance or health coverage for purposes of the 248.19 four-month requirement described in this subdivision. 248.20 (c) For purposes of this subdivision, Medicare Part A or B 248.21 coverage under title XVIII of the Social Security Act, United 248.22 States Code, title 42, sections 1395c to 1395w-4, is considered 248.23 health coverage. An applicant or enrollee may not refuse 248.24 Medicare coverage to establish eligibility for MinnesotaCare. 248.25 (d) Applicants who were recipients of medical assistance or 248.26 general assistance medical care within one month of application 248.27 must meet the provisions of this subdivision and subdivision 2. 248.28 (e) Effective October 1, 2003, applicants who were 248.29 recipients of medical assistance and had cost-effective health 248.30 insurance which was paid for by medical assistance are exempt 248.31 from the four-month requirement under this section. 248.32 (f) Notwithstanding paragraph (a), effective October 1, 248.33 2004, individuals enrolled in the MinnesotaCare program under 248.34 section 256L.04, subdivision 7, who have gross family income at 248.35 or below 75 percent are not subject to the requirement of having 248.36 no other health coverage for four months prior to application 249.1 and renewal. 249.2 [EFFECTIVE DATE.] This section is effective July 1, 2003, 249.3 except where a different effective date is specified in the text. 249.4 Sec. 82. Minnesota Statutes 2002, section 256L.09, 249.5 subdivision 4, is amended to read: 249.6 Subd. 4. [ELIGIBILITY AS MINNESOTA RESIDENT.] (a) For 249.7 purposes of this section, a permanent Minnesota resident is a 249.8 person who has demonstrated, through persuasive and objective 249.9 evidence, that the person is domiciled in the state and intends 249.10 to live in the state permanently. 249.11 (b) To be eligible as a permanent resident, an applicant 249.12 must demonstrate the requisite intent to live in the state 249.13 permanently by: 249.14 (1) showing that the applicant maintains a residence at a 249.15 verified address other than a place of public accommodation, 249.16 through the use of evidence of residence described in section 249.17 256D.02, subdivision 12a, clause (1); 249.18 (2) demonstrating that the applicant has been continuously 249.19 domiciled in the state for no less than 180 days immediately 249.20 before the application;and249.21 (3) signing an affidavit declaring that (A) the applicant 249.22 currently resides in the state and intends to reside in the 249.23 state permanently; and (B) the applicant did not come to the 249.24 state for the primary purpose of obtaining medical coverage or 249.25 treatment; 249.26 (4) effective October 1, 2004, single adults and adults in 249.27 households without children who have gross family income at or 249.28 below 75 percent of the federal poverty guidelines are exempt 249.29 from the requirements of clause (1); 249.30 (5) effective October 1, 2004, single adults and adults in 249.31 households without children who have gross family income at or 249.32 below 75 percent of the federal poverty guidelines are exempt 249.33 from clause (2), but shall demonstrate that they have been 249.34 continuously domiciled in the state for no less than 30 days 249.35 before the date of application. In cases of medical 249.36 emergencies, the 30-day residency requirement is waived; and 250.1 (6) effective October 1, 2004, migrant workers as defined 250.2 in section 256J.08 who are single adults and adults in 250.3 households without children who have gross family income at or 250.4 below 75 percent of the federal poverty guidelines are exempt 250.5 from the residency requirements of this section, provided the 250.6 migrant worker provides verification that the migrant family 250.7 worked in this state within the last 12 months and earned at 250.8 least $1,000 in gross wages during the time the migrant worker 250.9 worked in this state. 250.10 (c) A person who is temporarily absent from the state does 250.11 not lose eligibility for MinnesotaCare. "Temporarily absent 250.12 from the state" means the person is out of the state for a 250.13 temporary purpose and intends to return when the purpose of the 250.14 absence has been accomplished. A person is not temporarily 250.15 absent from the state if another state has determined that the 250.16 person is a resident for any purpose. If temporarily absent 250.17 from the state, the person must follow the requirements of the 250.18 health plan in which the person is enrolled to receive services. 250.19 Sec. 83. Minnesota Statutes 2002, section 256L.12, 250.20 subdivision 6, is amended to read: 250.21 Subd. 6. [COPAYMENTS AND BENEFIT LIMITS.] Enrollees are 250.22 responsible for all copayments in section 256L.03, subdivision4250.23 5, and shall pay copayments to the managed care plan or to its 250.24 participating providers. The enrollee is also responsible for 250.25 payment of inpatient hospital charges which exceed the 250.26 MinnesotaCare benefit limit. 250.27 Sec. 84. Minnesota Statutes 2002, section 256L.12, 250.28 subdivision 9, is amended to read: 250.29 Subd. 9. [RATE SETTING; PERFORMANCE WITHHOLDS.] (a) Rates 250.30 will be prospective, per capita, where possible. The 250.31 commissioner may allow health plans to arrange for inpatient 250.32 hospital services on a risk or nonrisk basis. The commissioner 250.33 shall consult with an independent actuary to determine 250.34 appropriate rates. 250.35 (b) For services rendered on or after January 1, 2003, to 250.36 December 31, 2003, the commissioner shall withhold .5 percent of 251.1 managed care plan payments under this section pending completion 251.2 of performance targets. The withheld funds must be returned no 251.3 sooner than July 1 and no later than July 31 of the following 251.4 year if performance targets in the contract are achieved. A 251.5 managed care plan may include as admitted assets under section 251.6 62D.044 any amount withheld under this paragraph that is 251.7 reasonably expected to be returned. 251.8 (c) For services rendered on or after January 1, 2004, the 251.9 commissioner shall withhold five percent of managed care plan 251.10 payments under this section pending completion of performance 251.11 targets. Each performance target must be quantifiable, 251.12 objective, measurable, and reasonably attainable. Criteria for 251.13 assessment of each performance target must be outlined in 251.14 writing prior to the contract effective date. The withheld 251.15 funds must be returned no sooner than July 1 and no later than 251.16 July 31 of the following calendar year if performance targets in 251.17 the contract are achieved. A managed care plan may include as 251.18 admitted assets under section 62D.044 any amount withheld under 251.19 this paragraph that is reasonably expected to be returned. 251.20 (d) The commissioner may exempt from paragraph (b) a 251.21 managed care plan that has entered into a managed care contract 251.22 with the commissioner in accordance with this section if the 251.23 contract was the initial contract between the managed care plan 251.24 and the commissioner, and it was entered into after January 1, 251.25 2000. This exemption shall apply for five years after the 251.26 initial contract was entered into by the managed care plan. 251.27 [EFFECTIVE DATE.] This section is effective for services 251.28 rendered on or after July 1, 2003, except as otherwise provided 251.29 in the statutory language. 251.30 Sec. 85. Minnesota Statutes 2002, section 256L.12, is 251.31 amending by adding a subdivision to read: 251.32 Subd. 9a. [RATE SETTING; RATABLE REDUCTION.] For services 251.33 rendered on or after October 1, 2003, the total payment made to 251.34 managed care plans under the MinnesotaCare program is reduced 251.35 0.5 percent. 251.36 Sec. 86. Minnesota Statutes 2002, section 256L.12, is 252.1 amended by adding a subdivision to read: 252.2 Subd. 9b. [ACTUARIAL SOUNDNESS.] All payments made to 252.3 managed care plans under the MinnesotaCare program shall be 252.4 actuarially sound pursuant to Code of Federal Regulations, title 252.5 42, section 438.6. In establishing payment rates for managed 252.6 care plans under the MinnesotaCare program, the commissioner 252.7 must consider, to the extent this information is available, 252.8 verifiable, and actuarially significant: (1) individual health 252.9 plan annual financial performance for public programs; and (2) 252.10 rate relationships and geographic payment relativities based on 252.11 actual health plan experience. The commissioner may recover any 252.12 administrative costs related to implementing this subdivision, 252.13 by assessing managed care plans in proportion to their share of 252.14 enrollees in the MinnesotaCare program. 252.15 Sec. 87. Minnesota Statutes 2002, section 256L.15, 252.16 subdivision 1, is amended to read: 252.17 Subdivision 1. [PREMIUM DETERMINATION.] (a) Families with 252.18 children and individuals shall pay a premium determined 252.19 according toa sliding fee based on a percentage of the family's252.20gross family incomesubdivision 2. 252.21 (b) Pregnant women and children under age two are exempt 252.22 from the provisions of section 256L.06, subdivision 3, paragraph 252.23 (b), clause (3), requiring disenrollment for failure to pay 252.24 premiums. For pregnant women, this exemption continues until 252.25 the first day of the month following the 60th day postpartum. 252.26 Women who remain enrolled during pregnancy or the postpartum 252.27 period, despite nonpayment of premiums, shall be disenrolled on 252.28 the first of the month following the 60th day postpartum for the 252.29 penalty period that otherwise applies under section 256L.06, 252.30 unless they begin paying premiums. 252.31 (c) Effective October 1, 2004, single adults and households 252.32 without children with gross family income at or below 75 percent 252.33 of the federal poverty guidelines who are eligible under section 252.34 256L.04, subdivision 7, do not have a premium obligation. 252.35 Sec. 88. Minnesota Statutes 2002, section 256L.15, 252.36 subdivision 2, is amended to read: 253.1 Subd. 2. [SLIDING FEE SCALE TO DETERMINE PERCENTAGE OF 253.2 GROSS INDIVIDUAL OR FAMILY INCOME.] (a) The commissioner shall 253.3 establish a sliding fee scale to determine the percentage of 253.4 grossindividual orfamily income that households at different 253.5 income levels must pay to obtain coverage through the 253.6 MinnesotaCare program. The sliding fee scale must be based on 253.7 the enrollee's grossindividual orfamily income. The sliding 253.8 fee scale must contain separate tables based on enrollment of 253.9 one, two, or three or more persons. The sliding fee scale 253.10 begins with a premium of 1.5 percent of grossindividual or253.11 family income forindividuals orfamilies with incomes below the 253.12 limits for the medical assistance program for families and 253.13 children in effect on January 1, 1999, and proceeds through the 253.14 following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 253.15 7.4, and 8.8 percent. These percentages are matched to evenly 253.16 spaced income steps ranging from the medical assistance income 253.17 limit for families and children in effect on January 1, 1999, to 253.18 275 percent of the federal poverty guidelines for the applicable 253.19 family size, up to a family size of five. The sliding fee scale 253.20 for a family of five must be used for families of more than 253.21 five. Effective October 1, 2003, the commissioner shall 253.22 increase each percentage by 0.5 percentage points for families 253.23 and children with incomes greater than 100 percent but not 253.24 exceeding 200 percent of the federal poverty guidelines and 253.25 shall increase each percentage by 1.0 percentage points for 253.26 families and children with incomes greater than 200 percent of 253.27 the federal poverty guidelines. The sliding fee scale and 253.28 percentages are not subject to the provisions of chapter 14. If 253.29 a familyor individualreports increased income after 253.30 enrollment, premiums shall not be adjusted until eligibility 253.31 renewal. 253.32 (b)(1) Enrolledindividuals andfamilies whose gross annual 253.33 income increases above 275 percent of the federal poverty 253.34 guideline shall pay the maximum premium. This clause expires 253.35 effective February 1, 2004. 253.36 (2) Effective October 1, 2003, enrolled single adults and 254.1 households without children who have gross family income above 254.2 75 percent of the federal poverty guidelines shall pay the 254.3 maximum premium. 254.4 (3) Effective February 1, 2004, adults in families with 254.5 children whose gross income is above 200 percent of the federal 254.6 poverty guidelines shall pay the maximum premium. 254.7 (4) The maximum premium is defined as a base charge for 254.8 one, two, or three or more enrollees so that if all 254.9 MinnesotaCare cases paid the maximum premium, the total revenue 254.10 would equal the total cost of MinnesotaCare medical coverage and 254.11 administration. In this calculation, administrative costs shall 254.12 be assumed to equal ten percent of the total. The costs of 254.13 medical coverage for pregnant women and children under age two 254.14 and the enrollees in these groups shall be excluded from the 254.15 total. The maximum premium for two enrollees shall be twice the 254.16 maximum premium for one, and the maximum premium for three or 254.17 more enrollees shall be three times the maximum premium for one. 254.18 (c) Effective July 1, 2005, single adults and households 254.19 without children who have gross family income above 75 percent 254.20 of the federal poverty guidelines and adults in families with 254.21 children whose gross income is above 200 percent of the federal 254.22 poverty guidelines shall pay the full cost premium. The full 254.23 cost premium is defined as a base charge for one, two, or three 254.24 or more enrollees so that if the base charge were paid by all 254.25 MinnesotaCare cases subject to the full cost premium, the total 254.26 revenue would approximately equal the total cost of 254.27 MinnesotaCare medical coverage and administration for cases 254.28 subject to the full cost premium. In this calculation, 254.29 administrative costs shall be assumed to equal ten percent of 254.30 the total. The full cost premium for two enrollees shall be 254.31 twice the full cost premium for one, and the full cost premium 254.32 for three or more enrollees shall be three times the full cost 254.33 premium for one. 254.34 [EFFECTIVE DATE.] The amendments to this section are 254.35 effective October 1, 2004, unless specified otherwise in the 254.36 statutory text. 255.1 Sec. 89. Minnesota Statutes 2002, section 256L.15, 255.2 subdivision 3, is amended to read: 255.3 Subd. 3. [EXCEPTIONS TO SLIDING SCALE.] An annual premium 255.4 of $48 is required for all children in families with income at 255.5 or less than175150 percent of federal poverty guidelines. 255.6 [EFFECTIVE DATE.] This section is effective July 1, 2003. 255.7 Sec. 90. Minnesota Statutes 2002, section 256L.17, 255.8 subdivision 2, is amended to read: 255.9 Subd. 2. [LIMIT ON TOTAL ASSETS.](a)Effective July 1, 255.10 2002, or upon federal approval, whichever is later, in order to 255.11 be eligible for the MinnesotaCare program, a household of two or 255.12 more persons must not own more than $30,000 in total net assets, 255.13 and a household of one person must not own more than $15,000 in 255.14 total net assets. 255.15(b) For purposes of this subdivision, assets are determined255.16according to section 256B.056, subdivision 3c.In addition to 255.17 these maximum amounts, an eligible individual or family may 255.18 accrue interest on these amounts, but they must be reduced to 255.19 the maximum at the time of an eligibility redetermination. The 255.20 value of assets that are not considered in determining 255.21 eligibility is the value of those assets excluded under the AFDC 255.22 state plan as of July 16, 1996, as required by the Personal 255.23 Responsibility and Work Opportunity Reconciliation Act of 1996 255.24 (PRWORA), Public Law 104-193, with the following exceptions: 255.25 (1) household goods and personal effects are not 255.26 considered; 255.27 (2) capital and operating assets of a trade or business up 255.28 to $200,000 are not considered; 255.29 (3) one motor vehicle is excluded for each person of legal 255.30 driving age who is employed or seeking employment; 255.31 (4) one burial plot and all other burial expenses equal to 255.32 the supplemental security income program asset limit are not 255.33 considered for each individual; 255.34 (5) court-ordered settlements up to $10,000 are not 255.35 considered; 255.36 (6) individual retirement accounts and funds are not 256.1 considered; and 256.2 (7) assets owned by children are not considered. 256.3 [EFFECTIVE DATE.] This section is effective July 1, 2003. 256.4 Sec. 91. Minnesota Statutes 2002, section 514.981, 256.5 subdivision 6, is amended to read: 256.6 Subd. 6. [TIME LIMITS; CLAIM LIMITS; LIENS ON LIFE ESTATES 256.7 AND JOINT TENANCIES.] (a) A medical assistance lien is a lien on 256.8 the real property it describes for a period of ten years from 256.9 the date it attaches according to section 514.981, subdivision 256.10 2, paragraph (a), except as otherwise provided for in sections 256.11 514.980 to 514.985. The agency may renew a medical assistance 256.12 lien for an additional ten years from the date it would 256.13 otherwise expire by recording or filing a certificate of renewal 256.14 before the lien expires. The certificate shall be recorded or 256.15 filed in the office of the county recorder or registrar of 256.16 titles for the county in which the lien is recorded or filed. 256.17 The certificate must refer to the recording or filing data for 256.18 the medical assistance lien it renews. The certificate need not 256.19 be attested, certified, or acknowledged as a condition for 256.20 recording or filing. The registrar of titles or the recorder 256.21 shall file, record, index, and return the certificate of renewal 256.22 in the same manner as provided for medical assistance liens in 256.23 section 514.982, subdivision 2. 256.24 (b) A medical assistance lien is not enforceable against 256.25 the real property of an estate to the extent there is a 256.26 determination by a court of competent jurisdiction, or by an 256.27 officer of the court designated for that purpose, that there are 256.28 insufficient assets in the estate to satisfy the agency's 256.29 medical assistance lien in whole or in part because of the 256.30 homestead exemption under section 256B.15, subdivision 4, the 256.31 rights of the surviving spouse or minor children under section 256.32 524.2-403, paragraphs (a) and (b), or claims with a priority 256.33 under section 524.3-805, paragraph (a), clauses (1) to (4). For 256.34 purposes of this section, the rights of the decedent's adult 256.35 children to exempt property under section 524.2-403, paragraph 256.36 (b), shall not be considered costs of administration under 257.1 section 524.3-805, paragraph (a), clause (1). 257.2 (c) Notwithstanding any law or rule to the contrary, the 257.3 provisions in clauses (1) to (7) apply if a life estate subject 257.4 to a medical assistance lien ends according to its terms, or if 257.5 a medical assistance recipient who owns a life estate or any 257.6 interest in real property as a joint tenant that is subject to a 257.7 medical assistance lien dies. 257.8 (1) The medical assistance recipient's life estate or joint 257.9 tenancy interest in the real property shall not end upon the 257.10 recipient's death but shall merge into the remainder interest or 257.11 other interest in real property the medical assistance recipient 257.12 owned in joint tenancy with others. The medical assistance lien 257.13 shall attach to and run with the remainder or other interest in 257.14 the real property to the extent of the medical assistance 257.15 recipient's interest in the property at the time of the 257.16 recipient's death as determined under this section. 257.17 (2) If the medical assistance recipient's interest was a 257.18 life estate in real property, the lien shall be a lien against 257.19 the portion of the remainder equal to the percentage factor for 257.20 the life estate of a person the medical assistance recipient's 257.21 age on the date the life estate ended according to its terms or 257.22 the date of the medical assistance recipient's death as listed 257.23 in the Life Estate Mortality Table in the health care program's 257.24 manual. 257.25 (3) If the medical assistance recipient owned the interest 257.26 in real property in joint tenancy with others, the lien shall be 257.27 a lien against the portion of that interest equal to the 257.28 fractional interest the medical assistance recipient would have 257.29 owned in the jointly owned interest had the medical assistance 257.30 recipient and the other owners held title to that interest as 257.31 tenants in common on the date the medical assistance recipient 257.32 died. 257.33 (4) The medical assistance lien shall remain a lien against 257.34 the remainder or other jointly owned interest for the length of 257.35 time and be renewable as provided in paragraph (a). 257.36 (5) Section 514.981, subdivision 5, paragraphs (a), clause 258.1 (4), (b), clauses (1) and (2); and subdivision 6, paragraph (b), 258.2 do not apply to medical assistance liens which attach to 258.3 interests in real property as provided under this subdivision. 258.4 (6) The continuation of a medical assistance recipient's 258.5 life estate or joint tenancy interest in real property after the 258.6 medical assistance recipient's death for the purpose of 258.7 recovering medical assistance provided for in sections 514.980 258.8 to 514.985 modifies common law principles holding that these 258.9 interests terminate on the death of the holder. 258.10 (7) Notwithstanding any law or rule to the contrary, no 258.11 release, satisfaction, discharge, or affidavit under section 258.12 256B.15 shall extinguish or terminate the life estate or joint 258.13 tenancy interest of a medical assistance recipient subject to a 258.14 lien under sections 514.980 to 514.985 on the date the recipient 258.15 dies. 258.16 (8) The provisions of clauses (1) to (7) do not apply to a 258.17 homestead owned of record, on the date the recipient dies, by 258.18 the recipient and the recipient's spouse as joint tenants with a 258.19 right of survivorship. 258.20 [EFFECTIVE DATE.] This section is effective August 1, 2003, 258.21 and applies to all medical assistance liens recorded or filed on 258.22 or after that date. 258.23 Sec. 92. Minnesota Statutes 2002, section 641.15, 258.24 subdivision 2, is amended to read: 258.25 Subd. 2. [MEDICAL AID.] Except as provided in section 258.26 466.101, the county board shall pay the costs of medical 258.27 services provided to prisoners. The amount paid by a county 258.28 board for a medical service shall not exceed the maximum allowed 258.29 medical assistance payment rate for the service, as determined 258.30 by the commissioner of human services. The county is entitled 258.31 to reimbursement from the prisoner for payment of medical bills 258.32 to the extent that the prisoner to whom the medical aid was 258.33 provided has the ability to pay the bills. The prisoner shall, 258.34 at a minimum, incur copayment obligations for health care 258.35 services provided by a county correctional facility. The county 258.36 board shall determine the copayment amount. Notwithstanding any 259.1 law to the contrary, the copayment shall be deducted from any of 259.2 the prisoner's funds held by the county, to the extent 259.3 possible. If there is a disagreement between the county and a 259.4 prisoner concerning the prisoner's ability to pay, the court 259.5 with jurisdiction over the defendant shall determine the extent, 259.6 if any, of the prisoner's ability to pay for the medical 259.7 services. If a prisoner is covered by health or medical 259.8 insurance or other health plan when medical services are 259.9 provided, the county providing the medical services has a right 259.10 of subrogation to be reimbursed by the insurance carrier for all 259.11 sums spent by it for medical services to the prisoner that are 259.12 covered by the policy of insurance or health plan, in accordance 259.13 with the benefits, limitations, exclusions, provider 259.14 restrictions, and other provisions of the policy or health 259.15 plan. The county may maintain an action to enforce this 259.16 subrogation right. The county does not have a right of 259.17 subrogation against the medical assistance program or the 259.18 general assistance medical care program. 259.19 Sec. 93. [PHARMACY PLUS WAIVER.] 259.20 The commissioner of human services shall seek a pharmacy 259.21 plus waiver from the Department of Health and Human Services 259.22 that uses the accumulated savings from all pharmacy and asset 259.23 transfer provisions in this act and previously adopted pharmacy 259.24 savings strategies as the factor to prove fiscal neutrality. 259.25 The commissioner shall expand eligibility for seniors and the 259.26 disabled up to 135 percent of the federal poverty guidelines for 259.27 the prescription drug program under Minnesota Statutes, section 259.28 256.955, to the extent that the new federal funding under this 259.29 waiver allows an expansion without an additional state 259.30 appropriation. 259.31 The commissioner shall also request that the prescription 259.32 drug discount program established under Minnesota Statutes, 259.33 section 256.954, be included in the waiver to require 259.34 manufacturer rebates and to reduce the administrative costs of 259.35 the program to the state. 259.36 Sec. 94. [REPORT ON PRESCRIPTION DRUG PROGRAMS.] 260.1 The commissioner of human services shall report to the 260.2 chairs and ranking minority members of the house and senate 260.3 committees with jurisdiction over health and human services 260.4 financing by November 1, 2004, on the status of the prescription 260.5 drug discount program under Minnesota Statutes, section 256.954, 260.6 and the prescription drug assistance program under Minnesota 260.7 Statutes, section 256.975, subdivision 9. The report must: 260.8 (1) describe the status of the pharmacy plus waiver for 260.9 Minnesota; 260.10 (2) evaluate the impact of the prescription drug assistance 260.11 program on the prescription drug program and the prescription 260.12 drug discount program; and 260.13 (3) provide recommendations on the most efficient 260.14 enrollment process for the prescription drug assistance program, 260.15 considering state, county, or private options and the benefit of 260.16 any automated enrollment systems under development by the 260.17 commissioner. 260.18 Sec. 95. [REVIEW OF SPECIAL TRANSPORTATION ELIGIBILITY 260.19 CRITERIA AND POTENTIAL COST SAVINGS.] 260.20 The commissioner of human services, in consultation with 260.21 the commissioner of transportation and special transportation 260.22 service providers, shall review eligibility criteria for medical 260.23 assistance special transportation services and shall evaluate 260.24 whether the level of special transportation services provided 260.25 should be based on the degree of impairment of the client, as 260.26 well as the medical diagnosis. The commissioner shall also 260.27 evaluate methods for reducing the cost of special transportation 260.28 services, including, but not limited to: 260.29 (1) requiring providers to maintain a daily log book 260.30 confirming delivery of clients to medical facilities; 260.31 (2) requiring providers to implement commercially available 260.32 computer mapping programs to calculate mileage for purposes of 260.33 reimbursement; and 260.34 (3) restricting special transportation service from being 260.35 provided solely for trips to pharmacies. 260.36 The commissioner shall present recommendations for changes 261.1 in the eligibility criteria and potential cost-savings for 261.2 special transportation services to the chairs and ranking 261.3 minority members of the house and senate committees having 261.4 jurisdiction over health and human services spending by January 261.5 15, 2004. The commissioner is prohibited from using a broker or 261.6 coordinator to manage special transportation services through 261.7 June 30, 2005, except for the purposes of checking for recipient 261.8 eligibility, authorizing recipients for the appropriate level of 261.9 transportation, and monitoring provider compliance with 261.10 Minnesota Statutes, section 256B.0625, subdivision 17. This 261.11 prohibition does not apply to the purchase or management of 261.12 common carrier transportation. 261.13 Sec. 96. [REBATES FOR MANAGED CARE.] 261.14 The commissioner of human services shall develop a proposal 261.15 to obtain increased pharmacy rebate revenue for recipients 261.16 served through the prepaid medical assistance program and the 261.17 MinnesotaCare program. The commissioner may recommend excluding 261.18 coverage for prescription drugs from prepaid medical assistance 261.19 programs and MinnesotaCare contracts, or may propose other 261.20 methods to obtain supplemental drug rebates for this 261.21 population. The commissioner shall present the proposal to the 261.22 chairs and ranking minority members of the house and senate 261.23 committees with jurisdiction over health and human services 261.24 finance issues. 261.25 Sec. 97. [FEDERAL APPROVAL.] 261.26 If the amendments to Minnesota Statutes, sections 256.046, 261.27 subdivision 1, and 256.98, subdivision 8, are not effective 261.28 because of prohibitions in federal law, the commissioner of 261.29 human services shall seek the federal waivers and authority 261.30 necessary to implement the provisions. 261.31 Sec. 98. [REVISOR'S INSTRUCTION.] 261.32 For sections in Minnesota Statutes and Minnesota Rules 261.33 affected by the repealed sections in this article, the revisor 261.34 shall delete internal cross-references where appropriate and 261.35 make changes necessary to correct the punctuation, grammar, or 261.36 structure of the remaining text and preserve its meaning. 262.1 Sec. 99. [REPEALER.] 262.2 (a) Minnesota Statutes 2002, sections 256.955, subdivision 262.3 8; 256B.056, subdivision 3c; 256B.057, subdivision 1b; and 262.4 256B.195, subdivision 5, are repealed July 1, 2003. 262.5 (b) Minnesota Statutes 2002, section 256L.04, subdivision 262.6 9, is repealed October 1, 2004. 262.7 (c) Minnesota Statutes 2002, section 256B.055, subdivision 262.8 10a, is repealed July 1, 2003, or upon federal approval, 262.9 whichever is later. 262.10 (d) Minnesota Statutes 2002, section 256L.02, subdivision 262.11 3, is repealed June 30, 2005. 262.12 ARTICLE 3 262.13 LONG-TERM CARE 262.14 Section 1. Minnesota Statutes 2002, section 61A.072, 262.15 subdivision 6, is amended to read: 262.16 Subd. 6. [ACCELERATED BENEFITS.] (a) "Accelerated 262.17 benefits" covered under this section are benefits payable under 262.18 the life insurance contract: 262.19 (1) to a policyholder or certificate holder, during the 262.20 lifetime of the insured,in anticipation of deathupon the 262.21 occurrence of a specified life-threatening or catastrophic 262.22 condition as defined by the policy or rider; 262.23 (2) that reduce the death benefit otherwise payable under 262.24 the life insurance contract; and 262.25 (3) that are payable upon the occurrence of a single 262.26 qualifying event that results in the payment of a benefit amount 262.27 fixed at the time of acceleration. 262.28 (b) "Qualifying event" means one or more of the following: 262.29 (1) a medical condition that would result in a drastically 262.30 limited life span as specified in the contract; 262.31 (2) a medical condition that has required or requires 262.32 extraordinary medical intervention, such as, but not limited to, 262.33 major organ transplant or continuous artificial life support 262.34 without which the insured would die;or262.35 (3) a condition that requires continuous confinement in an 262.36 eligible institution as defined in the contract if the insured 263.1 is expected to remain there for the rest of the insured's life; 263.2 (4) a long-term care illness or physical condition that 263.3 results in cognitive impairment or the inability to perform the 263.4 activities of daily life or the substantial and material duties 263.5 of any occupation; or 263.6 (5) other qualifying events that the commissioner approves 263.7 for a particular filing. 263.8 [EFFECTIVE DATE.] This section is effective the day 263.9 following final enactment and applies to policies issued on or 263.10 after that date. 263.11 Sec. 2. Minnesota Statutes 2002, section 62A.315, is 263.12 amended to read: 263.13 62A.315 [EXTENDED BASIC MEDICARE SUPPLEMENT PLAN; 263.14 COVERAGE.] 263.15 The extended basic Medicare supplement plan must have a 263.16 level of coverage so that it will be certified as a qualified 263.17 plan pursuant to section 62E.07, and will provide: 263.18 (1) coverage for all of the Medicare part A inpatient 263.19 hospital deductible and coinsurance amounts, and 100 percent of 263.20 all Medicare part A eligible expenses for hospitalization not 263.21 covered by Medicare; 263.22 (2) coverage for the daily copayment amount of Medicare 263.23 part A eligible expenses for the calendar year incurred for 263.24 skilled nursing facility care; 263.25 (3) coverage for the copayment amount of Medicare eligible 263.26 expenses under Medicare part B regardless of hospital 263.27 confinement, and the Medicare part B deductible amount; 263.28 (4) 80 percent of the usual and customary hospital and 263.29 medical expenses and supplies described in section 62E.06, 263.30 subdivision 1, not to exceed any charge limitation established 263.31 by the Medicare program or state law, the usual and customary 263.32 hospital and medical expenses and supplies, described in section 263.33 62E.06, subdivision 1, while in a foreign country, and 263.34 prescription drug expenses, not covered by Medicare; 263.35 (5) coverage for the reasonable cost of the first three 263.36 pints of blood, or equivalent quantities of packed red blood 264.1 cells as defined under federal regulations under Medicare parts 264.2 A and B, unless replaced in accordance with federal regulations; 264.3 (6) 100 percent of the cost of immunizations and routine 264.4 screening procedures for cancer, including mammograms and pap 264.5 smears; 264.6 (7) preventive medical care benefit: coverage for the 264.7 following preventive health services: 264.8 (i) an annual clinical preventive medical history and 264.9 physical examination that may include tests and services from 264.10 clause (ii) and patient education to address preventive health 264.11 care measures; 264.12 (ii) any one or a combination of the following preventive 264.13 screening tests or preventive services, the frequency of which 264.14 is considered medically appropriate: 264.15 (A) fecal occult blood test and/or digital rectal 264.16 examination; 264.17 (B) dipstick urinalysis for hematuria, bacteriuria, and 264.18 proteinuria; 264.19 (C) pure tone (air only) hearing screening test 264.20 administered or ordered by a physician; 264.21 (D) serum cholesterol screening every five years; 264.22 (E) thyroid function test; 264.23 (F) diabetes screening; 264.24 (iii) any other tests or preventive measures determined 264.25 appropriate by the attending physician. 264.26 Reimbursement shall be for the actual charges up to 100 264.27 percent of the Medicare-approved amount for each service as if 264.28 Medicare were to cover the service as identified in American 264.29 Medical Association current procedural terminology (AMA CPT) 264.30 codes to a maximum of $120 annually under this benefit. This 264.31 benefit shall not include payment for any procedure covered by 264.32 Medicare; 264.33 (8) at-home recovery benefit: coverage for services to 264.34 provide short-term at-home assistance with activities of daily 264.35 living for those recovering from an illness, injury, or surgery: 264.36 (i) for purposes of this benefit, the following definitions 265.1 shall apply: 265.2 (A) "activities of daily living" include, but are not 265.3 limited to, bathing, dressing, personal hygiene, transferring, 265.4 eating, ambulating, assistance with drugs that are normally 265.5 self-administered, and changing bandages or other dressings; 265.6 (B) "care provider" means a duly qualified or licensed home 265.7 health aide/homemaker, personal care aide, or nurse provided 265.8 through a licensed home health care agency or referred by a 265.9 licensed referral agency or licensed nurses registry; 265.10 (C) "home" means a place used by the insured as a place of 265.11 residence, provided that the place would qualify as a residence 265.12 for home health care services covered by Medicare. A hospital 265.13 or skilled nursing facility shall not be considered the 265.14 insured's place of residence; 265.15 (D) "at-home recovery visit" means the period of a visit 265.16 required to provide at-home recovery care, without limit on the 265.17 duration of the visit, except each consecutive four hours in a 265.18 24-hour period of services provided by a care provider is one 265.19 visit; 265.20 (ii) coverage requirements and limitations: 265.21 (A) at-home recovery services provided must be primarily 265.22 services that assist in activities of daily living; 265.23 (B) the insured's attending physician must certify that the 265.24 specific type and frequency of at-home recovery services are 265.25 necessary because of a condition for which a home care plan of 265.26 treatment was approved by Medicare; 265.27 (C) coverage is limited to: 265.28 (I) no more than the number and type of at-home recovery 265.29 visits certified as medically necessary by the insured's 265.30 attending physician. The total number of at-home recovery 265.31 visits shall not exceed the number of Medicare-approved home 265.32 health care visits under a Medicare-approved home care plan of 265.33 treatment; 265.34 (II) the actual charges for each visit up to a maximum 265.35 reimbursement of$40$100 per visit; 265.36 (III)$1,600$4,000 per calendar year; 266.1 (IV) seven visits in any one week; 266.2 (V) care furnished on a visiting basis in the insured's 266.3 home; 266.4 (VI) services provided by a care provider as defined in 266.5 this section; 266.6 (VII) at-home recovery visits while the insured is covered 266.7 under the policy or certificate and not otherwise excluded; 266.8 (VIII) at-home recovery visits received during the period 266.9 the insured is receiving Medicare-approved home care services or 266.10 no more than eight weeks after the service date of the last 266.11 Medicare-approved home health care visit; 266.12 (iii) coverage is excluded for: 266.13 (A) home care visits paid for by Medicare or other 266.14 government programs; and 266.15 (B) care provided byfamily members,unpaid volunteers,or 266.16 providers who are not care providers. 266.17 [EFFECTIVE DATE.] This section is effective January 1, 266.18 2004, and applies to policies issued on or after that date. 266.19 Sec. 3. Minnesota Statutes 2002, section 62A.48, is 266.20 amended by adding a subdivision to read: 266.21 Subd. 12. [REGULATORY FLEXIBILITY.] The commissioner may 266.22 upon written request issue an order to modify or suspend a 266.23 specific provision or provisions of sections 62A.46 to 62A.56 266.24 with respect to a specific long-term care insurance policy or 266.25 certificate upon a written finding that: 266.26 (1) the modification or suspension is in the best interest 266.27 of the insureds; 266.28 (2) the purpose to be achieved could not be effectively or 266.29 efficiently achieved without the modifications or suspension; 266.30 and 266.31 (3)(i) the modification or suspension is necessary to the 266.32 development of an innovative and reasonable approach for 266.33 insuring long-term care; 266.34 (ii) the policy or certificate is to be issued to residents 266.35 of a life care or continuing care retirement community or some 266.36 other residential community for the elderly and the modification 267.1 or suspension is reasonably related to the special needs or 267.2 nature of such a community; or 267.3 (iii) the modification or suspension is necessary to permit 267.4 long-term care insurance to be sold as part of, or in 267.5 conjunction with, another insurance product. 267.6 [EFFECTIVE DATE.] This section is effective January 1, 267.7 2004, and applies to policies issued on or after that date. 267.8 Sec. 4. Minnesota Statutes 2002, section 62A.49, is 267.9 amended by adding a subdivision to read: 267.10 Subd. 3. [PROHIBITED LIMITATIONS.] A long-term care 267.11 insurance policy or certificate shall not, if it provides 267.12 benefits for home health care or community care services, limit 267.13 or exclude benefits by: 267.14 (1) requiring that the insured would need care in a skilled 267.15 nursing facility if home health care services were not provided; 267.16 (2) requiring that the insured first or simultaneously 267.17 receive nursing or therapeutic services in a home, community, or 267.18 institutional setting before home health care services are 267.19 covered; 267.20 (3) limiting eligible services to services provided by a 267.21 registered nurse or licensed practical nurse; 267.22 (4) requiring that a nurse or therapist provide services 267.23 covered by the policy that can be provided by a home health aide 267.24 or other licensed or certified home care worker acting within 267.25 the scope of licensure or certification; 267.26 (5) excluding coverage for personal care services provided 267.27 by a home health aide; 267.28 (6) requiring that the provision of home health care 267.29 services be at a level of certification or licensure greater 267.30 than that required by the eligible service; 267.31 (7) requiring that the insured have an acute condition 267.32 before home health care services are covered; 267.33 (8) limiting benefits to services provided by 267.34 Medicare-certified agencies or providers; 267.35 (9) excluding coverage for adult day care services; or 267.36 (10) excluding coverage based upon location or type of 268.1 residence in which the home health care services would be 268.2 provided. 268.3 [EFFECTIVE DATE.] This section is effective January 1, 268.4 2004, and applies to policies issued on or after that date. 268.5 Sec. 5. Minnesota Statutes 2002, section 62S.22, 268.6 subdivision 1, is amended to read: 268.7 Subdivision 1. [PROHIBITED LIMITATIONS.] A long-term care 268.8 insurance policy or certificate shall not, if it provides 268.9 benefits for home health care or community care services, limit 268.10 or exclude benefits by: 268.11 (1) requiring that the insured would need care in a skilled 268.12 nursing facility if home health care services were not provided; 268.13 (2) requiring that the insured first or simultaneously 268.14 receive nursing or therapeutic services in a home, community, or 268.15 institutional setting before home health care services are 268.16 covered; 268.17 (3) limiting eligible services to services provided by a 268.18 registered nurse or licensed practical nurse; 268.19 (4) requiring that a nurse or therapist provide services 268.20 covered by the policy that can be provided by a home health aide 268.21 or other licensed or certified home care worker acting within 268.22 the scope of licensure or certification; 268.23 (5) excluding coverage for personal care services provided 268.24 by a home health aide; 268.25 (6) requiring that the provision of home health care 268.26 services be at a level of certification or licensure greater 268.27 than that required by the eligible service; 268.28 (7) requiring that the insured have an acute condition 268.29 before home health care services are covered; 268.30 (8) limiting benefits to services provided by 268.31 Medicare-certified agencies or providers;or268.32 (9) excluding coverage for adult day care services; or 268.33 (10) excluding coverage based upon location or type of 268.34 residence in which the home health care services would be 268.35 provided. 268.36 [EFFECTIVE DATE.] This section is effective January 1, 269.1 2004, and applies to policies issued on or after that date. 269.2 Sec. 6. [62S.34] [REGULATORY FLEXIBILITY.] 269.3 The commissioner may upon written request issue an order to 269.4 modify or suspend a specific provision or provisions of this 269.5 chapter with respect to a specific long-term care insurance 269.6 policy or certificate upon a written finding that: 269.7 (1) the modification or suspension is in the best interest 269.8 of the insureds; 269.9 (2) the purpose to be achieved could not be effectively or 269.10 efficiently achieved without the modifications or suspension; 269.11 and 269.12 (3)(i) the modification or suspension is necessary to the 269.13 development of an innovative and reasonable approach for 269.14 insuring long-term care; 269.15 (ii) the policy or certificate is to be issued to residents 269.16 of a life care or continuing care retirement community or some 269.17 other residential community for the elderly and the modification 269.18 or suspension is reasonably related to the special needs or 269.19 nature of such a community; or 269.20 (iii) the modification or suspension is necessary to permit 269.21 long-term care insurance to be sold as part of, or in 269.22 conjunction with, another insurance product. 269.23 [EFFECTIVE DATE.] This section is effective January 1, 269.24 2004, and applies to policies issued on or after that date. 269.25 Sec. 7. Minnesota Statutes 2002, section 144A.04, 269.26 subdivision 3, is amended to read: 269.27 Subd. 3. [STANDARDS.] (a) The facility must meet the 269.28 minimum health, sanitation, safety and comfort standards 269.29 prescribed by the rules of the commissioner of health with 269.30 respect to the construction, equipment, maintenance and 269.31 operation of a nursing home. The commissioner of health may 269.32 temporarily waive compliance with one or more of the standards 269.33 if the commissioner determines that: 269.34(a)(1) temporary noncompliance with the standard will not 269.35 create an imminent risk of harm to a nursing home resident; and 269.36(b)(2) a controlling person on behalf of all other 270.1 controlling persons: 270.2(1)(i) has entered into a contract to obtain the materials 270.3 or labor necessary to meet the standard set by the commissioner 270.4 of health, but the supplier or other contractor has failed to 270.5 perform the terms of the contract and the inability of the 270.6 nursing home to meet the standard is due solely to that failure; 270.7 or 270.8(2)(ii) is otherwise making a diligent good faith effort 270.9 to meet the standard. 270.10 The commissioner shall make available to other nursing 270.11 homes information on facility-specific waivers related to 270.12 technology or physical plant that are granted. The commissioner 270.13 shall, upon the request of a facility, extend a waiver granted 270.14 to a specific facility related to technology or physical plant 270.15 to the facility making the request, if the commissioner 270.16 determines that the facility also satisfies clauses (1) and (2) 270.17 and any other terms and conditions of the waiver. 270.18 The commissioner of health shall allow, by rule, a nursing 270.19 home to provide fewer hours of nursing care to intermediate care 270.20 residents of a nursing home than required by the present rules 270.21 of the commissioner if the commissioner determines that the 270.22 needs of the residents of the home will be adequately met by a 270.23 lesser amount of nursing care. 270.24 (b) A facility is not required to seek a waiver for room 270.25 furniture or equipment under paragraph (a) when responding to 270.26 resident-specific requests, if the facility has discussed health 270.27 and safety concerns with the resident and the resident request 270.28 and discussion of health and safety concerns are documented in 270.29 the resident's patient record. 270.30 [EFFECTIVE DATE.] This section is effective July 1, 2003. 270.31 Sec. 8. Minnesota Statutes 2002, section 144A.04, is 270.32 amended by adding a subdivision to read: 270.33 Subd. 11. [INCONTINENT RESIDENTS.] Notwithstanding 270.34 Minnesota Rules, part 4658.0520, an incontinent resident must be 270.35 checked according to a specific time interval written in the 270.36 resident's care plan. The resident's attending physician must 271.1 authorize in writing any interval longer than two hours unless 271.2 the resident, if competent, or a family member or legally 271.3 appointed conservator, guardian, or health care agent of a 271.4 resident who is not competent, agrees in writing to waive 271.5 physician involvement in determining this interval, and this 271.6 waiver is documented in the resident's care plan. 271.7 [EFFECTIVE DATE.] This section is effective July 1, 2003. 271.8 Sec. 9. Minnesota Statutes 2002, section 144A.071, 271.9 subdivision 4a, is amended to read: 271.10 Subd. 4a. [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the 271.11 best interest of the state to ensure that nursing homes and 271.12 boarding care homes continue to meet the physical plant 271.13 licensing and certification requirements by permitting certain 271.14 construction projects. Facilities should be maintained in 271.15 condition to satisfy the physical and emotional needs of 271.16 residents while allowing the state to maintain control over 271.17 nursing home expenditure growth. 271.18 The commissioner of health in coordination with the 271.19 commissioner of human services, may approve the renovation, 271.20 replacement, upgrading, or relocation of a nursing home or 271.21 boarding care home, under the following conditions: 271.22 (a) to license or certify beds in a new facility 271.23 constructed to replace a facility or to make repairs in an 271.24 existing facility that was destroyed or damaged after June 30, 271.25 1987, by fire, lightning, or other hazard provided: 271.26 (i) destruction was not caused by the intentional act of or 271.27 at the direction of a controlling person of the facility; 271.28 (ii) at the time the facility was destroyed or damaged the 271.29 controlling persons of the facility maintained insurance 271.30 coverage for the type of hazard that occurred in an amount that 271.31 a reasonable person would conclude was adequate; 271.32 (iii) the net proceeds from an insurance settlement for the 271.33 damages caused by the hazard are applied to the cost of the new 271.34 facility or repairs; 271.35 (iv) the new facility is constructed on the same site as 271.36 the destroyed facility or on another site subject to the 272.1 restrictions in section 144A.073, subdivision 5; 272.2 (v) the number of licensed and certified beds in the new 272.3 facility does not exceed the number of licensed and certified 272.4 beds in the destroyed facility; and 272.5 (vi) the commissioner determines that the replacement beds 272.6 are needed to prevent an inadequate supply of beds. 272.7 Project construction costs incurred for repairs authorized under 272.8 this clause shall not be considered in the dollar threshold 272.9 amount defined in subdivision 2; 272.10 (b) to license or certify beds that are moved from one 272.11 location to another within a nursing home facility, provided the 272.12 total costs of remodeling performed in conjunction with the 272.13 relocation of beds does not exceed $1,000,000; 272.14 (c) to license or certify beds in a project recommended for 272.15 approval under section 144A.073; 272.16 (d) to license or certify beds that are moved from an 272.17 existing state nursing home to a different state facility, 272.18 provided there is no net increase in the number of state nursing 272.19 home beds; 272.20 (e) to certify and license as nursing home beds boarding 272.21 care beds in a certified boarding care facility if the beds meet 272.22 the standards for nursing home licensure, or in a facility that 272.23 was granted an exception to the moratorium under section 272.24 144A.073, and if the cost of any remodeling of the facility does 272.25 not exceed $1,000,000. If boarding care beds are licensed as 272.26 nursing home beds, the number of boarding care beds in the 272.27 facility must not increase beyond the number remaining at the 272.28 time of the upgrade in licensure. The provisions contained in 272.29 section 144A.073 regarding the upgrading of the facilities do 272.30 not apply to facilities that satisfy these requirements; 272.31 (f) to license and certify up to 40 beds transferred from 272.32 an existing facility owned and operated by the Amherst H. Wilder 272.33 Foundation in the city of St. Paul to a new unit at the same 272.34 location as the existing facility that will serve persons with 272.35 Alzheimer's disease and other related disorders. The transfer 272.36 of beds may occur gradually or in stages, provided the total 273.1 number of beds transferred does not exceed 40. At the time of 273.2 licensure and certification of a bed or beds in the new unit, 273.3 the commissioner of health shall delicense and decertify the 273.4 same number of beds in the existing facility. As a condition of 273.5 receiving a license or certification under this clause, the 273.6 facility must make a written commitment to the commissioner of 273.7 human services that it will not seek to receive an increase in 273.8 its property-related payment rate as a result of the transfers 273.9 allowed under this paragraph; 273.10 (g) to license and certify nursing home beds to replace 273.11 currently licensed and certified boarding care beds which may be 273.12 located either in a remodeled or renovated boarding care or 273.13 nursing home facility or in a remodeled, renovated, newly 273.14 constructed, or replacement nursing home facility within the 273.15 identifiable complex of health care facilities in which the 273.16 currently licensed boarding care beds are presently located, 273.17 provided that the number of boarding care beds in the facility 273.18 or complex are decreased by the number to be licensed as nursing 273.19 home beds and further provided that, if the total costs of new 273.20 construction, replacement, remodeling, or renovation exceed ten 273.21 percent of the appraised value of the facility or $200,000, 273.22 whichever is less, the facility makes a written commitment to 273.23 the commissioner of human services that it will not seek to 273.24 receive an increase in its property-related payment rate by 273.25 reason of the new construction, replacement, remodeling, or 273.26 renovation. The provisions contained in section 144A.073 273.27 regarding the upgrading of facilities do not apply to facilities 273.28 that satisfy these requirements; 273.29 (h) to license as a nursing home and certify as a nursing 273.30 facility a facility that is licensed as a boarding care facility 273.31 but not certified under the medical assistance program, but only 273.32 if the commissioner of human services certifies to the 273.33 commissioner of health that licensing the facility as a nursing 273.34 home and certifying the facility as a nursing facility will 273.35 result in a net annual savings to the state general fund of 273.36 $200,000 or more; 274.1 (i) to certify, after September 30, 1992, and prior to July 274.2 1, 1993, existing nursing home beds in a facility that was 274.3 licensed and in operation prior to January 1, 1992; 274.4 (j) to license and certify new nursing home beds to replace 274.5 beds in a facility acquired by the Minneapolis community 274.6 development agency as part of redevelopment activities in a city 274.7 of the first class, provided the new facility is located within 274.8 three miles of the site of the old facility. Operating and 274.9 property costs for the new facility must be determined and 274.10 allowed under section 256B.431 or 256B.434; 274.11 (k) to license and certify up to 20 new nursing home beds 274.12 in a community-operated hospital and attached convalescent and 274.13 nursing care facility with 40 beds on April 21, 1991, that 274.14 suspended operation of the hospital in April 1986. The 274.15 commissioner of human services shall provide the facility with 274.16 the same per diem property-related payment rate for each 274.17 additional licensed and certified bed as it will receive for its 274.18 existing 40 beds; 274.19 (l) to license or certify beds in renovation, replacement, 274.20 or upgrading projects as defined in section 144A.073, 274.21 subdivision 1, so long as the cumulative total costs of the 274.22 facility's remodeling projects do not exceed $1,000,000; 274.23 (m) to license and certify beds that are moved from one 274.24 location to another for the purposes of converting up to five 274.25 four-bed wards to single or double occupancy rooms in a nursing 274.26 home that, as of January 1, 1993, was county-owned and had a 274.27 licensed capacity of 115 beds; 274.28 (n) to allow a facility that on April 16, 1993, was a 274.29 106-bed licensed and certified nursing facility located in 274.30 Minneapolis to layaway all of its licensed and certified nursing 274.31 home beds. These beds may be relicensed and recertified in a 274.32 newly-constructed teaching nursing home facility affiliated with 274.33 a teaching hospital upon approval by the legislature. The 274.34 proposal must be developed in consultation with the interagency 274.35 committee on long-term care planning. The beds on layaway 274.36 status shall have the same status as voluntarily delicensed and 275.1 decertified beds, except that beds on layaway status remain 275.2 subject to the surcharge in section 256.9657. This layaway 275.3 provision expires July 1, 1998; 275.4 (o) to allow a project which will be completed in 275.5 conjunction with an approved moratorium exception project for a 275.6 nursing home in southern Cass county and which is directly 275.7 related to that portion of the facility that must be repaired, 275.8 renovated, or replaced, to correct an emergency plumbing problem 275.9 for which a state correction order has been issued and which 275.10 must be corrected by August 31, 1993; 275.11 (p) to allow a facility that on April 16, 1993, was a 275.12 368-bed licensed and certified nursing facility located in 275.13 Minneapolis to layaway, upon 30 days prior written notice to the 275.14 commissioner, up to 30 of the facility's licensed and certified 275.15 beds by converting three-bed wards to single or double 275.16 occupancy. Beds on layaway status shall have the same status as 275.17 voluntarily delicensed and decertified beds except that beds on 275.18 layaway status remain subject to the surcharge in section 275.19 256.9657, remain subject to the license application and renewal 275.20 fees under section 144A.07 and shall be subject to a $100 per 275.21 bed reactivation fee. In addition, at any time within three 275.22 years of the effective date of the layaway, the beds on layaway 275.23 status may be: 275.24 (1) relicensed and recertified upon relocation and 275.25 reactivation of some or all of the beds to an existing licensed 275.26 and certified facility or facilities located in Pine River, 275.27 Brainerd, or International Falls; provided that the total 275.28 project construction costs related to the relocation of beds 275.29 from layaway status for any facility receiving relocated beds 275.30 may not exceed the dollar threshold provided in subdivision 2 275.31 unless the construction project has been approved through the 275.32 moratorium exception process under section 144A.073; 275.33 (2) relicensed and recertified, upon reactivation of some 275.34 or all of the beds within the facility which placed the beds in 275.35 layaway status, if the commissioner has determined a need for 275.36 the reactivation of the beds on layaway status. 276.1 The property-related payment rate of a facility placing 276.2 beds on layaway status must be adjusted by the incremental 276.3 change in its rental per diem after recalculating the rental per 276.4 diem as provided in section 256B.431, subdivision 3a, paragraph 276.5 (c). The property-related payment rate for a facility 276.6 relicensing and recertifying beds from layaway status must be 276.7 adjusted by the incremental change in its rental per diem after 276.8 recalculating its rental per diem using the number of beds after 276.9 the relicensing to establish the facility's capacity day 276.10 divisor, which shall be effective the first day of the month 276.11 following the month in which the relicensing and recertification 276.12 became effective. Any beds remaining on layaway status more 276.13 than three years after the date the layaway status became 276.14 effective must be removed from layaway status and immediately 276.15 delicensed and decertified; 276.16 (q) to license and certify beds in a renovation and 276.17 remodeling project to convert 12 four-bed wards into 24 two-bed 276.18 rooms, expand space, and add improvements in a nursing home 276.19 that, as of January 1, 1994, met the following conditions: the 276.20 nursing home was located in Ramsey county; had a licensed 276.21 capacity of 154 beds; and had been ranked among the top 15 276.22 applicants by the 1993 moratorium exceptions advisory review 276.23 panel. The total project construction cost estimate for this 276.24 project must not exceed the cost estimate submitted in 276.25 connection with the 1993 moratorium exception process; 276.26 (r) to license and certify up to 117 beds that are 276.27 relocated from a licensed and certified 138-bed nursing facility 276.28 located in St. Paul to a hospital with 130 licensed hospital 276.29 beds located in South St. Paul, provided that the nursing 276.30 facility and hospital are owned by the same or a related 276.31 organization and that prior to the date the relocation is 276.32 completed the hospital ceases operation of its inpatient 276.33 hospital services at that hospital. After relocation, the 276.34 nursing facility's status under section 256B.431, subdivision 276.35 2j, shall be the same as it was prior to relocation. The 276.36 nursing facility's property-related payment rate resulting from 277.1 the project authorized in this paragraph shall become effective 277.2 no earlier than April 1, 1996. For purposes of calculating the 277.3 incremental change in the facility's rental per diem resulting 277.4 from this project, the allowable appraised value of the nursing 277.5 facility portion of the existing health care facility physical 277.6 plant prior to the renovation and relocation may not exceed 277.7 $2,490,000; 277.8 (s) to license and certify two beds in a facility to 277.9 replace beds that were voluntarily delicensed and decertified on 277.10 June 28, 1991; 277.11 (t) to allow 16 licensed and certified beds located on July 277.12 1, 1994, in a 142-bed nursing home and 21-bed boarding care home 277.13 facility in Minneapolis, notwithstanding the licensure and 277.14 certification after July 1, 1995, of the Minneapolis facility as 277.15 a 147-bed nursing home facility after completion of a 277.16 construction project approved in 1993 under section 144A.073, to 277.17 be laid away upon 30 days' prior written notice to the 277.18 commissioner. Beds on layaway status shall have the same status 277.19 as voluntarily delicensed or decertified beds except that they 277.20 shall remain subject to the surcharge in section 256.9657. The 277.21 16 beds on layaway status may be relicensed as nursing home beds 277.22 and recertified at any time within five years of the effective 277.23 date of the layaway upon relocation of some or all of the beds 277.24 to a licensed and certified facility located in Watertown, 277.25 provided that the total project construction costs related to 277.26 the relocation of beds from layaway status for the Watertown 277.27 facility may not exceed the dollar threshold provided in 277.28 subdivision 2 unless the construction project has been approved 277.29 through the moratorium exception process under section 144A.073. 277.30 The property-related payment rate of the facility placing 277.31 beds on layaway status must be adjusted by the incremental 277.32 change in its rental per diem after recalculating the rental per 277.33 diem as provided in section 256B.431, subdivision 3a, paragraph 277.34 (c). The property-related payment rate for the facility 277.35 relicensing and recertifying beds from layaway status must be 277.36 adjusted by the incremental change in its rental per diem after 278.1 recalculating its rental per diem using the number of beds after 278.2 the relicensing to establish the facility's capacity day 278.3 divisor, which shall be effective the first day of the month 278.4 following the month in which the relicensing and recertification 278.5 became effective. Any beds remaining on layaway status more 278.6 than five years after the date the layaway status became 278.7 effective must be removed from layaway status and immediately 278.8 delicensed and decertified; 278.9 (u) to license and certify beds that are moved within an 278.10 existing area of a facility or to a newly constructed addition 278.11 which is built for the purpose of eliminating three- and 278.12 four-bed rooms and adding space for dining, lounge areas, 278.13 bathing rooms, and ancillary service areas in a nursing home 278.14 that, as of January 1, 1995, was located in Fridley and had a 278.15 licensed capacity of 129 beds; 278.16 (v) to relocate 36 beds in Crow Wing county and four beds 278.17 from Hennepin county to a 160-bed facility in Crow Wing county, 278.18 provided all the affected beds are under common ownership; 278.19 (w) to license and certify a total replacement project of 278.20 up to 49 beds located in Norman county that are relocated from a 278.21 nursing home destroyed by flood and whose residents were 278.22 relocated to other nursing homes. The operating cost payment 278.23 rates for the new nursing facility shall be determined based on 278.24 the interim and settle-up payment provisions of Minnesota Rules, 278.25 part 9549.0057, and the reimbursement provisions of section 278.26 256B.431, except that subdivision 26, paragraphs (a) and (b), 278.27 shall not apply until the second rate year after the settle-up 278.28 cost report is filed. Property-related reimbursement rates 278.29 shall be determined under section 256B.431, taking into account 278.30 any federal or state flood-related loans or grants provided to 278.31 the facility; 278.32 (x) to license and certify a total replacement project of 278.33 up to 129 beds located in Polk county that are relocated from a 278.34 nursing home destroyed by flood and whose residents were 278.35 relocated to other nursing homes. The operating cost payment 278.36 rates for the new nursing facility shall be determined based on 279.1 the interim and settle-up payment provisions of Minnesota Rules, 279.2 part 9549.0057, and the reimbursement provisions of section 279.3 256B.431, except that subdivision 26, paragraphs (a) and (b), 279.4 shall not apply until the second rate year after the settle-up 279.5 cost report is filed. Property-related reimbursement rates 279.6 shall be determined under section 256B.431, taking into account 279.7 any federal or state flood-related loans or grants provided to 279.8 the facility; 279.9 (y) to license and certify beds in a renovation and 279.10 remodeling project to convert 13 three-bed wards into 13 two-bed 279.11 rooms and 13 single-bed rooms, expand space, and add 279.12 improvements in a nursing home that, as of January 1, 1994, met 279.13 the following conditions: the nursing home was located in 279.14 Ramsey county, was not owned by a hospital corporation, had a 279.15 licensed capacity of 64 beds, and had been ranked among the top 279.16 15 applicants by the 1993 moratorium exceptions advisory review 279.17 panel. The total project construction cost estimate for this 279.18 project must not exceed the cost estimate submitted in 279.19 connection with the 1993 moratorium exception process; 279.20 (z) to license and certify up to 150 nursing home beds to 279.21 replace an existing 285 bed nursing facility located in St. 279.22 Paul. The replacement project shall include both the renovation 279.23 of existing buildings and the construction of new facilities at 279.24 the existing site. The reduction in the licensed capacity of 279.25 the existing facility shall occur during the construction 279.26 project as beds are taken out of service due to the construction 279.27 process. Prior to the start of the construction process, the 279.28 facility shall provide written information to the commissioner 279.29 of health describing the process for bed reduction, plans for 279.30 the relocation of residents, and the estimated construction 279.31 schedule. The relocation of residents shall be in accordance 279.32 with the provisions of law and rule; 279.33 (aa) to allow the commissioner of human services to license 279.34 an additional 36 beds to provide residential services for the 279.35 physically handicapped under Minnesota Rules, parts 9570.2000 to 279.36 9570.3400, in a 198-bed nursing home located in Red Wing, 280.1 provided that the total number of licensed and certified beds at 280.2 the facility does not increase; 280.3 (bb) to license and certify a new facility in St. Louis 280.4 county with 44 beds constructed to replace an existing facility 280.5 in St. Louis county with 31 beds, which has resident rooms on 280.6 two separate floors and an antiquated elevator that creates 280.7 safety concerns for residents and prevents nonambulatory 280.8 residents from residing on the second floor. The project shall 280.9 include the elimination of three- and four-bed rooms; 280.10 (cc) to license and certify four beds in a 16-bed certified 280.11 boarding care home in Minneapolis to replace beds that were 280.12 voluntarily delicensed and decertified on or before March 31, 280.13 1992. The licensure and certification is conditional upon the 280.14 facility periodically assessing and adjusting its resident mix 280.15 and other factors which may contribute to a potential 280.16 institution for mental disease declaration. The commissioner of 280.17 human services shall retain the authority to audit the facility 280.18 at any time and shall require the facility to comply with any 280.19 requirements necessary to prevent an institution for mental 280.20 disease declaration, including delicensure and decertification 280.21 of beds, if necessary; 280.22 (dd) to license and certify 72 beds in an existing facility 280.23 in Mille Lacs county with 80 beds as part of a renovation 280.24 project. The renovation must include construction of an 280.25 addition to accommodate ten residents with beginning and 280.26 midstage dementia in a self-contained living unit; creation of 280.27 three resident households where dining, activities, and support 280.28 spaces are located near resident living quarters; designation of 280.29 four beds for rehabilitation in a self-contained area; 280.30 designation of 30 private rooms; and other improvements; 280.31 (ee) to license and certify beds in a facility that has 280.32 undergone replacement or remodeling as part of a planned closure 280.33 under section 256B.437; 280.34 (ff) to license and certify a total replacement project of 280.35 up to 124 beds located in Wilkin county that are in need of 280.36 relocation from a nursing home significantly damaged by flood. 281.1 The operating cost payment rates for the new nursing facility 281.2 shall be determined based on the interim and settle-up payment 281.3 provisions of Minnesota Rules, part 9549.0057, and the 281.4 reimbursement provisions of section 256B.431, except that 281.5 section 256B.431, subdivision 26, paragraphs (a) and (b), shall 281.6 not apply until the second rate year after the settle-up cost 281.7 report is filed. Property-related reimbursement rates shall be 281.8 determined under section 256B.431, taking into account any 281.9 federal or state flood-related loans or grants provided to the 281.10 facility; 281.11 (gg) to allow the commissioner of human services to license 281.12 an additional nine beds to provide residential services for the 281.13 physically handicapped under Minnesota Rules, parts 9570.2000 to 281.14 9570.3400, in a 240-bed nursing home located in Duluth, provided 281.15 that the total number of licensed and certified beds at the 281.16 facility does not increase; 281.17 (hh) to license and certify up to 120 new nursing facility 281.18 beds to replace beds in a facility in Anoka county, which was 281.19 licensed for 98 beds as of July 1, 2000, provided the new 281.20 facility is located within four miles of the existing facility 281.21 and is in Anoka county. Operating and property rates shall be 281.22 determined and allowed under section 256B.431 and Minnesota 281.23 Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or 281.24 256B.435. The provisions of section 256B.431, subdivision 26, 281.25 paragraphs (a) and (b), do not apply until the second rate year 281.26 following settle-up;or281.27 (ii) to transfer up to 98 beds of a 129-licensed bed 281.28 facility located in Anoka county that, as of March 25, 2001, is 281.29 in the active process of closing, to a 122-licensed bed 281.30 nonprofit nursing facility located in the city of Columbia 281.31 Heights or its affiliate. The transfer is effective when the 281.32 receiving facility notifies the commissioner in writing of the 281.33 number of beds accepted. The commissioner shall place all 281.34 transferred beds on layaway status held in the name of the 281.35 receiving facility. The layaway adjustment provisions of 281.36 section 256B.431, subdivision 30, do not apply to this layaway. 282.1 The receiving facility may only remove the beds from layaway for 282.2 recertification and relicensure at the receiving facility's 282.3 current site, or at a newly constructed facility located in 282.4 Anoka county. The receiving facility must receive statutory 282.5 authorization before removing these beds from layaway status; or 282.6 (jj) to license and certify beds as part of a project 282.7 involving the construction of a new addition, conversion of 282.8 existing space to a special care unit and short-term 282.9 rehabilitation unit, expansion of dining and activity 282.10 facilities, and related remodeling and improvements, in a 282.11 nursing facility located in Hubbard county licensed for 124 beds 282.12 as of March 3, 2003, provided that the total number of licensed 282.13 and certified beds at the facility does not increase. 282.14 Sec. 10. Minnesota Statutes 2002, section 144A.10, is 282.15 amended by adding a subdivision to read: 282.16 Subd. 16. [INDEPENDENT INFORMAL DISPUTE RESOLUTION.] (a) 282.17 Notwithstanding subdivision 15, a facility certified under the 282.18 federal Medicare or Medicaid programs may request from the 282.19 commissioner, in writing, an independent informal dispute 282.20 resolution process regarding any deficiency citation issued to 282.21 the facility. The facility must specify in its written request 282.22 each deficiency citation that it disputes. The commissioner 282.23 shall provide a hearing under sections 14.57 to 14.62. Upon the 282.24 written request of the facility, the parties must submit the 282.25 issues raised to arbitration by an administrative law judge. 282.26 (b) Upon receipt of a written request for an arbitration 282.27 proceeding, the commissioner shall file with the office of 282.28 administrative hearings a request for the appointment of an 282.29 arbitrator and simultaneously serve the facility with notice of 282.30 the request. The arbitrator for the dispute shall be an 282.31 administrative law judge appointed by the office of 282.32 administrative hearings. The disclosure provisions of section 282.33 572.10 and the notice provisions of section 572.12 apply. The 282.34 facility and the commissioner have the right to be represented 282.35 by an attorney. 282.36 (c) The commissioner and the facility may present written 283.1 evidence, depositions, and oral statements and arguments at the 283.2 arbitration proceeding. Oral statements and arguments may be 283.3 made by telephone. 283.4 (d) Within ten working days of the close of the arbitration 283.5 proceeding, the administrative law judge shall issue findings 283.6 regarding each of the deficiencies in dispute. The findings 283.7 shall be one or more of the following: 283.8 (1) Supported in full. The citation is supported in full, 283.9 with no deletion of findings and no change in the scope or 283.10 severity assigned to the deficiency citation. 283.11 (2) Supported in substance. The citation is supported, but 283.12 one or more findings are deleted without any change in the scope 283.13 or severity assigned to the deficiency. 283.14 (3) Deficient practice cited under wrong requirement of 283.15 participation. The citation is amended by moving it to the 283.16 correct requirement of participation. 283.17 (4) Scope not supported. The citation is amended through a 283.18 change in the scope assigned to the citation. 283.19 (5) Severity not supported. The citation is amended 283.20 through a change in the severity assigned to the citation. 283.21 (6) No deficient practice. The citation is deleted because 283.22 the findings did not support the citation or the negative 283.23 resident outcome was unavoidable. The findings of the 283.24 arbitrator are not binding on the commissioner. 283.25 (e) The commissioner shall reimburse the office of 283.26 administrative hearings for the costs incurred by that office 283.27 for the arbitration proceeding. The facility shall reimburse 283.28 the commissioner for the proportion of the costs that represent 283.29 the sum of deficiency citations supported in full under 283.30 paragraph (d), clause (1), or in substance under paragraph (d), 283.31 clause (2), divided by the total number of deficiencies 283.32 disputed. A deficiency citation for which the administrative 283.33 law judge's sole finding is that the deficient practice was 283.34 cited under the wrong requirements of participation shall not be 283.35 counted in the numerator or denominator in the calculation of 283.36 the proportion of costs. 284.1 [EFFECTIVE DATE.] This section is effective July 1, 2003. 284.2 Sec. 11. [144A.351] [BALANCING LONG-TERM CARE: REPORT 284.3 REQUIRED.] 284.4 The commissioners of health and human services, with the 284.5 cooperation of counties and regional entities, shall prepare a 284.6 report to the legislature by January 15, 2004, and biennially 284.7 thereafter, regarding the status of the full range of long-term 284.8 care services for the elderly in Minnesota. The report shall 284.9 address: 284.10 (1) demographics and need for long-term care in Minnesota; 284.11 (2) summary of county and regional reports on long-term 284.12 care gaps, surpluses, imbalances, and corrective action plans; 284.13 (3) status of long-term care services by county and region 284.14 including: 284.15 (i) changes in availability of the range of long-term care 284.16 services and housing options; 284.17 (ii) access problems regarding long-term care; and 284.18 (iii) comparative measures of long-term care availability 284.19 and progress over time; and 284.20 (4) recommendations regarding goals for the future of 284.21 long-term care services, policy changes, and resource needs. 284.22 Sec. 12. Minnesota Statutes 2002, section 144A.4605, 284.23 subdivision 4, is amended to read: 284.24 Subd. 4. [LICENSE REQUIRED.] (a) A housing with services 284.25 establishment registered under chapter 144D that is required to 284.26 obtain a home care license must obtain an assisted living home 284.27 care license according to this section or a class A or class E 284.28 license according to rule. A housing with services 284.29 establishment that obtains a class E license under this 284.30 subdivision remains subject to the payment limitations in 284.31 sections 256B.0913, subdivision55f, paragraph(h)(b), and 284.32 256B.0915, subdivision3, paragraph (g)3d. 284.33 (b) A board and lodging establishment registered for 284.34 special services as of December 31, 1996, and also registered as 284.35 a housing with services establishment under chapter 144D, must 284.36 deliver home care services according to sections 144A.43 to 285.1 144A.47, and may apply for a waiver from requirements under 285.2 Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a 285.3 licensed agency under the standards of section 157.17. Such 285.4 waivers as may be granted by the department will expire upon 285.5 promulgation of home care rules implementing section 144A.4605. 285.6 (c) An adult foster care provider licensed by the 285.7 department of human services and registered under chapter 144D 285.8 may continue to provide health-related services under its foster 285.9 care license until the promulgation of home care rules 285.10 implementing this section. 285.11 (d) An assisted living home care provider licensed under 285.12 this section must comply with the disclosure provisions of 285.13 section 325F.72 to the extent they are applicable. 285.14 Sec. 13. Minnesota Statutes 2002, section 256.9657, 285.15 subdivision 1, is amended to read: 285.16 Subdivision 1. [NURSING HOME LICENSE SURCHARGE.] (a) 285.17 Effective July 1, 1993, each non-state-operated nursing home 285.18 licensed under chapter 144A shall pay to the commissioner an 285.19 annual surcharge according to the schedule in subdivision 4. 285.20 The surcharge shall be calculated as $620 per licensed bed. If 285.21 the number of licensed beds is reduced, the surcharge shall be 285.22 based on the number of remaining licensed beds the second month 285.23 following the receipt of timely notice by the commissioner of 285.24 human services that beds have been delicensed. The nursing home 285.25 must notify the commissioner of health in writing when beds are 285.26 delicensed. The commissioner of health must notify the 285.27 commissioner of human services within ten working days after 285.28 receiving written notification. If the notification is received 285.29 by the commissioner of human services by the 15th of the month, 285.30 the invoice for the second following month must be reduced to 285.31 recognize the delicensing of beds. Beds on layaway status 285.32 continue to be subject to the surcharge. The commissioner of 285.33 human services must acknowledge a medical care surcharge appeal 285.34 within 30 days of receipt of the written appeal from the 285.35 provider. 285.36 (b) Effective July 1, 1994, the surcharge in paragraph (a) 286.1 shall be increased to $625. 286.2 (c) Effective August 15, 2002, the surcharge under 286.3 paragraph (b) shall be increased to $990. 286.4 (d) Effective July 15, 2003, the surcharge under paragraph 286.5 (c) shall be increased to $2,700. 286.6 (e) The commissioner may reduce, and may subsequently 286.7 restore, the surcharge under paragraph (d) based on the 286.8 commissioner's determination of a permissible surcharge. 286.9 (f) Between April 1, 2002, and August 15,20032004, a 286.10 facility governed by this subdivision may elect to assume full 286.11 participation in the medical assistance program by agreeing to 286.12 comply with all of the requirements of the medical assistance 286.13 program, including the rate equalization law in section 256B.48, 286.14 subdivision 1, paragraph (a), and all other requirements 286.15 established in law or rule, and to begin intake of new medical 286.16 assistance recipients. Rates will be determined under Minnesota 286.17 Rules, parts 9549.0010 to 9549.0080. Notwithstanding section 286.18 256B.431, subdivision 27, paragraph (i), rate calculations will 286.19 be subject to limits as prescribed in rule and law. Other than 286.20 the adjustments in sections 256B.431, subdivisions 30 and 32; 286.21 256B.437, subdivision 3, paragraph (b), Minnesota Rules, part 286.22 9549.0057, and any other applicable legislation enacted prior to 286.23 the finalization of rates, facilities assuming full 286.24 participation in medical assistance under this paragraph are not 286.25 eligible for any rate adjustments until the July 1 following 286.26 their settle-up period. 286.27 [EFFECTIVE DATE.] This section is effective June 30, 2003. 286.28 Sec. 14. Minnesota Statutes 2002, section 256.9657, is 286.29 amended by adding a subdivision to read: 286.30 Subd. 3a. [ICF/MR LICENSE SURCHARGE.] Effective July 1, 286.31 2003, each nonstate-operated facility as defined under section 286.32 256B.501, subdivision 1, shall pay to the commissioner an annual 286.33 surcharge according to the schedule in subdivision 4, paragraph 286.34 (d). The annual surcharge shall be $1,040 per licensed bed. If 286.35 the number of licensed beds is reduced, the surcharge shall be 286.36 based on the number of remaining licensed beds the second month 287.1 following the receipt of timely notice by the commissioner of 287.2 human services that beds have been delicensed. The facility 287.3 must notify the commissioner of health in writing when beds are 287.4 delicensed. The commissioner of health must notify the 287.5 commissioner of human services within ten working days after 287.6 receiving written notification. If the notification is received 287.7 by the commissioner of human services by the 15th of the month, 287.8 the invoice for the second following month must be reduced to 287.9 recognize the delicensing of beds. The commissioner may reduce, 287.10 and may subsequently restore, the surcharge under this 287.11 subdivision based on the commissioner's determination of a 287.12 permissible surcharge. 287.13 Sec. 15. Minnesota Statutes 2002, section 256.9657, 287.14 subdivision 4, is amended to read: 287.15 Subd. 4. [PAYMENTS INTO THE ACCOUNT.] (a) Payments to the 287.16 commissioner under subdivisions 1 to 3 must be paid in monthly 287.17 installments due on the 15th of the month beginning October 15, 287.18 1992. The monthly payment must be equal to the annual surcharge 287.19 divided by 12. Payments to the commissioner under subdivisions 287.20 2 and 3 for fiscal year 1993 must be based on calendar year 1990 287.21 revenues. Effective July 1 of each year, beginning in 1993, 287.22 payments under subdivisions 2 and 3 must be based on revenues 287.23 earned in the second previous calendar year. 287.24 (b) Effective October 1, 1995, and each October 1 287.25 thereafter, the payments in subdivisions 2 and 3 must be based 287.26 on revenues earned in the previous calendar year. 287.27 (c) If the commissioner of health does not provide by 287.28 August 15 of any year data needed to update the base year for 287.29 the hospital and health maintenance organization surcharges, the 287.30 commissioner of human services may estimate base year revenue 287.31 and use that estimate for the purposes of this section until 287.32 actual data is provided by the commissioner of health. 287.33 (d) Payments to the commissioner under subdivision 3a must 287.34 be paid in monthly installments due on the 15th of the month 287.35 beginning August 15, 2003. The monthly payment must be equal to 287.36 the annual surcharge divided by 12. 288.1 Sec. 16. Minnesota Statutes 2002, section 256.9754, 288.2 subdivision 2, is amended to read: 288.3 Subd. 2. [CREATION.]The community services development288.4grants programThere is createdunder the administration of the288.5commissioner of human servicesthe consolidated ElderCare 288.6 development grant fund for the purpose of rebalancing the 288.7 long-term care system and increasing home and community-based 288.8 care alternatives that sustain independent living. 288.9 Sec. 17. Minnesota Statutes 2002, section 256.9754, 288.10 subdivision 3, is amended to read: 288.11 Subd. 3. [PROVISION OF GRANTS.]The commissioner shall288.12make grants available to communities, providers of older adult288.13services identified in subdivision 1, or to a consortium of288.14providers of older adult services, to establish older adult288.15services.Grants may be provided for capital and other costs 288.16 including, but not limited to, start-up and training costs, 288.17 equipment, and supplies related to older adult services or other 288.18 residential or service alternatives to nursing facility care. 288.19 Grants may also be made to renovate current buildings, provide 288.20 transportation services, fund programs that would allow older 288.21 adults or disabled individuals to stay in their own homes by 288.22 sharing a home, fund programs that coordinate and manage formal 288.23 and informal services to older adults in their homes to enable 288.24 them to live as independently as possible in their own homes as 288.25 an alternative to nursing home care, or expand state-funded 288.26 programs in the area. Other services eligible for funding 288.27 include: transportation; chore services and homemaking; home 288.28 health care and personal care assistance; care coordination; 288.29 housing with services, such as assisted living and foster care; 288.30 home modification; adult day services; caregiver support and 288.31 respite; living-at-home block nurse; service integration and 288.32 development; telemedicine, telehomecare, or other 288.33 technology-based solutions; grocery shopping; and services 288.34 identified as needed for community transition. 288.35 Sec. 18. Minnesota Statutes 2002, section 256.9754, 288.36 subdivision 4, is amended to read: 289.1 Subd. 4. [ELIGIBILITY.] Grants may be awarded only to 289.2 communities and providers, including for-profits, nonprofits, 289.3 and governmental units, or to a consortium of providers that 289.4 have a local match of 25 percent in the form of cash or in-kind 289.5 services, except that for capital costs the match is 50 percent 289.6of the costs for the project in the form of donations, local tax289.7dollars, in-kind donations, fund-raising, or other local matches. 289.8 Sec. 19. Minnesota Statutes 2002, section 256.9754, 289.9 subdivision 5, is amended to read: 289.10 Subd. 5. [GRANT PREFERENCE.] The commissionerof human289.11servicesshall give preference when awarding grants under this 289.12 section to areas where nursing facility closures have occurred 289.13 or are occurring. The commissioner may award grants to the 289.14 extent grant funds are available and to the extent applications 289.15 are approved by the commissioner. Denial of approval of an 289.16 application in one year does not preclude submission of an 289.17 application in a subsequent year.The maximum grant amount is289.18limited to $750,000.289.19 Sec. 20. Minnesota Statutes 2002, section 256B.056, 289.20 subdivision 6, is amended to read: 289.21 Subd. 6. [ASSIGNMENT OF BENEFITS.] To be eligible for 289.22 medical assistance a person must have applied or must agree to 289.23 apply all proceeds received or receivable by the person or the 289.24 person'sspouselegal representative from any thirdpersonparty 289.25 liable for the costs of medical carefor the person, the spouse,289.26and children.The state agency shall require from any applicant289.27or recipient of medical assistance the assignment of any rights289.28to medical support and third party payments.By accepting or 289.29 receiving assistance, the person is deemed to have assigned the 289.30 person's rights to medical support and third party payments as 289.31 required by Title 19 of the Social Security Act. Persons must 289.32 cooperate with the state in establishing paternity and obtaining 289.33 third party payments. Bysigning an application foraccepting 289.34 medical assistance, a person assigns to the department of human 289.35 services all rights the person may have to medical support or 289.36 payments for medical expenses from any other person or entity on 290.1 their own or their dependent's behalf and agrees to cooperate 290.2 with the state in establishing paternity and obtaining third 290.3 party payments. Any rights or amounts so assigned shall be 290.4 applied against the cost of medical care paid for under this 290.5 chapter. Any assignment takes effect upon the determination 290.6 that the applicant is eligible for medical assistance and up to 290.7 three months prior to the date of application if the applicant 290.8 is determined eligible for and receives medical assistance 290.9 benefits. The application must contain a statement explaining 290.10 this assignment.Any assignment shall not be effective as to290.11benefits paid or provided under automobile accident coverage and290.12private health care coverage prior to notification of the290.13assignment by the person or organization providing the290.14benefits.For the purposes of this section, "the department of 290.15 human services or the state" includes prepaid health plans under 290.16 contract with the commissioner according to sections 256B.031, 290.17 256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 290.18 children's mental health collaboratives under section 245.493; 290.19 demonstration projects for persons with disabilities under 290.20 section 256B.77; nursing facilities under the alternative 290.21 payment demonstration project under section 256B.434; and the 290.22 county-based purchasing entities under section 256B.692. 290.23 Sec. 21. Minnesota Statutes 2002, section 256B.064, 290.24 subdivision 2, is amended to read: 290.25 Subd. 2. [IMPOSITION OF MONETARY RECOVERY AND SANCTIONS.] 290.26 (a) The commissioner shall determine any monetary amounts to be 290.27 recovered and sanctions to be imposed upon a vendor of medical 290.28 care under this section. Except as provided in 290.29paragraphparagraphs (b) and (d), neither a monetary recovery 290.30 nor a sanction will be imposed by the commissioner without prior 290.31 notice and an opportunity for a hearing, according to chapter 290.32 14, on the commissioner's proposed action, provided that the 290.33 commissioner may suspend or reduce payment to a vendor of 290.34 medical care, except a nursing home or convalescent care 290.35 facility, after notice and prior to the hearing if in the 290.36 commissioner's opinion that action is necessary to protect the 291.1 public welfare and the interests of the program. 291.2 (b) Except for a nursing home or convalescent care 291.3 facility, the commissioner may withhold or reduce payments to a 291.4 vendor of medical care without providing advance notice of such 291.5 withholding or reduction if either of the following occurs: 291.6 (1) the vendor is convicted of a crime involving the 291.7 conduct described in subdivision 1a; or 291.8 (2) the commissioner receives reliable evidence of fraud or 291.9 willful misrepresentation by the vendor. 291.10 (c) The commissioner must send notice of the withholding or 291.11 reduction of payments under paragraph (b) within five days of 291.12 taking such action. The notice must: 291.13 (1) state that payments are being withheld according to 291.14 paragraph (b); 291.15 (2) except in the case of a conviction for conduct 291.16 described in subdivision 1a, state that the withholding is for a 291.17 temporary period and cite the circumstances under which 291.18 withholding will be terminated; 291.19 (3) identify the types of claims to which the withholding 291.20 applies; and 291.21 (4) inform the vendor of the right to submit written 291.22 evidence for consideration by the commissioner. 291.23 The withholding or reduction of payments will not continue 291.24 after the commissioner determines there is insufficient evidence 291.25 of fraud or willful misrepresentation by the vendor, or after 291.26 legal proceedings relating to the alleged fraud or willful 291.27 misrepresentation are completed, unless the commissioner has 291.28 sent notice of intention to impose monetary recovery or 291.29 sanctions under paragraph (a). 291.30 (d) The commissioner may suspend or terminate a vendor's 291.31 participation in the program without providing advance notice 291.32 and an opportunity for a hearing when the suspension or 291.33 termination is required because of the vendor's exclusion from 291.34 participation in Medicare. Within five days of taking such 291.35 action, the commissioner must send notice of the suspension or 291.36 termination. The notice must: 292.1 (1) state that suspension or termination is the result of 292.2 the vendor's exclusion from Medicare; 292.3 (2) identify the effective date of the suspension or 292.4 termination; 292.5 (3) inform the vendor of the need to be reinstated to 292.6 Medicare before reapplying for participation in the program; and 292.7 (4) inform the vendor of the right to submit written 292.8 evidence for consideration by the commissioner. 292.9 (e) Upon receipt of a notice under paragraph (a) that a 292.10 monetary recovery or sanction is to be imposed, a vendor may 292.11 request a contested case, as defined in section 14.02, 292.12 subdivision 3, by filing with the commissioner a written request 292.13 of appeal. The appeal request must be received by the 292.14 commissioner no later than 30 days after the date the 292.15 notification of monetary recovery or sanction was mailed to the 292.16 vendor. The appeal request must specify: 292.17 (1) each disputed item, the reason for the dispute, and an 292.18 estimate of the dollar amount involved for each disputed item; 292.19 (2) the computation that the vendor believes is correct; 292.20 (3) the authority in statute or rule upon which the vendor 292.21 relies for each disputed item; 292.22 (4) the name and address of the person or entity with whom 292.23 contacts may be made regarding the appeal; and 292.24 (5) other information required by the commissioner. 292.25 Sec. 22. Minnesota Statutes 2002, section 256B.0913, 292.26 subdivision 2, is amended to read: 292.27 Subd. 2. [ELIGIBILITY FOR SERVICES.] Alternative care 292.28 services are available to Minnesotans age 65 or olderwho are292.29not eligible for medical assistance without a spenddown or292.30waiver obligation butwho would be eligible for medical 292.31 assistance within 180 days of admission to a nursing facility 292.32 and subject to subdivisions 4 to 13. 292.33 Sec. 23. Minnesota Statutes 2002, section 256B.0913, 292.34 subdivision 4, is amended to read: 292.35 Subd. 4. [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 292.36 NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 293.1 under the alternative care program is available to persons who 293.2 meet the following criteria: 293.3 (1) the person has been determined by a community 293.4 assessment under section 256B.0911 to be a person who would 293.5 require the level of care provided in a nursing facility, but 293.6 for the provision of services under the alternative care 293.7 program; 293.8 (2) the person is age 65 or older; 293.9 (3) the person would be eligible for medical assistance 293.10 within 180 days of admission to a nursing facility; 293.11 (4) the person is not ineligible for the medical assistance 293.12 program due to an asset transfer penalty; 293.13 (5) the person needs services that are not funded through 293.14 other state or federal funding;and293.15 (6) the monthly cost of the alternative care services 293.16 funded by the program for this person does not exceed 75 percent 293.17 of thestatewide weighted average monthly nursing facility rate293.18of the case mix resident class to which the individual293.19alternative care client would be assigned under Minnesota Rules,293.20parts 9549.0050 to 9549.0059, less the recipient's maintenance293.21needs allowance as described in section 256B.0915, subdivision293.221d, paragraph (a), until the first day of the state fiscal year293.23in which the resident assessment system, under section 256B.437,293.24for nursing home rate determination is implemented. Effective293.25on the first day of the state fiscal year in which a resident293.26assessment system, under section 256B.437, for nursing home rate293.27determination is implemented and the first day of each293.28subsequent state fiscal year, the monthly cost of alternative293.29care services for this person shall not exceed the alternative293.30care monthly cap for the case mix resident class to which the293.31alternative care client would be assigned under Minnesota Rules,293.32parts 9549.0050 to 9549.0059, which was in effect on the last293.33day of the previous state fiscal year, and adjusted by the293.34greater of any legislatively adopted home and community-based293.35services cost-of-living percentage increase or any legislatively293.36adopted statewide percent rate increase for nursing294.1facilitiesmonthly limit described under section 256B.0915, 294.2 subdivision 3a. This monthly limit does not prohibit the 294.3 alternative care client from payment for additional services, 294.4 but in no case may the cost of additional services purchased 294.5 under this section exceed the difference between the client's 294.6 monthly service limit defined under section 256B.0915, 294.7 subdivision 3, and the alternative care program monthly service 294.8 limit defined in this paragraph. If medical supplies and 294.9 equipment or environmental modifications are or will be 294.10 purchased for an alternative care services recipient, the costs 294.11 may be prorated on a monthly basis for up to 12 consecutive 294.12 months beginning with the month of purchase. If the monthly 294.13 cost of a recipient's other alternative care services exceeds 294.14 the monthly limit established in this paragraph, the annual cost 294.15 of the alternative care services shall be determined. In this 294.16 event, the annual cost of alternative care services shall not 294.17 exceed 12 times the monthly limit described in this paragraph.; 294.18 and 294.19 (7) the person is making timely payments of the assessed 294.20 monthly premium charge. A person is ineligible if payment or 294.21 the assessed monthly premium charge is over 60 days past due. 294.22 Following disenrollment due to nonpayment of a monthly premium, 294.23 eligibility shall not be reinstated for a period of 90 days 294.24 pending eligibility redetermination. 294.25 (b) Alternative care funding under this subdivision is not 294.26 available for a person who is a medical assistance recipient or 294.27 who would be eligible for medical assistance without a spenddown 294.28 or waiver obligation. A person whose initial application for 294.29 medical assistance and the elderly waiver program is being 294.30 processed may be served under the alternative care program for a 294.31 period up to 60 days. If the individual is found to be eligible 294.32 for medical assistance, medical assistance must be billed for 294.33 services payable under the federally approved elderly waiver 294.34 plan and delivered from the date the individual was found 294.35 eligible for the federally approved elderly waiver plan. 294.36 Notwithstanding this provision,upon federal approval,295.1 alternative care funds may not be used to pay for any service 295.2 the cost of which: (i) is payable by medical assistanceor295.3which; (ii) is used by a recipient to meet amedical assistance295.4income spenddown orwaiver obligation; or (iii) is used to pay a 295.5 medical assistance income spenddown for a person who is eligible 295.6 to participate in the federally approved elderly waiver program 295.7 under the special income standard provision. 295.8 (c) Alternative care funding is not available for a person 295.9 who resides in a licensed nursing home, certified boarding care 295.10 home, hospital, or intermediate care facility, except for case 295.11 management services which are provided in support of the 295.12 discharge planning processtofor a nursing home resident or 295.13 certified boarding care home resident to assist with a 295.14 relocation process to a community-based setting. 295.15 (d) Alternative care funding is not available for a person 295.16 whose income is greater than the maintenance needs allowance 295.17 under section 256B.0915, subdivision 1d, but equal to or less 295.18 than 120 percent of the federal poverty guideline effective July 295.19 1, in the year for which alternative care eligibility is 295.20 determined, who would be eligible for the elderly waiver with a 295.21 waiver obligation. 295.22 Sec. 24. Minnesota Statutes 2002, section 256B.0913, 295.23 subdivision 5, is amended to read: 295.24 Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.](a)295.25 Alternative care funding may be used for payment of costs of: 295.26 (1) adult foster care; 295.27 (2) adult day care; 295.28 (3) home health aide; 295.29 (4) homemaker services; 295.30 (5) personal care; 295.31 (6) case management; 295.32 (7) respite care; 295.33 (8) assisted living; 295.34 (9) residential care services; 295.35 (10) care-related supplies and equipment; 295.36 (11) meals delivered to the home; 296.1 (12) transportation; 296.2 (13) nursing services; 296.3 (14) chore services; 296.4 (15) companion services; 296.5 (16) nutrition services; 296.6 (17) training for direct informal caregivers; 296.7 (18) telehome caredevicestomonitor recipientsprovide 296.8 services in their own homesas an alternative to hospital care,296.9nursing home care, or homein conjunction with in-home visits; 296.10 (19)other services which includesdiscretionaryfunds and296.11direct cash payments to clients,services, for which counties 296.12 may make payment from their alternative care program allocation 296.13 or services not otherwise defined in this section or section 296.14 256B.0625, following approval by the commissioner, subject to296.15the provisions of paragraph (j). Total annual payments for296.16"other services" for all clients within a county may not exceed296.1725 percent of that county's annual alternative care program base296.18allocation;and296.19 (20) environmental modifications.; and 296.20 (21) direct cash payments for which counties may make 296.21 payment from their alternative care program allocation to 296.22 clients for the purpose of purchasing services, following 296.23 approval by the commissioner, and subject to the provisions of 296.24 subdivision 5h, until approval and implementation of 296.25 consumer-directed services through the federally approved 296.26 elderly waiver plan. Upon implementation, consumer-directed 296.27 services under the alternative care program are available 296.28 statewide and limited to the average monthly expenditures 296.29 representative of all alternative care program participants for 296.30 the same case mix resident class assigned in the most recent 296.31 fiscal year for which complete expenditure data is available. 296.32 Total annual payments for discretionary services and direct 296.33 cash payments, until the federally approved consumer-directed 296.34 service option is implemented statewide, for all clients within 296.35 a county may not exceed 25 percent of that county's annual 296.36 alternative care program base allocation. Thereafter, 297.1 discretionary services are limited to 25 percent of the county's 297.2 annual alternative care program base allocation. 297.3 Subd. 5a. [SERVICES; SERVICE DEFINITIONS; SERVICE 297.4 STANDARDS.] (a) Unless specified in statute, the services, 297.5 service definitions, and standards for alternative care services 297.6 shall be the same as the services, service definitions, and 297.7 standards specified in the federally approved elderly waiver 297.8 plan, except for transitional support services. 297.9 (b) The county agency must ensure that the funds are not 297.10 used to supplant services available through other public 297.11 assistance or services programs. 297.12(c) Unless specified in statute, the services, service297.13definitions, and standards for alternative care services shall297.14be the same as the services, service definitions, and standards297.15specified in the federally approved elderly waiver plan. Except297.16for the county agencies' approval of direct cash payments to297.17clients as described in paragraph (j) orFor a provider of 297.18 supplies and equipment when the monthly cost of the supplies and 297.19 equipment is less than $250, persons or agencies must be 297.20 employed by or under a contract with the county agency or the 297.21 public health nursing agency of the local board of health in 297.22 order to receive funding under the alternative care program. 297.23 Supplies and equipment may be purchased from a vendor not 297.24 certified to participate in the Medicaid program if the cost for 297.25 the item is less than that of a Medicaid vendor. 297.26 (c) Personal care services must meet the service standards 297.27 defined in the federally approved elderly waiver plan, except 297.28 that a county agency may contract with a client's relative who 297.29 meets the relative hardship waiver requirements or a relative 297.30 who meets the criteria and is also the responsible party under 297.31 an individual service plan that ensures the client's health and 297.32 safety and supervision of the personal care services by a 297.33 qualified professional as defined in section 256B.0625, 297.34 subdivision 19c. Relative hardship is established by the county 297.35 when the client's care causes a relative caregiver to do any of 297.36 the following: resign from a paying job, reduce work hours 298.1 resulting in lost wages, obtain a leave of absence resulting in 298.2 lost wages, incur substantial client-related expenses, provide 298.3 services to address authorized, unstaffed direct care time, or 298.4 meet special needs of the client unmet in the formal service 298.5 plan. 298.6(d)Subd. 5b. [ADULT FOSTER CARE RATE.] The adult foster 298.7 care rate shall be considered a difficulty of care payment and 298.8 shall not include room and board. The adult foster care rate 298.9 shall be negotiated between the county agency and the foster 298.10 care provider. The alternative care payment for the foster care 298.11 service in combination with the payment for other alternative 298.12 care services, including case management, must not exceed the 298.13 limit specified in subdivision 4, paragraph (a), clause (6). 298.14(e) Personal care services must meet the service standards298.15defined in the federally approved elderly waiver plan, except298.16that a county agency may contract with a client's relative who298.17meets the relative hardship waiver requirement as defined in298.18section 256B.0627, subdivision 4, paragraph (b), clause (10), to298.19provide personal care services if the county agency ensures298.20supervision of this service by a qualified professional as298.21defined in section 256B.0625, subdivision 19c.298.22(f)Subd. 5c. [RESIDENTIAL CARE SERVICES; SUPPORTIVE 298.23 SERVICES; HEALTH-RELATED SERVICES.] For purposes of this 298.24 section, residential care services are services which are 298.25 provided to individuals living in residential care homes. 298.26 Residential care homes are currently licensed as board and 298.27 lodging establishments under section 157.16, and are registered 298.28 with the department of health as providing special services 298.29 under section 157.17and are not subject to registrationexcept 298.30 settings that are currently registered under chapter 144D. 298.31 Residential care services are defined as "supportive services" 298.32 and "health-related services." "Supportive services" meansthe298.33provision of up to 24-hour supervision and oversight.298.34Supportive services includes: (1) transportation, when provided298.35by the residential care home only; (2) socialization, when298.36socialization is part of the plan of care, has specific goals299.1and outcomes established, and is not diversional or recreational299.2in nature; (3) assisting clients in setting up meetings and299.3appointments; (4) assisting clients in setting up medical and299.4social services; (5) providing assistance with personal laundry,299.5such as carrying the client's laundry to the laundry room.299.6Assistance with personal laundry does not include any laundry,299.7such as bed linen, that is included in the room and board rate299.8 services as defined in section 157.17, subdivision 1, paragraph 299.9 (a). "Health-related services"are limited to minimal299.10assistance with dressing, grooming, and bathing and providing299.11reminders to residents to take medications that are299.12self-administered or providing storage for medications, if299.13requestedmeans services covered in section 157.17, subdivision 299.14 1, paragraph (b). Individuals receiving residential care 299.15 services cannot receive homemaking services funded under this 299.16 section. 299.17(g)Subd. 5d. [ASSISTED LIVING SERVICES.] For the purposes 299.18 of this section, "assisted living" refers to supportive services 299.19 provided by a single vendor to clients who reside in the same 299.20 apartment building of three or more units which are not subject 299.21 to registration under chapter 144D and are licensed by the 299.22 department of health as a class A home care provider or a class 299.23 E home care provider. Assisted living services are defined as 299.24 up to 24-hour supervision,andoversight, and supportive 299.25 services as defined inclause (1)section 157.17, subdivision 1, 299.26 paragraph (a), individualized home care aide tasks as defined in 299.27clause (2)Minnesota Rules, part 4668.0110, and individualized 299.28 home management tasks as defined inclause (3)Minnesota Rules, 299.29 part 4668.0120 provided to residents of a residential center 299.30 living in their units or apartments with a full kitchen and 299.31 bathroom. A full kitchen includes a stove, oven, refrigerator, 299.32 food preparation counter space, and a kitchen utensil storage 299.33 compartment. Assisted living services must be provided by the 299.34 management of the residential center or by providers under 299.35 contract with the management or with the county. 299.36(1) Supportive services include:300.1(i) socialization, when socialization is part of the plan300.2of care, has specific goals and outcomes established, and is not300.3diversional or recreational in nature;300.4(ii) assisting clients in setting up meetings and300.5appointments; and300.6(iii) providing transportation, when provided by the300.7residential center only.300.8(2) Home care aide tasks means:300.9(i) preparing modified diets, such as diabetic or low300.10sodium diets;300.11(ii) reminding residents to take regularly scheduled300.12medications or to perform exercises;300.13(iii) household chores in the presence of technically300.14sophisticated medical equipment or episodes of acute illness or300.15infectious disease;300.16(iv) household chores when the resident's care requires the300.17prevention of exposure to infectious disease or containment of300.18infectious disease; and300.19(v) assisting with dressing, oral hygiene, hair care,300.20grooming, and bathing, if the resident is ambulatory, and if the300.21resident has no serious acute illness or infectious disease.300.22Oral hygiene means care of teeth, gums, and oral prosthetic300.23devices.300.24(3) Home management tasks means:300.25(i) housekeeping;300.26(ii) laundry;300.27(iii) preparation of regular snacks and meals; and300.28(iv) shopping.300.29 Subd. 5e. [FURTHER ASSISTED LIVING REQUIREMENTS.] (a) 300.30 Individuals receiving assisted living services shall not receive 300.31 both assisted living services and homemaking services. 300.32 Individualized means services are chosen and designed 300.33 specifically for each resident's needs, rather than provided or 300.34 offered to all residents regardless of their illnesses, 300.35 disabilities, or physical conditions. Assisted living services 300.36 as defined in this section shall not be authorized in boarding 301.1 and lodging establishments licensed according to sections 301.2 157.011 and 157.15 to 157.22. 301.3(h)(b) For establishments registered under chapter 144D, 301.4 assisted living services under this section means either the 301.5 services described inparagraph (g)subdivision 5d and delivered 301.6 by a class E home care provider licensed by the department of 301.7 health or the services described under section 144A.4605 and 301.8 delivered by an assisted living home care provider or a class A 301.9 home care provider licensed by the commissioner of health. 301.10(i)Subd. 5f. [PAYMENT RATES FOR ASSISTED LIVING SERVICES 301.11 AND RESIDENTIAL CARE.] (a) Payment for assisted living services 301.12 and residential care services shall be a monthly rate negotiated 301.13 and authorized by the county agency based on an individualized 301.14 service plan for each resident and may not cover direct rent or 301.15 food costs. 301.16(1)(b) The individualized monthly negotiated payment for 301.17 assisted living services as described inparagraph301.18(g)subdivision 5d or(h)5e, paragraph (b), and residential 301.19 care services as described inparagraph (f)subdivision 5c, 301.20 shall not exceed the nonfederal share in effect on July 1 of the 301.21 state fiscal year for which the rate limit is being calculated 301.22 of the greater of either the statewide or any of the geographic 301.23groups' weighted average monthly nursing facility payment rate301.24of the case mix resident class to which the alternative care301.25eligible client would be assigned under Minnesota Rules, parts301.269549.0050 to 9549.0059, less the maintenance needs allowance as301.27described in section 256B.0915, subdivision 1d, paragraph (a),301.28until the first day of the state fiscal year in which a resident301.29assessment system, under section 256B.437, of nursing home rate301.30determination is implemented. Effective on the first day of the301.31state fiscal year in which a resident assessment system, under301.32section 256B.437, of nursing home rate determination is301.33implemented and the first day of each subsequent state fiscal301.34year, the individualized monthly negotiated payment for the301.35services described in this clause shall not exceed the limit301.36described in this clause which was in effect on the last day of302.1the previous state fiscal year and which has been adjusted by302.2the greater of any legislatively adopted home and302.3community-based services cost-of-living percentage increase or302.4any legislatively adopted statewide percent rate increase for302.5nursing facilitiesgroups according to subdivision 4, paragraph 302.6 (a), clause (6). 302.7(2)(c) The individualized monthly negotiated payment for 302.8 assisted living services described under section 144A.4605 and 302.9 delivered by a provider licensed by the department of health as 302.10 a class A home care provider or an assisted living home care 302.11 provider and provided in a building that is registered as a 302.12 housing with services establishment under chapter 144D and that 302.13 provides 24-hour supervision in combination with the payment for 302.14 other alternative care services, including case management, must 302.15 not exceed the limit specified in subdivision 4, paragraph (a), 302.16 clause (6). 302.17(j)Subd. 5g. [PROVISIONS GOVERNING DIRECT CASH PAYMENTS.] 302.18 A county agency may make payment from their alternative care 302.19 program allocation for"other services" which include use of302.20"discretionary funds" for services that are not otherwise302.21defined in this section anddirect cash payments to the client 302.22 for the purpose of purchasing the services. The following 302.23 provisions apply to payments under thisparagraphsubdivision: 302.24 (1) a cash payment to a client under this provision cannot 302.25 exceed the monthly payment limit for that client as specified in 302.26 subdivision 4, paragraph (a), clause (6); and 302.27 (2) a county may not approve any cash payment for a client 302.28 who meets either of the following: 302.29 (i) has been assessed as having a dependency in 302.30 orientation, unless the client has an authorized 302.31 representative. An "authorized representative" means an 302.32 individual who is at least 18 years of age and is designated by 302.33 the person or the person's legal representative to act on the 302.34 person's behalf. This individual may be a family member, 302.35 guardian, representative payee, or other individual designated 302.36 by the person or the person's legal representative, if any, to 303.1 assist in purchasing and arranging for supports; or 303.2 (ii) is concurrently receiving adult foster care, 303.3 residential care, or assisted living services;. 303.4(3)Subd. 5h. [CASH PAYMENTS TO PERSONS.] (a) Cash 303.5 payments to a person or a person's family will be provided 303.6 through a monthly payment and be in the form of cash, voucher, 303.7 or direct county payment to a vendor. Fees or premiums assessed 303.8 to the person for eligibility for health and human services are 303.9 not reimbursable through this service option. Services and 303.10 goods purchased through cash payments must be identified in the 303.11 person's individualized care plan and must meet all of the 303.12 following criteria: 303.13(i)(1) they must be over and above the normal cost of 303.14 caring for the person if the person did not have functional 303.15 limitations; 303.16(ii)(2) they must be directly attributable to the person's 303.17 functional limitations; 303.18(iii)(3) they must have the potential to be effective at 303.19 meeting the goals of the program; and 303.20(iv)(4) they must be consistent with the needs identified 303.21 in the individualized service plan. The service plan shall 303.22 specify the needs of the person and family, the form and amount 303.23 of payment, the items and services to be reimbursed, and the 303.24 arrangements for management of the individual grant; and. 303.25(v)(b) The person, the person's family, or the legal 303.26 representative shall be provided sufficient information to 303.27 ensure an informed choice of alternatives. The local agency 303.28 shall document this information in the person's care plan, 303.29 including the type and level of expenditures to be reimbursed;. 303.30 (c) Persons receiving grants under this section shall have 303.31 the following responsibilities: 303.32 (1) spend the grant money in a manner consistent with their 303.33 individualized service plan with the local agency; 303.34 (2) notify the local agency of any necessary changes in the 303.35 grant expenditures; 303.36 (3) arrange and pay for supports; and 304.1 (4) inform the local agency of areas where they have 304.2 experienced difficulty securing or maintaining supports. 304.3 (d) The county shall report client outcomes, services, and 304.4 costs under this paragraph in a manner prescribed by the 304.5 commissioner. 304.6(4)Subd. 5i. [IMMUNITY.] The state of Minnesota, county, 304.7 lead agency under contract, or tribal government under contract 304.8 to administer the alternative care program shall not be liable 304.9 for damages, injuries, or liabilities sustained through the 304.10 purchase of direct supports or goods by the person, the person's 304.11 family, or the authorized representative with funds received 304.12 through the cash payments under this section. Liabilities 304.13 include, but are not limited to, workers' compensation, the 304.14 Federal Insurance Contributions Act (FICA), or the Federal 304.15 Unemployment Tax Act (FUTA);. 304.16(5) persons receiving grants under this section shall have304.17the following responsibilities:304.18(i) spend the grant money in a manner consistent with their304.19individualized service plan with the local agency;304.20(ii) notify the local agency of any necessary changes in304.21the grant expenditures;304.22(iii) arrange and pay for supports; and304.23(iv) inform the local agency of areas where they have304.24experienced difficulty securing or maintaining supports; and304.25(6) the county shall report client outcomes, services, and304.26costs under this paragraph in a manner prescribed by the304.27commissioner.304.28 Sec. 25. Minnesota Statutes 2002, section 256B.0913, 304.29 subdivision 6, is amended to read: 304.30 Subd. 6. [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] (a) 304.31 The alternative care program is administered by the county 304.32 agency. This agency is the lead agency responsible for the 304.33 local administration of the alternative care program as 304.34 described in this section. However, it may contract with the 304.35 public health nursing service to be the lead agency. The 304.36 commissioner may contract with federally recognized Indian 305.1 tribes with a reservation in Minnesota to serve as the lead 305.2 agency responsible for the local administration of the 305.3 alternative care program as described in the contract. 305.4 (b) Alternative care pilot projects operate according to 305.5 this section and the provisions of Laws 1993, First Special 305.6 Session chapter 1, article 5, section 133, under agreement with 305.7 the commissioner. Each pilot project agreement period shall 305.8 begin no later than the first payment cycle of the state fiscal 305.9 year and continue through the last payment cycle of the state 305.10 fiscal year. 305.11 Sec. 26. Minnesota Statutes 2002, section 256B.0913, 305.12 subdivision 7, is amended to read: 305.13 Subd. 7. [CASE MANAGEMENT.]Providers of case management305.14services for persons receiving services funded by the305.15alternative care program must meet the qualification305.16requirements and standards specified in section 256B.0915,305.17subdivision 1b.The case manager must not approve alternative 305.18 care funding for a client in any setting in which the case 305.19 manager cannot reasonably ensure the client's health and 305.20 safety. The case manager is responsible for the 305.21 cost-effectiveness of the alternative care individual care plan 305.22 and must not approve any care plan in which the cost of services 305.23 funded by alternative care and client contributions exceeds the 305.24 limit specified in section 256B.0915, subdivision 3, paragraph 305.25 (b).The county may allow a case manager employed by the county305.26to delegate certain aspects of the case management activity to305.27another individual employed by the county provided there is305.28oversight of the individual by the case manager. The case305.29manager may not delegate those aspects which require305.30professional judgment including assessments, reassessments, and305.31care plan development.305.32 Sec. 27. Minnesota Statutes 2002, section 256B.0913, 305.33 subdivision 8, is amended to read: 305.34 Subd. 8. [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 305.35 case manager shall implement the plan of care for each 305.36 alternative care client and ensure that a client's service needs 306.1 and eligibility are reassessed at least every 12 months. The 306.2 plan shall include any services prescribed by the individual's 306.3 attending physician as necessary to allow the individual to 306.4 remain in a community setting. In developing the individual's 306.5 care plan, the case manager should include the use of volunteers 306.6 from families and neighbors, religious organizations, social 306.7 clubs, and civic and service organizations to support the formal 306.8 home care services. The county shall be held harmless for 306.9 damages or injuries sustained through the use of volunteers 306.10 under this subdivision including workers' compensation 306.11 liability. The lead agency shall provide documentation in each 306.12 individual's plan of care and, if requested, to the commissioner 306.13 that the most cost-effective alternatives available have been 306.14 offered to the individual and that the individual was free to 306.15 choose among available qualified providers, both public and 306.16 private, including qualified case management or service 306.17 coordination providers other than those employed by the lead 306.18 agency when the lead agency maintains responsibility for prior 306.19 authorizing services in accordance with statutory and 306.20 administrative requirements. The case manager must give the 306.21 individual a ten-day written notice of any denial, termination, 306.22 or reduction of alternative care services. 306.23 (b) If the county administering alternative care services 306.24 is different than the county of financial responsibility, the 306.25 care plan may be implemented without the approval of the county 306.26 of financial responsibility. 306.27 Sec. 28. Minnesota Statutes 2002, section 256B.0913, 306.28 subdivision 10, is amended to read: 306.29 Subd. 10. [ALLOCATION FORMULA.] (a) The alternative care 306.30 appropriation for fiscal years 1992 and beyond shall cover only 306.31 alternative care eligible clients. By July 1 of each year, the 306.32 commissioner shall allocate to county agencies the state funds 306.33 available for alternative care for persons eligible under 306.34 subdivision 2. 306.35 (b) The adjusted base for each county is the county's 306.36 current fiscal year base allocation plus any targeted funds 307.1 approved during the current fiscal year. Calculations for 307.2 paragraphs (c) and (d) are to be made as follows: for each 307.3 county, the determination of alternative care program 307.4 expenditures shall be based on payments for services rendered 307.5 from April 1 through March 31 in the base year, to the extent 307.6 that claims have been submitted and paid by June 1 of that year. 307.7 (c) If the alternative care program expenditures as defined 307.8 in paragraph (b) are 95 percent or more of the county's adjusted 307.9 base allocation, the allocation for the next fiscal year is 100 307.10 percent of the adjusted base, plus inflation to the extent that 307.11 inflation is included in the state budget. 307.12 (d) If the alternative care program expenditures as defined 307.13 in paragraph (b) are less than 95 percent of the county's 307.14 adjusted base allocation, the allocation for the next fiscal 307.15 year is the adjusted base allocation less the amount of unspent 307.16 funds below the 95 percent level. 307.17 (e) If the annual legislative appropriation for the 307.18 alternative care program is inadequate to fund the combined 307.19 county allocations for a biennium, the commissioner shall 307.20 distribute to each county the entire annual appropriation as 307.21 that county's percentage of the computed base as calculated in 307.22 paragraphs (c) and (d). 307.23 (f) On agreement between the commissioner and the lead 307.24 agency, the commissioner may have discretion to reallocate 307.25 alternative care base allocations distributed to lead agencies 307.26 in which the base amount exceeds program expenditures. 307.27 Sec. 29. Minnesota Statutes 2002, section 256B.0913, 307.28 subdivision 12, is amended to read: 307.29 Subd. 12. [CLIENT PREMIUMS.] (a) A premium is required for 307.30 all alternative care eligible clients to help pay for the cost 307.31 of participating in the program. The amount of the premium for 307.32 the alternative care client shall be determined as follows: 307.33 (1) when the alternative care client's income less 307.34 recurring and predictable medical expenses isgreater than the307.35recipient's maintenance needs allowance as defined in section307.36256B.0915, subdivision 1d, paragraph (a), butless than 150 308.1 percent of the federal poverty guideline effective on July 1 of 308.2 the state fiscal year in which the premium is being computed, 308.3 and total assets are less than $10,000, the fee iszeroten 308.4 percent of the cost of alternative care services; or 308.5 (2) when the alternative care client's income less 308.6 recurring and predictable medical expenses is greater than or 308.7 equal to 150 percent of the federal poverty guideline effective 308.8 on July 1 of the state fiscal year in which the premium is being 308.9 computed, and total assets are less than $10,000, the fee is 25308.10percent of the cost of alternative care services or the308.11difference between 150 percent of the federal poverty guideline308.12effective on July 1 of the state fiscal year in which the308.13premium is being computed and the client's income less recurring308.14and predictable medical expenses, whichever is less; and308.15(3) when the alternative care client'sor total assets are 308.16 greater than or equal to $10,000, the fee is 25 percent of the 308.17 cost of alternative care services. 308.18 For married persons, total assets are defined as the total 308.19 marital assets less the estimated community spouse asset 308.20 allowance, under section 256B.059, if applicable. For married 308.21 persons, total income is defined as the client's income less the 308.22 monthly spousal allotment, under section 256B.058. 308.23 All alternative care servicesexcept case managementshall 308.24 be included in the estimated costs for the purpose of 308.25 determining25 percent ofthecostspremium amount. 308.26 Premiums are due and payable each month alternative care 308.27 services are received unless the actual cost of the services is 308.28 less than the premium, in which case the fee is the lesser 308.29 amount. 308.30 (b) The fee shall be waived by the commissioner when: 308.31 (1) a person who is residing in a nursing facility is 308.32 receiving case management only; 308.33 (2)a person is applying for medical assistance;308.34(3)a married couple is requesting an asset assessment 308.35 under the spousal impoverishment provisions; 308.36(4)(3) a person is found eligible for alternative care, 309.1 but is not yet receiving alternative care services;or309.2(5)(4) a person's fee under paragraph (a) is less than 309.3 $25; or 309.4 (5) a person has chosen to participate in a 309.5 consumer-directed service plan for which the cost is no greater 309.6 than the total cost of the person's alternative care service 309.7 plan less the monthly premium amount that would otherwise be 309.8 assessed. 309.9 (c) The county agency must record in the state's receivable 309.10 system the client's assessed premium amount or the reason the 309.11 premium has been waived. The commissioner will bill and collect 309.12 the premium from the client. Money collected must be deposited 309.13 in the general fund and is appropriated to the commissioner for 309.14 the alternative care program. The client must supply the county 309.15 with the client's social security number at the time of 309.16 application. The county shall supply the commissioner with the 309.17 client's social security number and other information the 309.18 commissioner requires to collect the premium from the client. 309.19 The commissioner shall collect unpaid premiums using the Revenue 309.20 Recapture Act in chapter 270A and other methods available to the 309.21 commissioner. The commissioner may require counties to inform 309.22 clients of the collection procedures that may be used by the 309.23 state if a premium is not paid. This paragraph does not apply 309.24 to alternative care pilot projects authorized in Laws 1993, 309.25 First Special Session chapter 1, article 5, section 133, if a 309.26 county operating under the pilot project reports the following 309.27 dollar amounts to the commissioner quarterly: 309.28 (1) total premiums billed to clients; 309.29 (2) total collections of premiums billed; and 309.30 (3) balance of premiums owed by clients. 309.31 If a county does not adhere to these reporting requirements, the 309.32 commissioner may terminate the billing, collecting, and 309.33 remitting portions of the pilot project and require the county 309.34 involved to operate under the procedures set forth in this 309.35 paragraph. 309.36 Sec. 30. Minnesota Statutes 2002, section 256B.0915, 310.1 subdivision 3, is amended to read: 310.2 Subd. 3. [LIMITS OF CASES, RATES, PAYMENTS, AND310.3FORECASTING.](a)The number of medical assistance waiver 310.4 recipients that a county may serve must be allocated according 310.5 to the number of medical assistance waiver cases open on July 1 310.6 of each fiscal year. Additional recipients may be served with 310.7 the approval of the commissioner. 310.8(b)Subd. 3a. [ELDERLY WAIVER COST LIMITS.] (a) The 310.9 monthly limit for the cost of waivered services to an individual 310.10 elderly waiver client shall be the weighted average monthly 310.11 nursing facility rate of the case mix resident class to which 310.12 the elderly waiver client would be assigned under Minnesota 310.13 Rules, parts 9549.0050 to 9549.0059, less the recipient's 310.14 maintenance needs allowance as described in subdivision 1d, 310.15 paragraph (a), until the first day of the state fiscal year in 310.16 which the resident assessment system as described in section 310.17 256B.437 for nursing home rate determination is implemented. 310.18 Effective on the first day of the state fiscal year in which the 310.19 resident assessment system as described in section 256B.437 for 310.20 nursing home rate determination is implemented and the first day 310.21 of each subsequent state fiscal year, the monthly limit for the 310.22 cost of waivered services to an individual elderly waiver client 310.23 shall be the rate of the case mix resident class to which the 310.24 waiver client would be assigned under Minnesota Rules, parts 310.25 9549.0050 to 9549.0059, in effect on the last day of the 310.26 previous state fiscal year, adjusted by the greater of any 310.27 legislatively adopted home and community-based services 310.28 cost-of-living percentage increase or any legislatively adopted 310.29 statewide percent rate increase for nursing facilities. 310.30(c)(b) If extended medical supplies and equipment or 310.31 environmental modifications are or will be purchased for an 310.32 elderly waiver client, the costs may be prorated for up to 12 310.33 consecutive months beginning with the month of purchase. If the 310.34 monthly cost of a recipient's waivered services exceeds the 310.35 monthly limit established in paragraph(b)(a), the annual cost 310.36 of all waivered services shall be determined. In this event, 311.1 the annual cost of all waivered services shall not exceed 12 311.2 times the monthly limit of waivered services as described in 311.3 paragraph(b)(a). 311.4(d)Subd. 3b. [COST LIMITS FOR ELDERLY WAIVER APPLICANTS 311.5 WHO RESIDE IN A NURSING FACILITY.] (a) For a person who is a 311.6 nursing facility resident at the time of requesting a 311.7 determination of eligibility for elderly waivered services, a 311.8 monthly conversion limit for the cost of elderly waivered 311.9 services may be requested. The monthly conversion limit for the 311.10 cost of elderly waiver services shall be the resident class 311.11 assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 311.12 for that resident in the nursing facility where the resident 311.13 currently resides until July 1 of the state fiscal year in which 311.14 the resident assessment system as described in section 256B.437 311.15 for nursing home rate determination is implemented. Effective 311.16 on July 1 of the state fiscal year in which the resident 311.17 assessment system as described in section 256B.437 for nursing 311.18 home rate determination is implemented, the monthly conversion 311.19 limit for the cost of elderly waiver services shall be the per 311.20 diem nursing facility rate as determined by the resident 311.21 assessment system as described in section 256B.437 for that 311.22 resident in the nursing facility where the resident currently 311.23 resides multiplied by 365 and divided by 12, less the 311.24 recipient's maintenance needs allowance as described in 311.25 subdivision 1d. The initially approved conversion rate may be 311.26 adjusted by the greater of any subsequent legislatively adopted 311.27 home and community-based services cost-of-living percentage 311.28 increase or any subsequent legislatively adopted statewide 311.29 percentage rate increase for nursing facilities. The limit 311.30 under thisclausesubdivision only applies to persons discharged 311.31 from a nursing facility after a minimum 30-day stay and found 311.32 eligible for waivered services on or after July 1, 1997. 311.33 (b) The following costs must be included in determining the 311.34 total monthly costs for the waiver client: 311.35 (1) cost of all waivered services, including extended 311.36 medical supplies and equipment and environmental modifications; 312.1 and 312.2 (2) cost of skilled nursing, home health aide, and personal 312.3 care services reimbursable by medical assistance. 312.4(e)Subd. 3c. [SERVICE APPROVAL AND CONTRACTING 312.5 PROVISIONS.] (a) Medical assistance funding for skilled nursing 312.6 services, private duty nursing, home health aide, and personal 312.7 care services for waiver recipients must be approved by the case 312.8 manager and included in the individual care plan. 312.9(f)(b) A county is not required to contract with a 312.10 provider of supplies and equipment if the monthly cost of the 312.11 supplies and equipment is less than $250. 312.12(g)Subd. 3d. [ADULT FOSTER CARE RATE.] The adult foster 312.13 care rate shall be considered a difficulty of care payment and 312.14 shall not include room and board. The adult foster care service 312.15 rate shall be negotiated between the county agency and the 312.16 foster care provider. The elderly waiver payment for the foster 312.17 care service in combination with the payment for all other 312.18 elderly waiver services, including case management, must not 312.19 exceed the limit specified in subdivision 3a, paragraph(b)(a). 312.20(h)Subd. 3e. [ASSISTED LIVING SERVICE RATE.] (a) Payment 312.21 for assisted living service shall be a monthly rate negotiated 312.22 and authorized by the county agency based on an individualized 312.23 service plan for each resident and may not cover direct rent or 312.24 food costs. 312.25(1)(b) The individualized monthly negotiated payment for 312.26 assisted living services as described in section 256B.0913, 312.27subdivision 5, paragraph (g) or (h)subdivisions 5d to 5f, and 312.28 residential care services as described in section 256B.0913, 312.29 subdivision5, paragraph (f)5c, shall not exceed the nonfederal 312.30 share, in effect on July 1 of the state fiscal year for which 312.31 the rate limit is being calculated, of the greater of either the 312.32 statewide or any of the geographic groups' weighted average 312.33 monthly nursing facility rate of the case mix resident class to 312.34 which the elderly waiver eligible client would be assigned under 312.35 Minnesota Rules, parts 9549.0050 to 9549.0059, less the 312.36 maintenance needs allowance as described in subdivision 1d, 313.1 paragraph (a), until the July 1 of the state fiscal year in 313.2 which the resident assessment system as described in section 313.3 256B.437 for nursing home rate determination is implemented. 313.4 Effective on July 1 of the state fiscal year in which the 313.5 resident assessment system as described in section 256B.437 for 313.6 nursing home rate determination is implemented and July 1 of 313.7 each subsequent state fiscal year, the individualized monthly 313.8 negotiated payment for the services described in this clause 313.9 shall not exceed the limit described in this clause which was in 313.10 effect on June 30 of the previous state fiscal year and which 313.11 has been adjusted by the greater of any legislatively adopted 313.12 home and community-based services cost-of-living percentage 313.13 increase or any legislatively adopted statewide percent rate 313.14 increase for nursing facilities. 313.15(2)(c) The individualized monthly negotiated payment for 313.16 assisted living services described in section 144A.4605 and 313.17 delivered by a provider licensed by the department of health as 313.18 a class A home care provider or an assisted living home care 313.19 provider and provided in a building that is registered as a 313.20 housing with services establishment under chapter 144D and that 313.21 provides 24-hour supervision in combination with the payment for 313.22 other elderly waiver services, including case management, must 313.23 not exceed the limit specified inparagraph (b)subdivision 3a. 313.24(i)Subd. 3f. [INDIVIDUAL SERVICE RATES; EXPENDITURE 313.25 FORECASTS.] (a) The county shall negotiate individual service 313.26 rates with vendors and may authorize payment for actual costs up 313.27 to the county's current approved rate. Persons or agencies must 313.28 be employed by or under a contract with the county agency or the 313.29 public health nursing agency of the local board of health in 313.30 order to receive funding under the elderly waiver program, 313.31 except as a provider of supplies and equipment when the monthly 313.32 cost of the supplies and equipment is less than $250. 313.33(j)(b) Reimbursement for the medical assistance recipients 313.34 under the approved waiver shall be made from the medical 313.35 assistance account through the invoice processing procedures of 313.36 the department's Medicaid Management Information System (MMIS), 314.1 only with the approval of the client's case manager. The budget 314.2 for the state share of the Medicaid expenditures shall be 314.3 forecasted with the medical assistance budget, and shall be 314.4 consistent with the approved waiver. 314.5(k)Subd. 3g. [SERVICE RATE LIMITS; STATE ASSUMPTION OF 314.6 COSTS.] (a) To improve access to community services and 314.7 eliminate payment disparities between the alternative care 314.8 program and the elderly waiver, the commissioner shall establish 314.9 statewide maximum service rate limits and eliminate 314.10 county-specific service rate limits. 314.11(1)(b) Effective July 1, 2001, for service rate limits, 314.12 except those described or defined inparagraphs (g) and314.13(h)subdivisions 3d and 3e, the rate limit for each service 314.14 shall be the greater of the alternative care statewide maximum 314.15 rate or the elderly waiver statewide maximum rate. 314.16(2)(c) Counties may negotiate individual service rates 314.17 with vendors for actual costs up to the statewide maximum 314.18 service rate limit. 314.19 Sec. 31. Minnesota Statutes 2002, section 256B.15, 314.20 subdivision 1, is amended to read: 314.21 Subdivision 1. [DEFINITION.] For purposes of this section, 314.22 "medical assistance" includes the medical assistance program 314.23 under this chapter and the general assistance medical care 314.24 program under chapter 256D, but does not include the alternative314.25care program for nonmedical assistance recipients under section314.26256B.0913, subdivision 4and alternative care for nonmedical 314.27 assistance recipients under section 256B.0913. 314.28 [EFFECTIVE DATE.] This section is effective July 1, 2003, 314.29 for decedents dying on or after that date. 314.30 Sec. 32. Minnesota Statutes 2002, section 256B.15, 314.31 subdivision 1a, is amended to read: 314.32 Subd. 1a. [ESTATES SUBJECT TO CLAIMS.] If a person 314.33 receives any medical assistance hereunder, on the person's 314.34 death, if single, or on the death of the survivor of a married 314.35 couple, either or both of whom received medical assistance, the 314.36 total amount paid for medical assistance rendered for the person 315.1 and spouse shall be filed as a claim against the estate of the 315.2 person or the estate of the surviving spouse in the court having 315.3 jurisdiction to probate the estate or to issue a decree of 315.4 descent according to sections 525.31 to 525.313. 315.5 A claim shall be filed if medical assistance was rendered 315.6 for either or both persons under one of the following 315.7 circumstances: 315.8 (a) the person was over 55 years of age, and received 315.9 services under this chapter, excluding alternative care; 315.10 (b) the person resided in a medical institution for six 315.11 months or longer, received services under this chapterexcluding315.12alternative care,and, at the time of institutionalization or 315.13 application for medical assistance, whichever is later, the 315.14 person could not have reasonably been expected to be discharged 315.15 and returned home, as certified in writing by the person's 315.16 treating physician. For purposes of this section only, a 315.17 "medical institution" means a skilled nursing facility, 315.18 intermediate care facility, intermediate care facility for 315.19 persons with mental retardation, nursing facility, or inpatient 315.20 hospital; or 315.21 (c) the person received general assistance medical care 315.22 services under chapter 256D. 315.23 The claim shall be considered an expense of the last 315.24 illness of the decedent for the purpose of section 524.3-805. 315.25 Any statute of limitations that purports to limit any county 315.26 agency or the state agency, or both, to recover for medical 315.27 assistance granted hereunder shall not apply to any claim made 315.28 hereunder for reimbursement for any medical assistance granted 315.29 hereunder. Notice of the claim shall be given to all heirs and 315.30 devisees of the decedent whose identity can be ascertained with 315.31 reasonable diligence. The notice must include procedures and 315.32 instructions for making an application for a hardship waiver 315.33 under subdivision 5; time frames for submitting an application 315.34 and determination; and information regarding appeal rights and 315.35 procedures. Counties are entitled to one-half of the nonfederal 315.36 share of medical assistance collections from estates that are 316.1 directly attributable to county effort. Counties are entitled 316.2 to ten percent of the collections for alternative care directly 316.3 attributable to county effort. 316.4 [EFFECTIVE DATE.] This section is effective July 1, 2003, 316.5 for decedents dying on or after that date. 316.6 Sec. 33. Minnesota Statutes 2002, section 256B.15, 316.7 subdivision 2, is amended to read: 316.8 Subd. 2. [LIMITATIONS ON CLAIMS.] The claim shall include 316.9 only the total amount of medical assistance rendered after age 316.10 55 or during a period of institutionalization described in 316.11 subdivision 1a, clause (b), and the total amount of general 316.12 assistance medical care rendered, and shall not include 316.13 interest. Claims that have been allowed but not paid shall bear 316.14 interest according to section 524.3-806, paragraph (d). A claim 316.15 against the estate of a surviving spouse who did not receive 316.16 medical assistance, for medical assistance rendered for the 316.17 predeceased spouse, is limited to the value of the assets of the 316.18 estate that were marital property or jointly owned property at 316.19 any time during the marriage. Claims for alternative care shall 316.20 be net of all premiums paid under section 256B.0913, subdivision 316.21 12, on or after July 1, 2003, and shall be limited to services 316.22 provided on or after July 1, 2003. 316.23 [EFFECTIVE DATE.] This section is effective July 1, 2003, 316.24 for decedents dying on or after that date. 316.25 Sec. 34. Minnesota Statutes 2002, section 256B.431, 316.26 subdivision 2r, is amended to read: 316.27 Subd. 2r. [PAYMENT RESTRICTIONS ON LEAVE DAYS.] Effective 316.28 July 1, 1993, the commissioner shall limit payment for leave 316.29 days in a nursing facility to 79 percent of that nursing 316.30 facility's total payment rate for the involved resident. For 316.31 services rendered on or after July 1, 2003, for facilities 316.32 reimbursed under this section or section 256B.434, the 316.33 commissioner shall limit payment for leave days in a nursing 316.34 facility to 60 percent of that nursing facility's total payment 316.35 rate for the involved resident. 316.36 Sec. 35. Minnesota Statutes 2002, section 256B.431, is 317.1 amended by adding a subdivision to read: 317.2 Subd. 2t. [PAYMENT LIMITATION.] For services rendered on 317.3 or after July 1, 2003, for facilities reimbursed under this 317.4 section or section 256B.434, the amount that shall be paid by 317.5 the Medicaid program shall only include a co-payment during a 317.6 Medicare-covered skilled nursing facility stay if the Medicare 317.7 rate less the resident's co-payment responsibility is less than 317.8 the Medicaid RUG-III case-mix payment rate. The amount that 317.9 shall be paid by the Medicaid program is equal to the amount by 317.10 which the Medicaid RUG-III case-mix payment rate exceeds the 317.11 Medicare rate less the co-payment responsibility. Managed care 317.12 plans paying for nursing home services under section 256B.69, 317.13 subdivision 6a, may limit payment under this subdivision. 317.14 Sec. 36. Minnesota Statutes 2002, section 256B.431, 317.15 subdivision 32, is amended to read: 317.16 Subd. 32. [PAYMENT DURING FIRST 90 DAYS.] (a) For rate 317.17 years beginning on or after July 1, 2001, the total payment rate 317.18 for a facility reimbursed under this section, section 256B.434, 317.19 or any other section for the first 90 paid days after admission 317.20 shall be: 317.21 (1) for the first 30 paid days, the rate shall be 120 317.22 percent of the facility's medical assistance rate for each case 317.23 mix class;and317.24 (2) for the next 60 paid days after the first 30 paid days, 317.25 the rate shall be 110 percent of the facility's medical 317.26 assistance rate for each case mix class.; 317.27(b)(3) beginning with the 91st paid day after admission, 317.28 the payment rate shall be the rate otherwise determined under 317.29 this section, section 256B.434, or any other section.; and 317.30(c)(4) payments under thissubdivision appliesparagraph 317.31 apply to admissions occurring on or after July 1, 2001, and 317.32 before July 1, 2003, and resident days before July 30, 2003. 317.33 (b) For rate years beginning on or after July 1, 2003, the 317.34 total payment rate for a facility reimbursed under this section, 317.35 section 256B.434, or any other section shall be: 317.36 (1) for the first 30 calendar days after admission, the 318.1 rate shall be 120 percent of the facility's medical assistance 318.2 rate for each RUG class; 318.3 (2) beginning with the 31st calendar day after admission, 318.4 the payment rate shall be the rate otherwise determined under 318.5 this section, section 256B.434, or any other section; and 318.6 (3) payments under this paragraph apply to admissions 318.7 occurring on or after July 1, 2003. 318.8 (c) Effective January 1, 2004, the enhanced rates under 318.9 this subdivision shall not be allowed if a resident has resided 318.10 in any nursing facility during the previous 30 calendar days. 318.11 Sec. 37. Minnesota Statutes 2002, section 256B.431, 318.12 subdivision 36, is amended to read: 318.13 Subd. 36. [EMPLOYEE SCHOLARSHIP COSTS AND TRAINING IN 318.14 ENGLISH AS A SECOND LANGUAGE.] (a) For the period between July 318.15 1, 2001, and June 30, 2003, the commissioner shall provide to 318.16 each nursing facility reimbursed under this section, section 318.17 256B.434, or any other section, a scholarship per diem of 25 318.18 cents to the total operating payment rate to be used: 318.19 (1) for employee scholarships that satisfy the following 318.20 requirements: 318.21 (i) scholarships are available to all employees who work an 318.22 average of at least 20 hours per week at the facility except the 318.23 administrator, department supervisors, and registered nurses; 318.24 and 318.25 (ii) the course of study is expected to lead to career 318.26 advancement with the facility or in long-term care, including 318.27 medical care interpreter services and social work; and 318.28 (2) to provide job-related training in English as a second 318.29 language. 318.30 (b) A facility receiving a rate adjustment under this 318.31 subdivision may submit to the commissioner on a schedule 318.32 determined by the commissioner and on a form supplied by the 318.33 commissioner a calculation of the scholarship per diem, 318.34 including: the amount received from this rate adjustment; the 318.35 amount used for training in English as a second language; the 318.36 number of persons receiving the training; the name of the person 319.1 or entity providing the training; and for each scholarship 319.2 recipient, the name of the recipient, the amount awarded, the 319.3 educational institution attended, the nature of the educational 319.4 program, the program completion date, and a determination of the 319.5 per diem amount of these costs based on actual resident days. 319.6 (c) On July 1, 2003, the commissioner shall remove the 25 319.7 cent scholarship per diem from the total operating payment rate 319.8 of each facility. 319.9(d) For rate years beginning after June 30, 2003, the319.10commissioner shall provide to each facility the scholarship per319.11diem determined in paragraph (b).319.12 Sec. 38. Minnesota Statutes 2002, section 256B.431, is 319.13 amended by adding a subdivision to read: 319.14 Subd. 38. [NURSING HOME RATE INCREASES EFFECTIVE IN FISCAL 319.15 YEAR 2003.] Effective June 1, 2003, the commissioner shall 319.16 provide to each nursing home reimbursed under this section or 319.17 section 256B.434, an increase in each case mix payment rate 319.18 equal to the increase in the per-bed surcharge paid under 319.19 section 256.9657, subdivision 1, paragraph (d), divided by 365 319.20 and further divided by .90. The increase shall not be subject 319.21 to any annual percentage increase. The 30-day advance notice 319.22 requirement in section 256B.47, subdivision 2, shall not apply 319.23 to rate increases resulting from this section. The commissioner 319.24 shall not adjust the rate increase under this subdivision unless 319.25 an adjustment under section 256.9657, subdivision 1, paragraph 319.26 (e), is greater than 1.5 percent of the surcharge amount. 319.27 [EFFECTIVE DATE.] This section is effective May 31, 2003. 319.28 Sec. 39. Minnesota Statutes 2002, section 256B.431, is 319.29 amended by adding a subdivision to read: 319.30 Subd. 39. [FACILITY RATES BEGINNING ON OR AFTER JULY 1, 319.31 2003.] For rate years beginning on or after July 1, 2003, 319.32 nursing facilities reimbursed under this section shall have 319.33 their July 1 operating payment rate be equal to their operating 319.34 payment rate in effect on the prior June 30th. 319.35 Sec. 40. Minnesota Statutes 2002, section 256B.431, is 319.36 amended by adding a subdivision to read: 320.1 Subd. 40. [DESIGNATION OF AREAS TO RECEIVE METROPOLITAN 320.2 RATES.] (a) For rate years beginning on or after July 1, 2003, 320.3 and subject to paragraph (b), nursing facilities located in 320.4 areas designated as metropolitan areas by the federal Office of 320.5 Management and Budget using census bureau data shall be 320.6 considered metro, in order to: 320.7 (1) determine rate increases under this section, section 320.8 256B.434, or any other section; and 320.9 (2) establish nursing facility reimbursement rates for the 320.10 new nursing facility reimbursement system developed under Laws 320.11 2002, chapter 220, article 14, section 19. 320.12 (b) Paragraph (a) applies only if designation as a metro 320.13 facility results in a level of reimbursement that is higher than 320.14 the level the facility would have received without application 320.15 of that paragraph. 320.16 [EFFECTIVE DATE.] This section is effective July 1, 2003. 320.17 Sec. 41. Minnesota Statutes 2002, section 256B.434, 320.18 subdivision 4, is amended to read: 320.19 Subd. 4. [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 320.20 nursing facilities which have their payment rates determined 320.21 under this section rather than section 256B.431, the 320.22 commissioner shall establish a rate under this subdivision. The 320.23 nursing facility must enter into a written contract with the 320.24 commissioner. 320.25 (b) A nursing facility's case mix payment rate for the 320.26 first rate year of a facility's contract under this section is 320.27 the payment rate the facility would have received under section 320.28 256B.431. 320.29 (c) A nursing facility's case mix payment rates for the 320.30 second and subsequent years of a facility's contract under this 320.31 section are the previous rate year's contract payment rates plus 320.32 an inflation adjustment and, for facilities reimbursed under 320.33 this section or section 256B.431, an adjustment to include the 320.34 cost of any increase in health department licensing fees for the 320.35 facility taking effect on or after July 1, 2001. The index for 320.36 the inflation adjustment must be based on the change in the 321.1 Consumer Price Index-All Items (United States City average) 321.2 (CPI-U) forecasted byData Resources, Inc.the commissioner of 321.3 finance's national economic consultant, as forecasted in the 321.4 fourth quarter of the calendar year preceding the rate year. 321.5 The inflation adjustment must be based on the 12-month period 321.6 from the midpoint of the previous rate year to the midpoint of 321.7 the rate year for which the rate is being determined. For the 321.8 rate years beginning on July 1, 1999, July 1, 2000, July 1, 321.9 2001,andJuly 1, 2002, July 1, 2003, and July 1, 2004, this 321.10 paragraph shall apply only to the property-related payment rate, 321.11 except that adjustments to include the cost of any increase in 321.12 health department licensing fees taking effect on or after July 321.13 1, 2001, shall be provided. In determining the amount of the 321.14 property-related payment rate adjustment under this paragraph, 321.15 the commissioner shall determine the proportion of the 321.16 facility's rates that are property-related based on the 321.17 facility's most recent cost report. 321.18 (d) The commissioner shall develop additional 321.19 incentive-based payments of up to five percent above the 321.20 standard contract rate for achieving outcomes specified in each 321.21 contract. The specified facility-specific outcomes must be 321.22 measurable and approved by the commissioner. The commissioner 321.23 may establish, for each contract, various levels of achievement 321.24 within an outcome. After the outcomes have been specified the 321.25 commissioner shall assign various levels of payment associated 321.26 with achieving the outcome. Any incentive-based payment cancels 321.27 if there is a termination of the contract. In establishing the 321.28 specified outcomes and related criteria the commissioner shall 321.29 consider the following state policy objectives: 321.30 (1) improved cost effectiveness and quality of life as 321.31 measured by improved clinical outcomes; 321.32 (2) successful diversion or discharge to community 321.33 alternatives; 321.34 (3) decreased acute care costs; 321.35 (4) improved consumer satisfaction; 321.36 (5) the achievement of quality; or 322.1 (6) any additional outcomes proposed by a nursing facility 322.2 that the commissioner finds desirable. 322.3 Sec. 42. Minnesota Statutes 2002, section 256B.434, 322.4 subdivision 10, is amended to read: 322.5 Subd. 10. [EXEMPTIONS.] (a) To the extent permitted by 322.6 federal law, (1) a facility that has entered into a contract 322.7 under this section is not required to file a cost report, as 322.8 defined in Minnesota Rules, part 9549.0020, subpart 13, for any 322.9 year after the base year that is the basis for the calculation 322.10 of the contract payment rate for the first rate year of the 322.11 alternative payment demonstration project contract; and (2) a 322.12 facility under contract is not subject to audits of historical 322.13 costs or revenues, or paybacks or retroactive adjustments based 322.14 on these costs or revenues, except audits, paybacks, or 322.15 adjustments relating to the cost report that is the basis for 322.16 calculation of the first rate year under the contract. 322.17 (b) A facility that is under contract with the commissioner 322.18 under this section is not subject to the moratorium on licensure 322.19 or certification of new nursing home beds in section 144A.071, 322.20 unless the project results in a net increase in bed capacity or 322.21 involves relocation of beds from one site to another. Contract 322.22 payment rates must not be adjusted to reflect any additional 322.23 costs that a nursing facility incurs as a result of a 322.24 construction project undertaken under this paragraph. In 322.25 addition, as a condition of entering into a contract under this 322.26 section, a nursing facility must agree that any future medical 322.27 assistance payments for nursing facility services will not 322.28 reflect any additional costs attributable to the sale of a 322.29 nursing facility under this section and to construction 322.30 undertaken under this paragraph that otherwise would not be 322.31 authorized under the moratorium in section 144A.073. Nothing in 322.32 this section prevents a nursing facility participating in the 322.33 alternative payment demonstration project under this section 322.34 from seeking approval of an exception to the moratorium through 322.35 the process established in section 144A.073, and if approved the 322.36 facility's rates shall be adjusted to reflect the cost of the 323.1 project. Nothing in this section prevents a nursing facility 323.2 participating in the alternative payment demonstration project 323.3 from seeking legislative approval of an exception to the 323.4 moratorium under section 144A.071, and, if enacted, the 323.5 facility's rates shall be adjusted to reflect the cost of the 323.6 project. 323.7 (c) Notwithstanding section 256B.48, subdivision 6, 323.8 paragraphs (c), (d), and (e), and pursuant to any terms and 323.9 conditions contained in the facility's contract, a nursing 323.10 facility that is under contract with the commissioner under this 323.11 section is in compliance with section 256B.48, subdivision 6, 323.12 paragraph (b), if the facility is Medicare certified. 323.13 (d) Notwithstanding paragraph (a), if by April 1, 1996, the 323.14 health care financing administration has not approved a required 323.15 waiver, or the Centers for Medicare and Medicaid Services 323.16 otherwise requires cost reports to be filed prior to the 323.17 waiver's approval, the commissioner shall require a cost report 323.18 for the rate year. 323.19 (e) A facility that is under contract with the commissioner 323.20 under this section shall be allowed to change therapy 323.21 arrangements from an unrelated vendor to a related vendor during 323.22 the term of the contract. The commissioner may develop 323.23 reasonable requirements designed to prevent an increase in 323.24 therapy utilization for residents enrolled in the medical 323.25 assistance program. 323.26 (f) Nursing facilities participating in the alternative 323.27 payment system demonstration project must either participate in 323.28 the alternative payment system quality improvement program 323.29 established by the commissioner or submit information on their 323.30 own quality improvement process to the commissioner for 323.31 approval. Nursing facilities that have had their own quality 323.32 improvement process approved by the commissioner must report 323.33 results for at least one key area of quality improvement 323.34 annually to the commissioner. 323.35 [EFFECTIVE DATE.] This section is effective July 1, 2003. 323.36 Sec. 43. Minnesota Statutes 2002, section 256B.48, 324.1 subdivision 1, is amended to read: 324.2 Subdivision 1. [PROHIBITED PRACTICES.] A nursing facility 324.3 is not eligible to receive medical assistance payments unless it 324.4 refrains from all of the following: 324.5 (a) Charging private paying residents rates for similar 324.6 services which exceed those which are approved by the state 324.7 agency for medical assistance recipients as determined by the 324.8 prospective desk audit rate, except under the following 324.9 circumstances: (1) the nursing facility may(1)(i) charge 324.10 private paying residents a higher rate for a private room,and 324.11(2)(ii) charge for special services which are not included in 324.12 the daily rate if medical assistance residents are charged 324.13 separately at the same rate for the same services in addition to 324.14 the daily rate paid by the commissioner.; (2) effective July 1, 324.15 2003, nursing facilities may charge private paying residents 324.16 rates up to two percent higher than the allowable payment rate 324.17 in effect on June 30, 2003, plus an adjustment equal to any 324.18 other rate increase provided in law, for the RUGs group 324.19 currently assigned to the resident; (3) effective July 1, 2004, 324.20 nursing facilities may charge private paying residents rates up 324.21 to four percent higher than the allowable payment rate in effect 324.22 on June 30, 2003, plus an adjustment equal to any other rate 324.23 increase provided in law, for the RUGs group currently assigned 324.24 to the resident; (4) effective July 1, 2005, nursing facilities 324.25 may charge private paying residents rates up to six percent 324.26 higher than the allowable payment rate in effect on June 30, 324.27 2003, plus an adjustment equal to any other rate increase 324.28 provided in law, for the RUGs group currently assigned to the 324.29 resident; and (5) effective July 1, 2006, nursing facilities may 324.30 charge private paying residents rates up to eight percent higher 324.31 than the allowable payment rate in effect on June 30, 2003, plus 324.32 an adjustment equal to any other rate increase provided in law, 324.33 for the RUGs group currently assigned to the resident. For 324.34 purposes of this subdivision, the allowable payment rate is the 324.35 total payment rate under section 256B.431 or 256B.434 including 324.36 adjustments for enhanced rates during the first 30 days under 325.1 section 256B.431, subdivision 32, and private room differentials 325.2 under clause (1), item (i), and Minnesota Rules, part 9549.0060, 325.3 subpart 11, item C. Nothing in this section precludes a nursing 325.4 facility from charging a rate allowable under the facility's 325.5 single room election option under Minnesota Rules, part 325.6 9549.0060, subpart 11. Services covered by the payment rate 325.7 must be the same regardless of payment source. Special 325.8 services, if offered, must be available to all residents in all 325.9 areas of the nursing facility and charged separately at the same 325.10 rate. Residents are free to select or decline special services. 325.11 Special services must not include services which must be 325.12 provided by the nursing facility in order to comply with 325.13 licensure or certification standards and that if not provided 325.14 would result in a deficiency or violation by the nursing 325.15 facility. Services beyond those required to comply with 325.16 licensure or certification standards must not be charged 325.17 separately as a special service if they were included in the 325.18 payment rate for the previous reporting year. A nursing 325.19 facility that charges a private paying resident a rate in 325.20 violation of this clause is subject to an action by the state of 325.21 Minnesota or any of its subdivisions or agencies for civil 325.22 damages. A private paying resident or the resident's legal 325.23 representative has a cause of action for civil damages against a 325.24 nursing facility that charges the resident rates in violation of 325.25 this clause. The damages awarded shall include three times the 325.26 payments that result from the violation, together with costs and 325.27 disbursements, including reasonable attorneys' fees or their 325.28 equivalent. A private paying resident or the resident's legal 325.29 representative, the state, subdivision or agency, or a nursing 325.30 facility may request a hearing to determine the allowed rate or 325.31 rates at issue in the cause of action. Within 15 calendar days 325.32 after receiving a request for such a hearing, the commissioner 325.33 shall request assignment of an administrative law judge under 325.34 sections 14.48 to 14.56 to conduct the hearing as soon as 325.35 possible or according to agreement by the parties. The 325.36 administrative law judge shall issue a report within 15 calendar 326.1 days following the close of the hearing. The prohibition set 326.2 forth in this clause shall not apply to facilities licensed as 326.3 boarding care facilities which are not certified as skilled or 326.4 intermediate care facilities level I or II for reimbursement 326.5 through medical assistance. 326.6 (b) Effective July 1, 2007, paragraph (a) no longer 326.7 applies, except that special services, if offered, must be 326.8 available to all residents of the nursing facility and charged 326.9 separately at the same rate. Residents are free to select or 326.10 decline special services. Special services must not include 326.11 services which must be provided by the nursing facility in order 326.12 to comply with licensure or certification standards and that if 326.13 not provided would result in a deficiency or violation by the 326.14 nursing facility. 326.15(b)(c)(1) Charging, soliciting, accepting, or receiving 326.16 from an applicant for admission to the facility, or from anyone 326.17 acting in behalf of the applicant, as a condition of admission, 326.18 expediting the admission, or as a requirement for the 326.19 individual's continued stay, any fee, deposit, gift, money, 326.20 donation, or other consideration not otherwise required as 326.21 payment under the state plan. For residents on medical 326.22 assistance, medical assistance payment according to the state 326.23 plan must be accepted as payment in full for continued stay, 326.24 except where otherwise provided for under statute; 326.25 (2) requiring an individual, or anyone acting in behalf of 326.26 the individual, to loan any money to the nursing facility; 326.27 (3) requiring an individual, or anyone acting in behalf of 326.28 the individual, to promise to leave all or part of the 326.29 individual's estate to the facility; or 326.30 (4) requiring a third-party guarantee of payment to the 326.31 facility as a condition of admission, expedited admission, or 326.32 continued stay in the facility. 326.33 Nothing in this paragraph would prohibit discharge for 326.34 nonpayment of services in accordance with state and federal 326.35 regulations. 326.36(c)(d) Requiring any resident of the nursing facility to 327.1 utilize a vendor of health care services chosen by the nursing 327.2 facility. A nursing facility may require a resident to use 327.3 pharmacies that utilize unit dose packing systems approved by 327.4 the Minnesota board of pharmacy, and may require a resident to 327.5 use pharmacies that are able to meet the federal regulations for 327.6 safe and timely administration of medications such as systems 327.7 with specific number of doses, prompt delivery of medications, 327.8 or access to medications on a 24-hour basis. Notwithstanding 327.9 the provisions of this paragraph, nursing facilities shall not 327.10 restrict a resident's choice of pharmacy because the pharmacy 327.11 utilizes a specific system of unit dose drug packing. 327.12(d)(e) Providing differential treatment on the basis of 327.13 status with regard to public assistance. 327.14(e)(f) Discriminating in admissions, services offered, or 327.15 room assignment on the basis of status with regard to public 327.16 assistanceor refusal to purchase special327.17services. Discrimination in admissionsdiscrimination, services 327.18 offered, or room assignment shall include, but is not limited to:327.19(1)basing admissions decisions uponassurance by the327.20applicant to the nursing facility, or the applicant's guardian327.21or conservator, that the applicant is neither eligible for nor327.22will seekinformation or assurances regarding current or future 327.23 eligibility for public assistance for payment of nursing 327.24 facility carecosts; and. 327.25(2) engaging in preferential selection from waiting lists327.26based on an applicant's ability to pay privately or an327.27applicant's refusal to pay for a special service.327.28 The collection and use by a nursing facility of financial 327.29 information of any applicant pursuant to a preadmission 327.30 screening program established by law shall not raise an 327.31 inference that the nursing facility is utilizing that 327.32 information for any purpose prohibited by this paragraph. 327.33(f)(g) Requiring any vendor of medical care as defined by 327.34 section 256B.02, subdivision 7, who is reimbursed by medical 327.35 assistance under a separate fee schedule, to pay any amount 327.36 based on utilization or service levels or any portion of the 328.1 vendor's fee to the nursing facility except as payment for 328.2 renting or leasing space or equipment or purchasing support 328.3 services from the nursing facility as limited by section 328.4 256B.433. All agreements must be disclosed to the commissioner 328.5 upon request of the commissioner. Nursing facilities and 328.6 vendors of ancillary services that are found to be in violation 328.7 of this provision shall each be subject to an action by the 328.8 state of Minnesota or any of its subdivisions or agencies for 328.9 treble civil damages on the portion of the fee in excess of that 328.10 allowed by this provision and section 256B.433. Damages awarded 328.11 must include three times the excess payments together with costs 328.12 and disbursements including reasonable attorney's fees or their 328.13 equivalent. 328.14(g)(h) Refusing, for more than 24 hours, to accept a 328.15 resident returning to the same bed or a bed certified for the 328.16 same level of care, in accordance with a physician's order 328.17 authorizing transfer, after receiving inpatient hospital 328.18 services. 328.19 (i) For a period not to exceed 180 days, the commissioner 328.20 may continue to make medical assistance payments to a nursing 328.21 facility or boarding care home which is in violation of this 328.22 section if extreme hardship to the residents would result. In 328.23 these cases the commissioner shall issue an order requiring the 328.24 nursing facility to correct the violation. The nursing facility 328.25 shall have 20 days from its receipt of the order to correct the 328.26 violation. If the violation is not corrected within the 20-day 328.27 period the commissioner may reduce the payment rate to the 328.28 nursing facility by up to 20 percent. The amount of the payment 328.29 rate reduction shall be related to the severity of the violation 328.30 and shall remain in effect until the violation is corrected. 328.31 The nursing facility or boarding care home may appeal the 328.32 commissioner's action pursuant to the provisions of chapter 14 328.33 pertaining to contested cases. An appeal shall be considered 328.34 timely if written notice of appeal is received by the 328.35 commissioner within 20 days of notice of the commissioner's 328.36 proposed action. 329.1 In the event that the commissioner determines that a 329.2 nursing facility is not eligible for reimbursement for a 329.3 resident who is eligible for medical assistance, the 329.4 commissioner may authorize the nursing facility to receive 329.5 reimbursement on a temporary basis until the resident can be 329.6 relocated to a participating nursing facility. 329.7 Certified beds in facilities which do not allow medical 329.8 assistance intake on July 1, 1984, or after shall be deemed to 329.9 be decertified for purposes of section 144A.071 only. 329.10 Sec. 44. Minnesota Statutes 2002, section 256B.5012, is 329.11 amended by adding a subdivision to read: 329.12 Subd. 5. [RATE INCREASE EFFECTIVE JUNE 1, 2003.] For rate 329.13 periods beginning on or after June 1, 2003, the commissioner 329.14 shall increase the total operating payment rate for each 329.15 facility reimbursed under this section by $3 per day. The 329.16 increase shall not be subject to any annual percentage increase. 329.17 [EFFECTIVE DATE.] This section is effective June 1, 2003. 329.18 Sec. 45. Minnesota Statutes 2002, section 256B.76, is 329.19 amended to read: 329.20 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 329.21 (a) Effective for services rendered on or after October 1, 329.22 1992, the commissioner shall make payments for physician 329.23 services as follows: 329.24 (1) payment for level one Centers for Medicare and Medicaid 329.25 Services' common procedural coding system codes titled "office 329.26 and other outpatient services," "preventive medicine new and 329.27 established patient," "delivery, antepartum, and postpartum 329.28 care," "critical care," cesarean delivery and pharmacologic 329.29 management provided to psychiatric patients, and level three 329.30 codes for enhanced services for prenatal high risk, shall be 329.31 paid at the lower of (i) submitted charges, or (ii) 25 percent 329.32 above the rate in effect on June 30, 1992. If the rate on any 329.33 procedure code within these categories is different than the 329.34 rate that would have been paid under the methodology in section 329.35 256B.74, subdivision 2, then the larger rate shall be paid; 329.36 (2) payments for all other services shall be paid at the 330.1 lower of (i) submitted charges, or (ii) 15.4 percent above the 330.2 rate in effect on June 30, 1992; 330.3 (3) all physician rates shall be converted from the 50th 330.4 percentile of 1982 to the 50th percentile of 1989, less the 330.5 percent in aggregate necessary to equal the above increases 330.6 except that payment rates for home health agency services shall 330.7 be the rates in effect on September 30, 1992; 330.8 (4) effective for services rendered on or after January 1, 330.9 2000, payment rates for physician and professional services 330.10 shall be increased by three percent over the rates in effect on 330.11 December 31, 1999, except for home health agency and family 330.12 planning agency services; and 330.13 (5) the increases in clause (4) shall be implemented 330.14 January 1, 2000, for managed care. 330.15 (b) Effective for services rendered on or after October 1, 330.16 1992, the commissioner shall make payments for dental services 330.17 as follows: 330.18 (1) dental services shall be paid at the lower of (i) 330.19 submitted charges, or (ii) 25 percent above the rate in effect 330.20 on June 30, 1992; 330.21 (2) dental rates shall be converted from the 50th 330.22 percentile of 1982 to the 50th percentile of 1989, less the 330.23 percent in aggregate necessary to equal the above increases; 330.24 (3) effective for services rendered on or after January 1, 330.25 2000, payment rates for dental services shall be increased by 330.26 three percent over the rates in effect on December 31, 1999; 330.27 (4) the commissioner shall award grants to community 330.28 clinics or other nonprofit community organizations, political 330.29 subdivisions, professional associations, or other organizations 330.30 that demonstrate the ability to provide dental services 330.31 effectively to public program recipients. Grants may be used to 330.32 fund the costs related to coordinating access for recipients, 330.33 developing and implementing patient care criteria, upgrading or 330.34 establishing new facilities, acquiring furnishings or equipment, 330.35 recruiting new providers, or other development costs that will 330.36 improve access to dental care in a region. In awarding grants, 331.1 the commissioner shall give priority to applicants that plan to 331.2 serve areas of the state in which the number of dental providers 331.3 is not currently sufficient to meet the needs of recipients of 331.4 public programs or uninsured individuals. The commissioner 331.5 shall consider the following in awarding the grants: 331.6 (i) potential to successfully increase access to an 331.7 underserved population; 331.8 (ii) the ability to raise matching funds; 331.9 (iii) the long-term viability of the project to improve 331.10 access beyond the period of initial funding; 331.11 (iv) the efficiency in the use of the funding; and 331.12 (v) the experience of the proposers in providing services 331.13 to the target population. 331.14 The commissioner shall monitor the grants and may terminate 331.15 a grant if the grantee does not increase dental access for 331.16 public program recipients. The commissioner shall consider 331.17 grants for the following: 331.18 (i) implementation of new programs or continued expansion 331.19 of current access programs that have demonstrated success in 331.20 providing dental services in underserved areas; 331.21 (ii) a pilot program for utilizing hygienists outside of a 331.22 traditional dental office to provide dental hygiene services; 331.23 and 331.24 (iii) a program that organizes a network of volunteer 331.25 dentists, establishes a system to refer eligible individuals to 331.26 volunteer dentists, and through that network provides donated 331.27 dental care services to public program recipients or uninsured 331.28 individuals; 331.29 (5) beginning October 1, 1999, the payment for tooth 331.30 sealants and fluoride treatments shall be the lower of (i) 331.31 submitted charge, or (ii) 80 percent of median 1997 charges; 331.32 (6) the increases listed in clauses (3) and (5) shall be 331.33 implemented January 1, 2000, for managed care; and 331.34 (7) effective for services provided on or after January 1, 331.35 2002, payment for diagnostic examinations and dental x-rays 331.36 provided to children under age 21 shall be the lower of (i) the 332.1 submitted charge, or (ii) 85 percent of median 1999 charges. 332.2 (c) Effective for dental services rendered on or after 332.3 January 1, 2002, the commissioner may, within the limits of 332.4 available appropriation, increase reimbursements to dentists and 332.5 dental clinics deemed by the commissioner to be critical access 332.6 dental providers. Reimbursement to a critical access dental 332.7 provider may be increased by not more than 50 percent above the 332.8 reimbursement rate that would otherwise be paid to the 332.9 provider. Payments to health plan companies shall be adjusted 332.10 to reflect increased reimbursements to critical access dental 332.11 providers as approved by the commissioner. In determining which 332.12 dentists and dental clinics shall be deemed critical access 332.13 dental providers, the commissioner shall review: 332.14 (1) the utilization rate in the service area in which the 332.15 dentist or dental clinic operates for dental services to 332.16 patients covered by medical assistance, general assistance 332.17 medical care, or MinnesotaCare as their primary source of 332.18 coverage; 332.19 (2) the level of services provided by the dentist or dental 332.20 clinic to patients covered by medical assistance, general 332.21 assistance medical care, or MinnesotaCare as their primary 332.22 source of coverage; and 332.23 (3) whether the level of services provided by the dentist 332.24 or dental clinic is critical to maintaining adequate levels of 332.25 patient access within the service area. 332.26 In the absence of a critical access dental provider in a service 332.27 area, the commissioner may designate a dentist or dental clinic 332.28 as a critical access dental provider if the dentist or dental 332.29 clinic is willing to provide care to patients covered by medical 332.30 assistance, general assistance medical care, or MinnesotaCare at 332.31 a level which significantly increases access to dental care in 332.32 the service area. 332.33 (d)Effective July 1, 2001, the medical assistance rates332.34for outpatient mental health services provided by an entity that332.35operates:332.36(1) a Medicare-certified comprehensive outpatient333.1rehabilitation facility; and333.2(2) a facility that was certified prior to January 1, 1993,333.3with at least 33 percent of the clients receiving rehabilitation333.4services in the most recent calendar year who are medical333.5assistance recipients, will be increased by 38 percent, when333.6those services are provided within the comprehensive outpatient333.7rehabilitation facility and provided to residents of nursing333.8facilities owned by the entity.333.9(e)An entity that operates both a Medicare certified 333.10 comprehensive outpatient rehabilitation facility and a facility 333.11 which was certified prior to January 1, 1993, that is licensed 333.12 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 333.13 whom at least 33 percent of the clients receiving rehabilitation 333.14 services in the most recent calendar year are medical assistance 333.15 recipients, shall be reimbursed by the commissioner for 333.16 rehabilitation services at rates that are 38 percent greater 333.17 than the maximum reimbursement rate allowed under paragraph (a), 333.18 clause (2), when those services are (1) provided within the 333.19 comprehensive outpatient rehabilitation facility and (2) 333.20 provided to residents of nursing facilities owned by the entity. 333.21 Sec. 46. Minnesota Statutes 2002, section 256B.761, is 333.22 amended to read: 333.23 256B.761 [REIMBURSEMENT FOR MENTAL HEALTH SERVICES.] 333.24 (a) Effective for services rendered on or after July 1, 333.25 2001, payment for medication management provided to psychiatric 333.26 patients, outpatient mental health services, day treatment 333.27 services, home-based mental health services, and family 333.28 community support services shall be paid at the lower of (1) 333.29 submitted charges, or (2) 75.6 percent of the 50th percentile of 333.30 1999 charges. 333.31 (b) Effective July 1, 2001, the medical assistance rates 333.32 for outpatient mental health services provided by an entity that 333.33 operates: (1) a Medicare-certified comprehensive outpatient 333.34 rehabilitation facility; and (2) a facility that was certified 333.35 prior to January 1, 1993, with at least 33 percent of the 333.36 clients receiving rehabilitation services in the most recent 334.1 calendar year who are medical assistance recipients, will be 334.2 increased by 38 percent, when those services are provided within 334.3 the comprehensive outpatient rehabilitation facility and 334.4 provided to residents of nursing facilities owned by the entity. 334.5 Sec. 47. Minnesota Statutes 2002, section 256D.03, 334.6 subdivision 3a, is amended to read: 334.7 Subd. 3a. [CLAIMS; ASSIGNMENT OF BENEFITS.] Claims must be 334.8 filed pursuant to section 256D.16. General assistance medical 334.9 care applicants and recipients must apply or agree to apply 334.10 third party health and accident benefits to the costs of medical 334.11 care. They must cooperate with the state in establishing 334.12 paternity and obtaining third party payments. Bysigning an334.13application foraccepting general assistance, a person assigns 334.14 to the department of human services all rights to medical 334.15 support or payments for medical expenses from another person or 334.16 entity on their own or their dependent's behalf and agrees to 334.17 cooperate with the state in establishing paternity and obtaining 334.18 third party payments. The application shall contain a statement 334.19 explaining the assignment. Any rights or amounts assigned shall 334.20 be applied against the cost of medical care paid for under this 334.21 chapter. An assignment is effective on the date general 334.22 assistance medical care eligibility takes effect.The334.23assignment shall not affect benefits paid or provided under334.24automobile accident coverage and private health care coverage334.25until the person or organization providing the benefits has334.26received notice of the assignment.334.27 Sec. 48. Minnesota Statutes 2002, section 256I.02, is 334.28 amended to read: 334.29 256I.02 [PURPOSE.] 334.30 The Group Residential Housing Act establishes a 334.31 comprehensive system of rates and payments for persons who 334.32 reside ina group residencethe community and who meet the 334.33 eligibility criteria under section 256I.04, subdivision 1. 334.34 Sec. 49. Minnesota Statutes 2002, section 256I.04, 334.35 subdivision 3, is amended to read: 334.36 Subd. 3. [MORATORIUM ON THE DEVELOPMENT OF GROUP 335.1 RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter 335.2 into agreements for new group residential housing beds with 335.3 total rates in excess of the MSA equivalent rate except: (1) 335.4for group residential housing establishments meeting the335.5requirements of subdivision 2a, clause (2) with department335.6approval; (2)for group residential housing establishments 335.7 licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 335.8 provided the facility is needed to meet the census reduction 335.9 targets for persons with mental retardation or related 335.10 conditions at regional treatment centers;(3)(2) to ensure 335.11 compliance with the federal Omnibus Budget Reconciliation Act 335.12 alternative disposition plan requirements for inappropriately 335.13 placed persons with mental retardation or related conditions or 335.14 mental illness;(4)(3) up to 80 beds in a single, specialized 335.15 facility located in Hennepin county that will provide housing 335.16 for chronic inebriates who are repetitive users of 335.17 detoxification centers and are refused placement in emergency 335.18 shelters because of their state of intoxication, and planning 335.19 for the specialized facility must have been initiated before 335.20 July 1, 1991, in anticipation of receiving a grant from the 335.21 housing finance agency under section 462A.05, subdivision 20a, 335.22 paragraph (b);(5)(4) notwithstanding the provisions of 335.23 subdivision 2a, for up to 190 supportive housing units in Anoka, 335.24 Dakota, Hennepin, or Ramsey county for homeless adults with a 335.25 mental illness, a history of substance abuse, or human 335.26 immunodeficiency virus or acquired immunodeficiency syndrome. 335.27 For purposes of this section, "homeless adult" means a person 335.28 who is living on the street or in a shelter or discharged from a 335.29 regional treatment center, community hospital, or residential 335.30 treatment program and has no appropriate housing available and 335.31 lacks the resources and support necessary to access appropriate 335.32 housing. At least 70 percent of the supportive housing units 335.33 must serve homeless adults with mental illness, substance abuse 335.34 problems, or human immunodeficiency virus or acquired 335.35 immunodeficiency syndrome who are about to be or, within the 335.36 previous six months, has been discharged from a regional 336.1 treatment center, or a state-contracted psychiatric bed in a 336.2 community hospital, or a residential mental health or chemical 336.3 dependency treatment program. If a person meets the 336.4 requirements of subdivision 1, paragraph (a), and receives a 336.5 federal or state housing subsidy, the group residential housing 336.6 rate for that person is limited to the supplementary rate under 336.7 section 256I.05, subdivision 1a, and is determined by 336.8 subtracting the amount of the person's countable income that 336.9 exceeds the MSA equivalent rate from the group residential 336.10 housing supplementary rate. A resident in a demonstration 336.11 project site who no longer participates in the demonstration 336.12 program shall retain eligibility for a group residential housing 336.13 payment in an amount determined under section 256I.06, 336.14 subdivision 8, using the MSA equivalent rate. Service funding 336.15 under section 256I.05, subdivision 1a, will end June 30, 1997, 336.16 if federal matching funds are available and the services can be 336.17 provided through a managed care entity. If federal matching 336.18 funds are not available, then service funding will continue 336.19 under section 256I.05, subdivision 1a; or (6) for group 336.20 residential housing beds in settings meeting the requirements of 336.21 subdivision 2a, clauses (1) and (3), which are used exclusively 336.22 for recipients receiving home and community-based waiver 336.23 services under sections 256B.0915, 256B.092, subdivision 5, 336.24 256B.093, and 256B.49, and who resided in a nursing facility for 336.25 the six months immediately prior to the month of entry into the 336.26 group residential housing setting. The group residential 336.27 housing rate for these beds must be set so that the monthly 336.28 group residential housing payment for an individual occupying 336.29 the bed when combined with the nonfederal share of services 336.30 delivered under the waiver for that person does not exceed the 336.31 nonfederal share of the monthly medical assistance payment made 336.32 for the person to the nursing facility in which the person 336.33 resided prior to entry into the group residential housing 336.34 establishment. The rate may not exceed the MSA equivalent rate 336.35 plus $426.37 for any case. 336.36 (b) A county agency may enter into a group residential 337.1 housing agreement for beds with rates in excess of the MSA 337.2 equivalent rate in addition to those currently covered under a 337.3 group residential housing agreement if the additional beds are 337.4 only a replacement of beds with rates in excess of the MSA 337.5 equivalent rate which have been made available due to closure of 337.6 a setting, a change of licensure or certification which removes 337.7 the beds from group residential housing payment, or as a result 337.8 of the downsizing of a group residential housing setting. The 337.9 transfer of available beds from one county to another can only 337.10 occur by the agreement of both counties. 337.11 Sec. 50. Minnesota Statutes 2002, section 256I.05, 337.12 subdivision 1, is amended to read: 337.13 Subdivision 1. [MAXIMUM RATES.](a)Monthly room and board 337.14 rates negotiated by a county agency for a recipient living in 337.15 group residential housing must not exceed the MSA equivalent 337.16 rate specified under section 256I.03, subdivision 5,.with the337.17exception that a county agency may negotiate a supplementary337.18room and board rate that exceeds the MSA equivalent rate for337.19recipients of waiver services under title XIX of the Social337.20Security Act. This exception is subject to the following337.21conditions:337.22(1) the setting is licensed by the commissioner of human337.23services under Minnesota Rules, parts 9555.5050 to 9555.6265;337.24(2) the setting is not the primary residence of the license337.25holder and in which the license holder is not the primary337.26caregiver; and337.27(3) the average supplementary room and board rate in a337.28county for a calendar year may not exceed the average337.29supplementary room and board rate for that county in effect on337.30January 1, 2000. For calendar years beginning on or after337.31January 1, 2002, within the limits of appropriations337.32specifically for this purpose, the commissioner shall increase337.33each county's supplemental room and board rate average on an337.34annual basis by a factor consisting of the percentage change in337.35the Consumer Price Index-All items, United States city average337.36(CPI-U) for that calendar year compared to the preceding338.1calendar year as forecasted by Data Resources, Inc., in the338.2third quarter of the preceding calendar year. If a county has338.3not negotiated supplementary room and board rates for any338.4facilities located in the county as of January 1, 2000, or has338.5an average supplemental room and board rate under $100 per338.6person as of January 1, 2000, it may submit a supplementary room338.7and board rate request with budget information for a facility to338.8the commissioner for approval.338.9The county agency may at any time negotiate a higher or lower338.10room and board rate than the average supplementary room and338.11board rate.338.12(b) Notwithstanding paragraph (a), clause (3), county338.13agencies may negotiate a supplementary room and board rate that338.14exceeds the MSA equivalent rate by up to $426.37 for up to five338.15facilities, serving not more than 20 individuals in total, that338.16were established to replace an intermediate care facility for338.17persons with mental retardation and related conditions located338.18in the city of Roseau that became uninhabitable due to flood338.19damage in June 2002.338.20 [EFFECTIVE DATE.] This section is effective July 1, 2004, 338.21 or upon receipt of federal approval of waiver amendment, 338.22 whichever is later. 338.23 Sec. 51. Minnesota Statutes 2002, section 256I.05, 338.24 subdivision 1a, is amended to read: 338.25 Subd. 1a. [SUPPLEMENTARY SERVICE RATES.] (a) Subject to 338.26 the provisions of section 256I.04, subdivision 3,in addition to338.27the room and board rate specified in subdivision 1,the county 338.28 agency may negotiate a payment not to exceed $426.37 for other 338.29 services necessary to provide room and board provided by the 338.30 group residence if the residence is licensed by or registered by 338.31 the department of health, or licensed by the department of human 338.32 services to provide services in addition to room and board, and 338.33 if the provider of services is not also concurrently receiving 338.34 funding for services for a recipient under a home and 338.35 community-based waiver under title XIX of the Social Security 338.36 Act; or funding from the medical assistance program under 339.1 section 256B.0627, subdivision 4, for personal care services for 339.2 residents in the setting; or residing in a setting which 339.3 receives funding under Minnesota Rules, parts 9535.2000 to 339.4 9535.3000. If funding is available for other necessary services 339.5 through a home and community-based waiver, or personal care 339.6 services under section 256B.0627, subdivision 4, then the GRH 339.7 rate is limited to the rate set in subdivision 1. Unless 339.8 otherwise provided in law, in no case may the supplementary 339.9 service rateplus the supplementary room and board rateexceed 339.10 $426.37. The registration and licensure requirement does not 339.11 apply to establishments which are exempt from state licensure 339.12 because they are located on Indian reservations and for which 339.13 the tribe has prescribed health and safety requirements. 339.14 Service payments under this section may be prohibited under 339.15 rules to prevent the supplanting of federal funds with state 339.16 funds. The commissioner shall pursue the feasibility of 339.17 obtaining the approval of the Secretary of Health and Human 339.18 Services to provide home and community-based waiver services 339.19 under title XIX of the Social Security Act for residents who are 339.20 not eligible for an existing home and community-based waiver due 339.21 to a primary diagnosis of mental illness or chemical dependency 339.22 and shall apply for a waiver if it is determined to be 339.23 cost-effective. 339.24 (b) The commissioner is authorized to make cost-neutral 339.25 transfers from the GRH fund for beds under this section to other 339.26 funding programs administered by the department after 339.27 consultation with the county or counties in which the affected 339.28 beds are located. The commissioner may also make cost-neutral 339.29 transfers from the GRH fund to county human service agencies for 339.30 beds permanently removed from the GRH census under a plan 339.31 submitted by the county agency and approved by the 339.32 commissioner. The commissioner shall report the amount of any 339.33 transfers under this provision annually to the legislature. 339.34 (c) The provisions of paragraph (b) do not apply to a 339.35 facility that has its reimbursement rate established under 339.36 section 256B.431, subdivision 4, paragraph (c). 340.1 Sec. 52. Minnesota Statutes 2002, section 256I.05, 340.2 subdivision 7c, is amended to read: 340.3 Subd. 7c. [DEMONSTRATION PROJECT.] The commissioner is 340.4 authorized to pursue a demonstration project under federal food 340.5 stamp regulation for the purpose of gaining federal 340.6 reimbursement of food and nutritional costs currently paid by 340.7 the state group residential housing program. The commissioner 340.8 shall seek approval no later than January 1, 2004. Any 340.9 reimbursement received is nondedicated revenue to the general 340.10 fund. 340.11 Sec. 53. [514.991] [ALTERNATIVE CARE LIENS; DEFINITIONS.] 340.12 Subdivision 1. [APPLICABILITY.] The definitions in this 340.13 section apply to sections 514.991 to 514.995. 340.14 Subd. 2. [ALTERNATIVE CARE AGENCY, AGENCY, OR 340.15 DEPARTMENT.] "Alternative care agency," "agency," or "department" 340.16 means the department of human services when it pays for or 340.17 provides alternative care benefits for a nonmedical assistance 340.18 recipient directly or through a county social services agency 340.19 under chapter 256B according to section 256B.0913. 340.20 Subd. 3. [ALTERNATIVE CARE BENEFIT OR 340.21 BENEFITS.] "Alternative care benefit" or "benefits" means a 340.22 benefit provided to a nonmedical assistance recipient under 340.23 chapter 256B according to section 256B.0913. 340.24 Subd. 4. [ALTERNATIVE CARE RECIPIENT OR 340.25 RECIPIENT.] "Alternative care recipient" or "recipient" means a 340.26 person who receives alternative care grant benefits. 340.27 Subd. 5. [ALTERNATIVE CARE LIEN OR LIEN.] "Alternative 340.28 care lien" or "lien" means a lien filed under sections 514.992 340.29 to 514.995. 340.30 [EFFECTIVE DATE.] This section is effective July 1, 2003, 340.31 for services for persons first enrolling in the alternative care 340.32 program on or after that date and on the first day of the first 340.33 eligibility renewal period for persons enrolled in the 340.34 alternative care program prior to July 1, 2003. 340.35 Sec. 54. [514.992] [ALTERNATIVE CARE LIEN.] 340.36 Subdivision 1. [PROPERTY SUBJECT TO LIEN; LIEN AMOUNT.] (a) 341.1 Subject to sections 514.991 to 514.995, payments made by an 341.2 alternative care agency to provide benefits to a recipient or to 341.3 the recipient's spouse who owns property in this state 341.4 constitute a lien in favor of the agency on all real property 341.5 the recipient owns at and after the time the benefits are first 341.6 paid. 341.7 (b) The amount of the lien is limited to benefits paid for 341.8 services provided to recipients over 55 years of age and 341.9 provided on and after July 1, 2003. 341.10 Subd. 2. [ATTACHMENT.] (a) A lien attaches to and becomes 341.11 enforceable against specific real property as of the date when 341.12 all of the following conditions are met: 341.13 (1) the agency has paid benefits for a recipient; 341.14 (2) the recipient has been given notice and an opportunity 341.15 for a hearing under paragraph (b); 341.16 (3) the lien has been filed as provided for in section 341.17 514.993 or memorialized on the certificate of title for the 341.18 property it describes; and 341.19 (4) all restrictions against enforcement have ceased to 341.20 apply. 341.21 (b) An agency may not file a lien until it has sent the 341.22 recipient, their authorized representative, or their legal 341.23 representative written notice of its lien rights by certified 341.24 mail, return receipt requested, or registered mail and there has 341.25 been an opportunity for a hearing under section 256.045. No 341.26 person other than the recipient shall have a right to a hearing 341.27 under section 256.045 prior to the time the lien is filed. The 341.28 hearing shall be limited to whether the agency has met all of 341.29 the prerequisites for filing the lien and whether any of the 341.30 exceptions in this section apply. 341.31 (c) An agency may not file a lien against the recipient's 341.32 homestead when any of the following exceptions apply: 341.33 (1) while the recipient's spouse is also physically present 341.34 and lawfully and continuously residing in the homestead; 341.35 (2) a child of the recipient who is under age 21 or who is 341.36 blind or totally and permanently disabled according to 342.1 supplemental security income criteria is also physically present 342.2 on the property and lawfully and continuously residing on the 342.3 property from and after the date the recipient first receives 342.4 benefits; 342.5 (3) a child of the recipient who has also lawfully and 342.6 continuously resided on the property for a period beginning at 342.7 least two years before the first day of the month in which the 342.8 recipient began receiving alternative care, and who provided 342.9 uncompensated care to the recipient which enabled the recipient 342.10 to live without alternative care services for the two-year 342.11 period; 342.12 (4) a sibling of the recipient who has an ownership 342.13 interest in the property of record in the office of the county 342.14 recorder or registrar of titles for the county in which the real 342.15 property is located and who has also continuously occupied the 342.16 homestead for a period of at least one year immediately prior to 342.17 the first day of the first month in which the recipient received 342.18 benefits and continuously since that date. 342.19 (d) A lien only applies to the real property it describes. 342.20 Subd. 3. [CONTINUATION OF LIEN.] A lien remains effective 342.21 from the time it is filed until it is paid, satisfied, 342.22 discharged, or becomes unenforceable under sections 514.991 to 342.23 514.995. 342.24 Subd. 4. [PRIORITY OF LIEN.] (a) A lien which attaches to 342.25 the real property it describes is subject to the rights of 342.26 anyone else whose interest in the real property is perfected of 342.27 record before the lien has been recorded or filed under section 342.28 514.993, including: 342.29 (1) an owner, other than the recipient or the recipient's 342.30 spouse; 342.31 (2) a good faith purchaser for value without notice of the 342.32 lien; 342.33 (3) a holder of a mortgage or security interest; or 342.34 (4) a judgment lien creditor whose judgment lien has 342.35 attached to the recipient's interest in the real property. 342.36 (b) The rights of the other person have the same 343.1 protections against an alternative care lien as are afforded 343.2 against a judgment lien that arises out of an unsecured 343.3 obligation and arises as of the time of the filing of an 343.4 alternative care grant lien under section 514.993. The lien 343.5 shall be inferior to a lien for property taxes and special 343.6 assessments and shall be superior to all other matters first 343.7 appearing of record after the time and date the lien is filed or 343.8 recorded. 343.9 Subd. 5. [SETTLEMENT, SUBORDINATION, AND RELEASE.] (a) An 343.10 agency may, with absolute discretion, settle or subordinate the 343.11 lien to any other lien or encumbrance of record upon the terms 343.12 and conditions it deems appropriate. 343.13 (b) The agency filing the lien shall release and discharge 343.14 the lien: 343.15 (1) if it has been paid, discharged, or satisfied; 343.16 (2) if it has received reimbursement for the amounts 343.17 secured by the lien, has entered into a binding and legally 343.18 enforceable agreement under which it is reimbursed for the 343.19 amount of the lien, or receives other collateral sufficient to 343.20 secure payment of the lien; 343.21 (3) against some, but not all, of the property it describes 343.22 upon the terms, conditions, and circumstances the agency deems 343.23 appropriate; 343.24 (4) to the extent it cannot be lawfully enforced against 343.25 the property it describes because of an error, omission, or 343.26 other material defect in the legal description contained in the 343.27 lien or a necessary prerequisite to enforcement of the lien; and 343.28 (5) if, in its discretion, it determines the filing or 343.29 enforcement of the lien is contrary to the public interest. 343.30 (c) The agency executing the lien shall execute and file 343.31 the release as provided for in section 514.993, subdivision 2. 343.32 Subd. 6. [LENGTH OF LIEN.] (a) A lien shall be a lien on 343.33 the real property it describes for a period of ten years from 343.34 the date it attaches according to subdivision 2, paragraph (a), 343.35 except as otherwise provided for in sections 514.992 to 343.36 514.995. The agency filing the lien may renew the lien for one 344.1 additional ten-year period from the date it would otherwise 344.2 expire by recording or filing a certificate of renewal before 344.3 the lien expires. The certificate of renewal shall be recorded 344.4 or filed in the office of the county recorder or registrar of 344.5 titles for the county in which the lien is recorded or filed. 344.6 The certificate must refer to the recording or filing data for 344.7 the lien it renews. The certificate need not be attested, 344.8 certified, or acknowledged as a condition for recording or 344.9 filing. The recorder or registrar of titles shall record, file, 344.10 index, and return the certificate of renewal in the same manner 344.11 provided for liens in section 514.993, subdivision 2. 344.12 (b) An alternative care lien is not enforceable against the 344.13 real property of an estate to the extent there is a 344.14 determination by a court of competent jurisdiction, or by an 344.15 officer of the court designated for that purpose, that there are 344.16 insufficient assets in the estate to satisfy the lien in whole 344.17 or in part because of the homestead exemption under section 344.18 256B.15, subdivision 4, the rights of a surviving spouse or a 344.19 minor child under section 524.2-403, paragraphs (a) and (b), or 344.20 claims with a priority under section 524.3-805, paragraph (a), 344.21 clauses (1) to (4). For purposes of this section, the rights of 344.22 the decedent's adult children to exempt property under section 344.23 524.2-403, paragraph (b), shall not be considered costs of 344.24 administration under section 524.3-805, paragraph (a), clause 344.25 (1). 344.26 [EFFECTIVE DATE.] This section is effective July 1, 2003, 344.27 for services for persons first enrolling in the alternative care 344.28 program on or after that date and on the first day of the first 344.29 eligibility renewal period for persons enrolled in the 344.30 alternative care program prior to July 1, 2003. 344.31 Sec. 55. [514.993] [LIEN; CONTENTS AND FILING.] 344.32 Subdivision 1. [CONTENTS.] A lien shall be dated and must 344.33 contain: 344.34 (1) the recipient's full name, last known address, and 344.35 social security number; 344.36 (2) a statement that benefits have been paid to or for the 345.1 recipient's benefit; 345.2 (3) a statement that all of the recipient's interests in 345.3 the in the real property described in the lien may be subject to 345.4 or affected by the agency's right to reimbursement for benefits; 345.5 (4) a legal description of the real property subject to the 345.6 lien and whether it is registered or abstract property; 345.7 (5) such other contents, if any, as the agency deems 345.8 appropriate. 345.9 Subd. 2. [FILING.] Any lien, release, or other document 345.10 required or permitted to be filed under sections 514.991 to 345.11 514.995 must be recorded or filed in the office of the county 345.12 recorder or registrar of titles, as appropriate, in the county 345.13 where the real property is located. Notwithstanding section 345.14 386.77, the agency shall pay the applicable filing fee for any 345.15 documents filed under sections 514.991 to 514.995. An 345.16 attestation, certification, or acknowledgment is not required as 345.17 a condition of filing. If the property described in the lien is 345.18 registered property, the registrar of titles shall record it on 345.19 the certificate of title for each parcel of property described 345.20 in the lien. If the property described in the lien is abstract 345.21 property, the recorder shall file the lien in the county's 345.22 grantor-grantee indexes and any tract indexes the county 345.23 maintains for each parcel of property described in the lien. 345.24 The recorder or registrar shall return the recorded or filed 345.25 lien to the agency at no cost. If the agency provides a 345.26 duplicate copy of the lien, the recorder or registrar of titles 345.27 shall show the recording or filing data on the copy and return 345.28 it to the agency at no cost. The agency is responsible for 345.29 filing any lien, release, or other documents under sections 345.30 514.991 to 514.995. 345.31 [EFFECTIVE DATE.] This section is effective July 1, 2003, 345.32 for services for persons first enrolling in the alternative care 345.33 program on or after that date and on the first day of the first 345.34 eligibility renewal period for persons enrolled in the 345.35 alternative care program prior to July 1, 2003. 345.36 Sec. 56. [514.994] [ENFORCEMENT; OTHER REMEDIES.] 346.1 Subdivision 1. [FORECLOSURE OR ENFORCEMENT OF LIEN.] The 346.2 agency may enforce or foreclose a lien filed under sections 346.3 514.991 to 514.995 in the manner provided for by law for 346.4 enforcement of judgment liens against real estate or by a 346.5 foreclosure by action under chapter 581. The lien shall remain 346.6 enforceable as provided for in sections 514.991 to 514.995 346.7 notwithstanding any laws limiting the enforceability of 346.8 judgments. 346.9 Subd. 2. [HOMESTEAD EXEMPTION.] The lien may not be 346.10 enforced against the homestead property of the recipient or the 346.11 spouse while they physically occupy it as their lawful residence. 346.12 Subd. 3. [AGENCY CLAIM OR REMEDY.] Sections 514.992 to 346.13 514.995 do not limit the agency's right to file a claim against 346.14 the recipient's estate or the estate of the recipient's spouse, 346.15 do not limit any other claims for reimbursement the agency may 346.16 have, and do not limit the availability of any other remedy to 346.17 the agency. 346.18 [EFFECTIVE DATE.] This section is effective July 1, 2003, 346.19 for services for persons first enrolling in the alternative care 346.20 program on or after that date and on the first day of the first 346.21 eligibility renewal period for persons enrolled in the 346.22 alternative care program prior to July 1, 2003. 346.23 Sec. 57. [514.995] [AMOUNTS RECEIVED TO SATISFY LIEN.] 346.24 Amounts the agency receives to satisfy the lien must be 346.25 deposited in the state treasury and credited to the fund from 346.26 which the benefits were paid. 346.27 [EFFECTIVE DATE.] This section is effective July 1, 2003, 346.28 for services for persons first enrolling in the alternative care 346.29 program on or after that date and on the first day of the first 346.30 eligibility renewal period for persons enrolled in the 346.31 alternative care program prior to July 1, 2003. 346.32 Sec. 58. Minnesota Statutes 2002, section 524.3-805, is 346.33 amended to read: 346.34 524.3-805 [CLASSIFICATION OF CLAIMS.] 346.35 (a) If the applicable assets of the estate are insufficient 346.36 to pay all claims in full, the personal representative shall 347.1 make payment in the following order: 347.2 (1) costs and expenses of administration; 347.3 (2) reasonable funeral expenses; 347.4 (3) debts and taxes with preference under federal law; 347.5 (4) reasonable and necessary medical, hospital, or nursing 347.6 home expenses of the last illness of the decedent, including 347.7 compensation of persons attending the decedent, a claim filed 347.8 under section 256B.15 for recovery of expenditures for 347.9 alternative care for nonmedical assistance recipients under 347.10 section 256B.0913, and including a claim filed pursuant to 347.11 section 256B.15; 347.12 (5) reasonable and necessary medical, hospital, and nursing 347.13 home expenses for the care of the decedent during the year 347.14 immediately preceding death; 347.15 (6) debts with preference under other laws of this state, 347.16 and state taxes; 347.17 (7) all other claims. 347.18 (b) No preference shall be given in the payment of any 347.19 claim over any other claim of the same class, and a claim due 347.20 and payable shall not be entitled to a preference over claims 347.21 not due, except that if claims for expenses of the last illness 347.22 involve only claims filed under section 256B.15 for recovery of 347.23 expenditures for alternative care for nonmedical assistance 347.24 recipients under section 256B.0913, section 246.53 for costs of 347.25 state hospital care and claims filed under section 256B.15, 347.26 claims filed to recover expenditures for alternative care for 347.27 nonmedical assistance recipients under section 256B.0913 shall 347.28 have preference over claims filed under both sections 246.53 and 347.29 other claims filed under section 256B.15, and claims filed under 347.30 section 246.53 have preference over claims filed under section 347.31 256B.15 for recovery of amounts other than those for 347.32 expenditures for alternative care for nonmedical assistance 347.33 recipients under section 256B.0913. 347.34 [EFFECTIVE DATE.] This section is effective July 1, 2003, 347.35 for decedents dying on or after that date. 347.36 Sec. 59. [IMPOSITION OF FEDERAL CERTIFICATION REMEDIES.] 348.1 The commissioner of health shall seek changes in the 348.2 federal policy that mandates the imposition of federal sanctions 348.3 without providing an opportunity for a nursing facility to 348.4 correct deficiencies, solely as the result of previous 348.5 deficiencies issued to the nursing facility. 348.6 [EFFECTIVE DATE.] This section is effective July 1, 2003. 348.7 Sec. 60. [REPORT ON LONG-TERM CARE.] 348.8 The report on long-term care services required under 348.9 Minnesota Statutes, section 144A.351, that is presented to the 348.10 legislature by January 15, 2004, must also address the 348.11 feasibility of offering government or private sector loans or 348.12 lines of credit to individuals age 65 and over, for the purchase 348.13 of long-term care services. 348.14 Sec. 61. [REPORTS; POTENTIAL SAVINGS TO STATE FROM CERTAIN 348.15 LONG-TERM CARE INSURANCE PURCHASE INCENTIVES.] 348.16 Subdivision 1. [LONG-TERM CARE INSURANCE 348.17 PARTNERSHIPS.] The commissioner of human services, in 348.18 consultation with the commissioner of commerce, shall report to 348.19 the legislature by January 15, 2004, on the feasibility of 348.20 Minnesota adopting a long-term care insurance partnership 348.21 program similar to those adopted in other states. In such a 348.22 program, the state would encourage purchase of private long-term 348.23 care insurance by permitting the insured to retain assets in 348.24 excess of those otherwise permitted for medical assistance 348.25 eligibility, if the insured later exhausts the private long-term 348.26 care insurance benefits. The report must include the 348.27 feasibility of obtaining any necessary federal waiver. The 348.28 report must comply with Minnesota Statutes, sections 3.195 and 348.29 3.197. 348.30 Subd. 2. [USE OF MEDICAL ASSISTANCE FUNDS TO SUBSIDIZE 348.31 PURCHASE OF LONG-TERM CARE INSURANCE.] The commissioner of human 348.32 services shall report to the legislature by January 15, 2004, on 348.33 the feasibility of using state medical assistance funds to 348.34 subsidize the purchase of private long-term care insurance by 348.35 individuals who would be unlikely to purchase it without a 348.36 subsidy, in order to generate long-term savings of medical 349.1 assistance expenditures. The report must comply with Minnesota 349.2 Statutes, sections 3.195 and 3.197. 349.3 Subd. 3. [NURSING FACILITY BENEFITS IN MEDICARE SUPPLEMENT 349.4 COVERAGE.] The commissioner of human services must study and 349.5 quantify the cost or savings to the state if a nursing facility 349.6 benefit were added to Medicare-related coverage, as defined in 349.7 Minnesota Statutes, section 62Q.01, subdivision 6. The 349.8 commissioner shall report to the legislature by January 15, 349.9 2004. The report must comply with Minnesota Statutes, sections 349.10 3.195 and 3.197. 349.11 [EFFECTIVE DATE.] This section is effective July 1, 2003. 349.12 Sec. 62. [REVISOR'S INSTRUCTION.] 349.13 For sections in Minnesota Statutes and Minnesota Rules 349.14 affected by the repealed sections in this article, the revisor 349.15 shall delete internal cross-references where appropriate and 349.16 make changes necessary to correct the punctuation, grammar, or 349.17 structure of the remaining text and preserve its meaning. 349.18 Sec. 63. [REPEALER.] 349.19 (a) Minnesota Statutes 2002, sections 256.973; 256.9772; 349.20 256B.0928; and 256B.437, subdivision 2, are repealed effective 349.21 July 1, 2003. 349.22 (b) Minnesota Statutes 2002, sections 62J.66; 62J.68; 349.23 144A.071, subdivision 5; and 144A.35, are repealed. 349.24 (c) Laws 1998, chapter 407, article 4, section 63, is 349.25 repealed. 349.26 (d) Minnesota Rules, parts 9505.3045; 9505.3050; 9505.3055; 349.27 9505.3060; 9505.3068; 9505.3070; 9505.3075; 9505.3080; 349.28 9505.3090; 9505.3095; 9505.3100; 9505.3105; 9505.3107; 349.29 9505.3110; 9505.3115; 9505.3120; 9505.3125; 9505.3130; 349.30 9505.3138; 9505.3139; 9505.3140; 9505.3680; 9505.3690; and 349.31 9505.3700, are repealed effective July 1, 2003. 349.32 ARTICLE 4 349.33 CONTINUING CARE FOR PERSONS WITH DISABILITIES 349.34 Section 1. Minnesota Statutes 2002, section 174.30, 349.35 subdivision 1, is amended to read: 349.36 Subdivision 1. [APPLICABILITY.] (a) The operating 350.1 standards for special transportation service adopted under this 350.2 section do not apply to special transportation provided by: 350.3 (1) a common carrier operating on fixed routes and 350.4 schedules; 350.5 (2) a volunteer driver using a private automobile; 350.6 (3) a school bus as defined in section 169.01, subdivision 350.7 6; or 350.8 (4) an emergency ambulance regulated under chapter 144. 350.9 (b) The operating standards adopted under this section only 350.10 apply to providers of special transportation service who receive 350.11 grants or other financial assistance from either the state or 350.12 the federal government, or both, to provide or assist in 350.13 providing that service; except that the operating standards 350.14 adopted under this section do not apply to any nursing home 350.15 licensed under section 144A.02, to any board and care facility 350.16 licensed under section 144.50, or to any day training and 350.17 habilitation services, day care, or group home facility licensed 350.18 under sections 245A.01 to 245A.19 unless the facility or program 350.19 provides transportation to nonresidents on a regular basis and 350.20 the facility receives reimbursement, other than per diem 350.21 payments, for that service under rules promulgated by the 350.22 commissioner of human services. 350.23 (c) Notwithstanding paragraph (b), the operating standards 350.24 adopted under this section do not apply to any vendor of 350.25 services licensed under chapter 245B that provides 350.26 transportation services to consumers or residents of other 350.27 vendors licensed under chapter 245B. 350.28 Sec. 2. Minnesota Statutes 2002, section 245B.06, 350.29 subdivision 8, is amended to read: 350.30 Subd. 8. [LEAVING THE RESIDENCE.] As specified in each 350.31 consumer's individual service plan, each consumer requiring a 350.32 24-hour plan of caremustmay leave the residence to participate 350.33 in regular education, employment, or community activities. 350.34 License holders, providing services to consumers living in a 350.35 licensed site, shall ensure that they are prepared to care for 350.36 consumers whenever they are at the residence during the day 351.1 because of illness, work schedules, or other reasons. 351.2 Sec. 3. Minnesota Statutes 2002, section 245B.07, 351.3 subdivision 11, is amended to read: 351.4 Subd. 11. [TRAVEL TIME TO AND FROM A DAY TRAINING AND 351.5 HABILITATION SITE.] Except in unusual circumstances, the license 351.6 holder must not transport a consumer receiving services for 351.7 longer thanone hour90 minutes per one-way trip. Nothing in 351.8 this subdivision relieves the provider of the obligation to 351.9 provide the number of program hours as identified in the 351.10 individualized service plan. 351.11 Sec. 4. Minnesota Statutes 2002, section 246.54, is 351.12 amended to read: 351.13 246.54 [LIABILITY OF COUNTY; REIMBURSEMENT.] 351.14 Subdivision 1. [COUNTY PORTION FOR COST OF CARE.] Except 351.15 for chemical dependency services provided under sections 254B.01 351.16 to 254B.09, the client's county shall pay to the state of 351.17 Minnesota a portion of the cost of care provided in a regional 351.18 treatment center or a state nursing facility to a client legally 351.19 settled in that county. A county's payment shall be made from 351.20 the county's own sources of revenue and payments shall be paid 351.21 as follows: payments to the state from the county shall 351.22 equalten20 percent of the cost of care, as determined by the 351.23 commissioner, for each day, or the portion thereof, that the 351.24 client spends at a regional treatment center or a state nursing 351.25 facility. If payments received by the state under sections 351.26 246.50 to 246.53 exceed9080 percent of the cost of care, the 351.27 county shall be responsible for paying the state only the 351.28 remaining amount. The county shall not be entitled to 351.29 reimbursement from the client, the client's estate, or from the 351.30 client's relatives, except as provided in section 246.53. No 351.31 such payments shall be made for any client who was last 351.32 committed prior to July 1, 1947. 351.33 Subd. 2. [EXCEPTIONS.] Subdivision 1 does not apply to 351.34 services provided at the Minnesota security hospital, the 351.35 Minnesota sex offender program, or the Minnesota extended 351.36 treatment options program. For services at these facilities, a 352.1 county's payment shall be made from the county's own sources of 352.2 revenue and payments shall be paid as follows: payments to the 352.3 state from the county shall equal ten percent of the cost of 352.4 care, as determined by the commissioner, for each day, or the 352.5 portion thereof, that the client spends at the facility. If 352.6 payments received by the state under sections 246.50 to 246.53 352.7 exceed 90 percent of the cost of care, the county shall be 352.8 responsible for paying the state only the remaining amount. The 352.9 county shall not be entitled to reimbursement from the client, 352.10 the client's estate, or from the client's relatives, except as 352.11 provided in section 246.53. 352.12 [EFFECTIVE DATE.] This section is effective January 1, 2004. 352.13 Sec. 5. Minnesota Statutes 2002, section 252.32, 352.14 subdivision 1, is amended to read: 352.15 Subdivision 1. [PROGRAM ESTABLISHED.] In accordance with 352.16 state policy established in section 256F.01 that all children 352.17 are entitled to live in families that offer safe, nurturing, 352.18 permanent relationships, and that public services be directed 352.19 toward preventing the unnecessary separation of children from 352.20 their families, and because many families who have children with 352.21mental retardation or related conditionsdisabilities have 352.22 special needs and expenses that other families do not have, the 352.23 commissioner of human services shall establish a program to 352.24 assist families who havedependentsdependent children with 352.25mental retardation or related conditionsdisabilities living in 352.26 their home. The program shall make support grants available to 352.27 the families. 352.28 Sec. 6. Minnesota Statutes 2002, section 252.32, 352.29 subdivision 1a, is amended to read: 352.30 Subd. 1a. [SUPPORT GRANTS.] (a) Provision of support 352.31 grants must be limited to families who require support and whose 352.32 dependents are under the age of2221and who have mental352.33retardation or who have a related conditionand who have been 352.34determined by a screening team establishedcertified disabled 352.35 under section256B.092 to be at risk of352.36institutionalization256B.055, subdivision 12, paragraphs (a), 353.1 (b), (c), (d), and (e). Families who are receiving home and 353.2 community-based waivered services for persons with mental 353.3 retardation or related conditions are not eligible for support 353.4 grants. 353.5Families receiving grants who will be receiving home and353.6community-based waiver services for persons with mental353.7retardation or a related condition for their family member353.8within the grant year, and who have ongoing payments for353.9environmental or vehicle modifications which have been approved353.10by the county as a grant expense and would have qualified for353.11payment under this waiver may receive a onetime grant payment353.12from the commissioner to reduce or eliminate the principal of353.13the remaining debt for the modifications, not to exceed the353.14maximum amount allowable for the remaining years of eligibility353.15for a family support grant. The commissioner is authorized to353.16use up to $20,000 annually from the grant appropriation for this353.17purpose. Any amount unexpended at the end of the grant year353.18shall be allocated by the commissioner in accordance with353.19subdivision 3a, paragraph (b), clause (2).Families whose 353.20 annual adjusted gross income is $60,000 or more are not eligible 353.21 for support grants except in cases where extreme hardship is 353.22 demonstrated. Beginning in state fiscal year 1994, the 353.23 commissioner shall adjust the income ceiling annually to reflect 353.24 the projected change in the average value in the United States 353.25 Department of Labor Bureau of Labor Statistics consumer price 353.26 index (all urban) for that year. 353.27 (b) Support grants may be made available as monthly subsidy 353.28 grants and lump sum grants. 353.29 (c) Support grants may be issued in the form of cash, 353.30 voucher, and direct county payment to a vendor. 353.31 (d) Applications for the support grant shall be made by the 353.32 legal guardian to the county social service agency. The 353.33 application shall specify the needs of the families, the form of 353.34 the grant requested by the families, andthatthefamilies have353.35agreed to use the support grant foritems and serviceswithin353.36the designated reimbursable expense categories and354.1recommendations of the countyto be reimbursed. 354.2(e) Families who were receiving subsidies on the date of354.3implementation of the $60,000 income limit in paragraph (a)354.4continue to be eligible for a family support grant until354.5December 31, 1991, if all other eligibility criteria are met.354.6After December 31, 1991, these families are eligible for a grant354.7in the amount of one-half the grant they would otherwise354.8receive, for as long as they remain eligible under other354.9eligibility criteria.354.10 Sec. 7. Minnesota Statutes 2002, section 252.32, 354.11 subdivision 3, is amended to read: 354.12 Subd. 3. [AMOUNT OF SUPPORT GRANT; USE.] Support grant 354.13 amounts shall be determined by the county social service 354.14 agency.Each serviceServices anditemitems purchased with a 354.15 support grant must: 354.16 (1) be over and above the normal costs of caring for the 354.17 dependent if the dependent did not have a disability; 354.18 (2) be directly attributable to the dependent's disabling 354.19 condition; and 354.20 (3) enable the family to delay or prevent the out-of-home 354.21 placement of the dependent. 354.22 The design and delivery of services and items purchased 354.23 under this section must suit the dependent's chronological age 354.24 and be provided in the least restrictive environment possible, 354.25 consistent with the needs identified in the individual service 354.26 plan. 354.27 Items and services purchased with support grants must be 354.28 those for which there are no other public or private funds 354.29 available to the family. Fees assessed to parents for health or 354.30 human services that are funded by federal, state, or county 354.31 dollars are not reimbursable through this program. 354.32 In approving or denying applications, the county shall 354.33 consider the following factors: 354.34 (1) the extent and areas of the functional limitations of 354.35 the disabled child; 354.36 (2) the degree of need in the home environment for 355.1 additional support; and 355.2 (3) the potential effectiveness of the grant to maintain 355.3 and support the person in the family environment. 355.4 The maximum monthly grant amount shall be $250 per eligible 355.5 dependent, or $3,000 per eligible dependent per state fiscal 355.6 year, within the limits of available funds. The county social 355.7 service agency may consider the dependent's supplemental 355.8 security income in determining the amount of the support grant. 355.9The county social service agency may exceed $3,000 per state355.10fiscal year per eligible dependent for emergency circumstances355.11in cases where exceptional resources of the family are required355.12to meet the health, welfare-safety needs of the child.355.13County social service agencies shall continue to provide355.14funds to families receiving state grants on June 30, 1997, if355.15eligibility criteria continue to be met.Any adjustments to 355.16 their monthly grant amount must be based on the needs of the 355.17 family and funding availability. 355.18 Sec. 8. Minnesota Statutes 2002, section 252.32, 355.19 subdivision 3c, is amended to read: 355.20 Subd. 3c. [COUNTY BOARD RESPONSIBILITIES.] County boards 355.21 receiving funds under this section shall: 355.22 (1)determine the needs of families for services in355.23accordance with section 256B.092 or 256E.08 and any rules355.24adopted under those sections;submit a plan to the department 355.25 for the management of the family support grant program. The 355.26 plan must include the projected number of families the county 355.27 will serve and policies and procedures for: 355.28 (i) identifying potential families for the program; 355.29 (ii) grant distribution; 355.30 (iii) waiting list procedures; and 355.31 (iv) prioritization of families to receive grants; 355.32 (2) determine the eligibility of all persons proposed for 355.33 program participation; 355.34 (3) approve a plan for items and services to be reimbursed 355.35 and inform families of the county's approval decision; 355.36 (4) issue support grants directly to, or on behalf of, 356.1 eligible families; 356.2 (5) inform recipients of their right to appeal under 356.3 subdivision 3e; 356.4 (6) submit quarterly financial reports under subdivision 3b 356.5 and indicateon the screening documentsthe annual grant level 356.6 for each family, the families denied grants, and the families 356.7 eligible but waiting for funding; and 356.8 (7) coordinate services with other programs offered by the 356.9 county. 356.10 Sec. 9. Minnesota Statutes 2002, section 252.41, 356.11 subdivision 3, is amended to read: 356.12 Subd. 3. [DAY TRAINING AND HABILITATION SERVICES FOR 356.13 ADULTS WITH MENTAL RETARDATION, RELATED CONDITIONS.] "Day 356.14 training and habilitation services for adults with mental 356.15 retardation and related conditions" means services that: 356.16 (1) include supervision, training, assistance, and 356.17 supported employment, work-related activities, or other 356.18 community-integrated activities designed and implemented in 356.19 accordance with the individual service and individual 356.20 habilitation plans required under Minnesota Rules, parts 356.21 9525.0015 to 9525.0165, to help an adult reach and maintain the 356.22 highest possible level of independence, productivity, and 356.23 integration into the community; and 356.24 (2) are provided under contract with the county where the 356.25 services are delivered by a vendor licensed under sections 356.26 245A.01 to 245A.16 and 252.28, subdivision 2, to provide day 356.27 training and habilitation services; and356.28(3) are regularly provided to one or more adults with356.29mental retardation or related conditions in a place other than356.30the adult's own home or residence unless medically356.31contraindicated. 356.32 Day training and habilitation services reimbursable under 356.33 this section do not include special education and related 356.34 services as defined in the Education of the Handicapped Act, 356.35 United States Code, title 20, chapter 33, section 1401, clauses 356.36 (6) and (17), or vocational services funded under section 110 of 357.1 the Rehabilitation Act of 1973, United States Code, title 29, 357.2 section 720, as amended. 357.3 Sec. 10. Minnesota Statutes 2002, section 252.46, 357.4 subdivision 1, is amended to read: 357.5 Subdivision 1. [RATES.] (a) Payment rates to vendors, 357.6 except regional centers, for county-funded day training and 357.7 habilitation services and transportation provided to persons 357.8 receiving day training and habilitation services established by 357.9 a county board are governed by subdivisions 2 to 19. The 357.10 commissioner shall approve the following three payment rates for 357.11 services provided by a vendor: 357.12 (1) a full-day service rate for persons who receive at 357.13 least six service hours a day, including the time it takes to 357.14 transport the person to and from the service site; 357.15 (2) a partial-day service rate that must not exceed 75 357.16 percent of the full-day service rate for persons who receive 357.17 less than a full day of service; and 357.18 (3) a transportation rate for providing, or arranging and 357.19 paying for, transportation of a person to and from the person's 357.20 residence to the service site. 357.21(b) The commissioner may also approve an hourly job-coach,357.22follow-along rate for services provided by one employee at or en357.23route to or from community locations to supervise, support, and357.24assist one person receiving the vendor's services to learn357.25job-related skills necessary to obtain or retain employment when357.26and where no other persons receiving services are present and357.27when all the following criteria are met:357.28(1) the vendor requests and the county recommends the357.29optional rate;357.30(2) the service is prior authorized by the county on the357.31Medicaid Management Information System for no more than 414357.32hours in a 12-month period and the daily per person charge to357.33medical assistance does not exceed the vendor's approved full357.34day plus transportation rates;357.35(3) separate full day, partial day, and transportation357.36rates are not billed for the same person on the same day;358.1(4) the approved hourly rate does not exceed the sum of the358.2vendor's current average hourly direct service wage, including358.3fringe benefits and taxes, plus a component equal to the358.4vendor's average hourly nondirect service wage expenses; and358.5(5) the actual revenue received for provision of hourly358.6job-coach, follow-along services is subtracted from the vendor's358.7total expenses for the same time period and those adjusted358.8expenses are used for determining recommended full day and358.9transportation payment rates under subdivision 5 in accordance358.10with the limitations in subdivision 3.358.11 (b) Notwithstanding any law or rule to the contrary, the 358.12 commissioner may authorize county participation in a voluntary 358.13 individualized payment rate structure for day training and 358.14 habilitation services to allow a county the flexibility to 358.15 change, after consulting with providers, from a site-based 358.16 payment rate structure to an individual payment rate structure 358.17 for the providers of day training and habilitation services in 358.18 the county. The commissioner shall seek input from providers 358.19 and consumers in establishing procedures for determining the 358.20 structure of voluntary individualized payment rates to ensure 358.21 that there is no additional cost to the state or counties and 358.22 that the rate structure is cost-neutral to providers of day 358.23 training and habilitation services, on July 1, 2004, or on day 358.24 one of the individual rate structure, whichever is later. 358.25 (c) Medical assistance rates for home and community-based 358.26 service provided under section 256B.501, subdivision 4, by 358.27 licensed vendors of day training and habilitation services must 358.28 not be greater than the rates for the same services established 358.29 by counties under sections 252.40 to 252.46. For very dependent 358.30 persons with special needs the commissioner may approve an 358.31 exception to the approved payment rate under section 256B.501, 358.32 subdivision 4 or 8. 358.33 Sec. 11. Minnesota Statutes 2002, section 256.476, 358.34 subdivision 3, is amended to read: 358.35 Subd. 3. [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person 358.36 is eligible to apply for a consumer support grant if the person 359.1 meets all of the following criteria: 359.2 (1) the person is eligible for and has been approved to 359.3 receive services under medical assistance as determined under 359.4 sections 256B.055 and 256B.056 or the person has been approved 359.5 to receive a grant under the developmental disability family 359.6 support program under section 252.32; 359.7 (2) the person is able to direct and purchase the person's 359.8 own care and supports, or the person has a family member, legal 359.9 representative, or other authorized representative who can 359.10 purchase and arrange supports on the person's behalf; 359.11 (3) the person has functional limitations, requires ongoing 359.12 supports to live in the community, and is at risk of or would 359.13 continue institutionalization without such supports; and 359.14 (4) the person will live in a home. For the purpose of 359.15 this section, "home" means the person's own home or home of a 359.16 person's family member. These homes are natural home settings 359.17 and are not licensed by the department of health or human 359.18 services. 359.19 (b) Persons may not concurrently receive a consumer support 359.20 grant if they are: 359.21 (1) receivinghome and community-based services under359.22United States Code, title 42, section 1396h(c);personal care 359.23 attendant and home health aide services, or private duty nursing 359.24 under section 256B.0625; a developmental disability family 359.25 support grant; or alternative care services under section 359.26 256B.0913; or 359.27 (2) residing in an institutional or congregate care setting. 359.28 (c) A person or person's family receiving a consumer 359.29 support grant shall not be charged a fee or premium by a local 359.30 agency for participating in the program. 359.31 (d)The commissioner may limit the participation of359.32recipients of services from federal waiver programs in the359.33consumer support grant program if the participation of these359.34individuals will result in an increase in the cost to the359.35state.Individuals receiving home and community-based waivers 359.36 under United States Code, title 42, section 1396h(c), are not 360.1 eligible for the consumer support grant, except for individuals 360.2 receiving consumer support grants before July 1, 2003, as long 360.3 as other eligibility criteria are met. 360.4 (e) The commissioner shall establish a budgeted 360.5 appropriation each fiscal year for the consumer support grant 360.6 program. The number of individuals participating in the program 360.7 will be adjusted so the total amount allocated to counties does 360.8 not exceed the amount of the budgeted appropriation. The 360.9 budgeted appropriation will be adjusted annually to accommodate 360.10 changes in demand for the consumer support grants. 360.11 Sec. 12. Minnesota Statutes 2002, section 256.476, 360.12 subdivision 4, is amended to read: 360.13 Subd. 4. [SUPPORT GRANTS; CRITERIA AND LIMITATIONS.] (a) A 360.14 county board may choose to participate in the consumer support 360.15 grant program. If a county has not chosen to participate by 360.16 July 1, 2002, the commissioner shall contract with another 360.17 county or other entity to provide access to residents of the 360.18 nonparticipating county who choose the consumer support grant 360.19 option. The commissioner shall notify the county board in a 360.20 county that has declined to participate of the commissioner's 360.21 intent to enter into a contract with another county or other 360.22 entity at least 30 days in advance of entering into the 360.23 contract. The local agency shall establish written procedures 360.24 and criteria to determine the amount and use of support grants. 360.25 These procedures must include, at least, the availability of 360.26 respite care, assistance with daily living, and adaptive aids. 360.27 The local agency may establish monthly or annual maximum amounts 360.28 for grants and procedures where exceptional resources may be 360.29 required to meet the health and safety needs of the person on a 360.30 time-limited basis, however, the total amount awarded to each 360.31 individual may not exceed the limits established in subdivision 360.32 11. 360.33 (b) Support grants to a person or a person's family will be 360.34 provided through a monthly subsidy payment and be in the form of 360.35 cash, voucher, or direct county payment to vendor. Support 360.36 grant amounts must be determined by the local agency. Each 361.1 service and item purchased with a support grant must meet all of 361.2 the following criteria: 361.3 (1) it must be over and above the normal cost of caring for 361.4 the person if the person did not have functional limitations; 361.5 (2) it must be directly attributable to the person's 361.6 functional limitations; 361.7 (3) it must enable the person or the person's family to 361.8 delay or prevent out-of-home placement of the person; and 361.9 (4) it must be consistent with the needs identified in the 361.10 serviceplanagreement, when applicable. 361.11 (c) Items and services purchased with support grants must 361.12 be those for which there are no other public or private funds 361.13 available to the person or the person's family. Fees assessed 361.14 to the person or the person's family for health and human 361.15 services are not reimbursable through the grant. 361.16 (d) In approving or denying applications, the local agency 361.17 shall consider the following factors: 361.18 (1) the extent and areas of the person's functional 361.19 limitations; 361.20 (2) the degree of need in the home environment for 361.21 additional support; and 361.22 (3) the potential effectiveness of the grant to maintain 361.23 and support the person in the family environment or the person's 361.24 own home. 361.25 (e) At the time of application to the program or screening 361.26 for other services, the person or the person's family shall be 361.27 provided sufficient information to ensure an informed choice of 361.28 alternatives by the person, the person's legal representative, 361.29 if any, or the person's family. The application shall be made 361.30 to the local agency and shall specify the needs of the person 361.31 and family, the form and amount of grant requested, the items 361.32 and services to be reimbursed, and evidence of eligibility for 361.33 medical assistance. 361.34 (f) Upon approval of an application by the local agency and 361.35 agreement on a support plan for the person or person's family, 361.36 the local agency shall make grants to the person or the person's 362.1 family. The grant shall be in an amount for the direct costs of 362.2 the services or supports outlined in the service agreement. 362.3 (g) Reimbursable costs shall not include costs for 362.4 resources already available, such as special education classes, 362.5 day training and habilitation, case management, other services 362.6 to which the person is entitled, medical costs covered by 362.7 insurance or other health programs, or other resources usually 362.8 available at no cost to the person or the person's family. 362.9 (h) The state of Minnesota, the county boards participating 362.10 in the consumer support grant program, or the agencies acting on 362.11 behalf of the county boards in the implementation and 362.12 administration of the consumer support grant program shall not 362.13 be liable for damages, injuries, or liabilities sustained 362.14 through the purchase of support by the individual, the 362.15 individual's family, or the authorized representative under this 362.16 section with funds received through the consumer support grant 362.17 program. Liabilities include but are not limited to: workers' 362.18 compensation liability, the Federal Insurance Contributions Act 362.19 (FICA), or the Federal Unemployment Tax Act (FUTA). For 362.20 purposes of this section, participating county boards and 362.21 agencies acting on behalf of county boards are exempt from the 362.22 provisions of section 268.04. 362.23 Sec. 13. Minnesota Statutes 2002, section 256.476, 362.24 subdivision 5, is amended to read: 362.25 Subd. 5. [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a) 362.26 For the purpose of transferring persons to the consumer support 362.27 grant program fromspecific programs or services, such asthe 362.28 developmental disability family support program and personal 362.29 care assistant services, home health aide services, or private 362.30 duty nursing services, the amount of funds transferred by the 362.31 commissioner between the developmental disability family support 362.32 program account, the medical assistance account, or the consumer 362.33 support grant account shall be based on each county's 362.34 participation in transferring persons to the consumer support 362.35 grant program from those programs and services. 362.36 (b) At the beginning of each fiscal year, county 363.1 allocations for consumer support grants shall be based on: 363.2 (1) the number of persons to whom the county board expects 363.3 to provide consumer supports grants; 363.4 (2) their eligibility for current program and services; 363.5 (3) the amount of nonfederal dollars allowed under 363.6 subdivision 11; and 363.7 (4) projected dates when persons will start receiving 363.8 grants. County allocations shall be adjusted periodically by 363.9 the commissioner based on the actual transfer of persons or 363.10 service openings, and the nonfederal dollars associated with 363.11 those persons or service openings, to the consumer support grant 363.12 program. 363.13 (c) The amount of funds transferred by the commissioner 363.14 from the medical assistance account for an individual may be 363.15 changed if it is determined by the county or its agent that the 363.16 individual's need for support has changed. 363.17 (d) The authority to utilize funds transferred to the 363.18 consumer support grant account for the purposes of implementing 363.19 and administering the consumer support grant program will not be 363.20 limited or constrained by the spending authority provided to the 363.21 program of origination. 363.22 (e) The commissioner may use up to five percent of each 363.23 county's allocation, as adjusted, for payments for 363.24 administrative expenses, to be paid as a proportionate addition 363.25 to reported direct service expenditures. 363.26 (f) The county allocation for each individual or 363.27 individual's family cannot exceed the amount allowed under 363.28 subdivision 11. 363.29 (g) The commissioner may recover, suspend, or withhold 363.30 payments if the county board, local agency, or grantee does not 363.31 comply with the requirements of this section. 363.32 (h) Grant funds unexpended by consumers shall return to the 363.33 state once a year. The annual return of unexpended grant funds 363.34 shall occur in the quarter following the end of the state fiscal 363.35 year. 363.36 Sec. 14. Minnesota Statutes 2002, section 256.482, 364.1 subdivision 8, is amended to read: 364.2 Subd. 8. [SUNSET.] Notwithstanding section 15.059, 364.3 subdivision 5, the council on disability shall not sunset until 364.4 June 30,20032007. 364.5 [EFFECTIVE DATE.] This section is effective May 30, 2003. 364.6 Sec. 15. Minnesota Statutes 2002, section 256B.0621, 364.7 subdivision 4, is amended to read: 364.8 Subd. 4. [RELOCATION TARGETED CASE MANAGEMENT PROVIDER 364.9 QUALIFICATIONS.]The following qualifications and certification364.10standards must be met by providers of relocation targeted case364.11management:364.12(a) The commissioner must certify each provider of364.13relocation targeted case management before enrollment. The364.14certification process shall examine the provider's ability to364.15meet the requirements in this subdivision and other federal and364.16state requirements of this service. A certified relocation364.17targeted case management provider may subcontract with another364.18provider to deliver relocation targeted case management364.19services. Subcontracted providers must demonstrate the ability364.20to provide the services outlined in subdivision 6.364.21(b)(a) A relocation targeted case management provider is 364.22 an enrolled medical assistance provider who is determined by the 364.23 commissioner to have all of the following characteristics: 364.24 (1) the legal authority to provide public welfare under 364.25 sections 393.01, subdivision 7; and 393.07; or a federally 364.26 recognized Indian tribe; 364.27 (2) the demonstrated capacity and experience to provide the 364.28 components of case management to coordinate and link community 364.29 resources needed by the eligible population; 364.30 (3) the administrative capacity and experience to serve the 364.31 target population for whom it will provide services and ensure 364.32 quality of services under state and federal requirements; 364.33 (4) the legal authority to provide complete investigative 364.34 and protective services under section 626.556, subdivision 10; 364.35 and child welfare and foster care services under section 393.07, 364.36 subdivisions 1 and 2; or a federally recognized Indian tribe; 365.1 (5) a financial management system that provides accurate 365.2 documentation of services and costs under state and federal 365.3 requirements; and 365.4 (6) the capacity to document and maintain individual case 365.5 records under state and federal requirements. 365.6 (b) A provider of targeted case management under section 365.7 256B.0625, subdivision 20, may be deemed a certified provider of 365.8 relocation targeted case management. 365.9 (c) A relocation targeted case management provider may 365.10 subcontract with another provider to deliver relocation targeted 365.11 case management services. Subcontracted providers must 365.12 demonstrate the ability to provide the services outlined in 365.13 subdivision 6, and have a procedure in place that notifies the 365.14 recipient and the recipient's legal representative of any 365.15 conflict of interest if the contracted targeted case management 365.16 provider also provides, or will provide, the recipient's 365.17 services and supports. Contracted providers must provide 365.18 information on all conflicts of interest and obtain the 365.19 recipient's informed consent or provide the recipient with 365.20 alternatives. 365.21 Sec. 16. [256B.0622] [INTENSIVE REHABILITATIVE MENTAL 365.22 HEALTH SERVICES.] 365.23 Subdivision 1. [SCOPE.] Subject to federal approval, 365.24 medical assistance covers medically necessary, intensive 365.25 nonresidential and residential rehabilitative mental health 365.26 services as defined in subdivision 2, for recipients as defined 365.27 in subdivision 3, when the services are provided by an entity 365.28 meeting the standards in this section. 365.29 Subd. 2. [DEFINITIONS.] For purposes of this section, the 365.30 following terms have the meanings given them. 365.31 (a) "Intensive nonresidential rehabilitative mental health 365.32 services" means adult rehabilitative mental health services as 365.33 defined in section 256B.0623, subdivision 2, paragraph (a), 365.34 except that these services are provided by a multidisciplinary 365.35 staff using a total team approach consistent with assertive 365.36 community treatment, the Fairweather Lodge treatment model, and 366.1 other evidence-based practices, and directed to recipients with 366.2 a serious mental illness who require intensive services. 366.3 (b) "Intensive residential rehabilitative mental health 366.4 services" means short-term, time-limited services provided in a 366.5 residential setting to recipients who are in need of more 366.6 restrictive settings and are at risk of significant functional 366.7 deterioration if they do not receive these services. Services 366.8 are designed to develop and enhance psychiatric stability, 366.9 personal and emotional adjustment, self-sufficiency, and skills 366.10 to live in a more independent setting. Services must be 366.11 directed toward a targeted discharge date with specified client 366.12 outcomes and must be consistent with evidence-based practices. 366.13 (c) "Evidence-based practices" are nationally recognized 366.14 mental health services that are proven by substantial research 366.15 to be effective in helping individuals with serious mental 366.16 illness obtain specific treatment goals. 366.17 (d) "Overnight staff" means a member of the intensive 366.18 residential rehabilitative mental health treatment team who is 366.19 responsible during hours when recipients are typically asleep. 366.20 (e) "Treatment team" means all staff who provide services 366.21 under this section to recipients. At a minimum, this includes 366.22 the clinical supervisor, mental health professionals, mental 366.23 health practitioners, and mental health rehabilitation workers. 366.24 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 366.25 individual who: 366.26 (1) is age 18 or older; 366.27 (2) is eligible for medical assistance; 366.28 (3) is diagnosed with a mental illness; 366.29 (4) because of a mental illness, has substantial disability 366.30 and functional impairment in three or more of the areas listed 366.31 in section 245.462, subdivision 11a, so that self-sufficiency is 366.32 markedly reduced; 366.33 (5) has one or more of the following: a history of two or 366.34 more inpatient hospitalizations in the past year, significant 366.35 independent living instability, homelessness, or very frequent 366.36 use of mental health and related services yielding poor 367.1 outcomes; and 367.2 (6) in the written opinion of a licensed mental health 367.3 professional, has the need for mental health services that 367.4 cannot be met with other available community-based services, or 367.5 is likely to experience a mental health crisis or require a more 367.6 restrictive setting if intensive rehabilitative mental health 367.7 services are not provided. 367.8 Subd. 4. [PROVIDER CERTIFICATION AND CONTRACT 367.9 REQUIREMENTS.] (a) The intensive nonresidential rehabilitative 367.10 mental health services provider must: 367.11 (1) have a contract with the host county to provide 367.12 intensive adult rehabilitative mental health services; and 367.13 (2) be certified by the commissioner as being in compliance 367.14 with this section and section 256B.0623. 367.15 (b) The intensive residential rehabilitative mental health 367.16 services provider must: 367.17 (1) be licensed under Minnesota Rules, parts 9520.0500 to 367.18 9520.0670; 367.19 (2) not exceed 16 beds per site; 367.20 (3) comply with the additional standards in this section; 367.21 and 367.22 (4) have a contract with the host county to provide these 367.23 services. 367.24 (c) The commissioner shall develop procedures for counties 367.25 and providers to submit contracts and other documentation as 367.26 needed to allow the commissioner to determine whether the 367.27 standards in this section are met. 367.28 Subd. 5. [STANDARDS APPLICABLE TO BOTH NONRESIDENTIAL AND 367.29 RESIDENTIAL PROVIDERS.] (a) Services must be provided by 367.30 qualified staff as defined in section 256B.0623, subdivision 5, 367.31 who are trained and supervised according to section 256B.0623, 367.32 subdivision 6, except that mental health rehabilitation workers 367.33 acting as overnight staff are not required to comply with 367.34 section 256B.0623, subdivision 5, clause (3)(iv). 367.35 (b) The clinical supervisor must be an active member of the 367.36 treatment team. The treatment team must meet with the clinical 368.1 supervisor at least weekly to discuss recipients' progress and 368.2 make rapid adjustments to meet recipients' needs. The team 368.3 meeting shall include recipient-specific case reviews and 368.4 general treatment discussions among team members. 368.5 Recipient-specific case reviews and planning must be documented 368.6 in the individual recipient's treatment record. 368.7 (c) Treatment staff must have prompt access in person or by 368.8 telephone to a mental health practitioner or mental health 368.9 professional. The provider must have the capacity to promptly 368.10 and appropriately respond to emergent needs and make any 368.11 necessary staffing adjustments to assure the health and safety 368.12 of recipients. 368.13 (d) The initial functional assessment must be completed 368.14 within ten days of intake and updated at least every three 368.15 months or prior to discharge from the service, whichever comes 368.16 first. 368.17 (e) The initial individual treatment plan must be completed 368.18 within ten days of intake and reviewed and updated at least 368.19 monthly with the recipient. 368.20 Subd. 6. [ADDITIONAL STANDARDS APPLICABLE ONLY TO 368.21 INTENSIVE RESIDENTIAL REHABILITATIVE MENTAL HEALTH 368.22 SERVICES.] (a) The provider of intensive residential services 368.23 must have sufficient staff to provide 24 hour per day coverage 368.24 to deliver the rehabilitative services described in the 368.25 treatment plan and to safely supervise and direct the activities 368.26 of recipients given the recipient's level of behavioral and 368.27 psychiatric stability, cultural needs, and vulnerability. The 368.28 provider must have the capacity within the facility to provide 368.29 integrated services for chemical dependency, illness management 368.30 services, and family education when appropriate. 368.31 (b) At a minimum: 368.32 (1) staff must be available and provide direction and 368.33 supervision whenever recipients are present in the facility; 368.34 (2) staff must remain awake during all work hours; 368.35 (3) there must be a staffing ratio of at least one to nine 368.36 recipients for each day and evening shift. If more than nine 369.1 recipients are present at the residential site, there must be a 369.2 minimum of two staff during day and evening shifts, one of whom 369.3 must be a mental health practitioner or mental health 369.4 professional; 369.5 (4) if services are provided to recipients who need the 369.6 services of a medical professional, the provider shall assure 369.7 that these services are provided either by the provider's own 369.8 medical staff or through referral to a medical professional; and 369.9 (5) the provider must employ or contract with a licensed 369.10 registered nurse to ensure the effectiveness and safety of 369.11 medication administration in the facility. 369.12 Subd. 7. [ADDITIONAL STANDARDS FOR NONRESIDENTIAL 369.13 SERVICES.] The standards in this subdivision apply to intensive 369.14 nonresidential rehabilitative mental health services. 369.15 (1) The treatment team must use team treatment, not an 369.16 individual treatment model. 369.17 (2) The clinical supervisor must function as a practicing 369.18 clinician at least on a part-time basis. 369.19 (3) The staffing ratio must not exceed ten recipients to 369.20 one full-time equivalent treatment team position. 369.21 (4) Services must be available at times that meet client 369.22 needs. 369.23 (5) The treatment team must actively and assertively engage 369.24 and reach out to the recipient's family members and significant 369.25 others, after obtaining the recipient's permission. 369.26 (6) The treatment team must establish ongoing communication 369.27 and collaboration between the team, family, and significant 369.28 others and educate the family and significant others about 369.29 mental illness, symptom management, and the family's role in 369.30 treatment. 369.31 (7) The treatment team must provide interventions to 369.32 promote positive interpersonal relationships. 369.33 Subd. 8. [MEDICAL ASSISTANCE PAYMENT FOR INTENSIVE 369.34 REHABILITATIVE MENTAL HEALTH SERVICES.] (a) Payment for 369.35 residential and nonresidential services in this section shall be 369.36 based on one daily rate per provider inclusive of the following 370.1 services received by an eligible recipient in a given calendar 370.2 day: all rehabilitative services under this section and crisis 370.3 stabilization services under section 256B.0624. 370.4 (b) Except as indicated in paragraph (c), payment will not 370.5 be made to more than one entity for each recipient for services 370.6 provided under this section on a given day. If services under 370.7 this section are provided by a team that includes staff from 370.8 more than one entity, the team must determine how to distribute 370.9 the payment among the members. 370.10 (c) The host county shall recommend to the commissioner one 370.11 rate for each entity that will bill medical assistance for 370.12 residential services under this section and two rates for each 370.13 nonresidential provider. The first nonresidential rate is for 370.14 recipients who are not receiving residential services. The 370.15 second nonresidential rate is for recipients who are temporarily 370.16 receiving residential services and need continued contact with 370.17 the nonresidential team to assure timely discharge from 370.18 residential services. In developing these rates, the host 370.19 county shall consider and document: 370.20 (1) the cost for similar services in the local trade area; 370.21 (2) actual costs incurred by entities providing the 370.22 services; 370.23 (3) the intensity and frequency of services to be provided 370.24 to each recipient; 370.25 (4) the degree to which recipients will receive services 370.26 other than services under this section; 370.27 (5) the costs of other services, such as case management, 370.28 that will be separately reimbursed; and 370.29 (6) input from the local planning process authorized by the 370.30 adult mental health initiative under section 245.4661, regarding 370.31 recipients' service needs. 370.32 (d) The rate for intensive rehabilitative mental health 370.33 services must exclude room and board, as defined in section 370.34 256I.03, subdivision 6, and services not covered under this 370.35 section, such as case management, partial hospitalization, home 370.36 care, and inpatient services. Physician services that are not 371.1 separately billed may be included in the rate to the extent that 371.2 a psychiatrist is a member of the treatment team. The county's 371.3 recommendation shall specify the period for which the rate will 371.4 be applicable, not to exceed two years. 371.5 (e) When services under this section are provided by an 371.6 assertive community team, case management functions must be an 371.7 integral part of the team. The county must allocate costs which 371.8 are reimbursable under this section versus costs which are 371.9 reimbursable through case management or other reimbursement, so 371.10 that payment is not duplicated. 371.11 (f) The rate for a provider must not exceed the rate 371.12 charged by that provider for the same service to other payors. 371.13 (g) The commissioner shall approve or reject the county's 371.14 rate recommendation, based on the commissioner's own analysis of 371.15 the criteria in paragraph (c). 371.16 Subd. 9. [PROVIDER ENROLLMENT; RATE SETTING FOR 371.17 COUNTY-OPERATED ENTITIES.] Counties that employ their own staff 371.18 to provide services under this section shall apply directly to 371.19 the commissioner for enrollment and rate setting. In this case, 371.20 a county contract is not required and the commissioner shall 371.21 perform the program review and rate setting duties which would 371.22 otherwise be required of counties under this section. 371.23 Subd. 10. [PROVIDER ENROLLMENT; RATE SETTING FOR 371.24 SPECIALIZED PROGRAM.] A provider proposing to serve a 371.25 subpopulation of eligible recipients may bypass the county 371.26 approval procedures in this section and receive approval for 371.27 provider enrollment and rate setting directly from the 371.28 commissioner under the following circumstances: 371.29 (1) the provider demonstrates that the subpopulation to be 371.30 served requires a specialized program which is not available 371.31 from county-approved entities; and 371.32 (2) the subpopulation to be served is of such a low 371.33 incidence that it is not feasible to develop a program serving a 371.34 single county or regional group of counties. 371.35 For providers meeting the criteria in clauses (1) and (2), 371.36 the commissioner shall perform the program review and rate 372.1 setting duties which would otherwise be required of counties 372.2 under this section. 372.3 Sec. 17. Minnesota Statutes 2002, section 256B.0623, 372.4 subdivision 2, is amended to read: 372.5 Subd. 2. [DEFINITIONS.] For purposes of this section, the 372.6 following terms have the meanings given them. 372.7 (a) "Adult rehabilitative mental health services" means 372.8 mental health services which are rehabilitative and enable the 372.9 recipient to develop and enhance psychiatric stability, social 372.10 competencies, personal and emotional adjustment, and independent 372.11 living and community skills, when these abilities are impaired 372.12 by the symptoms of mental illness. Adult rehabilitative mental 372.13 health services are also appropriate when provided to enable a 372.14 recipient to retain stability and functioning, if the recipient 372.15 would be at risk of significant functional decompensation or 372.16 more restrictive service settings without these services. 372.17 (1) Adult rehabilitative mental health services instruct, 372.18 assist, and support the recipient in areas such as: 372.19 interpersonal communication skills, community resource 372.20 utilization and integration skills, crisis assistance, relapse 372.21 prevention skills, health care directives, budgeting and 372.22 shopping skills, healthy lifestyle skills and practices, cooking 372.23 and nutrition skills, transportation skills, medication 372.24 education and monitoring, mental illness symptom management 372.25 skills, household management skills, employment-related skills, 372.26 and transition to community living services. 372.27 (2) These services shall be provided to the recipient on a 372.28 one-to-one basis in the recipient's home or another community 372.29 setting or in groups. 372.30 (b) "Medication education services" means services provided 372.31 individually or in groups which focus on educating the recipient 372.32 about mental illness and symptoms; the role and effects of 372.33 medications in treating symptoms of mental illness; and the side 372.34 effects of medications. Medication education is coordinated 372.35 with medication management services and does not duplicate it. 372.36 Medication education services are provided by physicians, 373.1 pharmacists, physician's assistants, or registered nurses. 373.2 (c) "Transition to community living services" means 373.3 services which maintain continuity of contact between the 373.4 rehabilitation services provider and the recipient and which 373.5 facilitate discharge from a hospital, residential treatment 373.6 program under Minnesota Rules, chapter 9505, board and lodging 373.7 facility, or nursing home. Transition to community living 373.8 services are not intended to provide other areas of adult 373.9 rehabilitative mental health services. 373.10 Sec. 18. Minnesota Statutes 2002, section 256B.0623, 373.11 subdivision 4, is amended to read: 373.12 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) The provider 373.13 entity must be:373.14(1) a county operated entity certified by the state; or373.15(2) a noncounty entity certified by the entity's host373.16countycertified by the state following the certification 373.17 process and procedures developed by the commissioner. 373.18 (b) The certification process is a determination as to 373.19 whether the entity meets the standards in this subdivision. The 373.20 certification must specify which adult rehabilitative mental 373.21 health services the entity is qualified to provide. 373.22 (c)If an entity seeks to provide services outside its host373.23county, itA noncounty provider entity must obtain additional 373.24 certification from each county in which it will provide 373.25 services. The additional certification must be based on the 373.26 adequacy of the entity's knowledge of that county's local health 373.27 and human service system, and the ability of the entity to 373.28 coordinate its services with the other services available in 373.29 that county. A county-operated entity must obtain this 373.30 additional certification from any other county in which it will 373.31 provide services. 373.32 (d) Recertification must occur at least everytwothree 373.33 years. 373.34 (e) The commissioner may intervene at any time and 373.35 decertify providers with cause. The decertification is subject 373.36 to appeal to the state. A county board may recommend that the 374.1 state decertify a provider for cause. 374.2 (f) The adult rehabilitative mental health services 374.3 provider entity must meet the following standards: 374.4 (1) have capacity to recruit, hire, manage, and train 374.5 mental health professionals, mental health practitioners, and 374.6 mental health rehabilitation workers; 374.7 (2) have adequate administrative ability to ensure 374.8 availability of services; 374.9 (3) ensure adequate preservice and inservice and ongoing 374.10 training for staff; 374.11 (4) ensure that mental health professionals, mental health 374.12 practitioners, and mental health rehabilitation workers are 374.13 skilled in the delivery of the specific adult rehabilitative 374.14 mental health services provided to the individual eligible 374.15 recipient; 374.16 (5) ensure that staff is capable of implementing culturally 374.17 specific services that are culturally competent and appropriate 374.18 as determined by the recipient's culture, beliefs, values, and 374.19 language as identified in the individual treatment plan; 374.20 (6) ensure enough flexibility in service delivery to 374.21 respond to the changing and intermittent care needs of a 374.22 recipient as identified by the recipient and the individual 374.23 treatment plan; 374.24 (7) ensure that the mental health professional or mental 374.25 health practitioner, who is under the clinical supervision of a 374.26 mental health professional, involved in a recipient's services 374.27 participates in the development of the individual treatment 374.28 plan; 374.29 (8) assist the recipient in arranging needed crisis 374.30 assessment, intervention, and stabilization services; 374.31 (9) ensure that services are coordinated with other 374.32 recipient mental health services providers and the county mental 374.33 health authority and the federally recognized American Indian 374.34 authority and necessary others after obtaining the consent of 374.35 the recipient. Services must also be coordinated with the 374.36 recipient's case manager or care coordinator if the recipient is 375.1 receiving case management or care coordination services; 375.2 (10) develop and maintain recipient files, individual 375.3 treatment plans, and contact charting; 375.4 (11) develop and maintain staff training and personnel 375.5 files; 375.6 (12) submit information as required by the state; 375.7 (13) establish and maintain a quality assurance plan to 375.8 evaluate the outcome of services provided; 375.9 (14) keep all necessary records required by law; 375.10 (15) deliver services as required by section 245.461; 375.11 (16) comply with all applicable laws; 375.12 (17) be an enrolled Medicaid provider; 375.13 (18) maintain a quality assurance plan to determine 375.14 specific service outcomes and the recipient's satisfaction with 375.15 services; and 375.16 (19) develop and maintain written policies and procedures 375.17 regarding service provision and administration of the provider 375.18 entity. 375.19(g) The commissioner shall develop statewide procedures for375.20provider certification, including timelines for counties to375.21certify qualified providers.375.22 Sec. 19. Minnesota Statutes 2002, section 256B.0623, 375.23 subdivision 5, is amended to read: 375.24 Subd. 5. [QUALIFICATIONS OF PROVIDER STAFF.] Adult 375.25 rehabilitative mental health services must be provided by 375.26 qualified individual provider staff of a certified provider 375.27 entity. Individual provider staff must be qualified under one 375.28 of the following criteria: 375.29 (1) a mental health professional as defined in section 375.30 245.462, subdivision 18, clauses (1) to (5); 375.31 (2) a mental health practitioner as defined in section 375.32 245.462, subdivision 17. The mental health practitioner must 375.33 work under the clinical supervision of a mental health 375.34 professional; or 375.35 (3) a mental health rehabilitation worker. A mental health 375.36 rehabilitation worker means a staff person working under the 376.1 direction of a mental health practitioner or mental health 376.2 professional and under the clinical supervision of a mental 376.3 health professional in the implementation of rehabilitative 376.4 mental health services as identified in the recipient's 376.5 individual treatment plan who: 376.6 (i) is at least 21 years of age; 376.7 (ii) has a high school diploma or equivalent; 376.8 (iii) has successfully completed 30 hours of training 376.9 during the past two years in all of the following areas: 376.10 recipient rights, recipient-centered individual treatment 376.11 planning, behavioral terminology, mental illness, co-occurring 376.12 mental illness and substance abuse, psychotropic medications and 376.13 side effects, functional assessment, local community resources, 376.14 adult vulnerability, recipient confidentiality; and 376.15 (iv) meets the qualifications in subitem (A) or (B): 376.16 (A) has an associate of arts degree in one of the 376.17 behavioral sciences or human services, or is a registered nurse 376.18 without a bachelor's degree, or who within the previous ten 376.19 years has: 376.20 (1) three years of personal life experience with serious 376.21 and persistent mental illness; 376.22 (2) three years of life experience as a primary caregiver 376.23 to an adult with a serious mental illness or traumatic brain 376.24 injury; or 376.25 (3) 4,000 hours of supervised paid work experience in the 376.26 delivery of mental health services to adults with a serious 376.27 mental illness or traumatic brain injury; or 376.28 (B)(1) is fluent in the non-English language or competent 376.29 in the culture of the ethnic group to which at least5020 376.30 percent of the mental health rehabilitation worker's clients 376.31 belong; 376.32 (2) receives during the first 2,000 hours of work, monthly 376.33 documented individual clinical supervision by a mental health 376.34 professional; 376.35 (3) has 18 hours of documented field supervision by a 376.36 mental health professional or practitioner during the first 160 377.1 hours of contact work with recipients, and at least six hours of 377.2 field supervision quarterly during the following year; 377.3 (4) has review and cosignature of charting of recipient 377.4 contacts during field supervision by a mental health 377.5 professional or practitioner; and 377.6 (5) has 40 hours of additional continuing education on 377.7 mental health topics during the first year of employment. 377.8 Sec. 20. Minnesota Statutes 2002, section 256B.0623, 377.9 subdivision 6, is amended to read: 377.10 Subd. 6. [REQUIRED TRAINING AND SUPERVISION.] (a) Mental 377.11 health rehabilitation workers must receive ongoing continuing 377.12 education training of at least 30 hours every two years in areas 377.13 of mental illness and mental health services and other areas 377.14 specific to the population being served. Mental health 377.15 rehabilitation workers must also be subject to the ongoing 377.16 direction and clinical supervision standards in paragraphs (c) 377.17 and (d). 377.18 (b) Mental health practitioners must receive ongoing 377.19 continuing education training as required by their professional 377.20 license; or if the practitioner is not licensed, the 377.21 practitioner must receive ongoing continuing education training 377.22 of at least 30 hours every two years in areas of mental illness 377.23 and mental health services. Mental health practitioners must 377.24 meet the ongoing clinical supervision standards in paragraph (c). 377.25 (c) Clinical supervision may be provided by a full or 377.26 part-time qualified professional employed by or under contract 377.27 with the provider entity. Clinical supervision may be provided 377.28 by interactive videoconferencing according to procedures 377.29 developed by the commissioner. A mental health professional 377.30 providing clinical supervision of staff delivering adult 377.31 rehabilitative mental health services must provide the following 377.32 guidance: 377.33 (1) review the information in the recipient's file; 377.34 (2) review and approve initial and updates of individual 377.35 treatment plans; 377.36 (3) meet with mental health rehabilitation workers and 378.1 practitioners, individually or in small groups, at least monthly 378.2 to discuss treatment topics of interest to the workers and 378.3 practitioners; 378.4 (4) meet with mental health rehabilitation workers and 378.5 practitioners, individually or in small groups, at least monthly 378.6 to discuss treatment plans of recipients, and approve by 378.7 signature and document in the recipient's file any resulting 378.8 plan updates; 378.9 (5) meet at leasttwice a monthmonthly with the directing 378.10 mental health practitioner, if there is one, to review needs of 378.11 the adult rehabilitative mental health services program, review 378.12 staff on-site observations and evaluate mental health 378.13 rehabilitation workers, plan staff training, review program 378.14 evaluation and development, and consult with the directing 378.15 practitioner; and 378.16 (6) be available for urgent consultation as the individual 378.17 recipient needs or the situation necessitates; and378.18(7) provide clinical supervision by full- or part-time378.19mental health professionals employed by or under contract with378.20the provider entity. 378.21 (d) An adult rehabilitative mental health services provider 378.22 entity must have a treatment director who is a mental health 378.23 practitioner or mental health professional. The treatment 378.24 director must ensure the following: 378.25 (1) while delivering direct services to recipients, a newly 378.26 hired mental health rehabilitation worker must be directly 378.27 observed delivering services to recipients bythea mental 378.28 health practitioner or mental health professional for at least 378.29 six hours per 40 hours worked during the first 160 hours that 378.30 the mental health rehabilitation worker works; 378.31 (2) the mental health rehabilitation worker must receive 378.32 ongoing on-site direct service observation by a mental health 378.33 professional or mental health practitioner for at least six 378.34 hours for every six months of employment; 378.35 (3) progress notes are reviewed from on-site service 378.36 observation prepared by the mental health rehabilitation worker 379.1 and mental health practitioner for accuracy and consistency with 379.2 actual recipient contact and the individual treatment plan and 379.3 goals; 379.4 (4) immediate availability by phone or in person for 379.5 consultation by a mental health professional or a mental health 379.6 practitioner to the mental health rehabilitation services worker 379.7 during service provision; 379.8 (5) oversee the identification of changes in individual 379.9 recipient treatment strategies, revise the plan, and communicate 379.10 treatment instructions and methodologies as appropriate to 379.11 ensure that treatment is implemented correctly; 379.12 (6) model service practices which: respect the recipient, 379.13 include the recipient in planning and implementation of the 379.14 individual treatment plan, recognize the recipient's strengths, 379.15 collaborate and coordinate with other involved parties and 379.16 providers; 379.17 (7) ensure that mental health practitioners and mental 379.18 health rehabilitation workers are able to effectively 379.19 communicate with the recipients, significant others, and 379.20 providers; and 379.21 (8) oversee the record of the results of on-site 379.22 observation and charting evaluation and corrective actions taken 379.23 to modify the work of the mental health practitioners and mental 379.24 health rehabilitation workers. 379.25 (e) A mental health practitioner who is providing treatment 379.26 direction for a provider entity must receive supervision at 379.27 least monthly from a mental health professional to: 379.28 (1) identify and plan for general needs of the recipient 379.29 population served; 379.30 (2) identify and plan to address provider entity program 379.31 needs and effectiveness; 379.32 (3) identify and plan provider entity staff training and 379.33 personnel needs and issues; and 379.34 (4) plan, implement, and evaluate provider entity quality 379.35 improvement programs. 379.36 Sec. 21. Minnesota Statutes 2002, section 256B.0623, 380.1 subdivision 8, is amended to read: 380.2 Subd. 8. [DIAGNOSTIC ASSESSMENT.] Providers of adult 380.3 rehabilitative mental health services must complete a diagnostic 380.4 assessment as defined in section 245.462, subdivision 9, within 380.5 five days after the recipient's second visit or within 30 days 380.6 after intake, whichever occurs first. In cases where a 380.7 diagnostic assessment is available that reflects the recipient's 380.8 current status, and has been completed within 180 days preceding 380.9 admission, an update must be completed. An update shall include 380.10 a written summary by a mental health professional of the 380.11 recipient's current mental health status and service needs. If 380.12 the recipient's mental health status has changed significantly 380.13 since the adult's most recent diagnostic assessment, a new 380.14 diagnostic assessment is required. For initial implementation 380.15 of adult rehabilitative mental health services, until June 30, 380.16 2005, a diagnostic assessment that reflects the recipient's 380.17 current status and has been completed within the past three 380.18 years preceding admission is acceptable. 380.19 Sec. 22. Minnesota Statutes 2002, section 256B.0625, 380.20 subdivision 19c, is amended to read: 380.21 Subd. 19c. [PERSONAL CARE.] Medical assistance covers 380.22 personal care assistant services provided by an individual who 380.23 is qualified to provide the services according to subdivision 380.24 19a and section 256B.0627, where the services are prescribed by 380.25 a physician in accordance with a plan of treatment and are 380.26 supervised by the recipient or a qualified professional. 380.27 "Qualified professional" means a mental health professional as 380.28 defined in section 245.462, subdivision 18, or 245.4871, 380.29 subdivision 27; or a registered nurse as defined in sections 380.30 148.171 to 148.285, or a licensed social worker as defined in 380.31 section 148B.21. As part of the assessment, the county public 380.32 health nurse will assist the recipient or responsible party to 380.33 identify the most appropriate person to provide supervision of 380.34 the personal care assistant. The qualified professional shall 380.35 perform the duties described in Minnesota Rules, part 9505.0335, 380.36 subpart 4. 381.1 Sec. 23. Minnesota Statutes 2002, section 256B.0627, 381.2 subdivision 1, is amended to read: 381.3 Subdivision 1. [DEFINITION.] (a) "Activities of daily 381.4 living" includes eating, toileting, grooming, dressing, bathing, 381.5 transferring, mobility, and positioning. 381.6 (b) "Assessment" means a review and evaluation of a 381.7 recipient's need for home care services conducted in person. 381.8 Assessments for private duty nursing shall be conducted by a 381.9 registered private duty nurse. Assessments for home health 381.10 agency services shall be conducted by a home health agency 381.11 nurse. Assessments for personal care assistant services shall 381.12 be conducted by the county public health nurse or a certified 381.13 public health nurse under contract with the county. A 381.14 face-to-face assessment must include: documentation of health 381.15 status, determination of need, evaluation of service 381.16 effectiveness, identification of appropriate services, service 381.17 plan development or modification, coordination of services, 381.18 referrals and follow-up to appropriate payers and community 381.19 resources, completion of required reports, recommendation of 381.20 service authorization, and consumer education. Once the need 381.21 for personal care assistant services is determined under this 381.22 section, the county public health nurse or certified public 381.23 health nurse under contract with the county is responsible for 381.24 communicating this recommendation to the commissioner and the 381.25 recipient. A face-to-face assessment for personal care 381.26 assistant services is conducted on those recipients who have 381.27 never had a county public health nurse assessment. A 381.28 face-to-face assessment must occur at least annually or when 381.29 there is a significant change in the recipient's condition or 381.30 when there is a change in the need for personal care assistant 381.31 services. A service update may substitute for the annual 381.32 face-to-face assessment when there is not a significant change 381.33 in recipient condition or a change in the need for personal care 381.34 assistant service. A service update or review for temporary 381.35 increase includes a review of initial baseline data, evaluation 381.36 of service effectiveness, redetermination of service need, 382.1 modification of service plan and appropriate referrals, update 382.2 of initial forms, obtaining service authorization, and on going 382.3 consumer education. Assessments for medical assistance home 382.4 care services for mental retardation or related conditions and 382.5 alternative care services for developmentally disabled home and 382.6 community-based waivered recipients may be conducted by the 382.7 county public health nurse to ensure coordination and avoid 382.8 duplication. Assessments must be completed on forms provided by 382.9 the commissioner within 30 days of a request for home care 382.10 services by a recipient or responsible party. 382.11 (c) "Care plan" means a written description of personal 382.12 care assistant services developed by the qualified professional 382.13 or the recipient's physician with the recipient or responsible 382.14 party to be used by the personal care assistant with a copy 382.15 provided to the recipient or responsible party. 382.16 (d) "Complex and regular private duty nursing care" means: 382.17 (1) complex care is private duty nursing provided to 382.18 recipients who are ventilator dependent or for whom a physician 382.19 has certified that were it not for private duty nursing the 382.20 recipient would meet the criteria for inpatient hospital 382.21 intensive care unit (ICU) level of care; and 382.22 (2) regular care is private duty nursing provided to all 382.23 other recipients. 382.24 (e) "Health-related functions" means functions that can be 382.25 delegated or assigned by a licensed health care professional 382.26 under state law to be performed by a personal care attendant. 382.27 (f) "Home care services" means a health service, determined 382.28 by the commissioner as medically necessary, that is ordered by a 382.29 physician and documented in a service plan that is reviewed by 382.30 the physician at least once every 60 days for the provision of 382.31 home health services, or private duty nursing, or at least once 382.32 every 365 days for personal care. Home care services are 382.33 provided to the recipient at the recipient's residence that is a 382.34 place other than a hospital or long-term care facility or as 382.35 specified in section 256B.0625. 382.36 (g) "Instrumental activities of daily living" includes meal 383.1 planning and preparation, managing finances, shopping for food, 383.2 clothing, and other essential items, performing essential 383.3 household chores, communication by telephone and other media, 383.4 and getting around and participating in the community. 383.5 (h) "Medically necessary" has the meaning given in 383.6 Minnesota Rules, parts 9505.0170 to 9505.0475. 383.7 (i) "Personal care assistant" means a person who: 383.8 (1) is at least 18 years old, except for persons 16 to 18 383.9 years of age who participated in a related school-based job 383.10 training program or have completed a certified home health aide 383.11 competency evaluation; 383.12 (2) is able to effectively communicate with the recipient 383.13 and personal care provider organization; 383.14 (3) effective July 1, 1996, has completed one of the 383.15 training requirements as specified in Minnesota Rules, part 383.16 9505.0335, subpart 3, items A to D; 383.17 (4) has the ability to, and provides covered personal care 383.18 assistant services according to the recipient's care plan, 383.19 responds appropriately to recipient needs, and reports changes 383.20 in the recipient's condition to the supervising qualified 383.21 professional or physician; 383.22 (5) is not a consumer of personal care assistant services; 383.23 and 383.24 (6) is subject to criminal background checks and procedures 383.25 specified in section 245A.04. 383.26 (j) "Personal care provider organization" means an 383.27 organization enrolled to provide personal care assistant 383.28 services under the medical assistance program that complies with 383.29 the following: (1) owners who have a five percent interest or 383.30 more, and managerial officials are subject to a background study 383.31 as provided in section 245A.04. This applies to currently 383.32 enrolled personal care provider organizations and those agencies 383.33 seeking enrollment as a personal care provider organization. An 383.34 organization will be barred from enrollment if an owner or 383.35 managerial official of the organization has been convicted of a 383.36 crime specified in section 245A.04, or a comparable crime in 384.1 another jurisdiction, unless the owner or managerial official 384.2 meets the reconsideration criteria specified in section 245A.04; 384.3 (2) the organization must maintain a surety bond and liability 384.4 insurance throughout the duration of enrollment and provides 384.5 proof thereof. The insurer must notify the department of human 384.6 services of the cancellation or lapse of policy; and (3) the 384.7 organization must maintain documentation of services as 384.8 specified in Minnesota Rules, part 9505.2175, subpart 7, as well 384.9 as evidence of compliance with personal care assistant training 384.10 requirements. 384.11 (k) "Responsible party" means an individualresiding with a384.12recipient of personal care assistant serviceswho is capable of 384.13 providing thesupportive caresupport necessary to assist the 384.14 recipient to live in the community, is at least 18 years 384.15 old, actively participates in planning and directing of personal 384.16 care assistant services, and is notathe personal care 384.17 assistant. The responsible party must be accessible to the 384.18 recipient and the personal care assistant when personal care 384.19 services are being provided and monitor the services at least 384.20 weekly according to the plan of care. The responsible party 384.21 must be identified at the time of assessment and listed on the 384.22 recipient's service agreement and care plan. Responsible 384.23 partieswho are parents of minors or guardians of minors or384.24incapacitated personsmay delegate the responsibility to another 384.25 adultduring a temporary absence of at least 24 hours but not384.26more than six months. The person delegated as a responsible384.27party must be able to meet the definition of responsible party,384.28except that the delegated responsible party is required to384.29reside with the recipient only while serving as the responsible384.30partywho is not the personal care assistant. The responsible 384.31 party must assure that the delegate performs the functions of 384.32 the responsible party, is identified at the time of the 384.33 assessment, and is listed on the service agreement and the care 384.34 plan. Foster care license holders may be designated the 384.35 responsible party for residents of the foster care home if case 384.36 management is provided as required in section 256B.0625, 385.1 subdivision 19a. For persons who, as of April 1, 1992, are 385.2 sharing personal care assistant services in order to obtain the 385.3 availability of 24-hour coverage, an employee of the personal 385.4 care provider organization may be designated as the responsible 385.5 party if case management is provided as required in section 385.6 256B.0625, subdivision 19a. 385.7 (l) "Service plan" means a written description of the 385.8 services needed based on the assessment developed by the nurse 385.9 who conducts the assessment together with the recipient or 385.10 responsible party. The service plan shall include a description 385.11 of the covered home care services, frequency and duration of 385.12 services, and expected outcomes and goals. The recipient and 385.13 the provider chosen by the recipient or responsible party must 385.14 be given a copy of the completed service plan within 30 calendar 385.15 days of the request for home care services by the recipient or 385.16 responsible party. 385.17 (m) "Skilled nurse visits" are provided in a recipient's 385.18 residence under a plan of care or service plan that specifies a 385.19 level of care which the nurse is qualified to provide. These 385.20 services are: 385.21 (1) nursing services according to the written plan of care 385.22 or service plan and accepted standards of medical and nursing 385.23 practice in accordance with chapter 148; 385.24 (2) services which due to the recipient's medical condition 385.25 may only be safely and effectively provided by a registered 385.26 nurse or a licensed practical nurse; 385.27 (3) assessments performed only by a registered nurse; and 385.28 (4) teaching and training the recipient, the recipient's 385.29 family, or other caregivers requiring the skills of a registered 385.30 nurse or licensed practical nurse. 385.31 (n) "Telehomecare" means the use of telecommunications 385.32 technology by a home health care professional to deliver home 385.33 health care services, within the professional's scope of 385.34 practice, to a patient located at a site other than the site 385.35 where the practitioner is located. 385.36 Sec. 24. Minnesota Statutes 2002, section 256B.0627, 386.1 subdivision 4, is amended to read: 386.2 Subd. 4. [PERSONAL CARE ASSISTANT SERVICES.] (a) The 386.3 personal care assistant services that are eligible for payment 386.4 are services and supports furnished to an individual, as needed, 386.5 to assist in accomplishing activities of daily living; 386.6 instrumental activities of daily living; health-related 386.7 functions through hands-on assistance, supervision, and cuing; 386.8 and redirection and intervention for behavior including 386.9 observation and monitoring. 386.10 (b) Payment for services will be made within the limits 386.11 approved using the prior authorized process established in 386.12 subdivision 5. 386.13 (c) The amount and type of services authorized shall be 386.14 based on an assessment of the recipient's needs in these areas: 386.15 (1) bowel and bladder care; 386.16 (2) skin care to maintain the health of the skin; 386.17 (3) repetitive maintenance range of motion, muscle 386.18 strengthening exercises, and other tasks specific to maintaining 386.19 a recipient's optimal level of function; 386.20 (4) respiratory assistance; 386.21 (5) transfers and ambulation; 386.22 (6) bathing, grooming, and hairwashing necessary for 386.23 personal hygiene; 386.24 (7) turning and positioning; 386.25 (8) assistance with furnishing medication that is 386.26 self-administered; 386.27 (9) application and maintenance of prosthetics and 386.28 orthotics; 386.29 (10) cleaning medical equipment; 386.30 (11) dressing or undressing; 386.31 (12) assistance with eating and meal preparation and 386.32 necessary grocery shopping; 386.33 (13) accompanying a recipient to obtain medical diagnosis 386.34 or treatment; 386.35 (14) assisting, monitoring, or prompting the recipient to 386.36 complete the services in clauses (1) to (13); 387.1 (15) redirection, monitoring, and observation that are 387.2 medically necessary and an integral part of completing the 387.3 personal care assistant services described in clauses (1) to 387.4 (14); 387.5 (16) redirection and intervention for behavior, including 387.6 observation and monitoring; 387.7 (17) interventions for seizure disorders, including 387.8 monitoring and observation if the recipient has had a seizure 387.9 that requires intervention within the past three months; 387.10 (18) tracheostomy suctioning using a clean procedure if the 387.11 procedure is properly delegated by a registered nurse. Before 387.12 this procedure can be delegated to a personal care assistant, a 387.13 registered nurse must determine that the tracheostomy suctioning 387.14 can be accomplished utilizing a clean rather than a sterile 387.15 procedure and must ensure that the personal care assistant has 387.16 been taught the proper procedure; and 387.17 (19) incidental household services that are an integral 387.18 part of a personal care service described in clauses (1) to (18). 387.19 For purposes of this subdivision, monitoring and observation 387.20 means watching for outward visible signs that are likely to 387.21 occur and for which there is a covered personal care service or 387.22 an appropriate personal care intervention. For purposes of this 387.23 subdivision, a clean procedure refers to a procedure that 387.24 reduces the numbers of microorganisms or prevents or reduces the 387.25 transmission of microorganisms from one person or place to 387.26 another. A clean procedure may be used beginning 14 days after 387.27 insertion. 387.28 (d) The personal care assistant services that are not 387.29 eligible for payment are the following: 387.30 (1) services not ordered by the physician; 387.31 (2) assessments by personal care assistant provider 387.32 organizations or by independently enrolled registered nurses; 387.33 (3) services that are not in the service plan; 387.34 (4) services provided by the recipient's spouse, legal 387.35 guardian for an adult or child recipient, or parent of a 387.36 recipient under age 18; 388.1 (5) services provided by a foster care provider of a 388.2 recipient who cannot direct the recipient's own care, unless 388.3 monitored by a county or state case manager under section 388.4 256B.0625, subdivision 19a; 388.5 (6) services provided by the residential or program license 388.6 holder in a residence for more than four persons; 388.7 (7) services that are the responsibility of a residential 388.8 or program license holder under the terms of a service agreement 388.9 and administrative rules; 388.10 (8) sterile procedures; 388.11 (9) injections of fluids into veins, muscles, or skin; 388.12 (10)services provided by parents of adult recipients,388.13adult children, or siblings of the recipient, unless these388.14relatives meet one of the following hardship criteria and the388.15commissioner waives this requirement:388.16(i) the relative resigns from a part-time or full-time job388.17to provide personal care for the recipient;388.18(ii) the relative goes from a full-time to a part-time job388.19with less compensation to provide personal care for the388.20recipient;388.21(iii) the relative takes a leave of absence without pay to388.22provide personal care for the recipient;388.23(iv) the relative incurs substantial expenses by providing388.24personal care for the recipient; or388.25(v) because of labor conditions, special language needs, or388.26intermittent hours of care needed, the relative is needed in388.27order to provide an adequate number of qualified personal care388.28assistants to meet the medical needs of the recipient;388.29(11)homemaker services that are not an integral part of a 388.30 personal care assistant services; 388.31(12)(11) home maintenance, or chore services; 388.32(13)(12) services not specified under paragraph (a); and 388.33(14)(13) services not authorized by the commissioner or 388.34 the commissioner's designee. 388.35 (e) The recipient or responsible party may choose to 388.36 supervise the personal care assistant or to have a qualified 389.1 professional, as defined in section 256B.0625, subdivision 19c, 389.2 provide the supervision. As required under section 256B.0625, 389.3 subdivision 19c, the county public health nurse, as a part of 389.4 the assessment, will assist the recipient or responsible party 389.5 to identify the most appropriate person to provide supervision 389.6 of the personal care assistant. Health-related delegated tasks 389.7 performed by the personal care assistant will be under the 389.8 supervision of a qualified professional or the direction of the 389.9 recipient's physician. If the recipient has a qualified 389.10 professional, Minnesota Rules, part 9505.0335, subpart 4, 389.11 applies. 389.12 Sec. 25. Minnesota Statutes 2002, section 256B.0627, 389.13 subdivision 9, is amended to read: 389.14 Subd. 9. [FLEXIBLE USE OF PERSONAL CARE ASSISTANT HOURS.] 389.15 (a)The commissioner may allow for the flexible use of personal389.16care assistant hours."Flexible use" means the scheduled use of 389.17 authorized hours of personal care assistant services, which vary 389.18 within the length of the service authorization in order to more 389.19 effectively meet the needs and schedule of the recipient. 389.20 Recipients may use their approved hours flexibly within the 389.21 service authorization period for medically necessary covered 389.22 services specified in the assessment required in subdivision 1. 389.23 The flexible use of authorized hours does not increase the total 389.24 amount of authorized hours available to a recipient as 389.25 determined under subdivision 5. The commissioner shall not 389.26 authorize additional personal care assistant services to 389.27 supplement a service authorization that is exhausted before the 389.28 end date under a flexible service use plan, unless the county 389.29 public health nurse determines a change in condition and a need 389.30 for increased services is established. 389.31 (b)The recipient or responsible party, together with the389.32county public health nurse, shall determine whether flexible use389.33is an appropriate option based on the needs and preferences of389.34the recipient or responsible party, and, if appropriate, must389.35ensure that the allocation of hours covers the ongoing needs of389.36the recipient over the entire service authorization period. As390.1part of the assessment and service planning process, the390.2recipient or responsible party must work with the county public390.3health nurse to develop a written month-to-month plan of the390.4projected use of personal care assistant services that is part390.5of the service plan and ensures that the:390.6(1) health and safety needs of the recipient will be met;390.7(2) total annual authorization will not exceed before the390.8end date; and390.9(3) how actual use of hours will be monitored.390.10(c) If the actual use of personal care assistant service390.11varies significantly from the use projected in the plan, the390.12written plan must be promptly updated by the recipient or390.13responsible party and the county public health nurse.390.14(d)The recipient or responsible party, together with the 390.15 provider, must work to monitor and document the use of 390.16 authorized hours and ensure that a recipient is able to manage 390.17 services effectively throughout the authorized period.The390.18provider must ensure that the month-to-month plan is390.19incorporated into the care plan.Upon request of the recipient 390.20 or responsible party, the provider must furnish regular updates 390.21 to the recipient or responsible party on the amount of personal 390.22 care assistant services used. 390.23(e) The recipient or responsible party may revoke the390.24authorization for flexible use of hours by notifying the390.25provider and county public health nurse in writing.390.26(f) If the requirements in paragraphs (a) to (e) have not390.27substantially been met, the commissioner shall deny, revoke, or390.28suspend the authorization to use authorized hours flexibly. The390.29recipient or responsible party may appeal the commissioner's390.30action according to section 256.045. The denial, revocation, or390.31suspension to use the flexible hours option shall not affect the390.32recipient's authorized level of personal care assistant services390.33as determined under subdivision 5.390.34 Sec. 26. Minnesota Statutes 2002, section 256B.0911, 390.35 subdivision 4d, is amended to read: 390.36 Subd. 4d. [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 391.1 YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 391.2 ensure that individuals with disabilities or chronic illness are 391.3 served in the most integrated setting appropriate to their needs 391.4 and have the necessary information to make informed choices 391.5 about home and community-based service options. 391.6 (b) Individuals under 65 years of age who are admitted to a 391.7 nursing facility from a hospital must be screened prior to 391.8 admission as outlined in subdivisions 4a through 4c. 391.9 (c) Individuals under 65 years of age who are admitted to 391.10 nursing facilities with only a telephone screening must receive 391.11 a face-to-face assessment from the long-term care consultation 391.12 team member of the county in which the facility is located or 391.13 from the recipient's county case manager within20 working40 391.14 calendar days of admission. 391.15 (d) Individuals under 65 years of age who are admitted to a 391.16 nursing facility without preadmission screening according to the 391.17 exemption described in subdivision 4b, paragraph (a), clause 391.18 (3), and who remain in the facility longer than 30 days must 391.19 receive a face-to-face assessment within 40 days of admission. 391.20 (e) At the face-to-face assessment, the long-term care 391.21 consultation team member or county case manager must perform the 391.22 activities required under subdivision 3b. 391.23 (f) For individuals under 21 years of age, a screening 391.24 interview which recommends nursing facility admission must be 391.25 face-to-face and approved by the commissioner before the 391.26 individual is admitted to the nursing facility. 391.27 (g) In the event that an individual under 65 years of age 391.28 is admitted to a nursing facility on an emergency basis, the 391.29 county must be notified of the admission on the next working 391.30 day, and a face-to-face assessment as described in paragraph (c) 391.31 must be conducted within20 working days40 calendar days of 391.32 admission. 391.33 (h) At the face-to-face assessment, the long-term care 391.34 consultation team member or the case manager must present 391.35 information about home and community-based options so the 391.36 individual can make informed choices. If the individual chooses 392.1 home and community-based services, the long-term care 392.2 consultation team member or case manager must complete a written 392.3 relocation plan within 20 working days of the visit. The plan 392.4 shall describe the services needed to move out of the facility 392.5 and a time line for the move which is designed to ensure a 392.6 smooth transition to the individual's home and community. 392.7 (i) An individual under 65 years of age residing in a 392.8 nursing facility shall receive a face-to-face assessment at 392.9 least every 12 months to review the person's service choices and 392.10 available alternatives unless the individual indicates, in 392.11 writing, that annual visits are not desired. In this case, the 392.12 individual must receive a face-to-face assessment at least once 392.13 every 36 months for the same purposes. 392.14 (j) Notwithstanding the provisions of subdivision 6, the 392.15 commissioner may pay county agencies directly for face-to-face 392.16 assessments for individuals under 65 years of age who are being 392.17 considered for placement or residing in a nursing facility. 392.18 Sec. 27. Minnesota Statutes 2002, section 256B.0915, is 392.19 amended by adding a subdivision to read: 392.20 Subd. 9. [TRIBAL MANAGEMENT OF ELDERLY WAIVER.] 392.21 Notwithstanding contrary provisions of this section, or those in 392.22 other state laws or rules, the commissioner and White Earth 392.23 reservation may develop a model for tribal management of the 392.24 elderly waiver program and implement this model through a 392.25 contract between the state and White Earth reservation. The 392.26 model shall include the provision of tribal waiver case 392.27 management, assessment for personal care assistance, and 392.28 administrative requirements otherwise carried out by counties 392.29 but shall not include tribal financial eligibility determination 392.30 for medical assistance. 392.31 Sec. 28. Minnesota Statutes 2002, section 256B.092, 392.32 subdivision 1a, is amended to read: 392.33 Subd. 1a. [CASE MANAGEMENT ADMINISTRATION AND SERVICES.] 392.34 (a) The administrative functions of case management provided to 392.35 or arranged for a person include: 392.36 (1)intakereview of eligibility for services; 393.1 (2)diagnosisscreening; 393.2 (3)screeningintake; 393.3 (4)service authorizationdiagnosis; 393.4 (5)review of eligibility for servicesthe completion and 393.5 authorization of services based upon an individualized service 393.6 plan; and 393.7 (6) responding to requests for conciliation conferences and 393.8 appeals according to section 256.045 made by the person, the 393.9 person's legal guardian or conservator, or the parent if the 393.10 person is a minor. 393.11 (b) Case management service activities provided to or 393.12 arranged for a person include: 393.13 (1) development of the individual service plan;393.14 (2) informing the individual or the individual's legal 393.15 guardian or conservator, or parent if the person is a minor, of 393.16 service options; 393.17 (3) consulting with relevant medical experts or service 393.18 providers; 393.19(3)(4) assisting the person in the identification of 393.20 potential providers; 393.21(4)(5) assisting the person to access services; 393.22(5)(6) coordination of services, if coordination is not 393.23 provided by another service provider; 393.24(6)(7) evaluation and monitoring of the services 393.25 identified in the plan; and 393.26(7)(8) annual reviews of service plans and services 393.27 provided. 393.28 (c) Case management administration and service activities 393.29 that are provided to the person with mental retardation or a 393.30 related condition shall be provided directly by county agencies 393.31 or under contract. 393.32 (d) Case managers are responsible for the administrative 393.33 duties and service provisions listed in paragraphs (a) and (b). 393.34 Case managers shall collaborate with consumers, families, legal 393.35 representatives, and relevant medical experts and service 393.36 providers in the development and annual review of the 394.1 individualized service and habilitation plans. 394.2 (e) The department of human services shall offer ongoing 394.3 education in case management to case managers. Case managers 394.4 shall receive no less than ten hours of case management 394.5 education and disability-related training each year. 394.6 Sec. 29. Minnesota Statutes 2002, section 256B.092, 394.7 subdivision 5, is amended to read: 394.8 Subd. 5. [FEDERAL WAIVERS.] (a) The commissioner shall 394.9 apply for any federal waivers necessary to secure, to the extent 394.10 allowed by law, federal financial participation under United 394.11 States Code, title 42, sections 1396 et seq., as amended, for 394.12 the provision of services to persons who, in the absence of the 394.13 services, would need the level of care provided in a regional 394.14 treatment center or a community intermediate care facility for 394.15 persons with mental retardation or related conditions. The 394.16 commissioner may seek amendments to the waivers or apply for 394.17 additional waivers under United States Code, title 42, sections 394.18 1396 et seq., as amended, to contain costs. The commissioner 394.19 shall ensure that payment for the cost of providing home and 394.20 community-based alternative services under the federal waiver 394.21 plan shall not exceed the cost of intermediate care services 394.22 including day training and habilitation services that would have 394.23 been provided without the waivered services. 394.24 (b) The commissioner, in administering home and 394.25 community-based waivers for persons with mental retardation and 394.26 related conditions, shall ensure that day services for eligible 394.27 persons are not provided by the person's residential service 394.28 provider, unless the person or the person's legal representative 394.29 is offered a choice of providers and agrees in writing to 394.30 provision of day services by the residential service provider. 394.31 The individual service plan for individuals who choose to have 394.32 their residential service provider provide their day services 394.33 must describe how health, safety,andprotection, and 394.34 habilitation needs will be metby, including how frequent and 394.35 regular contact with persons other than the residential service 394.36 provider will occur. The individualized service plan must 395.1 address the provision of services during the day outside the 395.2 residence on weekdays. 395.3 Sec. 30. Minnesota Statutes 2002, section 256B.095, is 395.4 amended to read: 395.5 256B.095 [QUALITY ASSURANCEPROJECTSYSTEM ESTABLISHED.] 395.6 (a) Effective July 1, 1998,an alternativea quality 395.7 assurancelicensingsystemprojectfor persons with 395.8 developmental disabilities, which includes an alternative 395.9 quality assurance licensing system for programsfor persons with395.10developmental disabilities, is established in Dodge, Fillmore, 395.11 Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele, 395.12 Wabasha, and Winona counties for the purpose of improving the 395.13 quality of services provided to persons with developmental 395.14 disabilities. A county, at its option, may choose to have all 395.15 programs for persons with developmental disabilities located 395.16 within the county licensed under chapter 245A using standards 395.17 determined under the alternative quality assurance licensing 395.18 systemprojector may continue regulation of these programs 395.19 under the licensing system operated by the commissioner. The 395.20 project expires on June 30,20052007. 395.21 (b) Effective July 1, 2003, a county not listed in 395.22 paragraph (a) may apply to participate in the quality assurance 395.23 system established under paragraph (a). The commission 395.24 established under section 256B.0951 may, at its option, allow 395.25 additional counties to participate in the system. 395.26 (c) Effective July 1, 2003, any county or group of counties 395.27 not listed in paragraph (a) may establish a quality assurance 395.28 system under this section. A new system established under this 395.29 section shall have the same rights and duties as the system 395.30 established under paragraph (a). A new system shall be governed 395.31 by a commission under section 256B.0951. The commissioner shall 395.32 appoint the initial commission members based on recommendations 395.33 from advocates, families, service providers, and counties in the 395.34 geographic area included in the new system. Counties that 395.35 choose to participate in a new system shall have the duties 395.36 assigned under section 256B.0952. The new system shall 396.1 establish a quality assurance process under section 256B.0953. 396.2 The provisions of section 256B.0954 shall apply to a new system 396.3 established under this paragraph. The commissioner shall 396.4 delegate authority to a new system established under this 396.5 paragraph according to section 256B.0955. 396.6 [EFFECTIVE DATE.] This section is effective July 1, 2003. 396.7 Sec. 31. Minnesota Statutes 2002, section 256B.0951, 396.8 subdivision 1, is amended to read: 396.9 Subdivision 1. [MEMBERSHIP.] Theregion 10quality 396.10 assurance commission is established. The commission consists of 396.11 at least 14 but not more than 21 members as follows: at least 396.12 three but not more than five members representing advocacy 396.13 organizations; at least three but not more than five members 396.14 representing consumers, families, and their legal 396.15 representatives; at least three but not more than five members 396.16 representing service providers; at least three but not more than 396.17 five members representing counties; and the commissioner of 396.18 human services or the commissioner's designee.Initial396.19membership of the commission shall be recruited and approved by396.20the region 10 stakeholders group. Prior to approving the396.21commission's membership, the stakeholders group shall provide to396.22the commissioner a list of the membership in the stakeholders396.23group, as of February 1, 1997, a brief summary of meetings held396.24by the group since July 1, 1996, and copies of any materials396.25prepared by the group for public distribution.The first 396.26 commission shall establish membership guidelines for the 396.27 transition and recruitment of membership for the commission's 396.28 ongoing existence. Members of the commission who do not receive 396.29 a salary or wages from an employer for time spent on commission 396.30 duties may receive a per diem payment when performing commission 396.31 duties and functions. All members may be reimbursed for 396.32 expenses related to commission activities. Notwithstanding the 396.33 provisions of section 15.059, subdivision 5, the commission 396.34 expires on June 30,20052007. 396.35 [EFFECTIVE DATE.] This section is effective July 1, 2003. 396.36 Sec. 32. Minnesota Statutes 2002, section 256B.0951, 397.1 subdivision 2, is amended to read: 397.2 Subd. 2. [AUTHORITY TO HIRE STAFF; CHARGE FEES; PROVIDE 397.3 TECHNICAL ASSISTANCE.] (a) The commission may hire staff to 397.4 perform the duties assigned in this section. 397.5 (b) The commission may charge fees for its services. 397.6 (c) The commission may provide technical assistance to 397.7 other counties, families, providers, and advocates interested in 397.8 participating in a quality assurance system under section 397.9 256B.095, paragraph (b) or (c). 397.10 [EFFECTIVE DATE.] This section is effective July 1, 2003. 397.11 Sec. 33. Minnesota Statutes 2002, section 256B.0951, 397.12 subdivision 3, is amended to read: 397.13 Subd. 3. [COMMISSION DUTIES.] (a) By October 1, 1997, the 397.14 commission, in cooperation with the commissioners of human 397.15 services and health, shall do the following: (1) approve an 397.16 alternative quality assurance licensing system based on the 397.17 evaluation of outcomes; (2) approve measurable outcomes in the 397.18 areas of health and safety, consumer evaluation, education and 397.19 training, providers, and systems that shall be evaluated during 397.20 the alternative licensing process; and (3) establish variable 397.21 licensure periods not to exceed three years based on outcomes 397.22 achieved. For purposes of this subdivision, "outcome" means the 397.23 behavior, action, or status of a person that can be observed or 397.24 measured and can be reliably and validly determined. 397.25 (b) By January 15, 1998, the commission shall approve, in 397.26 cooperation with the commissioner of human services, a training 397.27 program for members of the quality assurance teams established 397.28 under section 256B.0952, subdivision 4. 397.29 (c) The commission and the commissioner shall establish an 397.30 ongoing review process for the alternative quality assurance 397.31 licensing system. The review shall take into account the 397.32 comprehensive nature of the alternative system, which is 397.33 designed to evaluate the broad spectrum of licensed and 397.34 unlicensed entities that provide services to clients, as397.35compared to the current licensing system. 397.36 (d)The commission shall contract with an independent398.1entity to conduct a financial review of the alternative quality398.2assurance project. The review shall take into account the398.3comprehensive nature of the alternative system, which is398.4designed to evaluate the broad spectrum of licensed and398.5unlicensed entities that provide services to clients, as398.6compared to the current licensing system. The review shall398.7include an evaluation of possible budgetary savings within the398.8department of human services as a result of implementation of398.9the alternative quality assurance project. If a federal waiver398.10is approved under subdivision 7, the financial review shall also398.11evaluate possible savings within the department of health. This398.12review must be completed by December 15, 2000.398.13(e) The commission shall submit a report to the legislature398.14by January 15, 2001, on the results of the review process for398.15the alternative quality assurance project, a summary of the398.16results of the independent financial review, and a398.17recommendation on whether the project should be extended beyond398.18June 30, 2001.398.19(f)Thecommissionercommission, in consultation with 398.20 thecommissioncommissioner, shallexamine the feasibility of398.21expandingwork cooperatively with other populations to expand 398.22 theprojectsystem tootherthose populationsor geographic398.23areasand identify barriers to expansion. The commissioner 398.24 shall report findings and recommendations to the legislature by 398.25 December 15, 2004. 398.26 [EFFECTIVE DATE.] This section is effective July 1, 2003. 398.27 Sec. 34. Minnesota Statutes 2002, section 256B.0951, 398.28 subdivision 5, is amended to read: 398.29 Subd. 5. [VARIANCE OF CERTAIN STANDARDS PROHIBITED.] The 398.30 safety standards, rights, or procedural protections under 398.31 sections 245.825; 245.91 to 245.97; 245A.04, subdivisions 3, 3a, 398.32 3b, and 3c; 245A.09, subdivision 2, paragraph (c), clauses (2) 398.33 and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, 398.34 subdivisions 1b, clause (7), and 10; 626.556; 626.557, and 398.35 procedures for the monitoring of psychotropic medications shall 398.36 not be varied under the alternativelicensingquality assurance 399.1 licensing systemproject. The commission may make 399.2 recommendations to the commissioners of human services and 399.3 health or to the legislature regarding alternatives to or 399.4 modifications of the rules and procedures referenced in this 399.5 subdivision. 399.6 [EFFECTIVE DATE.] This section is effective July 1, 2003. 399.7 Sec. 35. Minnesota Statutes 2002, section 256B.0951, 399.8 subdivision 7, is amended to read: 399.9 Subd. 7. [WAIVER OF RULES.] If a federal waiver is 399.10 approved under subdivision 8, the commissioner of health may 399.11 exempt residents of intermediate care facilities for persons 399.12 with mental retardation (ICFs/MR) who participate in the 399.13 alternative quality assuranceprojectsystem established in 399.14 section 256B.095 from the requirements of Minnesota Rules, 399.15 chapter 4665. 399.16 [EFFECTIVE DATE.] This section is effective July 1, 2003. 399.17 Sec. 36. Minnesota Statutes 2002, section 256B.0951, 399.18 subdivision 9, is amended to read: 399.19 Subd. 9. [EVALUATION.] The commission, in consultation 399.20 with the commissioner of human services, shall conduct an 399.21 evaluation of thealternativequality assurance system, and 399.22 present a report to the commissioner by June 30, 2004. 399.23 [EFFECTIVE DATE.] This section is effective July 1, 2003. 399.24 Sec. 37. Minnesota Statutes 2002, section 256B.0952, 399.25 subdivision 1, is amended to read: 399.26 Subdivision 1. [NOTIFICATION.]For each year of the399.27project, region 10Counties shall give notice to the commission 399.28 and commissioners of human services and healthby March 15of 399.29 intent to join thequality assurancealternative quality 399.30 assurance licensing system, effective July 1 of that year. A 399.31 county choosing to participate in the alternative quality 399.32 assurance licensing system commits to participateuntil June 30,399.332005. Counties participating in the quality assurance399.34alternative licensing system as of January 1, 2001, shall notify399.35the commission and the commissioners of human services and399.36health by March 15, 2001, of intent to continue participation.400.1Counties that elect to continue participation must participate400.2in the alternative licensing system until June 30, 2005for 400.3 three years. 400.4 [EFFECTIVE DATE.] This section is effective July 1, 2003. 400.5 Sec. 38. Minnesota Statutes 2002, section 256B.0953, 400.6 subdivision 2, is amended to read: 400.7 Subd. 2. [LICENSURE PERIODS.] (a) In order to be licensed 400.8 under the alternative quality assuranceprocesslicensing 400.9 system, a facility, program, or service must satisfy the health 400.10 and safety outcomes approved for thepilot projectalternative 400.11 quality assurance licensing system. 400.12 (b) Licensure shall be approved for periods of one to three 400.13 years for a facility, program, or service that satisfies the 400.14 requirements of paragraph (a) and achieves the outcome 400.15 measurements in the categories of consumer evaluation, education 400.16 and training, providers, and systems. 400.17 [EFFECTIVE DATE.] This section is effective July 1, 2003. 400.18 Sec. 39. Minnesota Statutes 2002, section 256B.0955, is 400.19 amended to read: 400.20 256B.0955 [DUTIES OF THE COMMISSIONER OF HUMAN SERVICES.] 400.21 (a) Effective July 1, 1998, the commissioner of human 400.22 services shall delegate authority to perform licensing functions 400.23 and activities, in accordance with section 245A.16, to counties 400.24 participating in the alternative quality assurance licensing 400.25 system. The commissioner shall not license or reimburse a 400.26 facility, program, or service for persons with developmental 400.27 disabilities in a county that participates in the 400.28 alternative quality assurance licensing system if the 400.29 commissioner has received from the appropriate county 400.30 notification that the facility, program, or service has been 400.31 reviewed by a quality assurance team and has failed to qualify 400.32 for licensure. 400.33 (b) The commissioner may conduct random licensing 400.34 inspections based on outcomes adopted under section 256B.0951 at 400.35 facilities, programs, and services governed by the alternative 400.36 quality assurance licensing system. The role of such random 401.1 inspections shall be to verify that the alternative quality 401.2 assurance licensing system protects the safety and well-being of 401.3 consumers and maintains the availability of high-quality 401.4 services for persons with developmental disabilities. 401.5(c) The commissioner shall provide technical assistance and401.6support or training to the alternative licensing system pilot401.7project.401.8 [EFFECTIVE DATE.] This section is effective July 1, 2003. 401.9 Sec. 40. Minnesota Statutes 2002, section 256B.19, 401.10 subdivision 1, is amended to read: 401.11 Subdivision 1. [DIVISION OF COST.] The state and county 401.12 share of medical assistance costs not paid by federal funds 401.13 shall be as follows: 401.14 (1) beginning January 1, 1992, 50 percent state funds and 401.15 50 percent county funds for the cost of placement of severely 401.16 emotionally disturbed children in regional treatment centers; 401.17and401.18 (2) beginning January 1, 2003, 80 percent state funds and 401.19 20 percent county funds for the costs of nursing facility 401.20 placements of persons with disabilities under the age of 65 that 401.21 have exceeded 90 days. This clause shall be subject to chapter 401.22 256G and shall not apply to placements in facilities not 401.23 certified to participate in medical assistance.; 401.24 (3) beginning January 1, 2004, 90 percent state funds and 401.25 10 percent county funds for the costs of placements that have 401.26 exceeded 90 days in intermediate care facilities for persons 401.27 with mental retardation or a related condition that have seven 401.28 or more beds. This provision includes pass-through payments 401.29 made under section 256B.5015; and 401.30 (4) beginning January 1, 2004, when state funds are used to 401.31 pay for a nursing facility placement due to the facility's 401.32 status as an institution for mental diseases (IMD), the county 401.33 shall pay 20 percent of the nonfederal share of costs that have 401.34 exceeded 90 days. This clause is subject to chapter 256G. 401.35 For counties that participate in a Medicaid demonstration 401.36 project under sections 256B.69 and 256B.71, the division of the 402.1 nonfederal share of medical assistance expenses for payments 402.2 made to prepaid health plans or for payments made to health 402.3 maintenance organizations in the form of prepaid capitation 402.4 payments, this division of medical assistance expenses shall be 402.5 95 percent by the state and five percent by the county of 402.6 financial responsibility. 402.7 In counties where prepaid health plans are under contract 402.8 to the commissioner to provide services to medical assistance 402.9 recipients, the cost of court ordered treatment ordered without 402.10 consulting the prepaid health plan that does not include 402.11 diagnostic evaluation, recommendation, and referral for 402.12 treatment by the prepaid health plan is the responsibility of 402.13 the county of financial responsibility. 402.14 Sec. 41. Minnesota Statutes 2002, section 256B.47, 402.15 subdivision 2, is amended to read: 402.16 Subd. 2. [NOTICE TO RESIDENTS.] (a) No increase in nursing 402.17 facility rates for private paying residents shall be effective 402.18 unless the nursing facility notifies the resident or person 402.19 responsible for payment of the increase in writing 30 days 402.20 before the increase takes effect. 402.21 A nursing facility may adjust its rates without giving the 402.22 notice required by this subdivision when the purpose of the rate 402.23 adjustment is to reflect anecessarychange in thelevel of care402.24provided to acase-mix classification of the resident. If the 402.25 state fails to set rates as required by section 402.26 256B.431, subdivision 1, the time required for giving notice is 402.27 decreased by the number of days by which the state was late in 402.28 setting the rates. 402.29 (b) If the state does not set rates by the date required in 402.30 section 256B.431, subdivision 1, nursing facilities shall meet 402.31 the requirement for advance notice by informing the resident or 402.32 person responsible for payments, on or before the effective date 402.33 of the increase, that a rate increase will be effective on that 402.34 date. If the exact amount has not yet been determined, the 402.35 nursing facility may raise the rates by the amount anticipated 402.36 to be allowed. Any amounts collected from private pay residents 403.1 in excess of the allowable rate must be repaid to private pay 403.2 residents with interest at the rate used by the commissioner of 403.3 revenue for the late payment of taxes and in effect on the date 403.4 the rate increase is effective. 403.5 Sec. 42. [256B.492] [REGIONAL MANAGEMENT OF HOME AND 403.6 COMMUNITY-BASED WAIVER SERVICES.] 403.7 Subdivision 1. [REGION.] For the purposes of this section, 403.8 "region" means a county or a group of counties that have formed 403.9 a joint powers agreement to manage the home and community-based 403.10 waiver services. 403.11 Subd. 2. [PURPOSE.] Counties may form joint powers 403.12 agreements for the purpose of regionally managing the home and 403.13 community-based waiver services under sections 256B.0916 and 403.14 256B.49. Counties are encouraged to form joint powers 403.15 agreements with other counties to regionally manage the home and 403.16 community-based waiver services under sections 256B.0916 and 403.17 256B.49. 403.18 Subd. 3. [REGIONAL WAIVER AUTHORITY.] One of the parties 403.19 to the joint powers agreement or a new regional waiver authority 403.20 entity shall be designated the regional waiver authority and 403.21 shall monitor regional authorizations and expenditures. The 403.22 joint powers agreement shall specify how decisions are made on 403.23 authorizations and expenditures from the home and 403.24 community-based waiver allocation. 403.25 Subd. 4. [FISCAL MANAGEMENT.] A region may reserve up to 403.26 two percent of its home and community-based allocation in a 403.27 given fiscal year to meet unanticipated needs. 403.28 Subd. 5. [ALTERNATIVE METHOD.] When waiver resources are 403.29 to be distributed to a group of counties that elect not to form 403.30 a region, the commissioner may (1) require a joint powers 403.31 agreement; (2) contract with a public or private agency; or (3) 403.32 require both to administer the waiver program for that 403.33 geographic area. The commissioner is responsible for assuring 403.34 that funds are used properly within the amount allocated. 403.35 Sec. 43. [256B.493] [COST MANAGEMENT OF HOME AND 403.36 COMMUNITY-BASED WAIVERED SERVICES.] 404.1 (a) The commissioner of human services shall efficiently 404.2 allocate and manage limited home and community-based waiver 404.3 services program resources to achieve the following outcomes: 404.4 (1) the establishment of feasible and viable alternatives 404.5 for persons in institutional or hospital settings to relocate to 404.6 home and community-based settings; 404.7 (2) the availability of timely assistance to persons at 404.8 imminent risk of institutional or hospital placement or whose 404.9 health and safety is at immediate risk; and 404.10 (3) the maximum provision of essential community supports 404.11 to eligible persons in need of and waiting for home and 404.12 community-based service alternatives. 404.13 (b) The commissioner shall monitor the costs of home and 404.14 community-based services, and may adjust home and 404.15 community-based service allocations, as necessary, to assure 404.16 that program costs are managed within available funding. When 404.17 making this determination, the commissioner shall give 404.18 consideration to offsets that may occur in other programs as a 404.19 result of the availability and use of home and community-based 404.20 services. 404.21 (c) The commissioner shall allocate home and 404.22 community-based resources to local/regional entities in a manner 404.23 that considers: 404.24 (1) the historical costs of serving individuals in a county 404.25 or region; 404.26 (2) the individualized service plans for current recipients 404.27 and eligible individuals expected to enter the waiver during the 404.28 fiscal year; and 404.29 (3) the need for crisis services or other short-term 404.30 services required because of unforeseen circumstances. 404.31 (d) The commissioner may reallocate resources from one 404.32 county or region to another if available funding in that county 404.33 or region is not likely to be spent and the reallocation is 404.34 necessary to achieve the outcomes specified in paragraph (a). 404.35 Sec. 44. Minnesota Statutes 2002, section 256B.501, 404.36 subdivision 1, is amended to read: 405.1 Subdivision 1. [DEFINITIONS.] For the purposes of this 405.2 section, the following terms have the meaning given them. 405.3 (a) "Commissioner" means the commissioner of human services. 405.4 (b) "Facility" means a facility licensed as a mental 405.5 retardation residential facility under section 252.28, licensed 405.6 as a supervised living facility under chapter 144, and certified 405.7 as an intermediate care facility for persons with mental 405.8 retardation or related conditions. The term does not include a 405.9 state regional treatment center. 405.10 (c) "Habilitation services" means health and social 405.11 services directed toward increasing and maintaining the 405.12 physical, intellectual, emotional, and social functioning of 405.13 persons with mental retardation or related conditions. 405.14 Habilitation services include therapeutic activities, 405.15 assistance, training, supervision, and monitoring in the areas 405.16 of self-care, sensory and motor development, interpersonal 405.17 skills, communication, socialization, reduction or elimination 405.18 of maladaptive behavior, community living and mobility, health 405.19 care, leisure and recreation, money management, and household 405.20 chores. 405.21 (d) "Services during the day" means services or supports 405.22 provided to a person that enables the person to be fully 405.23 integrated into the community. Services during the day must 405.24 include habilitation services, and may include a variety of 405.25 supports to enable the person to exercise choices for community 405.26 integration and inclusion activities. Services during the day 405.27 may include, but are not limited to: supported work, support 405.28 during community activities, community volunteer opportunities, 405.29 adult day care, recreational activities, and other 405.30 individualized integrated supports. 405.31 (e) "Waivered service" means home or community-based 405.32 service authorized under United States Code, title 42, section 405.33 1396n(c), as amended through December 31, 1987, and defined in 405.34 the Minnesota state plan for the provision of medical assistance 405.35 services. Waivered services include, at a minimum, case 405.36 management, family training and support, developmental training 406.1 homes, supervised living arrangements, semi-independent living 406.2 services, respite care, and training and habilitation services. 406.3 Sec. 45. Minnesota Statutes 2002, section 256B.501, is 406.4 amended by adding a subdivision to read: 406.5 Subd. 3m. [SERVICES DURING THE DAY.] When establishing a 406.6 rate for services during the day, the commissioner shall ensure 406.7 that these services comply with active treatment requirements 406.8 for persons residing in an ICF/MR as defined under federal 406.9 regulations and shall ensure that day services for eligible 406.10 persons are not provided by the person's residential service 406.11 provider, unless the person or the person's legal representative 406.12 is offered a choice of providers and agrees in writing to 406.13 provision of day services by the residential service provider, 406.14 consistent with the individual service plan. The individual 406.15 service plan for individuals who choose to have their 406.16 residential service provider provide their day services must 406.17 describe how health, safety, protection, and habilitation needs 406.18 will be met, including how frequent and regular contact with 406.19 persons other than the residential service provider will occur. 406.20 The individualized service plan must address the provision of 406.21 services during the day outside the residence. 406.22 Sec. 46. Minnesota Statutes 2002, section 256B.5013, 406.23 subdivision 4, is amended to read: 406.24 Subd. 4. [TEMPORARYRATE ADJUSTMENTSTO ADDRESS OCCUPANCY406.25AND ACCESSFOR SHORT-TERM ADMISSIONS FOR CRISIS OR SPECIALIZED 406.26 MEDICAL CARE.] Beginning July 1,20022003, the 406.27 commissionershall adjust the total payment rate for up to 75406.28days for the remaining recipients for facilities in which the406.29monthly occupancy rate of licensed beds is 75 percent or406.30greater. This mechanism shall not be used to pay for hospital406.31or therapeutic leave days beyond the maximums allowedmay 406.32 designate up to 25 beds in ICF/MR facilities statewide for the 406.33 purpose of providing short-term admissions due to crisis care 406.34 needs or care for medically fragile individuals. The 406.35 commissioner shall adjust the total payment rate for up to 75 406.36 days for the remaining recipients of the facility when the 407.1 monthly rate of the crisis or respite bed is 50 percent or 407.2 greater. 407.3 Sec. 47. Minnesota Statutes 2002, section 256B.5015, is 407.4 amended to read: 407.5 256B.5015 [PASS-THROUGH OFTRAINING AND HABILITATIONOTHER 407.6 SERVICES COSTS.] 407.7 Subdivision 1. [DAY TRAINING AND HABILITATION SERVICES.] 407.8 Day training and habilitation services costs shall be paid as a 407.9 pass-through payment at the lowest rate paid for the comparable 407.10 services at that site under sections 252.40 to 252.46. The 407.11 pass-through payments for training and habilitation services 407.12 shall be paid separately by the commissioner and shall not be 407.13 included in the computation of the ICF/MR facility total payment 407.14 rate. 407.15 Subd. 2. [SERVICES DURING THE DAY.] Services during the 407.16 day, as defined in section 256B.501, but excluding day training 407.17 and habilitation services, shall be paid as a pass-through 407.18 payment no later than January 1, 2004. The commissioner shall 407.19 establish rates for these services, other than day training and 407.20 habilitation services, at levels that do not exceed 75 percent 407.21 of a recipient's day training and habilitation service costs 407.22 prior to the service change. 407.23 When establishing a rate for these services, the 407.24 commissioner shall also consider an individual recipient's needs 407.25 as identified in the individualized service plan and the 407.26 person's need for active treatment as defined under federal 407.27 regulations. The pass-through payments for services during the 407.28 day shall be paid separately by the commissioner and shall not 407.29 be included in the computation of the ICF/MR facility total 407.30 payment rate. 407.31 Sec. 48. Minnesota Statutes 2002, section 256B.82, is 407.32 amended to read: 407.33 256B.82 [PREPAID PLANS AND MENTAL HEALTH REHABILITATIVE 407.34 SERVICES.] 407.35 Medical assistance and MinnesotaCare prepaid health plans 407.36 may include coverage for adult mental health rehabilitative 408.1 services under section 256B.0623, intensive rehabilitative 408.2 services under section 256B.0622, and adult mental health crisis 408.3 response services under section 256B.0624, beginning January 1, 408.420042005. 408.5 By January 15,20032004, the commissioner shall report to 408.6 the legislature how these services should be included in prepaid 408.7 plans. The commissioner shall consult with mental health 408.8 advocates, health plans, and counties in developing this 408.9 report. The report recommendations must include a plan to 408.10 ensure coordination of these services between health plans and 408.11 counties, assure recipient access to essential community 408.12 providers, and monitor the health plans' delivery of services 408.13 through utilization review and quality standards. 408.14 Sec. 49. [256I.08] [COUNTY SHARE FOR CERTAIN NURSING 408.15 FACILITY STAYS.] 408.16 Beginning January 1, 2004, if group residential housing is 408.17 used to pay for a nursing facility placement due to the 408.18 facility's status as an Institution for Mental Diseases, the 408.19 county is liable for 20 percent of the nonfederal share of costs 408.20 for persons under the age of 65 that have exceeded 90 days. 408.21 Sec. 50. [HOME AND COMMUNITY-BASED WAIVERED SERVICE 408.22 PRIORITIES.] 408.23 For the 2004-2005 biennium, the commissioner shall monitor 408.24 all available home and community-based waiver resources to 408.25 support the following service priorities: 408.26 (1) children or adults who cannot be maintained safely in 408.27 their current living situation without waiver services; 408.28 (2) children or adults in unstable living situations due to 408.29 significant needs, age, or incapacity of the primary caregiver; 408.30 and 408.31 (3) other persons who have been screened and are eligible, 408.32 including those living in an institution. 408.33 Sec. 51. [HOME AND COMMUNITY-BASED WAIVER FOR PERSONS WITH 408.34 MENTAL RETARDATION OR A RELATED CONDITION; RESOURCE MANAGEMENT 408.35 STATEWIDE.] 408.36 The commissioner shall manage MR/RC waiver resources during 409.1 the 2004-2005 biennium to assure that all available funds are 409.2 allocated to meet the service priority needs and maintain a 409.3 reserve statewide of no more than three percent of available 409.4 funds. In order to effectively manage available resources to 409.5 meet service priorities, the commissioner shall enable counties 409.6 to manage resources on a regional basis. 409.7 Sec. 52. [DENIAL, REDUCTION, OR TERMINATION OF WAIVER 409.8 SERVICES.] 409.9 For the 2004-2005 biennium, when a county is evaluating 409.10 individual denials, reductions, or terminations of home and 409.11 community-based services under sections 256B.0916 and 256B.49 409.12 for an individual, the case manager shall offer to meet with the 409.13 individual or the individual's guardian and prioritize service 409.14 needs based on the individualized service plan. The reduction 409.15 in the authorized services for an individual due to changes in 409.16 funding for waivered services may not exceed the amount needed 409.17 to assure medically necessary services to meet the individual's 409.18 health, safety, and welfare. 409.19 Sec. 53. [DIRECTION TO THE COMMISSIONER; HOME AND 409.20 COMMUNITY-BASED SERVICES RESOURCE ALLOCATION METHOD 409.21 DEVELOPMENT.] 409.22 The commissioner shall consult with representatives of 409.23 persons with disabilities, their families and guardians, 409.24 counties, service providers, and advocacy organizations to 409.25 develop recommendations for a statewide method of allocating 409.26 resources sufficient to meet the identified needs of persons 409.27 eligible for home and community-based waiver services under 409.28 Minnesota Statutes, sections 256B.0916 and 256B.49. The 409.29 recommendations shall include provisions that address the 409.30 feasibility of (1) offering incentives to persons with less 409.31 urgent service needs who are receiving services or on the 409.32 waiting list to postpone their access to home and 409.33 community-based service options, (2) providing case management 409.34 services to individuals on the MR/RC waiting list, (3) analyzing 409.35 the impact of allocating resources on rates, payments, and 409.36 changes in services to people, (4) analyzing individual 410.1 capitation, and (5) evaluating whether the parental fee 410.2 structure should be modified to reflect service utilization 410.3 differences. The recommendations shall be provided to the 410.4 legislative committees with jurisdiction over health and human 410.5 services issues by January 15, 2005. A status report shall be 410.6 provided to the committee by January 15, 2004. 410.7 Sec. 54. [HOME AND COMMUNITY-BASED SERVICES FUNDING 410.8 METHODOLOGY.] 410.9 Beginning July 1, 2003, before making significant 410.10 administrative changes in the funding methodology for the home 410.11 and community-based waiver for persons with mental retardation 410.12 or a related condition, the commissioner shall consult with 410.13 representatives of counties, service providers, and persons with 410.14 disabilities and their families to provide specific information 410.15 about the funding formula and funding changes and the 410.16 opportunity to comment at least 90 days before the changes 410.17 become effective. 410.18 Sec. 55. [CASE MANAGEMENT ACCESS FOR PERSONS SEEKING 410.19 COMMUNITY-BASED SERVICES.] 410.20 When a person requests services authorized under Minnesota 410.21 Statutes, section 256B.0621, 256B.092, or 256B.49, subdivision 410.22 13, the county must determine whether the person qualifies, 410.23 begin the screening process, begin individualized service plan 410.24 development, and provide mandated case management services or 410.25 relocation service coordination to those eligible within a 410.26 reasonable time. If a county is unable to provide case 410.27 management services within the required time period under 410.28 sections 256B.0621, subdivision 7; 256B.49, subdivision 13; and 410.29 Minnesota Rules, parts 9525.0004 to 9525.0036, the county shall 410.30 contract for case management services to meet the obligation. 410.31 Sec. 56. [CASE MANAGEMENT SERVICES REDESIGN.] 410.32 In consultation with representatives for consumers, 410.33 consumer advocates, counties, and service providers, the 410.34 commissioner shall develop proposed legislation for case 410.35 management changes that will (1) streamline administration, (2) 410.36 improve consumer access to case management services, (3) assess 411.1 the feasibility of a comprehensive universal assessment protocol 411.2 for persons seeking community supports, (4) provide 411.3 recommendations to case managers on reasonable means to meet 411.4 consumer needs given resource allocation methods, (5) establish 411.5 accountability for funds and performance measures, (6) provide 411.6 for consumer choice of the case management service vendor, and 411.7 (7) evaluate whether case management services to individuals 411.8 with mental retardation or a related condition under Minnesota 411.9 Statutes, section 256B.092, not reimbursed as a waivered service 411.10 should be paid by the state. The proposed legislation shall be 411.11 provided to the legislative committees with jurisdiction over 411.12 health and human services issues by January 15, 2005. 411.13 Sec. 57. [VACANCY LISTINGS.] 411.14 The commissioner of human services shall work with 411.15 interested stakeholders on how provider and industry specific 411.16 Web sites can provide useful information to consumers on bed 411.17 vacancies for group residential housing providers and 411.18 intermediate care facilities for persons with mental retardation 411.19 and related conditions. Providers and industry trade 411.20 organizations are responsible for all costs related to 411.21 maintaining Web sites listing bed vacancies. 411.22 Sec. 58. [HOMELESS SERVICES; STATE CONTRACTS.] 411.23 The commissioner of human services may contract directly 411.24 with nonprofit organizations providing homeless services in two 411.25 or more counties. No more than two percent of the Children's 411.26 and Community Social Services Act funds may be set aside to 411.27 provide for contracts under this section. 411.28 Sec. 59. [GOVERNOR'S COUNCIL ON DEVELOPMENTAL DISABILITY, 411.29 OMBUDSMAN FOR MENTAL HEALTH AND MENTAL RETARDATION, AND COUNCIL 411.30 ON DISABILITIES.] 411.31 The governor's council on developmental disability under 411.32 Minnesota Statutes, section 16B.053, the ombudsman for mental 411.33 health and mental retardation under Minnesota Statutes, section 411.34 245.92, the centers for independent living, and the council on 411.35 disability under Minnesota Statutes, section 256.482, must study 411.36 the feasibility of (1) space coordination, (2) shared use of 412.1 technology, (3) coordination of resource priorities, and (4) 412.2 consolidation and make recommendations to the house and senate 412.3 committees with jurisdiction over these entities by January 15, 412.4 2004. 412.5 Sec. 60. [GOVERNOR'S COUNCIL ON DEVELOPMENTAL DISABILITY.] 412.6 The governor's council on developmental disability under 412.7 Minnesota Statutes, section 16B.053, shall provide an annual 412.8 report of its activities to the house and senate committees with 412.9 jurisdiction over human services by February 1 of each year. 412.10 Sec. 61. [LICENSING CHANGE.] 412.11 Notwithstanding any law or rule to the contrary, the 412.12 commissioner of human services shall allow an existing 412.13 intermediate care facility for persons with mental retardation 412.14 or related conditions located in Goodhue county serving 39 412.15 children to be converted to four separately licensed or 412.16 certified cottages serving up to six children each. 412.17 Sec. 62. [REVISOR'S INSTRUCTION.] 412.18 For sections in Minnesota Statutes and Minnesota Rules 412.19 affected by the repealed sections in this article, the revisor 412.20 shall delete internal cross-references where appropriate and 412.21 make changes necessary to correct the punctuation, grammar, or 412.22 structure of the remaining text and preserve its meaning. 412.23 Sec. 63. [REPEALER.] 412.24 (a) Minnesota Statutes 2002, section 252.32, subdivision 2, 412.25 is repealed July 1, 2003. 412.26 (b) Minnesota Statutes 2002, section 245.4712, subdivision 412.27 2, is repealed July 1, 2005. 412.28 (c) Laws 2001, First Special Session chapter 9, article 13, 412.29 section 24, is repealed July 1, 2003. 412.30 ARTICLE 5 412.31 CHILDREN'S SERVICES 412.32 Section 1. Minnesota Statutes 2002, section 256B.0625, 412.33 subdivision 20, is amended to read: 412.34 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 412.35 extent authorized by rule of the state agency, medical 412.36 assistance covers case management services to persons with 413.1 serious and persistent mental illness and children with severe 413.2 emotional disturbance. Services provided under this section 413.3 must meet the relevant standards in sections 245.461 to 413.4 245.4888, the Comprehensive Adult and Children's Mental Health 413.5 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 413.6 9505.0322, excluding subpart 10. 413.7 (b) Entities meeting program standards set out in rules 413.8 governing family community support services as defined in 413.9 section 245.4871, subdivision 17, are eligible for medical 413.10 assistance reimbursement for case management services for 413.11 children with severe emotional disturbance when these services 413.12 meet the program standards in Minnesota Rules, parts 9520.0900 413.13 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 413.14 (c) Medical assistance and MinnesotaCare payment for mental 413.15 health case management shall be made on a monthly basis. In 413.16 order to receive payment for an eligible child, the provider 413.17 must document at least a face-to-face contact with the child, 413.18 the child's parents, or the child's legal representative. To 413.19 receive payment for an eligible adult, the provider must 413.20 document: 413.21 (1) at least a face-to-face contact with the adult or the 413.22 adult's legal representative; or 413.23 (2) at least a telephone contact with the adult or the 413.24 adult's legal representative and document a face-to-face contact 413.25 with the adult or the adult's legal representative within the 413.26 preceding two months. 413.27 (d) Payment for mental health case management provided by 413.28 county or state staff shall be based on the monthly rate 413.29 methodology under section 256B.094, subdivision 6, paragraph 413.30 (b), with separate rates calculated for child welfare and mental 413.31 health, and within mental health, separate rates for children 413.32 and adults. 413.33 (e) Payment for mental health case management provided by 413.34 Indian health services or by agencies operated by Indian tribes 413.35 may be made according to this section or other relevant 413.36 federally approved rate setting methodology. 414.1 (f) Payment for mental health case management provided by 414.2 vendors who contract with a county or Indian tribe shall be 414.3 based on a monthly rate negotiated by the host county or tribe. 414.4 The negotiated rate must not exceed the rate charged by the 414.5 vendor for the same service to other payers. If the service is 414.6 provided by a team of contracted vendors, the county or tribe 414.7 may negotiate a team rate with a vendor who is a member of the 414.8 team. The team shall determine how to distribute the rate among 414.9 its members. No reimbursement received by contracted vendors 414.10 shall be returned to the county or tribe, except to reimburse 414.11 the county or tribe for advance funding provided by the county 414.12 or tribe to the vendor. 414.13 (g) If the service is provided by a team which includes 414.14 contracted vendors, tribal staff, and county or state staff, the 414.15 costs for county or state staff participation in the team shall 414.16 be included in the rate for county-provided services. In this 414.17 case, the contracted vendor, the tribal agency, and the county 414.18 may each receive separate payment for services provided by each 414.19 entity in the same month. In order to prevent duplication of 414.20 services, each entity must document, in the recipient's file, 414.21 the need for team case management and a description of the roles 414.22 of the team members. 414.23 (h) The commissioner shall calculate the nonfederal share 414.24 of actual medical assistance and general assistance medical care 414.25 payments for each county, based on the higher of calendar year 414.26 1995 or 1996, by service date, project that amount forward to 414.27 1999, and transfer one-half of the result from medical 414.28 assistance and general assistance medical care to each county's 414.29 mental health grants under sections 245.4886 and 256E.12 for 414.30 calendar year 1999. The annualized minimum amount added to each 414.31 county's mental health grant shall be $3,000 per year for 414.32 children and $5,000 per year for adults. The commissioner may 414.33 reduce the statewide growth factor in order to fund these 414.34 minimums. The annualized total amount transferred shall become 414.35 part of the base for future mental health grants for each county. 414.36 (i)Any net increase in revenue to the county or tribe as a415.1result of the change in this section must be used to provide415.2expanded mental health services as defined in sections 245.461415.3to 245.4888, the Comprehensive Adult and Children's Mental415.4Health Acts, excluding inpatient and residential treatment. For415.5adults, increased revenue may also be used for services and415.6consumer supports which are part of adult mental health projects415.7approved under Laws 1997, chapter 203, article 7, section 25.415.8For children, increased revenue may also be used for respite415.9care and nonresidential individualized rehabilitation services415.10as defined in section 245.492, subdivisions 17 and 23.415.11"Increased revenue" has the meaning given in Minnesota Rules,415.12part 9520.0903, subpart 3.415.13(j)Notwithstanding section 256B.19, subdivision 1, the 415.14 nonfederal share of costs for mental health case management 415.15 shall be provided by the recipient's county of responsibility, 415.16 as defined in sections 256G.01 to 256G.12, from sources other 415.17 than federal funds or funds used to match other federal funds. 415.18 If the service is provided by a tribal agency, the nonfederal 415.19 share, if any, shall be provided by the recipient's tribe. 415.20(k)(j) The commissioner may suspend, reduce, or terminate 415.21 the reimbursement to a provider that does not meet the reporting 415.22 or other requirements of this section. The county of 415.23 responsibility, as defined in sections 256G.01 to 256G.12, or, 415.24 if applicable, the tribal agency, is responsible for any federal 415.25 disallowances. The county or tribe may share this 415.26 responsibility with its contracted vendors. 415.27(l)(k) The commissioner shall set aside a portion of the 415.28 federal funds earned under this section to repay the special 415.29 revenue maximization account under section 256.01, subdivision 415.30 2, clause (15). The repayment is limited to: 415.31 (1) the costs of developing and implementing this section; 415.32 and 415.33 (2) programming the information systems. 415.34(m)(l) Payments to counties and tribal agencies for case 415.35 management expenditures under this section shall only be made 415.36 from federal earnings from services provided under this 416.1 section. Payments to county-contracted vendors shall include 416.2 both the federal earnings and the county share. 416.3(n)(m) Notwithstanding section 256B.041, county payments 416.4 for the cost of mental health case management services provided 416.5 by county or state staff shall not be made to the state 416.6 treasurer. For the purposes of mental health case management 416.7 services provided by county or state staff under this section, 416.8 the centralized disbursement of payments to counties under 416.9 section 256B.041 consists only of federal earnings from services 416.10 provided under this section. 416.11(o)(n) Case management services under this subdivision do 416.12 not include therapy, treatment, legal, or outreach services. 416.13(p)(o) If the recipient is a resident of a nursing 416.14 facility, intermediate care facility, or hospital, and the 416.15 recipient's institutional care is paid by medical assistance, 416.16 payment for case management services under this subdivision is 416.17 limited to the last 180 days of the recipient's residency in 416.18 that facility and may not exceed more than six months in a 416.19 calendar year. 416.20(q)(p) Payment for case management services under this 416.21 subdivision shall not duplicate payments made under other 416.22 program authorities for the same purpose. 416.23(r)(q) By July 1, 2000, the commissioner shall evaluate 416.24 the effectiveness of the changes required by this section, 416.25 including changes in number of persons receiving mental health 416.26 case management, changes in hours of service per person, and 416.27 changes in caseload size. 416.28(s)(r) For each calendar year beginning with the calendar 416.29 year 2001, the annualized amount of state funds for each county 416.30 determined under paragraph (h) shall be adjusted by the county's 416.31 percentage change in the average number of clients per month who 416.32 received case management under this section during the fiscal 416.33 year that ended six months prior to the calendar year in 416.34 question, in comparison to the prior fiscal year. 416.35(t)(s) For counties receiving the minimum allocation of 416.36 $3,000 or $5,000 described in paragraph (h), the adjustment in 417.1 paragraph(s)(r) shall be determined so that the county 417.2 receives the higher of the following amounts: 417.3 (1) a continuation of the minimum allocation in paragraph 417.4 (h); or 417.5 (2) an amount based on that county's average number of 417.6 clients per month who received case management under this 417.7 section during the fiscal year that ended six months prior to 417.8 the calendar year in question, times the average statewide grant 417.9 per person per month for counties not receiving the minimum 417.10 allocation. 417.11(u)(t) The adjustments in paragraphs(s)(r) and 417.12(t)(s) shall be calculated separately for children and adults. 417.13 Sec. 2. Minnesota Statutes 2002, section 256B.0625, 417.14 subdivision 23, is amended to read: 417.15 Subd. 23. [DAY TREATMENT SERVICES.] Medical assistance 417.16 covers day treatment services as specified in sections 245.462, 417.17 subdivision 8, and 245.4871, subdivision 10, that are provided 417.18 under contract with the county board. Notwithstanding Minnesota 417.19 Rules, part 9505.0323, subpart 15, the commissioner may set 417.20 authorization thresholds for day treatment for adults according 417.21 to section 256B.0625, subdivision 25. Effective July 1, 2004, 417.22 medical assistance covers day treatment services for children as 417.23 specified under section 256B.0943. Medical assistance coverage 417.24 for day treatment for adults ends on June 30, 2005. 417.25 Sec. 3. Minnesota Statutes 2002, section 256B.0625, is 417.26 amended by adding a subdivision to read: 417.27 Subd. 35a. [CHILDREN'S MENTAL HEALTH CRISIS RESPONSE 417.28 SERVICES.] Medical assistance covers children's mental health 417.29 crisis response services according to section 256B.0944. 417.30 [EFFECTIVE DATE.] This section is effective July 1, 2004. 417.31 Sec. 4. Minnesota Statutes 2002, section 256B.0625, is 417.32 amended by adding a subdivision to read: 417.33 Subd. 35b. [CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.] 417.34 Medical assistance covers children's therapeutic services and 417.35 supports according to section 256B.0943. 417.36 [EFFECTIVE DATE.] This section is effective July 1, 2004. 418.1 Sec. 5. Minnesota Statutes 2002, section 256B.0625, is 418.2 amended by adding a subdivision to read: 418.3 Subd. 45. [SUBACUTE PSYCHIATRIC CARE FOR PERSONS UNDER 21 418.4 YEARS OF AGE.] Medical assistance covers subacute psychiatric 418.5 care for person under 21 years of age when: 418.6 (1) the services meet the requirements of Code of Federal 418.7 Regulations, title 42, section 440.160; 418.8 (2) the facility is accredited as a psychiatric treatment 418.9 facility by the joint commission on accreditation of healthcare 418.10 organizations, the commission on accreditation of rehabilitation 418.11 facilities, or the council on accreditation; and 418.12 (3) the facility is licensed by the commissioner of health 418.13 under section 144.50. 418.14 [EFFECTIVE DATE.] This section is effective July 1, 2003. 418.15 Sec. 6. [256B.0943] [CHILDREN'S THERAPEUTIC SERVICES AND 418.16 SUPPORTS.] 418.17 Subdivision 1. [DEFINITIONS.] For purposes of this 418.18 section, the following terms have the meanings given them. 418.19 (a) "Children's therapeutic services and supports" means 418.20 the flexible package of mental health services for children who 418.21 require varying therapeutic and rehabilitative levels of 418.22 intervention. The services are time-limited interventions that 418.23 are delivered using various treatment modalities and 418.24 combinations of services designed to reach treatment outcomes 418.25 identified in the individual treatment plan. 418.26 (b) "Clinical supervision" means the overall responsibility 418.27 of the mental health professional for the control and direction 418.28 of individualized treatment planning, service delivery, and 418.29 treatment review for each client. A mental health professional 418.30 who is an enrolled Minnesota health care program provider 418.31 accepts full professional responsibility for a supervisee's 418.32 actions and decisions, instructs the supervisee in the 418.33 supervisee's work, and oversees or directs the supervisee's work. 418.34 (c) "County board" means the county board of commissioners 418.35 or board established under sections 402.01 to 402.10 or 471.59. 418.36 (d) "Crisis assistance" has the meaning given in section 419.1 245.4871, subdivision 9a. 419.2 (e) "Culturally competent provider" means a provider who 419.3 understands and can utilize to a client's benefit the client's 419.4 culture when providing services to the client. A provider may 419.5 be culturally competent because the provider is of the same 419.6 cultural or ethnic group as the client or the provider has 419.7 developed the knowledge and skills through training and 419.8 experience to provide services to culturally diverse clients. 419.9 (f) "Day treatment program" for children means a site-based 419.10 structured program consisting of group psychotherapy for more 419.11 than three individuals and other intensive therapeutic services 419.12 provided by a multidisciplinary team, under the clinical 419.13 supervision of a mental health professional. 419.14 (g) "Diagnostic assessment" has the meaning given in 419.15 section 245.4871, subdivision 11. 419.16 (h) "Direct service time" means the time that a mental 419.17 health professional, mental health practitioner, or mental 419.18 health behavioral aide spends face-to-face with a client and the 419.19 client's family. Direct service time includes time in which the 419.20 provider obtains a client's history or provides service 419.21 components of children's therapeutic services and supports. 419.22 Direct service time does not include time doing work before and 419.23 after providing direct services, including scheduling, 419.24 maintaining clinical records, consulting with others about the 419.25 client's mental health status, preparing reports, receiving 419.26 clinical supervision directly related to the client's 419.27 psychotherapy session, and revising the client's individual 419.28 treatment plan. 419.29 (i) "Direction of mental health behavioral aide" means the 419.30 activities of a mental health professional or mental health 419.31 practitioner in guiding the mental health behavioral aide in 419.32 providing services to a client. The direction of a mental 419.33 health behavioral aide must be based on the client's 419.34 individualized treatment plan and meet the requirements in 419.35 subdivision 6, paragraph (b), clause (5). 419.36 (j) "Emotional disturbance" has the meaning given in 420.1 section 245.4871, subdivision 15. For persons at least age 18 420.2 but under age 21, mental illness has the meaning given in 420.3 section 245.462, subdivision 20, paragraph (a). 420.4 (k) "Individual behavioral plan" means a plan of 420.5 intervention, treatment, and services for a child written by a 420.6 mental health professional or mental health practitioner, under 420.7 the clinical supervision of a mental health professional, to 420.8 guide the work of the mental health behavioral aide. 420.9 (l) "Individual treatment plan" has the meaning given in 420.10 section 245.4871, subdivision 21. 420.11 (m) "Mental health professional" means an individual as 420.12 defined in section 245.4871, subdivision 27, clauses (1) to (5), 420.13 or tribal vendor as defined in section 256B.02, subdivision 7, 420.14 paragraph (b). 420.15 (n) "Preschool program" means a day program licensed under 420.16 Minnesota Rules, parts 9503.0005 to 9503.0175, and enrolled as a 420.17 children's therapeutic services and supports provider to provide 420.18 a structured treatment program to a child who is at least 33 420.19 months old but who has not yet attended the first day of 420.20 kindergarten. 420.21 (o) "Skills training" means individual, family, or group 420.22 training designed to improve the basic functioning of the child 420.23 with emotional disturbance and the child's family in the 420.24 activities of daily living and community living, and to improve 420.25 the social functioning of the child and the child's family in 420.26 areas important to the child's maintaining or reestablishing 420.27 residency in the community. Individual, family, and group 420.28 skills training must: 420.29 (1) consist of activities designed to promote skill 420.30 development of the child and the child's family in the use of 420.31 age-appropriate daily living skills, interpersonal and family 420.32 relationships, and leisure and recreational services; 420.33 (2) consist of activities that will assist the family's 420.34 understanding of normal child development and to use parenting 420.35 skills that will help the child with emotional disturbance 420.36 achieve the goals outlined in the child's individual treatment 421.1 plan; and 421.2 (3) promote family preservation and unification, promote 421.3 the family's integration with the community, and reduce the use 421.4 of unnecessary out-of-home placement or institutionalization of 421.5 children with emotional disturbance. 421.6 Subd. 2. [COVERED SERVICE COMPONENTS OF CHILDREN'S 421.7 THERAPEUTIC SERVICES AND SUPPORTS.] (a) Subject to federal 421.8 approval, medical assistance covers medically necessary 421.9 children's therapeutic services and supports as defined in this 421.10 section that an eligible provider entity under subdivisions 4 421.11 and 5 provides to a client eligible under subdivision 3. 421.12 (b) The service components of children's therapeutic 421.13 services and supports are: 421.14 (1) individual, family, and group psychotherapy; 421.15 (2) individual, family, or group skills training provide by 421.16 a mental health professional or mental health practitioner; 421.17 (3) crisis assistance; 421.18 (4) mental health behavioral aide services; and 421.19 (5) direction of a mental health behavioral aide. 421.20 (c) Service components may be combined to constitute 421.21 therapeutic programs, including day treatment programs and 421.22 preschool programs. Although day treatment and preschool 421.23 programs have specific client and provider eligibility 421.24 requirements, medical assistance only pays for the service 421.25 components listed in paragraph (b). 421.26 Subd. 3. [DETERMINATION OF CLIENT ELIGIBILITY.] A client's 421.27 eligibility to receive children's therapeutic services and 421.28 supports under this section shall be determined based on a 421.29 diagnostic assessment by a mental health professional that is 421.30 performed within 180 days of the initial start of service. The 421.31 diagnostic assessment must: 421.32 (1) include current diagnoses on all five axes of the 421.33 client's current mental health status; 421.34 (2) determine whether a child under age 18 has a diagnosis 421.35 of emotional disturbance or, if the person is between the ages 421.36 of 18 and 21, whether the person has a mental illness; 422.1 (3) document children's therapeutic services and supports 422.2 as medically necessary to address an identified disability, 422.3 functional impairment, and the individual client's needs and 422.4 goals; 422.5 (4) be used in the development of the individualized 422.6 treatment plan; and 422.7 (5) be completed annually until age 18. For individuals 422.8 between age 18 and 21, unless a client's mental health condition 422.9 has changed markedly since the client's most recent diagnostic 422.10 assessment, annual updating is necessary. For the purpose of 422.11 this section, "updating" means a written summary, including 422.12 current diagnoses on all five axes, by a mental health 422.13 professional of the client's current mental health status and 422.14 service needs. 422.15 Subd. 4. [PROVIDER ENTITY CERTIFICATION.] (a) Effective 422.16 July 1, 2003, the commissioner shall establish an initial 422.17 provider entity application and certification process and 422.18 recertification process to determine whether a provider entity 422.19 has an administrative and clinical infrastructure that meets the 422.20 requirements in subdivisions 5 and 6. The commissioner shall 422.21 recertify a provider entity at least every three years. The 422.22 commissioner shall establish a process for decertification of a 422.23 provider entity that no longer meets the requirements in this 422.24 section. The county, tribe, and the commissioner shall be 422.25 mutually responsible and accountable for the county's, tribe's, 422.26 and state's part of the certification, recertification, and 422.27 decertification processes. 422.28 (b) For purposes of this section, a provider entity must be: 422.29 (1) an Indian health services facility or a facility owned 422.30 and operated by a tribe or tribal organization operating as a 422.31 638 facility under Public Law 93-368 certified by the state; 422.32 (2) a county-operated entity certified by the state; or 422.33 (3) a noncounty entity recommended for certification by the 422.34 provider's host county and certified by the state. 422.35 Subd. 5. [PROVIDER ENTITY ADMINISTRATIVE INFRASTRUCTURE 422.36 REQUIREMENTS.] (a) To be an eligible provider entity under this 423.1 section, a provider entity must have an administrative 423.2 infrastructure that establishes authority and accountability for 423.3 decision making and oversight of functions, including finance, 423.4 personnel, system management, clinical practice, and performance 423.5 measurement. The provider must have written policies and 423.6 procedures that it reviews and updates every three years and 423.7 distributes to staff initially and upon each subsequent update. 423.8 (b) The administrative infrastructure written policies and 423.9 procedures must include: 423.10 (1) personnel procedures, including a process for: (i) 423.11 recruiting, hiring, training, and retention of culturally and 423.12 linguistically competent providers; (ii) conducting a criminal 423.13 background check on all direct service providers and volunteers; 423.14 (iii) investigating, reporting, and acting on violations of 423.15 ethical conduct standards; (iv) investigating, reporting, and 423.16 acting on violations of data privacy policies that are compliant 423.17 with federal and state laws; (v) utilizing volunteers, including 423.18 screening applicants, training and supervising volunteers, and 423.19 providing liability coverage for volunteers; and (vi) 423.20 documenting that a mental health professional, mental health 423.21 practitioner, or mental health behavioral aide meets the 423.22 applicable provider qualification criteria, training criteria 423.23 under subdivision 8, and clinical supervision or direction of a 423.24 mental health behavioral aide requirements under subdivision 6; 423.25 (2) fiscal procedures, including internal fiscal control 423.26 practices and a process for collecting revenue that is compliant 423.27 with federal and state laws; 423.28 (3) if a client is receiving services from a case manager 423.29 or other provider entity, a service coordination process that 423.30 ensures services are provided in the most appropriate manner to 423.31 achieve maximum benefit to the client. The provider entity must 423.32 ensure coordination and nonduplication of services consistent 423.33 with county board coordination procedures established under 423.34 section 245.4881, subdivision 5; 423.35 (4) a performance measurement system, including monitoring 423.36 to determine cultural appropriateness of services identified in 424.1 the individual treatment plan, as determined by the client's 424.2 culture, beliefs, values, and language, and family-driven 424.3 services; and 424.4 (5) a process to establish and maintain individual client 424.5 records. The client's records must include: (i) the client's 424.6 personal information; (ii) forms applicable to data privacy; 424.7 (iii) the client's diagnostic assessment, updates, tests, 424.8 individual treatment plan, and individual behavior plan, if 424.9 necessary; (iv) documentation of service delivery as specified 424.10 under subdivision 6; (v) telephone contacts; (vi) discharge 424.11 plan; and (vii) if applicable, insurance information. 424.12 Subd. 6. [PROVIDER ENTITY CLINICAL INFRASTRUCTURE 424.13 REQUIREMENTS.] (a) To be an eligible provider entity under this 424.14 section, a provider entity must have a clinical infrastructure 424.15 that utilizes diagnostic assessment, an individualized treatment 424.16 plan, service delivery, and individual treatment plan review 424.17 that are culturally competent, child-centered, and family-driven 424.18 to achieve maximum benefit for the client. The provider entity 424.19 must review and update the clinical policies and procedures 424.20 every three years and must distribute the policies and 424.21 procedures to staff initially and upon each subsequent update. 424.22 (b) The clinical infrastructure written policies and 424.23 procedures must include policies and procedures for: 424.24 (1) providing or obtaining a client's diagnostic assessment 424.25 that identifies acute and chronic clinical disorders, 424.26 co-occurring medical conditions, sources of psychological and 424.27 environmental problems, and a functional assessment. The 424.28 functional assessment must clearly summarize the client's 424.29 individual strengths and needs; 424.30 (2) developing an individual treatment plan that is: (i) 424.31 based on the information in the client's diagnostic assessment; 424.32 (ii) developed no later than the end of the first psychotherapy 424.33 session after the completion of the client's diagnostic 424.34 assessment by the mental health professional who provides the 424.35 client's psychotherapy; (iii) developed through a 424.36 child-centered, family-driven planning process that identifies 425.1 service needs and individualized, planned, and 425.2 culturally-appropriate interventions that contain specific 425.3 treatment goals and objectives for the client and the client's 425.4 family or foster family; (iv) reviewed at least once every 90 425.5 days and revised, if necessary; and (v) signed by the client or, 425.6 if appropriate, by the client's parent or other person 425.7 authorized by statute to consent to mental health services for 425.8 the client; 425.9 (3) developing an individual behavior plan that documents 425.10 services to be provided by the mental health behavioral aide. 425.11 The individual behavior plan must include: (i) detailed 425.12 instructions on the service to be provided; (ii) time allocated 425.13 to each service; (iii) methods of documenting the child's 425.14 behavior; (iv) methods of monitoring the child's progress in 425.15 reaching objectives; and (v) goals to increase or decrease 425.16 targeted behavior as identified in the individual treatment 425.17 plan; 425.18 (4) clinical supervision of the mental health practitioner 425.19 and mental health behavioral aide. A mental health professional 425.20 must document the clinical supervision the professional provides 425.21 by cosigning individual treatment plans and making entries in 425.22 the client's record on supervisory activities. Clinical 425.23 supervision does not include the authority to make or terminate 425.24 court-ordered placements of the child. A clinical supervisor 425.25 must be available for urgent consultation as required by the 425.26 individual client's needs or the situation. Clinical 425.27 supervision may occur individually or in a small group to 425.28 discuss treatment and review progress toward goals. The focus 425.29 of clinical supervision must be the client's treatment needs and 425.30 progress and the mental health practitioner's or behavioral 425.31 aide's ability to provide services; 425.32 (5) providing direction to a mental health behavioral 425.33 aide. For entities that employ mental health behavioral aides, 425.34 the clinical supervisor must be employed by the provider entity 425.35 to ensure necessary and appropriate oversight for the client's 425.36 treatment and continuity of care. The mental health 426.1 professional or mental health practitioner giving direction must 426.2 begin with the goals on the individualized treatment plan, and 426.3 instruct the mental health behavioral aide on how to construct 426.4 therapeutic activities and interventions that will lead to goal 426.5 attainment. The professional or practitioner giving direction 426.6 must also instruct the mental health behavioral aide about the 426.7 client's diagnosis, functional status, and other characteristics 426.8 that are likely to affect service delivery. Direction must also 426.9 include determining that the mental health behavioral aide has 426.10 the skills to interact with the client and the client's family 426.11 in ways that convey personal and cultural respect and that the 426.12 aide actively solicits information relevant to treatment from 426.13 the family. The aide must be able to clearly explain the 426.14 activities the aide is doing with the client and the activities' 426.15 relationship to treatment goals. Direction is more didactic 426.16 than is supervision and requires the professional or 426.17 practitioner providing it to continuously evaluate the mental 426.18 health behavioral aide's ability to carry out the activities of 426.19 the individualized treatment plan and the individualized 426.20 behavior plan. When providing direction, the professional or 426.21 practitioner must: (i) review progress notes prepared by the 426.22 mental health behavioral aide for accuracy and consistency with 426.23 diagnostic assessment, treatment plan, and behavior goals and 426.24 the professional or practitioner must approve and sign the 426.25 progress notes; (ii) identify changes in treatment strategies, 426.26 revise the individual behavior plan, and communicate treatment 426.27 instructions and methodologies as appropriate to ensure that 426.28 treatment is implemented correctly; (iii) demonstrate 426.29 family-friendly behaviors that support healthy collaboration 426.30 among the child, the child's family, and providers as treatment 426.31 is planned and implemented; (iv) ensure that the mental health 426.32 behavioral aide is able to effectively communicate with the 426.33 child, the child's family, and the provider; and (v) record the 426.34 results of any evaluation and corrective actions taken to modify 426.35 the work of the mental health behavioral aide; 426.36 (6) providing service delivery that implements the 427.1 individual treatment plan and meets the requirements under 427.2 subdivision 9; and 427.3 (7) individual treatment plan review. The review must 427.4 determine the extent to which the services have met the goals 427.5 and objectives in the previous treatment plan. The review must 427.6 assess the client's progress and ensure that services and 427.7 treatment goals continue to be necessary and appropriate to the 427.8 client and the client's family or foster family. Revision of 427.9 the individual treatment plan does not require a new diagnostic 427.10 assessment unless the client's mental health status has changed 427.11 markedly. The updated treatment plan must be signed by the 427.12 client, if appropriate, and by the client's parent or other 427.13 person authorized by statute to give consent to the mental 427.14 health services for the child. 427.15 Subd. 7. [QUALIFICATIONS OF INDIVIDUAL AND TEAM 427.16 PROVIDERS.] (a) An individual or team provider working within 427.17 the scope of the provider's practice or qualifications may 427.18 provide service components of children's therapeutic services 427.19 and supports that are identified as medically necessary in a 427.20 client's individual treatment plan. 427.21 (b) An individual provider and multidisciplinary team 427.22 include: 427.23 (1) a mental health professional as defined in subdivision 427.24 1, paragraph (m); 427.25 (2) a mental health practitioner as defined in section 427.26 245.4871, subdivision 26. The mental health practitioner must 427.27 work under the clinical supervision of a mental health 427.28 professional; 427.29 (3) a mental health behavioral aide working under the 427.30 direction of a mental health professional to implement the 427.31 rehabilitative mental health services identified in the client's 427.32 individual treatment plan. A level I mental health behavioral 427.33 aide must: (i) be at least 18 years old; (ii) have a high 427.34 school diploma or general equivalency diploma (GED) or two years 427.35 of experience as a primary caregiver to a child with severe 427.36 emotional disturbance within the previous ten years; and (iii) 428.1 meet preservices and continuing education requirements under 428.2 subdivision 8. A level II mental health behavioral aide must: 428.3 (i) be at least 18 years old; (ii) have an associate or 428.4 bachelor's degree or 4,000 hours of experience in delivering 428.5 clinical services in the treatment of mental illness concerning 428.6 children or adolescents; and (iii) meet preservice and 428.7 continuing education requirements in subdivision 8; 428.8 (4) a preschool program multidisciplinary team that 428.9 includes at least one mental health professional and one or more 428.10 of the following individuals under the clinical supervision of a 428.11 mental health professional: (i) a mental health practitioner; 428.12 or (ii) a program person, including a teacher, assistant 428.13 teacher, or aide, who meets the qualifications and training 428.14 standards of a level I mental health behavioral aide; or 428.15 (5) a day treatment multidisciplinary team that includes at 428.16 least one mental health professional and one mental health 428.17 practitioner. 428.18 Subd. 8. [REQUIRED PRESERVICE AND CONTINUING 428.19 EDUCATION.] (a) A provider entity shall establish a plan to 428.20 provide preservice and continuing education for staff. The plan 428.21 must clearly describe the type of training necessary to maintain 428.22 current skills and obtain new skills, and that relates to the 428.23 provider entity's goals and objectives for services offered. 428.24 (b) A provider that employs a mental health behavioral aide 428.25 under this section must require the mental health behavioral 428.26 aide to complete 30 hours of preservice training. The 428.27 preservice training must include topics specified in Minnesota 428.28 Rules, part 9535.4068, subparts 1 and 2, and parent team 428.29 training. The preservice training must include 15 hours of 428.30 in-person training of a mental health behavioral aide in mental 428.31 health services delivery and eight hours of parent team 428.32 training. Components of parent team training include: 428.33 (1) partnering with parents; 428.34 (2) fundamentals of family support; 428.35 (3) fundamentals of policy and decision making; 428.36 (4) defining equal partnership; 429.1 (5) complexities of the parent and service provider 429.2 partnership in multiple service delivery systems due to system 429.3 strengths and weaknesses; 429.4 (6) sibling impacts; 429.5 (7) support networks; and 429.6 (8) community resources. 429.7 (c) A provider entity that employs a mental health 429.8 practitioner and a mental health behavioral aide to provide 429.9 children's therapeutic services and supports under this section 429.10 must require the mental health practitioner and mental health 429.11 behavioral aide to complete 20 hours of continuing education 429.12 every two calendar years. The continuing education must be 429.13 related to serving the needs of a child with emotional 429.14 disturbance in the child's home environment and the child's 429.15 family. The topics covered in orientation and training must 429.16 conform to Minnesota Rules, part 9535.4068. 429.17 (d) The provider entity must document the mental health 429.18 practitioner's or mental health behavioral aide's annual 429.19 completion of the required continuing education. The 429.20 documentation must include the date, subject, and number of 429.21 hours of the continuing education, and attendance records, as 429.22 verified by the staff member's signature, job title, and the 429.23 instructor's name. The provider entity must keep documentation 429.24 for each employee, including records of attendance at 429.25 professional workshops and conferences, at a central location 429.26 and in the employee's personnel file. 429.27 Subd. 9. [SERVICE DELIVERY CRITERIA.] (a) In delivering 429.28 services under this section, a certified provider entity must 429.29 ensure that: 429.30 (1) each individual provider's caseload size permits the 429.31 provider to deliver services to both clients with severe, 429.32 complex needs and clients with less intensive needs. The 429.33 provider's caseload size should reasonably enable the provider 429.34 to play an active role in service planning, monitoring, and 429.35 delivering services to meet the client's and client's family's 429.36 needs, as specified in each client's individual treatment plan; 430.1 (2) site-based programs, including day treatment and 430.2 preschool programs, provide staffing and facilities to ensure 430.3 the client's health, safety, and protection of rights, and that 430.4 the programs are able to implement each client's individual 430.5 treatment plan; 430.6 (3) a day treatment program is provided to a group of 430.7 clients by a multidisciplinary staff under the clinical 430.8 supervision of a mental health professional. The day treatment 430.9 program must be provided in and by: (i) an outpatient hospital 430.10 accredited by the joint commission on accreditation of health 430.11 organizations and licensed under sections 144.50 to 144.55; (ii) 430.12 a community mental health center under section 245.62; and (iii) 430.13 an entity that is under contract with the county board to 430.14 operate a program that meets the requirements of sections 430.15 245.4712, subdivision 2, and 245.4884, subdivision 2, and 430.16 Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment 430.17 program must stabilize the client's mental health status while 430.18 developing and improving the client's independent living and 430.19 socialization skills. The goal of the day treatment program 430.20 must be to reduce or relieve the effects of mental illness and 430.21 provide training to enable the client to live in the community. 430.22 The program must be available at least one day a week for a 430.23 minimum three-hour time block. The three-hour time block must 430.24 include at least one hour, but no more than two hours, of 430.25 individual or group psychotherapy. The remainder of the 430.26 three-hour time block may include recreation therapy, 430.27 socialization therapy, or independent living skills therapy, but 430.28 only if the therapies are included in the client's individual 430.29 treatment plan. Day treatment programs are not part of 430.30 inpatient or residential treatment services; and 430.31 (4) a preschool program is a structured treatment program 430.32 offered to a child who is at least 33 months old, but who has 430.33 not yet reached the first day of kindergarten, by a preschool 430.34 multidisciplinary team in a day program licensed under Minnesota 430.35 Rules, parts 9503.0005 to 9503.0175. The program must be 430.36 available at least one day a week for a minimum two-hour time 431.1 block. The structured treatment program may include individual 431.2 or group psychotherapy and recreation therapy, socialization 431.3 therapy, or independent living skills therapy, if included in 431.4 the client's individual treatment plan. 431.5 (b) A provider entity must delivery the service components 431.6 of children's therapeutic services and supports in compliance 431.7 with the following requirements: 431.8 (1) individual, family, and group psychotherapy must be 431.9 delivered as specified in Minnesota Rules, parts 9505.0523; 431.10 (2) individual, family, or group skills training must be 431.11 provided by a mental health professional or a mental health 431.12 practitioner who has a consulting relationship with a mental 431.13 health professional who accepts full professional responsibility 431.14 for the training; 431.15 (3) crisis assistance must be an intense, time-limited, and 431.16 designed to resolve or stabilize crisis through arrangements for 431.17 direct intervention and support services to the child and the 431.18 child's family. Crisis assistance must utilize resources 431.19 designed to address abrupt or substantial changes in the 431.20 functioning of the child or the child's family as evidenced by a 431.21 sudden change in behavior with negative consequences for well 431.22 being, a loss of usual coping mechanisms, or the presentation of 431.23 danger to self or others; 431.24 (4) medically necessary services that are provided by a 431.25 mental health behavioral aide must be designed to improve the 431.26 functioning of the child and support the family in activities of 431.27 daily and community living. A mental health behavioral aide 431.28 must document the delivery of services in written progress 431.29 notes. The mental health behavioral aide must implement goals 431.30 in the treatment plan for the child's emotional disturbance that 431.31 allow the child to acquire developmentally and therapeutically 431.32 appropriate daily living skills, social skills, and leisure and 431.33 recreational skills through targeted activities. These 431.34 activities may include: 431.35 (i) assisting a child as needed with skills development in 431.36 dressing, eating, and toileting; 432.1 (ii) assisting, monitoring, and guiding the child to 432.2 complete tasks, including facilitating the child's participation 432.3 in medical appointments; 432.4 (iii) observing the child and intervening to redirect the 432.5 child's inappropriate behavior; 432.6 (iv) assisting the child in using age-appropriate 432.7 self-management skills as related to the child's emotional 432.8 disorder or mental illness, including problem solving, decision 432.9 making, communication, conflict resolution, anger management, 432.10 social skills, and recreational skills; 432.11 (v) implementing deescalation techniques as recommended by 432.12 the mental health professional; 432.13 (vi) implementing any other mental health service that the 432.14 mental health professional has approved as being within the 432.15 scope of the behavioral aide's duties; or 432.16 (vii) assisting the parents to develop and use parenting 432.17 skills that help the child achieve the goals outlined in the 432.18 child's individual treatment plan or individual behavioral 432.19 plan. Parenting skills must be directed exclusively to the 432.20 child's treatment; and 432.21 (5) direction of a mental health behavioral aide must 432.22 include the following: 432.23 (i) a total of one hour of on-site observation by a mental 432.24 health professional during the first 12 hours of service 432.25 provided to a child; 432.26 (ii) ongoing on-site observation by a mental health 432.27 professional or mental health practitioner for at least a total 432.28 of one hour during every 40 hours of service provided to a 432.29 child; and 432.30 (iii) immediate accessibility of the mental health 432.31 professional or mental health practitioner to the mental health 432.32 behavioral aide during service provision. 432.33 Subd. 10. [SERVICE AUTHORIZATION.] The commissioner shall 432.34 publish in the State Register a list of health services that 432.35 require prior authorization, as well as the criteria and 432.36 standards used to select health services on the list. The list 433.1 and the criteria and standards used to formulate the list are 433.2 not subject to the requirements of sections 14.001 to 14.69. 433.3 The commissioner's decision on whether prior authorization is 433.4 required for a health service is not subject to administrative 433.5 appeal. 433.6 Subd. 11. [DOCUMENTATION AND BILLING.] (a) A provider 433.7 entity must document the services it provides under this 433.8 section. The provider entity must ensure that the entity's 433.9 documentation standards meet the requirements of federal and 433.10 state laws. Services billed under this section that are not 433.11 documented according to this subdivision shall be subject to 433.12 monetary recovery by the commissioner. 433.13 (b) An individual mental health provider must promptly 433.14 document the following in a client's record after providing 433.15 services to the client: 433.16 (1) each occurrence of the client's mental health service, 433.17 including the date, type, length, and scope of the service; 433.18 (2) the name of the person who gave the service; 433.19 (3) contact made with other persons interested in the 433.20 client, including representatives of the courts, corrections 433.21 systems, or schools. The provider must document the name and 433.22 date of each contact; 433.23 (4) any contact made with the client's other mental health 433.24 providers, case manager, family members, primary caregiver, 433.25 legal representative, or the reason the provider did not contact 433.26 the client's family members, primary caregiver, or legal 433.27 representative, if applicable; and 433.28 (5) required clinical supervision, as appropriate. 433.29 Subd. 12. [EXCLUDED SERVICES.] The following services are 433.30 not eligible for medical assistance payment as children's 433.31 therapeutic services and supports: 433.32 (1) service components of children's therapeutic services 433.33 and supports simultaneously provided by more than one provider 433.34 entity unless prior authorization is obtained; 433.35 (2) children's therapeutic services and supports provided 433.36 in violation of medical assistance policy in Minnesota Rules, 434.1 part 9505.0220; 434.2 (3) mental health behavioral aide services provided by a 434.3 personal care assistant who is not qualified as a mental health 434.4 behavioral aide and employed by a certified children's 434.5 therapeutic services and supports provider entity; 434.6 (4) services that are the responsibility of a residential 434.7 or program license holder, including foster care providers under 434.8 the terms of a service agreement or administrative rules 434.9 governing licensure; 434.10 (5) up to 15 hours of children's therapeutic services and 434.11 supports provided within a six-month period to a child with 434.12 severe emotional disturbance who is residing in a hospital, a 434.13 group home as defined in Minnesota Rules, part 9560.0520, 434.14 subpart 4, a residential treatment facility licensed under 434.15 Minnesota Rules, parts 9545.0900 to 9545.1090, a regional 434.16 treatment center, or other institutional group setting or who is 434.17 participating in a program of partial hospitalization are 434.18 eligible for medical assistance payment if part of the discharge 434.19 plan; and 434.20 (6) adjunctive activities that may be offered by a provider 434.21 entity but are not otherwise covered by medical assistance, 434.22 including: 434.23 (i) a service that is primarily recreation oriented or that 434.24 is provided in a setting that is not medically supervised. This 434.25 includes sports activities, exercise groups, activities such as 434.26 craft hours, leisure time, social hours, meal or snack time, 434.27 trips to community activities, and tours; 434.28 (ii) a social or educational service that does not have or 434.29 cannot reasonably be expected to have a therapeutic outcome 434.30 related to the client's emotional disturbance; 434.31 (iii) consultation with other providers or service agency 434.32 staff about the care or progress of a client; 434.33 (iv) prevention or education programs provided to the 434.34 community; and 434.35 (v) treatment for clients with primary diagnoses of alcohol 434.36 or other drug abuse. 435.1 [EFFECTIVE DATE.] Unless otherwise specified, this section 435.2 is effective July 1, 2004. 435.3 Sec. 7. [256B.0944] [COVERED SERVICES; CHILDREN'S MENTAL 435.4 HEALTH CRISIS RESPONSE SERVICES.] 435.5 Subdivision 1. [DEFINITIONS.] For purposes of this 435.6 section, the following terms have the meanings given them. 435.7 (a) "Mental health crisis" means a child's behavioral, 435.8 emotional, or psychiatric situation that, but for the provision 435.9 of crisis response services to the child, would likely result in 435.10 significantly reduced levels of functioning in primary 435.11 activities of daily living, an emergency situation, or the 435.12 child's placement in a more restrictive setting, including, but 435.13 not limited to, inpatient hospitalization. 435.14 (b) "Mental health emergency" means a child's behavioral, 435.15 emotional, or psychiatric situation that causes an immediate 435.16 need for mental health services and is consistent with section 435.17 62Q.55. A physician, mental health professional, or crisis 435.18 mental health practitioner determines a mental health crisis or 435.19 emergency for medical assistance reimbursement with input from 435.20 the client and the client's family, if possible. 435.21 (c) "Mental health crisis assessment" means an immediate 435.22 face-to-face assessment by a physician, mental health 435.23 professional, or mental health practitioner under the clinical 435.24 supervision of a mental health professional, following a 435.25 screening that suggests the child may be experiencing a mental 435.26 health crisis or mental health emergency situation. 435.27 (d) "Mental health mobile crisis intervention services" 435.28 means face-to-face, short-term intensive mental health services 435.29 initiated during a mental health crisis or mental health 435.30 emergency. Mental health mobile crisis services must help the 435.31 recipient cope with immediate stressors, identify and utilize 435.32 available resources and strengths, and begin to return to the 435.33 recipient's baseline level of functioning. Mental health mobile 435.34 services must be provided on-site by a mobile crisis 435.35 intervention team outside of an emergency room, urgent care, or 435.36 an inpatient hospital setting. 436.1 (e) "Mental health crisis stabilization services" means 436.2 individualized mental health services provided to a recipient 436.3 following crisis intervention services that are designed to 436.4 restore the recipient to the recipient's prior functional 436.5 level. The individual treatment plan recommending mental health 436.6 crisis stabilization must be completed by the intervention team 436.7 or by staff after an inpatient or urgent care visit. Mental 436.8 health crisis stabilization services may be provided in the 436.9 recipient's home, the home of a family member or friend of the 436.10 recipient, schools, another community setting, or a short-term 436.11 supervised, licensed residential program if the service is not 436.12 included in the facility's cost pool or per diem. Mental health 436.13 crisis stabilization is not reimbursable when provided as part 436.14 of a partial hospitalization or day treatment program. 436.15 Subd. 2. [MEDICAL ASSISTANCE COVERAGE.] Medical assistance 436.16 covers medically necessary children's mental health crisis 436.17 response services, subject to federal approval, if provided to 436.18 an eligible recipient under subdivision 3, by a qualified 436.19 provider entity under subdivision 4 or a qualified individual 436.20 provider working within the provider's scope of practice, and 436.21 identified in the recipient's individual crisis treatment plan 436.22 under subdivision 8. 436.23 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 436.24 individual who: 436.25 (1) is eligible for medical assistance; 436.26 (2) is under age 18 or between the ages of 18 and 21; 436.27 (3) is screened as possibly experiencing a mental health 436.28 crisis or mental health emergency where a mental health crisis 436.29 assessment is needed; 436.30 (4) is assessed as experiencing a mental health crisis or 436.31 mental health emergency, and mental health mobile crisis 436.32 intervention or mental health crisis stabilization services are 436.33 determined to be medically necessary; and 436.34 (5) meets the criteria for emotional disturbance or mental 436.35 illness. 436.36 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) A crisis 437.1 intervention and crisis stabilization provider entity must meet 437.2 the administrative and clinical standards specified in section 437.3 256B.0943, subdivisions 5 and 6, meet the standards listed in 437.4 paragraph (b), and be: 437.5 (1) an Indian health service facility or facility owned and 437.6 operated by a tribe or a tribal organization operating under 437.7 Public Law 93-638 as a 638 facility; 437.8 (2) a county-board operated entity; or 437.9 (3) a provider entity that is under contract with the 437.10 county board in the county where the potential crisis or 437.11 emergency is occurring. 437.12 (b) The children's mental health crisis response services 437.13 provider entity must: 437.14 (1) ensure that mental health crisis assessment and mobile 437.15 crisis intervention services are available 24 hours a day, seven 437.16 days a week; 437.17 (2) directly provide the services or, if services are 437.18 subcontracted, the provider entity must maintain clinical 437.19 responsibility for services and billing; 437.20 (3) ensure that crisis intervention services are provided 437.21 in a manner consistent with sections 245.487 to 245.4888; and 437.22 (4) develop and maintain written policies and procedures 437.23 regarding service provision that include safety of staff and 437.24 recipients in high-risk situations. 437.25 Subd. 5. [MOBILE CRISIS INTERVENTION STAFF 437.26 QUALIFICATIONS.] (a) To provide children's mental health mobile 437.27 crisis intervention services, a mobile crisis intervention team 437.28 must include: 437.29 (1) at least two mental health professionals as defined in 437.30 section 256B.0943, subdivision 1, paragraph (m); or 437.31 (2) a combination of at least one mental health 437.32 professional and one mental health practitioner as defined in 437.33 section 245.4871, subdivision 26, with the required mental 437.34 health crisis training and under the clinical supervision of a 437.35 mental health professional on the team. 437.36 (b) The team must have at least two people with at least 438.1 one member providing on-site crisis intervention services when 438.2 needed. Team members must be experienced in mental health 438.3 assessment, crisis intervention techniques, and clinical 438.4 decision making under emergency conditions and have knowledge of 438.5 local services and resources. The team must recommend and 438.6 coordinate the team's services with appropriate local resources, 438.7 including as the county social services agency, mental health 438.8 service providers, and local law enforcement, if necessary. 438.9 Subd. 6. [INITIAL SCREENING, CRISIS ASSESSMENT, AND MOBILE 438.10 INTERVENTION TREATMENT PLANNING.] (a) Before initiating mobile 438.11 crisis intervention services, a screening of the potential 438.12 crisis situation must be conducted. The screening may use the 438.13 resources of crisis assistance and emergency services as defined 438.14 in sections 245.4871, subdivision 14, and 245.4879, subdivisions 438.15 1 and 2. The screening must gather information, determine 438.16 whether a crisis situation exists, identify the parties 438.17 involved, and determine an appropriate response. 438.18 (b) If a crisis exists, a crisis assessment must be 438.19 completed. A crisis assessment must evaluate any immediate 438.20 needs for which emergency services are needed and, as time 438.21 permits, the recipient's current life situation, sources of 438.22 stress, mental health problems and symptoms, strengths, cultural 438.23 considerations, support network, vulnerabilities, and current 438.24 functioning. 438.25 (c) If the crisis assessment determines mobile crisis 438.26 intervention services are needed, the intervention services must 438.27 be provided promptly. As the opportunity presents itself during 438.28 the intervention, at least two members of the mobile crisis 438.29 intervention team must confer directly or by telephone about the 438.30 assessment, treatment plan, and actions taken and needed. At 438.31 least one of the team members must be on site providing crisis 438.32 intervention services. If providing on-site crisis intervention 438.33 services, a mental health practitioner must seek clinical 438.34 supervision as required under subdivision 9. 438.35 (d) The mobile crisis intervention team must develop an 438.36 initial, brief crisis treatment plan as soon as appropriate but 439.1 no later than 24 hours after the initial face-to-face 439.2 intervention. The plan must address the needs and problems 439.3 noted in the crisis assessment and include measurable short-term 439.4 goals, cultural considerations, and frequency and type of 439.5 services to be provided to achieve the goals and reduce or 439.6 eliminate the crisis. The crisis treatment plan must be updated 439.7 as needed to reflect current goals and services. The team must 439.8 involve the client and the client's family in developing and 439.9 implementing the plan. 439.10 (e) The team must document in progress notes which 439.11 short-term goals have been met and when no further crisis 439.12 intervention services are required. 439.13 (f) If the client's crisis is stabilized, but the client 439.14 needs a referral for mental health crisis stabilization services 439.15 or to other services, the team must provide a referral to these 439.16 services. If the recipient has a case manager, planning for 439.17 other services must be coordinated with the case manager. 439.18 Subd. 7. [CRISIS STABILIZATION SERVICES.] (a) Crisis 439.19 stabilization services must be provided by a mental health 439.20 professional or a mental health practitioner who works under the 439.21 clinical supervision of a mental health professional and for a 439.22 crisis stabilization services provider entity, and must meet the 439.23 following standards: 439.24 (1) a crisis stabilization treatment plan must be developed 439.25 which meets the criteria in subdivision 8; 439.26 (2) services must be delivered according to the treatment 439.27 plan and include face-to-face contact with the recipient by 439.28 qualified staff for further assessment, help with referrals, 439.29 updating the crisis stabilization treatment plan, supportive 439.30 counseling, skills training, and collaboration with other 439.31 service providers in the community; and 439.32 (3) mental health practitioners must have completed at 439.33 least 30 hours of training in crisis intervention and 439.34 stabilization during the past two years. 439.35 Subd. 8. [TREATMENT PLAN.] (a)The individual crisis 439.36 stabilization treatment plan must include, at a minimum: 440.1 (1) a list of problems identified in the assessment; 440.2 (2) a list of the recipient's strengths and resources; 440.3 (3) concrete, measurable short-term goals and tasks to be 440.4 achieved, including time frames for achievement of the goals; 440.5 (4) specific objectives directed toward the achievement of 440.6 each goal; 440.7 (5) documentation of the participants involved in the 440.8 service planning; 440.9 (6) planned frequency and type of services initiated; 440.10 (7) a crisis response action plan if a crisis should occur; 440.11 and 440.12 (8) clear progress notes on the outcome of goals. 440.13 (b) The client, if clinically appropriate, must be a 440.14 participant in the development of the crisis stabilization 440.15 treatment plan. The client or the client's legal guardian must 440.16 sign the service plan or documentation must be provided why this 440.17 was not possible. A copy of the plan must be given to the 440.18 client and the client's legal guardian. The plan should include 440.19 services arranged, including specific providers where applicable. 440.20 (c) A treatment plan must be developed by a mental health 440.21 professional or mental health practitioner under the clinical 440.22 supervision of a mental health professional. A written plan 440.23 must be completed within 24 hours of beginning services with the 440.24 client. 440.25 Subd. 9. [SUPERVISION.] (a) A mental health practitioner 440.26 may provide crisis assessment and mobile crisis intervention 440.27 services if the following clinical supervision requirements are 440.28 met: 440.29 (1) the mental health provider entity must accept full 440.30 responsibility for the services provided; 440.31 (2) the mental health professional of the provider entity, 440.32 who is an employee or under contract with the provider entity, 440.33 must be immediately available by telephone or in person for 440.34 clinical supervision; 440.35 (3) the mental health professional is consulted, in person 440.36 or by telephone, during the first three hours when a mental 441.1 health practitioner provides on-site service; and 441.2 (4) the mental health professional must review and approve 441.3 the tentative crisis assessment and crisis treatment plan, 441.4 document the consultation, and sign the crisis assessment and 441.5 treatment plan within the next business day. 441.6 (b) If the mobile crisis intervention services continue 441.7 into a second calendar day, a mental health professional must 441.8 contact the client face-to-face on the second day to provide 441.9 services and update the crisis treatment plan. The on-site 441.10 observation must be documented in the client's record and signed 441.11 by the mental health professional. 441.12 Subd. 10. [CLIENT RECORD.] The provider must maintain a 441.13 file for each client that complies with the requirements under 441.14 section 256B.0943, subdivision 11, and contains the following 441.15 information: 441.16 (1) individual crisis treatment plans signed by the 441.17 recipient, mental health professional, and mental health 441.18 practitioner who developed the crisis treatment plan, or if the 441.19 recipient refused to sign the plan, the date and reason stated 441.20 by the recipient for not signing the plan; 441.21 (2) signed release of information forms; 441.22 (3) recipient health information and current medications; 441.23 (4) emergency contacts for the recipient; 441.24 (5) case records that document the date of service, place 441.25 of service delivery, signature of the person providing the 441.26 service, and the nature, extent, and units of service. Direct 441.27 or telephone contact with the recipient's family or others 441.28 should be documented; 441.29 (6) required clinical supervision by mental health 441.30 professionals; 441.31 (7) summary of the recipient's case reviews by staff; and 441.32 (8) any written information by the recipient that the 441.33 recipient wants in the file. 441.34 Subd. 11. [EXCLUDED SERVICES.] The following services are 441.35 excluded from reimbursement under this section: 441.36 (1) room and board services; 442.1 (2) services delivered to a recipient while admitted to an 442.2 inpatient hospital; 442.3 (3) transportation services under children's mental health 442.4 crisis response service; 442.5 (4) services provided and billed by a provider who is not 442.6 enrolled under medical assistance to provide children's mental 442.7 health crisis response services; 442.8 (5) crisis response services provided by a residential 442.9 treatment center to clients in their facility; 442.10 (6) services performed by volunteers; 442.11 (7) direct billing of time spent "on call" when not 442.12 delivering services to a recipient; 442.13 (8) provider service time included in case management 442.14 reimbursement; 442.15 (9) outreach services to potential recipients; and 442.16 (10) a mental health service that is not medically 442.17 necessary. 442.18 [EFFECTIVE DATE.] This section is effective July 1, 2004. 442.19 Sec. 8. Minnesota Statutes 2002, section 256B.0945, 442.20 subdivision 2, is amended to read: 442.21 Subd. 2. [COVERED SERVICES.] All services must be included 442.22 in a child's individualized treatment or multiagency plan of 442.23 care as defined in chapter 245. 442.24(a) For facilities that are institutions for mental442.25diseases according to statute and regulation or are not442.26institutions for mental diseases but are approved by the442.27commissioner to provide services under this paragraph, medical442.28assistance covers the full contract rate, including room and442.29board if the services meet the requirements of Code of Federal442.30Regulations, title 42, section 440.160.442.31(b)For facilities that are not institutions for mental 442.32 diseases according to federal statute and regulationand are not442.33providing services under paragraph (a), medical assistance 442.34 covers mental health related services that are required to be 442.35 provided by a residential facility under section 245.4882 and 442.36 administrative rules promulgated thereunder, except for room and 443.1 board. 443.2 Sec. 9. Minnesota Statutes 2002, section 256B.0945, 443.3 subdivision 4, is amended to read: 443.4 Subd. 4. [PAYMENT RATES.] (a) Notwithstanding sections 443.5 256B.19 and 256B.041, payments to counties for residential 443.6 services provided by a residential facility shall only be made 443.7 of federal earnings for services provided under this section, 443.8 and the nonfederal share of costs for services provided under 443.9 this section shall be paid by the county from sources other than 443.10 federal funds or funds used to match other federal funds. 443.11Payment to counties for services provided according to443.12subdivision 2, paragraph (a), shall be the federal share of the443.13contract rate.Payment to counties for services provided 443.14 according tosubdivision 2, paragraph (b),this section shall be 443.15 a proportion of the per day contract rate that relates to 443.16 rehabilitative mental health services and shall not include 443.17 payment for costs or services that are billed to the IV-E 443.18 program as room and board. 443.19 (b) The commissioner shall set aside a portion not to 443.20 exceed five percent of the federal funds earned under this 443.21 section to cover the state costs of administering this section. 443.22 Any unexpended funds from the set-aside shall be distributed to 443.23 the counties in proportion to their earnings under this section. 443.24 Sec. 10. Minnesota Statutes 2002, section 256F.10, 443.25 subdivision 6, is amended to read: 443.26 Subd. 6. [DISTRIBUTION OF NEW FEDERAL REVENUE.] (a) Except 443.27 for portion set aside in paragraph (b), the federal funds earned 443.28 under this section and section 256B.094 by providers shall be 443.29 paid to each provider based on its earnings, and must be used by443.30each provider to expand preventive child welfare services. 443.31 If a county or tribal social services agency chooses to be a 443.32 provider of child welfare targeted case management and if that 443.33 county or tribal social services agency also joins a local 443.34 children's mental health collaborative as authorized by the 1993 443.35 legislature, then the federal reimbursement received by the 443.36 county or tribal social services agency for providing child 444.1 welfare targeted case management services to children served by 444.2 the local collaborative shall be transferred by the county or 444.3 tribal social services agency to the integrated fund. The 444.4 federal reimbursement transferred to the integrated fund by the 444.5 county or tribal social services agency must not be used for 444.6 residential care other than respite care described under 444.7 subdivision 7, paragraph (d). 444.8 (b) The commissioner shall set aside a portion of the 444.9 federal funds earned under this section to repay the special 444.10 revenue maximization account under section 256.01, subdivision 444.11 2, clause (15). The repayment is limited to: 444.12 (1) the costs of developing and implementing this section 444.13 and sections 256B.094 and 256J.48; 444.14 (2) programming the information systems; and 444.15 (3) the lost federal revenue for the central office claim 444.16 directly caused by the implementation of these sections. 444.17 Any unexpended funds from the set aside under this 444.18 paragraph shall be distributed to providers according to 444.19 paragraph (a). 444.20 Sec. 11. Minnesota Statutes 2002, section 257.05, is 444.21 amended to read: 444.22 257.05 [IMPORTATION.] 444.23 Subdivision 1. [NOTIFICATION AND DUTIES OF COMMISSIONER.] 444.24 No person, except as provided bysubdivisionsubdivisions 2 and 444.25 3, shall bring or send into the state any child for the purpose 444.26 of placing the child out or procuring the child's adoption 444.27 without first obtaining the consent of the commissioner of human 444.28 services, and such person shall conform to all rules of the 444.29 commissioner of human services and laws of the state of 444.30 Minnesota relating to protection of children in foster care. 444.31 Before any child shall be brought or sent into the state for the 444.32 purpose of being placed in foster care, the person bringing or 444.33 sending the child into the state shall first notify the 444.34 commissioner of human services of the person's intention, and 444.35 shall obtain from the commissioner of human services a 444.36 certificate stating that the home in which the child is to be 445.1 placed is, in the opinion of the commissioner of human services, 445.2 a suitable adoptive home for the child if legal adoption is 445.3 contemplated or that the home meets the commissioner's 445.4 requirements for licensing of foster homes if legal adoption is 445.5 not contemplated. The commissioner is responsible for 445.6 protecting the child's interests so long as the child remains 445.7 within the state and until the child reaches the age of 18 or is 445.8 legally adopted. Notice to the commissioner shall state the 445.9 name, age, and personal description of the child, and the name 445.10 and address of the person with whom the child is to be placed, 445.11 and such other information about the child and the foster home 445.12 as may be required by the commissioner. 445.13 Subd. 2. [EXEMPT RELATIVES.] A parent, stepparent, 445.14 grandparent, brother, sister and aunt or uncle in the first 445.15 degree of the minor child who bring a child into the state for 445.16 placement within their own home shall be exempt from the 445.17 provisions of subdivision 1. This relationship may be by blood 445.18 or marriage. 445.19 Subd. 3. [INTERNATIONAL ADOPTIONS.] Subject to state and 445.20 federal laws and rules, adoption agencies licensed under chapter 445.21 245A and Minnesota Rules, parts 9545.0755 to 9545.0845, and 445.22 county social services agencies are authorized to certify that 445.23 the prospective adoptive home of a child brought into the state 445.24 from another country for the purpose of adoption is a suitable 445.25 home, or that the home meets the commissioner's requirements for 445.26 licensing of foster homes if legal adoption is not contemplated. 445.27 Sec. 12. Minnesota Statutes 2002, section 259.67, 445.28 subdivision 4, is amended to read: 445.29 Subd. 4. [ELIGIBILITY CONDITIONS.] (a) The placing agency 445.30 shall use the AFDC requirements as specified in federal law as 445.31 of July 16, 1996, when determining the child's eligibility for 445.32 adoption assistance under title IV-E of the Social Security 445.33 Act. If the child does not qualify, the placing agency shall 445.34 certify a child as eligible for state funded adoption assistance 445.35 only if the following criteria are met: 445.36 (1) Due to the child's characteristics or circumstances it 446.1 would be difficult to provide the child an adoptive home without 446.2 adoption assistance. 446.3 (2)(i) A placement agency has made reasonable efforts to 446.4 place the child for adoption without adoption assistance, but 446.5 has been unsuccessful; or 446.6 (ii) the child's licensed foster parents desire to adopt 446.7 the child and it is determined by the placing agency that the 446.8 adoption is in the best interest of the child. 446.9 (3) The child has been a ward of the commissioneror, a 446.10 Minnesota-licensed child-placing agency, or a tribal social 446.11 service agency of Minnesota recognized by the Secretary of the 446.12 Interior. 446.13 (b) For purposes of this subdivision, the characteristics 446.14 or circumstances that may be considered in determining whether a 446.15 child is a child with special needs under United States Code, 446.16 title 42, chapter 7, subchapter IV, part E, or meets the 446.17 requirements of paragraph (a), clause (1), are the following: 446.18 (1) The child is a member of a sibling group to be placed 446.19 as one unit in which at least one sibling is older than 15 446.20 months of age or is described in clause (2) or (3). 446.21 (2) The child has documented physical, mental, emotional, 446.22 or behavioral disabilities. 446.23 (3) The child has a high risk of developing physical, 446.24 mental, emotional, or behavioral disabilities. 446.25 (4) The child is adopted according to tribal law without a 446.26 termination of parental rights or relinquishment, provided that 446.27 the tribe has documented the valid reason why the child cannot 446.28 or should not be returned to the home of the child's parent. 446.29 (c) When a child's eligibility for adoption assistance is 446.30 based upon the high risk of developing physical, mental, 446.31 emotional, or behavioral disabilities, payments shall not be 446.32 made under the adoption assistance agreement unless and until 446.33 the potential disability manifests itself as documented by an 446.34 appropriate health care professional. 446.35 Sec. 13. Minnesota Statutes 2002, section 260C.141, 446.36 subdivision 2, is amended to read: 447.1 Subd. 2. [REVIEW OF FOSTER CARE STATUS.] The social 447.2 services agency responsible for the placement of a child in a 447.3 residential facility, as defined in section 260C.212, 447.4 subdivision 1, pursuant to a voluntary release by the child's 447.5 parent or parents must proceed in juvenile court to review the 447.6 foster care status of the child in the manner provided in this 447.7 section. 447.8 (a) Except for a child in placement due solely to the 447.9 child's developmental disability or emotional disturbance, when 447.10 a child continues in voluntary placement according to section 447.11 260C.212, subdivision 8, a petition shall be filed alleging the 447.12 child to be in need of protection or services or seeking 447.13 termination of parental rights or other permanent placement of 447.14 the child away from the parent within 90 days of the date of the 447.15 voluntary placement agreement. The petition shall state the 447.16 reasons why the child is in placement, the progress on the 447.17 out-of-home placement plan required under section 260C.212, 447.18 subdivision 1, and the statutory basis for the petition under 447.19 section 260C.007, subdivision 6, 260C.201, subdivision 11, or 447.20 260C.301. 447.21 (1) In the case of a petition alleging the child to be in 447.22 need of protection or services filed under this paragraph, if 447.23 all parties agree and the court finds it is in the best 447.24 interests of the child, the court may find the petition states a 447.25 prima facie case that: 447.26 (i) the child's needs are being met; 447.27 (ii) the placement of the child in foster care is in the 447.28 best interests of the child; 447.29 (iii) reasonable efforts to reunify the child and the 447.30 parent or guardian are being made; and 447.31 (iv) the child will be returned home in the next three 447.32 months. 447.33 (2) If the court makes findings under paragraph (1), the 447.34 court shall approve the voluntary arrangement and continue the 447.35 matter for up to three more months to ensure the child returns 447.36 to the parents' home. The responsible social services agency 448.1 shall: 448.2 (i) report to the court when the child returns home and the 448.3 progress made by the parent on the out-of-home placement plan 448.4 required under section 260C.212, in which case the court shall 448.5 dismiss jurisdiction; 448.6 (ii) report to the court that the child has not returned 448.7 home, in which case the matter shall be returned to the court 448.8 for further proceedings under section 260C.163; or 448.9 (iii) if any party does not agree to continue the matter 448.10 under paragraph (1) and this paragraph, the matter shall proceed 448.11 under section 260C.163. 448.12 (b) In the case of a child in voluntary placement due 448.13 solely to the child's developmental disability or emotional 448.14 disturbance according to section 260C.212, subdivision 9, the 448.15 following procedures apply: 448.16 (1) [REPORT TO COURT.] (i) Unless the county attorney 448.17 determines that a petition under subdivision 1 is appropriate, 448.18 without filing a petition, a written report shall be forwarded 448.19 to the court within 165 days of the date of the voluntary 448.20 placement agreement. The written report shall contain necessary 448.21 identifying information for the court to proceed, a copy of the 448.22 out-of-home placement plan required under section 260C.212, 448.23 subdivision 1, a written summary of the proceedings of any 448.24 administrative review required under section 260C.212, 448.25 subdivision 7, and any other information the responsible social 448.26 services agency, parent or guardian, the child or the foster 448.27 parent or other residential facility wants the court to consider. 448.28 (ii) The responsible social services agency, where 448.29 appropriate, must advise the child, parent or guardian, the 448.30 foster parent, or representative of the residential facility of 448.31 the requirements of this section and of their right to submit 448.32 information to the court. If the child, parent or guardian, 448.33 foster parent, or representative of the residential facility 448.34 wants to send information to the court, the responsible social 448.35 services agency shall advise those persons of the reporting date 448.36 and the identifying information necessary for the court 449.1 administrator to accept the information and submit it to a judge 449.2 with the agency's report. The responsible social services 449.3 agency must also notify those persons that they have the right 449.4 to be heard in person by the court and how to exercise that 449.5 right. The responsible social services agency must also provide 449.6 notice that an in-court hearing will not be held unless 449.7 requested by a parent or guardian, foster parent, or the child. 449.8 (iii) After receiving the required report, the court has 449.9 jurisdiction to make the following determinations and must do so 449.10 within ten days of receiving the forwarded report: (A) whether 449.11 or not the placement of the child is in the child's best 449.12 interests; and (B) whether the parent and agency are 449.13 appropriately planning for the child. Unless requested by a 449.14 parent or guardian, foster parent, or child, no in-court hearing 449.15 need be held in order for the court to make findings and issue 449.16 an order under this paragraph. 449.17 (iv) If the court finds the placement is in the child's 449.18 best interests and that the agency and parent are appropriately 449.19 planning for the child, the court shall issue an order 449.20 containing explicit, individualized findings to support its 449.21 determination. The court shall send a copy of the order to the 449.22 county attorney, the responsible social services agency, the 449.23 parent or guardian, the child, and the foster parents. The 449.24 court shall also send the parent or guardian, the child, and the 449.25 foster parent notice of the required review under clause (2). 449.26 (v) If the court finds continuing the placement not to be 449.27 in the child's best interests or that the agency or the parent 449.28 or guardian is not appropriately planning for the child, the 449.29 court shall notify the county attorney, the responsible social 449.30 services agency, the parent or guardian, the foster parent, the 449.31 child, and the county attorney of the court's determinations and 449.32 the basis for the court's determinations. 449.33 (2) [PERMANENCY REVIEW BY PETITION.] If a child with a 449.34 developmental disability or an emotional disturbance continues 449.35 in out-of-home placement for 13 months from the date of a 449.36 voluntary placement, a petition alleging the child to be in need 450.1 of protection or services, for termination of parental rights, 450.2 or for permanent placement of the child away from the parent 450.3 under section 260C.201 shall be filed. The court shall conduct 450.4 a permanency hearing on the petition no later than 14 months 450.5 after the date of the voluntary placement. At the permanency 450.6 hearing, the court shall determine the need for an order 450.7 permanently placing the child away from the parent or determine 450.8 whether there are compelling reasons that continued voluntary 450.9 placement is in the child's best interests. A petition alleging 450.10 the child to be in need of protection or services shall state 450.11 the date of the voluntary placement agreement, the nature of the 450.12 child's developmental disability or emotional disturbance, the 450.13 plan for the ongoing care of the child, the parents' 450.14 participation in the plan, the responsible social services 450.15 agency's efforts to finalize a plan for the permanent placement 450.16 of the child, and the statutory basis for the petition. 450.17 (i) If a petition alleging the child to be in need of 450.18 protection or services is filed under this paragraph, the court 450.19 may find, based on the contents of the sworn petition, and the 450.20 agreement of all parties, including the child, where 450.21 appropriate, that there are compelling reasons that the 450.22 voluntary arrangement is in the best interests of the child and 450.23 that the responsible social services agency has made reasonable 450.24 efforts to finalize a plan for the permanent placement of the 450.25 child, approve the continued voluntary placement, and continue 450.26 the matter under the court's jurisdiction for the purpose of 450.27 reviewing the child's placement as a continued voluntary 450.28 arrangement every 12 months as long as the child continues in 450.29 out-of-home placement. The matter must be returned to the court 450.30 for further review every 12 months as long as the child remains 450.31 in placement. The court shall give notice to the parent or 450.32 guardian of the continued review requirements under this 450.33 section. Nothing in this paragraph shall be construed to mean 450.34 the court must order permanent placement for the child under 450.35 section 260C.201, subdivision 11, as long as the court finds 450.36 compelling reasons at the first review required under this 451.1 section. 451.2 (ii) If a petition for termination of parental rights, for 451.3 transfer of permanent legal and physical custody to a relative, 451.4 for long-term foster care, or for foster care for a specified 451.5 period of time is filed, the court must proceed under section 451.6 260C.201, subdivision 11. 451.7 (3) If any party, including the child, disagrees with the 451.8 voluntary arrangement, the court shall proceed under section 451.9 260C.163. 451.10 Sec. 14. Minnesota Statutes 2002, section 626.559, 451.11 subdivision 5, is amended to read: 451.12 Subd. 5. [REVENUE.] The commissioner of human services 451.13 shall add the following funds to the funds appropriated under 451.14 section 626.5591, subdivision 2, to develop and support training: 451.15 (a) The commissioner of human services shall submit claims 451.16 for federal reimbursement earned through the activities and 451.17 services supported through department of human services child 451.18 protection or child welfare training funds. Federal revenue 451.19 earned must be used to improve and expand training services by 451.20 the department. The department expenditures eligible for 451.21 federal reimbursement under this section must not be made from 451.22 federal funds or funds used to match other federal funds. 451.23 (b) Each year, the commissioner of human services shall 451.24 withhold from funds distributed to each county under Minnesota 451.25 Rules, parts 9550.0300 to 9550.0370, an amount equivalent to 1.5 451.26 percent of each county's annual title XX allocation under 451.27 section256E.07256M.50. The commissioner must use these funds 451.28 to ensure decentralization of training. 451.29 (c) The federal revenue under this subdivision is available 451.30 for these purposes until the funds are expended. 451.31 Sec. 15. [TRANSITION TO CHILDREN'S THERAPEUTIC SERVICES 451.32 AND SUPPORTS.] 451.33 Beginning July 1, 2003, the commissioner shall use the 451.34 provider entity certification process under section 256B.0943 451.35 instead of the provider certification process required under 451.36 Minnesota Rules, parts 9505.0324; 9505.0326; and 9505.0327. 452.1 Sec. 16. [CONFLICTS.] 452.2 The amendments to Minnesota Statutes 2002, section 256F.10, 452.3 subdivision 6, in this article prevail over any conflicting law 452.4 that amends or repeals it regardless of the order or date of 452.5 enactment. 452.6 Sec. 17. [REVISOR'S INSTRUCTION.] 452.7 For sections in Minnesota Statutes and Minnesota Rules 452.8 affected by the repealed sections in this article, the revisor 452.9 shall delete internal cross-references where appropriate and 452.10 make changes necessary to correct the punctuation, grammar, or 452.11 structure of the remaining text and preserve its meaning. 452.12 Sec. 18. [REPEALER.] 452.13 (a) Minnesota Statutes 2002, sections 256B.0945, 452.14 subdivision 10; and 256F.10, subdivision 7, are repealed. 452.15 (b) Minnesota Statutes 2002, section 256B.0625, 452.16 subdivisions 35 and 36, are repealed effective July 1, 2004. 452.17 (c) Minnesota Rules, parts 9505.0324; 9505.0326; and 452.18 9505.0327, are repealed effective July 1, 2004. 452.19 ARTICLE 6 452.20 COMMUNITY SERVICES ACT 452.21 Section 1. [256M.01] [CITATION.] 452.22 Sections 256M.01 to 256M.80 may be cited as the "Children 452.23 and Community Services Act." This act establishes a fund to 452.24 address the needs of children, adolescents, and adults within 452.25 each county in accordance with a service plan entered into by 452.26 the board of county commissioners of each county in consultation 452.27 with stakeholders. The service plan shall specify the outcomes 452.28 to be achieved, the general strategies to be employed, and the 452.29 respective state and county roles. The service plan shall be 452.30 reviewed and updated every two years, or sooner if both the 452.31 state and the county deem it necessary. Nothing in this act is 452.32 intended to limit the ability of counties to provide services to 452.33 adults over age 25. 452.34 Sec. 2. [256M.10] [DEFINITIONS.] 452.35 Subdivision 1. [SCOPE.] For the purposes of sections 452.36 256M.01 to 256M.80, the terms defined in this section have the 453.1 meanings given them. 453.2 Subd. 2. [CHILDREN AND COMMUNITY SERVICES.] (a) "Children 453.3 and community services" means services provided or arranged for 453.4 by county boards for children, adolescents and other individuals 453.5 in transition from childhood to adulthood, and adults who 453.6 experience dependency, abuse, neglect, poverty, disability, 453.7 chronic health conditions, or other factors, including ethnicity 453.8 and race, that may result in poor outcomes or disparities, as 453.9 well as services for family members to support those individuals. 453.10 These services may be provided by professionals or 453.11 nonprofessionals, including the person's natural supports in the 453.12 community. 453.13 (b) Children and community services do not include services 453.14 under the public assistance programs known as the Minnesota 453.15 family investment program, Minnesota supplemental aid, medical 453.16 assistance, general assistance, general assistance medical care, 453.17 MinnesotaCare, or community health services. 453.18 Subd. 3. [COMMISSIONER.] "Commissioner" means the 453.19 commissioner of human services. 453.20 Subd. 4. [COUNTY BOARD.] "County board" means the board of 453.21 county commissioners in each county. 453.22 Subd. 5. [FORMER CHILDREN'S SERVICES AND COMMUNITY SERVICE 453.23 GRANTS.] "Former children's services and community service 453.24 grants" means allocations for the following grants: 453.25 (1) community social service grants under sections 252.24, 453.26 256E.06, and 256E.14; 453.27 (2) family preservation grants under section 256F.05, 453.28 subdivision 3; 453.29 (3) concurrent permanency planning grants under section 453.30 260C.213, subdivision 5; 453.31 (4) social service block grants (Title XX) under section 453.32 256E.07; and 453.33 (5) children's mental health grants under sections 245.4886 453.34 and 260.152. 453.35 Subd. 6. [HUMAN SERVICES BOARD.] "Human services board" 453.36 means a board established under section 402.02; Laws 1974, 454.1 chapter 293; or Laws 1976, chapter 340. 454.2 Sec. 3. [256M.20] [DUTIES OF COMMISSIONER OF HUMAN 454.3 SERVICES.] 454.4 Subdivision 1. [GENERAL SUPERVISION.] Each year the 454.5 commissioner shall allocate funds to each county according to 454.6 section 256M.40 and service plans under section 256M.30. The 454.7 funds shall be used to address the needs of children, 454.8 adolescents, and adults. The commissioner, in consultation with 454.9 counties, shall provide technical assistance and evaluate county 454.10 performance in achieving outcomes. 454.11 Subd. 2. [ADDITIONAL DUTIES.] The commissioner shall: 454.12 (1) provide necessary information and assistance to each 454.13 county for establishing baselines and desired improvements on 454.14 safety, permanency, and well-being for children, adolescents, 454.15 and adults; 454.16 (2) provide training, technical assistance, and other 454.17 supports to each county board to assist in needs assessment, 454.18 planning, implementation, and monitoring of outcomes and service 454.19 quality; 454.20 (3) specify requirements for reports, including fiscal 454.21 reports to account for funds distributed; 454.22 (4) request waivers from federal programs as necessary to 454.23 implement this act; and 454.24 (5) have authority under sections 14.055 and 14.056 to 454.25 grant a variance to existing state rules as needed to eliminate 454.26 barriers to achieving desired outcomes. 454.27 Subd. 3. [SANCTIONS.] The commissioner shall establish and 454.28 maintain a monitoring program designed to reduce the possibility 454.29 of noncompliance with federal laws and federal regulations that 454.30 may result in federal fiscal sanctions. If a county is not 454.31 complying with federal law or federal regulation and the 454.32 noncompliance may result in federal fiscal sanctions, the 454.33 commissioner may withhold a portion of the county's share of 454.34 state and federal funds for that program. The amount withheld 454.35 must be equal to the percentage difference between the level of 454.36 compliance maintained by the county and the level of compliance 455.1 required by the federal regulations, multiplied by the county's 455.2 share of state and federal funds for the program. The state and 455.3 federal funds may be withheld until the county is found to be in 455.4 compliance with all federal laws or federal regulations 455.5 applicable to the program. If a county remains out of 455.6 compliance for more than six consecutive months, the 455.7 commissioner may reallocate the withheld funds to counties that 455.8 are in compliance with the federal regulations. 455.9 Subd. 4. [CORRECTIVE ACTION PROCEDURE.] The commissioner 455.10 must comply with the following procedures when reducing county 455.11 funds under subdivision 3. 455.12 (a) The commissioner shall notify the county, by certified 455.13 mail, of the statute, rule, federal law, or federal regulation 455.14 with which the county has not complied. 455.15 (b) The commissioner shall give the county 30 days to 455.16 demonstrate to the commissioner that the county is in compliance 455.17 with the statute, rule, federal law, or federal regulation cited 455.18 in the notice or to develop a corrective action plan to address 455.19 the problem. Upon request from the county, the commissioner 455.20 shall provide technical assistance to the county in developing a 455.21 corrective action plan. The county shall have 30 days from the 455.22 date the technical assistance is provided to develop the 455.23 corrective action plan. 455.24 (c) The commissioner shall take no further action if the 455.25 county demonstrates compliance with the statute, rule, federal 455.26 law, or federal regulation cited in the notice. 455.27 (d) The commissioner shall review and approve or disapprove 455.28 the corrective action plan within 30 days after the commissioner 455.29 receives the corrective action plan. 455.30 (e) If the commissioner approves the corrective action plan 455.31 submitted by the county, the county has 90 days after the date 455.32 of approval to implement the corrective action plan. 455.33 (f) If the county fails to demonstrate compliance or fails 455.34 to implement the corrective action plan approved by the 455.35 commissioner, the commissioner may reduce the county's share of 455.36 state or federal funds according to subdivision 3. 456.1 Sec. 4. [256M.30] [SERVICE PLAN.] 456.2 Subdivision 1. [SERVICE PLAN SUBMITTED TO COMMISSIONER.] 456.3 Effective January 1, 2004, and each two-year period thereafter, 456.4 each county must have a biennial service plan submitted to the 456.5 commissioner in order to receive funds. Counties may submit 456.6 multicounty or regional service plans. 456.7 Subd. 2. [CONTENTS.] The service plan shall be completed 456.8 in a form prescribed by the commissioner. The plan must include: 456.9 (1) a statement of the needs of the children, adolescents, 456.10 and adults who experience the conditions defined in section 456.11 256M.10, subdivision 2, paragraph (a), and strengths and 456.12 resources available in the community to address those needs; 456.13 (2) strategies the county will pursue to achieve the 456.14 performance targets. Strategies must include specification of 456.15 how funds under this section and other community resources will 456.16 be used to achieve desired performance targets; and 456.17 (3) description of the county's process to solicit public 456.18 input and a summary of that input. 456.19 Subd. 3. [CHILDREN'S SERVICES.] In developing the plan 456.20 required under this section, a county shall endeavor, within the 456.21 limits of funds available, to consider the continuing need for 456.22 services and programs that were funded by the former children's 456.23 services and community service grants. 456.24 Subd. 4. [INFORMATION.] The commissioner shall provide 456.25 each county with information and technical assistance needed to 456.26 complete the service plan, including: information on child 456.27 safety, permanency, and well-being in the county; comparisons 456.28 with other counties; baseline performance on outcome measures; 456.29 and promising program practices. 456.30 Subd. 5. [TIMELINES.] The preliminary service plan must be 456.31 submitted to the commissioner by October 15, 2003, and October 456.32 15 of every two years thereafter. 456.33 Subd. 6. [PUBLIC COMMENT.] The county board must determine 456.34 how citizens in the county will participate in the development 456.35 of the service plan and provide opportunities for such 456.36 participation. The county must allow a period of no less than 457.1 30 days prior to the submission of the plan to the commissioner 457.2 to solicit comments from the public on the contents of the plan. 457.3 Sec. 5. [256M.40] [STATE CHILDREN AND COMMUNITY SERVICES 457.4 GRANT ALLOCATION.] 457.5 Subdivision 1. [FORMULA.] The commissioner shall allocate 457.6 state funds appropriated for children and community services 457.7 grants to each county board on a calendar year basis in an 457.8 amount determined according to the formula in paragraphs (a) to 457.9 (c). 457.10 (a) For July 1, 2003, through December 31, 2003, the 457.11 commissioner shall allocate funds to each county equal to that 457.12 county's allocation for the grants under section 256M.10, 457.13 subdivision 5, for calendar year 2003 less payments made on or 457.14 before June 30, 2003. 457.15 (b) For calendar year 2004 and 2005, the commissioner shall 457.16 allocate available funds to each county in proportion to that 457.17 county's share of the calendar year 2003 allocations for the 457.18 grants under section 256M.10, subdivision 5. 457.19 (c) For calendar year 2006 and each calendar year 457.20 thereafter, the commissioner shall allocate available funds to 457.21 each county in proportion to that county's share in the 457.22 preceding calendar year. 457.23 Subd. 2. [PROJECT OF REGIONAL SIGNIFICANCE; STUDY.] The 457.24 commissioner shall study whether and how to dedicate a portion 457.25 of the allocated funds for projects of regional significance. 457.26 The study shall include an analysis of the amount of annual 457.27 funding to be dedicated for projects of regional significance 457.28 and what efforts these projects must support. The commissioner 457.29 shall submit a report to the chairs of the house and senate 457.30 committees with jurisdiction over children and community 457.31 services grants by January 15, 2005. The commissioner of 457.32 finance, in preparing the proposed biennial budget for fiscal 457.33 years 2006 and 2007, is instructed to include $25 million each 457.34 year in funding for projects of regional significance under this 457.35 chapter. 457.36 Subd. 3. [PAYMENTS.] Calendar year allocations under 458.1 subdivision 1 shall be paid to counties on or before July 10 of 458.2 each year. 458.3 Sec. 6. [256M.50] [FEDERAL CHILDREN AND COMMUNITY SERVICES 458.4 GRANT ALLOCATION.] 458.5 In federal fiscal year 2004 and subsequent years, money for 458.6 social services received from the federal government to 458.7 reimburse counties for social service expenditures according to 458.8 Title XX of the Social Security Act shall be allocated to each 458.9 county according to section 256M.40, except for funds allocated 458.10 for administrative purposes and migrant day care. 458.11 Sec. 7. [256M.60] [DUTIES OF COUNTY BOARDS.] 458.12 Subdivision 1. [RESPONSIBILITIES.] The county board of 458.13 each county shall be responsible for administration and funding 458.14 of children and community services as defined in section 458.15 256M.10, subdivision 1. Each county board shall singly or in 458.16 combination with other county boards use funds available to the 458.17 county under this act to carry out these responsibilities. The 458.18 county board shall coordinate and facilitate the effective use 458.19 of formal and informal helping systems to best support and 458.20 nurture children, adolescents, and adults within the county who 458.21 experience dependency, abuse, neglect, poverty, disability, 458.22 chronic health conditions, or other factors, including ethnicity 458.23 and race, that may result in poor outcomes or disparities, as 458.24 well as services for family members to support such 458.25 individuals. This includes assisting individuals to function at 458.26 the highest level of ability while maintaining family and 458.27 community relationships to the greatest extent possible. 458.28 Subd. 2. [DAY TRAINING AND HABILITATION SERVICES; 458.29 ALTERNATIVE HABILITATION SERVICES.] To the extent provided in 458.30 the county service plan under section 256M.30, the county board 458.31 of each county shall be responsible for providing day training 458.32 and habilitation services or alternative habilitation services 458.33 during the day for persons with developmental disabilities to 458.34 the extent this is required by the person's individualized 458.35 service plan. 458.36 Subd. 3. [REPORTS.] The county board shall provide 459.1 necessary reports and data as required by the commissioner. 459.2 Subd. 4. [CONTRACTS FOR SERVICES.] The county board may 459.3 contract with a human services board, a multicounty board 459.4 established by a joint powers agreement, other political 459.5 subdivisions, a children's mental health collaborative, a family 459.6 services collaborative, or private organizations in discharging 459.7 its duties. 459.8 Subd. 5. [EXEMPTION FROM LIABILITY.] The state of 459.9 Minnesota, the county boards, or the agencies acting on behalf 459.10 of the county boards in the implementation and administration of 459.11 children and community services shall not be liable for damages, 459.12 injuries, or liabilities sustained through the purchase of 459.13 services by the individual, the individual's family, or the 459.14 authorized representative under this section. 459.15 Subd. 6. [FEES FOR SERVICES.] The county board may 459.16 establish a schedule of fees based upon clients' ability to pay 459.17 to be charged to recipients of children and community services. 459.18 Payment, in whole or in part, for services may be accepted from 459.19 any person except that no fee may be charged to persons or 459.20 families whose adjusted gross household income is below the 459.21 federal poverty level. When services are provided to any 459.22 person, including a recipient of aids administered by the 459.23 federal, state, or county government, payment of any charges due 459.24 may be billed to and accepted from a public assistance agency or 459.25 from any public or private corporation. 459.26 Sec. 8. [256M.70] [FISCAL LIMITATIONS.] 459.27 Subdivision 1. [DEMONSTRATION OF REASONABLE EFFORT.] The 459.28 county shall make reasonable efforts to comply with all children 459.29 and community services requirements. For the purposes of this 459.30 section, a county is making reasonable efforts if the county has 459.31 made efforts to comply with requirements within the limits of 459.32 available funding, including efforts to identify and apply for 459.33 commonly available state and federal funding for services. 459.34 Subd. 2. [IDENTIFICATION OF SERVICES TO BE PROVIDED.] If a 459.35 county has made reasonable efforts to provide services according 459.36 to the service plan under section 256M.30, but funds 460.1 appropriated for purposes of sections 256M.01 to 256M.80 are 460.2 insufficient, then the county may limit services according to 460.3 the following criteria: 460.4 (1) whether the services are needed to protect individuals 460.5 from maltreatment, abuse, and neglect; 460.6 (2) whether emergency and crisis services are needed to 460.7 protect clients from physical, emotional, or psychological harm; 460.8 (3) the need for assessment of persons applying for 460.9 services and referral to appropriate services when necessary; 460.10 (4) whether there is a need for public guardianship 460.11 services; 460.12 (5) the need for case management for persons with 460.13 developmental disabilities, children with serious emotional 460.14 disturbances, and adults with serious and persistent mental 460.15 illness; 460.16 (6) the need for day training and habilitation services or 460.17 alternative habilitative services during the day for adults with 460.18 developmental disabilities based on the individualized service 460.19 plan; 460.20 (7) whether there is a need to fulfill licensing 460.21 responsibilities delegated to the county by the commissioner 460.22 under section 245A.16; and 460.23 (8) whether subacute detoxification services are needed. 460.24 Subd. 3. [DENIAL, REDUCTION, OR TERMINATION OF SERVICES 460.25 DUE TO FISCAL LIMITATIONS.] Before a county denies, reduces, or 460.26 terminates services to an individual due to fiscal limitations, 460.27 the county must meet the requirements in this section. The 460.28 county must notify the individual and the individual's guardian 460.29 in writing of the reason for the denial, reduction, or 460.30 termination of services and must inform the individual and the 460.31 individual's guardian in writing that the county will, upon 460.32 request, meet to discuss alternatives before services are 460.33 terminated or reduced. No reduction in services for an 460.34 individual may be greater than twice the amount of the county 460.35 average reduction. 460.36 Sec. 9. [256M.80] [PROGRAM EVALUATION.] 461.1 Subdivision 1. [COUNTY EVALUATION.] Each county shall 461.2 submit to the commissioner data from the past calendar year on 461.3 the outcomes in the service plan. The commissioner shall 461.4 prescribe standard methods to be used by the counties in 461.5 providing the data. The data shall be submitted no later than 461.6 March 1 of each year, beginning with March 1, 2005. 461.7 Subd. 2. [STATEWIDE EVALUATION.] Six months after the end 461.8 of the first full calendar year and annually thereafter, the 461.9 commissioner shall prepare a report on the counties' progress in 461.10 improving the outcomes of children, adolescents, and adults 461.11 related to safety, permanency, and well-being. This report 461.12 shall be disseminated throughout the state. 461.13 Sec. 10. [256M.90] [GRANTS AND PURCHASE OF SERVICE 461.14 CONTRACTS.] 461.15 Subdivision 1. [AUTHORITY.] The local agency may purchase 461.16 community social services by grant or purchase of service 461.17 contract from agencies or individuals approved as vendors. 461.18 Subd. 2. [DUTIES OF LOCAL AGENCY.] The local agency must: 461.19 (1) use a written grant or purchase of service contract 461.20 when purchasing community social services. Every grant and 461.21 purchase of service contract must be completed, signed, and 461.22 approved by all parties to the agreement, including the county 461.23 board, unless the county board has designated the local agency 461.24 to sign on its behalf. No service shall be provided before the 461.25 effective date of the grant or purchase of service contract; 461.26 (2) determine a client's eligibility for purchased 461.27 services, or delegate the responsibility for making the 461.28 preliminary determination to the approved vendor under the terms 461.29 of the grant or purchase of service contract; 461.30 (3) ensure the development of an individual social service 461.31 plan based on the client's needs; 461.32 (4) monitor purchased services and evaluate grants and 461.33 contracts on the basis of client outcomes; and 461.34 (5) purchase only from approved vendors. 461.35 Subd. 3. [LOCAL AGENCY CRITERIA.] When the local agency 461.36 chooses to purchase community social services from a vendor that 462.1 is not subject to state licensing laws or department rules, the 462.2 local agency must establish written criteria for vendor approval 462.3 to ensure the health, safety, and well being of clients. 462.4 Subd. 4. [CASE RECORDS AND REPORTING REQUIREMENTS.] Case 462.5 records and data reporting requirements for grants and purchased 462.6 services are the same as case record and data reporting 462.7 requirements for direct services. 462.8 Subd. 5. [FILES.] The local agency must keep an 462.9 administrative file for each grant and contract. 462.10 Subd. 6. [CONTRACTING WITHIN AND ACROSS COUNTY LINES; LEAD 462.11 COUNTY CONTRACTS.] Paragraphs (a) to (e) govern contracting 462.12 within and across county lines and lead county contracts. 462.13 (a) Once a local agency and an approved vendor execute a 462.14 contract that meets the requirements of this subdivision, the 462.15 contract governs all other purchases of service from the vendor 462.16 by all other local agencies for the term of the contract. The 462.17 local agency that negotiated and entered into the contract 462.18 becomes the lead county for the contract. 462.19 (b) When the local agency in the county where a vendor is 462.20 located wants to purchase services from that vendor and the 462.21 vendor has no contract with the local agency or any other 462.22 county, the local agency must negotiate and execute a contract 462.23 with the vendor. 462.24 (c) When a local agency in one county wants to purchase 462.25 services from a vendor located in another county, it must notify 462.26 the local agency in the county where the vendor is located. 462.27 Within 30 days of being notified, the local agency in the 462.28 vendor's county must: 462.29 (1) if it has a contract with the vendor, send a copy to 462.30 the inquiring agency; 462.31 (2) if there is a contract with the vendor for which 462.32 another local agency is the lead county, identify the lead 462.33 county to the inquiring agency; or 462.34 (3) if no local agency has a contract with the vendor, 462.35 inform the inquiring agency whether it will negotiate a contract 462.36 and become the lead county. If the agency where the vendor is 463.1 located will not negotiate a contract with the vendor because of 463.2 concerns related to clients' health and safety, the agency must 463.3 share those concerns with the inquiring agency. 463.4 (d) If the local agency in the county where the vendor is 463.5 located declines to negotiate a contract with the vendor or 463.6 fails to respond within 30 days of receiving the notification 463.7 under paragraph (c), the inquiring agency is authorized to 463.8 negotiate a contract and must notify the local agency that 463.9 declined or failed to respond. 463.10 (e) When the inquiring county under paragraph (d) becomes 463.11 the lead county for a contract and the contract expires and 463.12 needs to be renegotiated, that county must again follow the 463.13 requirements under paragraph (c) and notify the local agency 463.14 where the vendor is located. The local agency where the vendor 463.15 is located has the option of becoming the lead county for the 463.16 new contract. If the local agency does not exercise the option, 463.17 paragraph (d) applies. 463.18 (f) This subdivision does not affect the requirement to 463.19 seek county concurrence under section 256B.092, subdivision 8a, 463.20 when the services are to be purchased for a person with mental 463.21 retardation or a related condition or under section 245.4711, 463.22 subdivision 3, when the services to be purchased are for an 463.23 adult with serious and persistent mental illness. 463.24 Subd. 7. [CONTRACTS WITH COMMUNITY MENTAL HEALTH 463.25 BOARDS.] A local agency within the geographic area served by a 463.26 community mental health board authorized by sections 245.61 to 463.27 245.69, may contract directly with the community mental health 463.28 board. However, if a local agency outside of the geographic 463.29 area served by a community mental health board wishes to 463.30 purchase services from the board, the local agency must follow 463.31 the requirements under subdivision 6. 463.32 Subd. 8. [PLACEMENT AGREEMENTS.] A placement agreement 463.33 must be used for residential services. Placement agreements are 463.34 valid when signed by authorized representatives of the facility 463.35 and the county of financial responsibility. If the county of 463.36 financial responsibility and the county where the approved 464.1 vendor is located are not the same, the county of financial 464.2 responsibility must, if requested, mail a copy of the placement 464.3 agreement to the county where the approved vendor is providing 464.4 the service and to the lead county within ten calendar days 464.5 after the date on which the placement agreement is signed. The 464.6 placement agreement must specify that the service will be 464.7 provided in accordance with the individual service plan as 464.8 required and must specify the unit cost, the date of placement, 464.9 and the date for the review of the placement. A placement 464.10 agreement may also be used for nonresidential services. 464.11 Sec. 11. [REVISOR'S INSTRUCTION.] 464.12 For sections in Minnesota Statutes and Minnesota Rules 464.13 affected by the repealed sections in this article, the revisor 464.14 shall delete internal cross-references where appropriate and 464.15 make changes necessary to correct the punctuation, grammar, or 464.16 structure of the remaining text and preserve its meaning. 464.17 Sec. 12. [REPEALER.] 464.18 (a) Minnesota Statutes 2002, sections 245.478; 245.4886; 464.19 245.4888; 245.496; 254A.17; 256B.0945, subdivisions 6, 7, 8, 9, 464.20 and 10; 256B.83; 256E.01; 256E.02; 256E.03; 256E.04; 256E.05; 464.21 256E.06; 256E.07; 256E.08; 256E.081; 256E.09; 256E.10; 256E.11; 464.22 256E.115; 256E.13; 256E.14; 256E.15; 256F.01; 256F.02; 256F.03; 464.23 256F.04; 256F.05; 256F.06; 256F.07; 256F.08; 256F.11; 256F.12; 464.24 256F.14; 257.075; 257.81; 260.152; and 626.562, are repealed. 464.25 (b) Minnesota Rules, parts 9550.0010; 9550.0020; 9550.0030; 464.26 9550.0040; 9550.0050; 9550.0060; 9550.0070; 9550.0080; 464.27 9550.0090; 9550.0091; 9550.0092; and 9550.0093, are repealed. 464.28 ARTICLE 7 464.29 HUMAN SERVICES LICENSING, COUNTY INITIATIVES, 464.30 AND MISCELLANEOUS 464.31 Section 1. Minnesota Statutes 2002, section 69.021, 464.32 subdivision 11, is amended to read: 464.33 Subd. 11. [EXCESS POLICE STATE-AID HOLDING ACCOUNT.] (a) 464.34 The excess police state-aid holding account is established in 464.35 the general fund. The excess police state-aid holding account 464.36 must be administered by the commissioner. 465.1 (b) Excess police state aid determined according to 465.2 subdivision 10, must be deposited in the excess police state-aid 465.3 holding account. 465.4 (c) From the balance in the excess police state-aid holding 465.5 account,$1,000,000$900,000 is appropriated to and must be 465.6 transferred annually to the ambulance service personnel 465.7 longevity award and incentive suspense account established by 465.8 section 144E.42, subdivision 2. 465.9 (d) If a police officer stress reduction program is created 465.10 by law and money is appropriated for that program, an amount 465.11 equal to that appropriation must be transferred from the balance 465.12 in the excess police state-aid holding account. 465.13 (e) On October 1, 1997, and annually on each subsequent 465.14 October 1, one-half of the balance of the excess police 465.15 state-aid holding account remaining after the deductions under 465.16 paragraphs (c) and (d) is appropriated for additional 465.17 amortization aid under section 423A.02, subdivision 1b. 465.18 (f) Annually, the remaining balance in the excess police 465.19 state-aid holding account, after the deductions under paragraphs 465.20 (c), (d), and (e), cancels to the general fund. 465.21 Sec. 2. Minnesota Statutes 2002, section 124D.23, 465.22 subdivision 2, is amended to read: 465.23 Subd. 2. [DUTIES.] (a) Each collaborative must: 465.24 (1) establish, with assistance from families and service 465.25 providers, clear goals for addressing the health, developmental, 465.26 educational, and family-related needs of children and youth and 465.27 use outcome-based indicators to measure progress toward 465.28 achieving those goals; 465.29 (2) establish a comprehensive planning process that 465.30 involves all sectors of the community, identifies local needs, 465.31 and surveys existing local programs; 465.32 (3) integrate service funding sources so that children and 465.33 their families obtain services from providers best able to 465.34 anticipate and meet their needs; 465.35 (4) coordinate families' services to avoid duplicative and 465.36 overlapping assessment and intake procedures; 466.1 (5) focus primarily on family-centered services; 466.2 (6) encourage parents and volunteers to actively 466.3 participate by using flexible scheduling and actively recruiting 466.4 volunteers; 466.5 (7) provide services in locations that are readily 466.6 accessible to children and families; 466.7 (8) usenew or reallocatedfunds toimprove or466.8enhanceprovide servicesprovidedto children and their 466.9 families; 466.10 (9) identify federal, state, and local institutional 466.11 barriers to coordinating services and suggest ways to remove 466.12 these barriers; and 466.13 (10) design and implement an integrated local service 466.14 delivery system for children and their families that coordinates 466.15 services across agencies and is client centered. The delivery 466.16 system shall provide a continuum of services for children birth 466.17 to age 18, or birth through age 21 for individuals with 466.18 disabilities. The collaborative shall describe the community 466.19 plan for serving pregnant women and children from birth to age 466.20 six. 466.21 (b) The outcome-based indicators developed in paragraph 466.22 (a), clause (1), may include the number of low birth weight 466.23 babies, the infant mortality rate, the number of children who 466.24 are adequately immunized and healthy, require out-of-home 466.25 placement or long-term special education services, and the 466.26 number of minor parents. 466.27 Sec. 3. Minnesota Statutes 2002, section 245.4932, 466.28 subdivision 1, is amended to read: 466.29 Subdivision 1. [COLLABORATIVE RESPONSIBILITIES.] The 466.30 children's mental health collaborative shall have the following 466.31 authority and responsibilities regarding federal revenue 466.32 enhancement: 466.33 (1) the collaborative must establish an integrated fund; 466.34 (2) the collaborative shall designate a lead county or 466.35 other qualified entity as the fiscal agency for reporting, 466.36 claiming, and receiving payments; 467.1 (3) the collaborative or lead county may enter into 467.2 subcontracts with other counties, school districts, special 467.3 education cooperatives, municipalities, and other public and 467.4 nonprofit entities for purposes of identifying and claiming 467.5 eligible expenditures to enhance federal reimbursement; 467.6 (4) the collaborative shall use any enhanced revenue 467.7 attributable to the activities of the collaborative, including 467.8 administrative and service revenue,solelyto provide mental 467.9 health services or to expand the operational target population.467.10The lead county or other qualified entity may not use enhanced467.11federal revenue for any other purpose; 467.12 (5)the members of the collaborative must continue the base467.13level of expenditures, as defined in section 245.492,467.14subdivision 2, for services for children with emotional or467.15behavioral disturbances and their families from any state,467.16county, federal, or other public or private funding source467.17which, in the absence of the new federal reimbursement earned467.18under sections 245.491 to 245.496, would have been available for467.19those services. The base year for purposes of this subdivision467.20shall be the accounting period closest to state fiscal year467.211993;467.22(6)the collaborative or lead county must develop and 467.23 maintain an accounting and financial management system adequate 467.24 to support all claims for federal reimbursement, including a 467.25 clear audit trail and any provisions specified in the contract 467.26 with the commissioner of human services; 467.27(7)(6) the collaborative or its members may elect to pay 467.28 the nonfederal share of the medical assistance costs for 467.29 services designated by the collaborative; and 467.30(8)(7) the lead county or other qualified entity may not 467.31 use federal funds or local funds designated as matching for 467.32 other federal funds to provide the nonfederal share of medical 467.33 assistance. 467.34 Sec. 4. Minnesota Statutes 2002, section 245A.035, 467.35 subdivision 3, is amended to read: 467.36 Subd. 3. [REQUIREMENTS FOR EMERGENCY LICENSE.] Before an 468.1 emergency license may be issued, the following requirements must 468.2 be met: 468.3 (1) the county agency must conduct an initial inspection of 468.4 the premises where the foster care is to be provided to ensure 468.5 the health and safety of any child placed in the home. The 468.6 county agency shall conduct the inspection using a form 468.7 developed by the commissioner; 468.8 (2) at the time of the inspection or placement, whichever 468.9 is earlier, the relative being considered for an emergency 468.10 license shall receive an application form for a child foster 468.11 care license; 468.12 (3) whenever possible, prior to placing the child in the 468.13 relative's home, the relative being considered for an emergency 468.14 license shall provide the information required by section 468.15 245A.04, subdivision 3, paragraph(b)(k); and 468.16 (4) if the county determines, prior to the issuance of an 468.17 emergency license, that anyone requiring a background study may 468.18 be disqualified under section 245A.04, and the disqualification 468.19 is one which the commissioner cannot set aside, an emergency 468.20 license shall not be issued. 468.21 Sec. 5. Minnesota Statutes 2002, section 245A.04, 468.22 subdivision 3, is amended to read: 468.23 Subd. 3. [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 468.24 (a) Individuals and organizations that are required in statute 468.25 to initiate background studies under this section shall comply 468.26 with the following requirements: 468.27 (1) Applicants for licensure, license holders, and other 468.28 entities as provided in this section must submit completed 468.29 background study forms to the commissioner before individuals 468.30 specified in paragraph (c), clauses (1) to (4), (6), and (7), 468.31 begin positions allowing direct contact in any licensed program. 468.32 (2) Applicants and license holders under the jurisdiction 468.33 of other state agencies who are required in other statutory 468.34 sections to initiate background studies under this section must 468.35 submit completed background study forms to the commissioner 468.36 prior to the background study subject beginning in a position 469.1 allowing direct contact in the licensed program, or where 469.2 applicable, prior to being employed. 469.3 (3) Organizations required to initiate background studies 469.4 under section 256B.0627 for individuals described in paragraph 469.5 (c), clause (5), must submit a completed background study form 469.6 to the commissioner before those individuals begin a position 469.7 allowing direct contact with persons served by the 469.8 organization. The commissioner shall recover the cost of these 469.9 background studies through a fee of no more than $12 per study 469.10 charged to the organization responsible for submitting the 469.11 background study form. The fees collected under this paragraph 469.12 are appropriated to the commissioner for the purpose of 469.13 conducting background studies. 469.14 Upon receipt of the background study forms from the 469.15 entities in clauses (1) to (3), the commissioner shall complete 469.16 the background study as specified under this section and provide 469.17 notices required in subdivision 3a. Unless otherwise specified, 469.18 the subject of a background study may have direct contact with 469.19 persons served by a program after the background study form is 469.20 mailed or submitted to the commissioner pending notification of 469.21 the study results under subdivision 3a. A county agency may 469.22 accept a background study completed by the commissioner under 469.23 this section in place of the background study required under 469.24 section 245A.16, subdivision 3, in programs with joint licensure 469.25 as home and community-based services and adult foster care for 469.26 people with developmental disabilities when the license holder 469.27 does not reside in the foster care residence and the subject of 469.28 the study has been continuously affiliated with the license 469.29 holder since the date of the commissioner's study. 469.30 (b) The definitions in this paragraph apply only to 469.31 subdivisions 3 to 3e. 469.32 (1) "Background study" means the review of records 469.33 conducted by the commissioner to determine whether a subject is 469.34 disqualified from direct contact with persons served by a 469.35 program, and where specifically provided in statutes, whether a 469.36 subject is disqualified from having access to persons served by 470.1 a program. 470.2 (2) "Continuous, direct supervision" means an individual is 470.3 within sight or hearing of the supervising person to the extent 470.4 that supervising person is capable at all times of intervening 470.5 to protect the health and safety of the persons served by the 470.6 program. 470.7 (3) "Contractor" means any person, regardless of employer, 470.8 who is providing program services for hire under the control of 470.9 the provider. 470.10 (4) "Direct contact" means providing face-to-face care, 470.11 training, supervision, counseling, consultation, or medication 470.12 assistance to persons served by the program. 470.13 (5) "Reasonable cause" means information or circumstances 470.14 exist which provide the commissioner with articulable suspicion 470.15 that further pertinent information may exist concerning a 470.16 subject. The commissioner has reasonable cause when, but not 470.17 limited to, the commissioner has received a report from the 470.18 subject, the license holder, or a third party indicating that 470.19 the subject has a history that would disqualify the person or 470.20 that may pose a risk to the health or safety of persons 470.21 receiving services. 470.22 (6) "Subject of a background study" means an individual on 470.23 whom a background study is required or completed. 470.24 (c) The applicant, license holder, registrant under section 470.25 144A.71, subdivision 1, bureau of criminal apprehension, 470.26 commissioner of health, and county agencies, after written 470.27 notice to the individual who is the subject of the study, shall 470.28 help with the study by giving the commissioner criminal 470.29 conviction data and reports about the maltreatment of adults 470.30 substantiated under section 626.557 and the maltreatment of 470.31 minors in licensed programs substantiated under section 470.32 626.556. If a background study is initiated by an applicant or 470.33 license holder and the applicant or license holder receives 470.34 information about the possible criminal or maltreatment history 470.35 of an individual who is the subject of the background study, the 470.36 applicant or license holder must immediately provide the 471.1 information to the commissioner. The individuals to be studied 471.2 shall include: 471.3 (1) the applicant; 471.4 (2) persons age 13 and over living in the household where 471.5 the licensed program will be provided; 471.6 (3) current employees or contractors of the applicant who 471.7 will have direct contact with persons served by the facility, 471.8 agency, or program; 471.9 (4) volunteers or student volunteers who have direct 471.10 contact with persons served by the program to provide program 471.11 services, if the contact is not under the continuous, direct 471.12 supervision by an individual listed in clause (1) or (3); 471.13 (5) any person required under section 256B.0627 to have a 471.14 background study completed under this section; 471.15 (6) persons ages 10 to 12 living in the household where the 471.16 licensed services will be provided when the commissioner has 471.17 reasonable cause; and 471.18 (7) persons who, without providing direct contact services 471.19 at a licensed program, may have unsupervised access to children 471.20 or vulnerable adults receiving services from the program 471.21 licensed to provide family child care for children, foster care 471.22 for children in the provider's own home, or foster care or day 471.23 care services for adults in the provider's own home when the 471.24 commissioner has reasonable cause. 471.25 (d) According to paragraph (c), clauses (2) and (6), the 471.26 commissioner shall review records from the juvenile courts. For 471.27 persons under paragraph (c), clauses (1), (3), (4), (5), and 471.28 (7), who are ages 13 to 17, the commissioner shall review 471.29 records from the juvenile courts when the commissioner has 471.30 reasonable cause. The juvenile courts shall help with the study 471.31 by giving the commissioner existing juvenile court records on 471.32 individuals described in paragraph (c), clauses (2), (6), and 471.33 (7), relating to delinquency proceedings held within either the 471.34 five years immediately preceding the background study or the 471.35 five years immediately preceding the individual's 18th birthday, 471.36 whichever time period is longer. The commissioner shall destroy 472.1 juvenile records obtained pursuant to this subdivision when the 472.2 subject of the records reaches age 23. 472.3 (e) Beginning August 1, 2001, the commissioner shall 472.4 conduct all background studies required under this chapter and 472.5 initiated by supplemental nursing services agencies registered 472.6 under section 144A.71, subdivision 1. Studies for the agencies 472.7 must be initiated annually by each agency. The commissioner 472.8 shall conduct the background studies according to this chapter. 472.9 The commissioner shall recover the cost of the background 472.10 studies through a fee of no more than $8 per study, charged to 472.11 the supplemental nursing services agency. The fees collected 472.12 under this paragraph are appropriated to the commissioner for 472.13 the purpose of conducting background studies. 472.14 (f) For purposes of this section, a finding that a 472.15 delinquency petition is proven in juvenile court shall be 472.16 considered a conviction in state district court. 472.17 (g) A study of an individual in paragraph (c), clauses (1) 472.18 to (7), shall be conducted at least upon application for initial 472.19 license for all license types or registration under section 472.20 144A.71, subdivision 1, and at reapplication for a license for 472.21 family child care, child foster care, and adult foster care. 472.22 The commissioner is not required to conduct a study of an 472.23 individual at the time of reapplication for a license or if the 472.24 individual has been continuously affiliated with a foster care 472.25 provider licensed by the commissioner of human services and 472.26 registered under chapter 144D, other than a family day care or 472.27 foster care license, if: (i) a study of the individual was 472.28 conducted either at the time of initial licensure or when the 472.29 individual became affiliated with the license holder; (ii) the 472.30 individual has been continuously affiliated with the license 472.31 holder since the last study was conducted; and (iii) the 472.32 procedure described in paragraph (j) has been implemented and 472.33 was in effect continuously since the last study was conducted. 472.34 For the purposes of this section, a physician licensed under 472.35 chapter 147 is considered to be continuously affiliated upon the 472.36 license holder's receipt from the commissioner of health or 473.1 human services of the physician's background study results. For 473.2 individuals who are required to have background studies under 473.3 paragraph (c) and who have been continuously affiliated with a 473.4 foster care provider that is licensed in more than one county, 473.5 criminal conviction data may be shared among those counties in 473.6 which the foster care programs are licensed. A county agency's 473.7 receipt of criminal conviction data from another county agency 473.8 shall meet the criminal data background study requirements of 473.9 this section. 473.10 (h) The commissioner may also conduct studies on 473.11 individuals specified in paragraph (c), clauses (3) and (4), 473.12 when the studies are initiated by: 473.13 (i) personnel pool agencies; 473.14 (ii) temporary personnel agencies; 473.15 (iii) educational programs that train persons by providing 473.16 direct contact services in licensed programs; and 473.17 (iv) professional services agencies that are not licensed 473.18 and which contract with licensed programs to provide direct 473.19 contact services or individuals who provide direct contact 473.20 services. 473.21 (i) Studies on individuals in paragraph (h), items (i) to 473.22 (iv), must be initiated annually by these agencies, programs, 473.23 and individuals. Except as provided in paragraph (a), clause 473.24 (3), no applicant, license holder, or individual who is the 473.25 subject of the study shall pay any fees required to conduct the 473.26 study. 473.27 (1) At the option of the licensed facility, rather than 473.28 initiating another background study on an individual required to 473.29 be studied who has indicated to the licensed facility that a 473.30 background study by the commissioner was previously completed, 473.31 the facility may make a request to the commissioner for 473.32 documentation of the individual's background study status, 473.33 provided that: 473.34 (i) the facility makes this request using a form provided 473.35 by the commissioner; 473.36 (ii) in making the request the facility informs the 474.1 commissioner that either: 474.2 (A) the individual has been continuously affiliated with a 474.3 licensed facility since the individual's previous background 474.4 study was completed, or since October 1, 1995, whichever is 474.5 shorter; or 474.6 (B) the individual is affiliated only with a personnel pool 474.7 agency, a temporary personnel agency, an educational program 474.8 that trains persons by providing direct contact services in 474.9 licensed programs, or a professional services agency that is not 474.10 licensed and which contracts with licensed programs to provide 474.11 direct contact services or individuals who provide direct 474.12 contact services; and 474.13 (iii) the facility provides notices to the individual as 474.14 required in paragraphs (a) to (j), and that the facility is 474.15 requesting written notification of the individual's background 474.16 study status from the commissioner. 474.17 (2) The commissioner shall respond to each request under 474.18 paragraph (1) with a written or electronic notice to the 474.19 facility and the study subject. If the commissioner determines 474.20 that a background study is necessary, the study shall be 474.21 completed without further request from a licensed agency or 474.22 notifications to the study subject. 474.23 (3) When a background study is being initiated by a 474.24 licensed facility or a foster care provider that is also 474.25 registered under chapter 144D, a study subject affiliated with 474.26 multiple licensed facilities may attach to the background study 474.27 form a cover letter indicating the additional facilities' names, 474.28 addresses, and background study identification numbers. When 474.29 the commissioner receives such notices, each facility identified 474.30 by the background study subject shall be notified of the study 474.31 results. The background study notice sent to the subsequent 474.32 agencies shall satisfy those facilities' responsibilities for 474.33 initiating a background study on that individual. 474.34 (j) If an individual who is affiliated with a program or 474.35 facility regulated by the department of human services or 474.36 department of health or who is affiliated with any type of home 475.1 care agency or provider of personal care assistance services, is 475.2 convicted of a crime constituting a disqualification under 475.3 subdivision 3d, the probation officer or corrections agent shall 475.4 notify the commissioner of the conviction. For the purpose of 475.5 this paragraph, "conviction" has the meaning given it in section 475.6 609.02, subdivision 5. The commissioner, in consultation with 475.7 the commissioner of corrections, shall develop forms and 475.8 information necessary to implement this paragraph and shall 475.9 provide the forms and information to the commissioner of 475.10 corrections for distribution to local probation officers and 475.11 corrections agents. The commissioner shall inform individuals 475.12 subject to a background study that criminal convictions for 475.13 disqualifying crimes will be reported to the commissioner by the 475.14 corrections system. A probation officer, corrections agent, or 475.15 corrections agency is not civilly or criminally liable for 475.16 disclosing or failing to disclose the information required by 475.17 this paragraph. Upon receipt of disqualifying information, the 475.18 commissioner shall provide the notifications required in 475.19 subdivision 3a, as appropriate to agencies on record as having 475.20 initiated a background study or making a request for 475.21 documentation of the background study status of the individual. 475.22 This paragraph does not apply to family day care and child 475.23 foster care programs. 475.24 (k) The individual who is the subject of the study must 475.25 provide the applicant or license holder with sufficient 475.26 information to ensure an accurate study including the 475.27 individual's first, middle, and last name and all other names by 475.28 which the individual has been known; home address, city, county, 475.29 and state of residence for the past five years; zip code; sex; 475.30 date of birth; and driver's license number or state 475.31 identification number. The applicant or license holder shall 475.32 provide this information about an individual in paragraph (c), 475.33 clauses (1) to (7), on forms prescribed by the commissioner. By 475.34 January 1, 2000, for background studies conducted by the 475.35 department of human services, the commissioner shall implement a 475.36 system for the electronic transmission of: (1) background study 476.1 information to the commissioner; and (2) background study 476.2 results to the license holder. The commissioner may request 476.3 additional information of the individual, which shall be 476.4 optional for the individual to provide, such as the individual's 476.5 social security number or race. 476.6 (l) For programs directly licensed by the commissioner, a 476.7 study must include information related to names of substantiated 476.8 perpetrators of maltreatment of vulnerable adults that has been 476.9 received by the commissioner as required under section 626.557, 476.10 subdivision 9c, paragraph (i), and the commissioner's records 476.11 relating to the maltreatment of minors in licensed programs, 476.12 information from juvenile courts as required in paragraph (c) 476.13 for persons listed in paragraph (c), clauses (2), (6), and (7), 476.14 and information from the bureau of criminal apprehension. For 476.15 child foster care, adult foster care, and family day care homes, 476.16 the study must include information from the county agency's 476.17 record of substantiated maltreatment of adults, and the 476.18 maltreatment of minors, information from juvenile courts as 476.19 required in paragraph (c) for persons listed in paragraph (c), 476.20 clauses (2), (6), and (7), and information from the bureau of 476.21 criminal apprehension. The commissioner may also review arrest 476.22 and investigative information from the bureau of criminal 476.23 apprehension, the commissioner of health, a county attorney, 476.24 county sheriff, county agency, local chief of police, other 476.25 states, the courts, or the Federal Bureau of Investigation if 476.26 the commissioner has reasonable cause to believe the information 476.27 is pertinent to the disqualification of an individual listed in 476.28 paragraph (c), clauses (1) to (7). The commissioner is not 476.29 required to conduct more than one review of a subject's records 476.30 from the Federal Bureau of Investigation if a review of the 476.31 subject's criminal history with the Federal Bureau of 476.32 Investigation has already been completed by the commissioner and 476.33 there has been no break in the subject's affiliation with the 476.34 license holder who initiated the background study. 476.35 (m) For any background study completed under this section, 476.36 when the commissioner has reasonable cause to believe that 477.1 further pertinent information may exist on the subject, the 477.2 subject shall provide a set of classifiable fingerprints 477.3 obtained from an authorized law enforcement agency. For 477.4 purposes of requiring fingerprints, the commissioner shall be 477.5 considered to have reasonable cause under, but not limited to, 477.6 the following circumstances: 477.7 (1) information from the bureau of criminal apprehension 477.8 indicates that the subject is a multistate offender; 477.9 (2) information from the bureau of criminal apprehension 477.10 indicates that multistate offender status is undetermined; or 477.11 (3) the commissioner has received a report from the subject 477.12 or a third party indicating that the subject has a criminal 477.13 history in a jurisdiction other than Minnesota. 477.14 (n) The failure or refusal of an applicant, license holder, 477.15 or registrant under section 144A.71, subdivision 1, to cooperate 477.16 with the commissioner is reasonable cause to disqualify a 477.17 subject, deny a license application or immediately suspend, 477.18 suspend, or revoke a license or registration. Failure or 477.19 refusal of an individual to cooperate with the study is just 477.20 cause for denying or terminating employment of the individual if 477.21 the individual's failure or refusal to cooperate could cause the 477.22 applicant's application to be denied or the license holder's 477.23 license to be immediately suspended, suspended, or revoked. 477.24 (o) The commissioner shall not consider an application to 477.25 be complete until all of the information required to be provided 477.26 under this subdivision has been received. 477.27 (p) No person in paragraph (c), clauses (1) to (7), who is 477.28 disqualified as a result of this section may be retained by the 477.29 agency in a position involving direct contact with persons 477.30 served by the program and no person in paragraph (c), clauses 477.31 (2), (6), and (7), or as provided elsewhere in statute who is 477.32 disqualified as a result of this section may be allowed access 477.33 to persons served by the program, unless the commissioner has 477.34 provided written notice to the agency stating that: 477.35 (1) the individual may remain in direct contact during the 477.36 period in which the individual may request reconsideration as 478.1 provided in subdivision 3a, paragraph (b), clause (2) or (3); 478.2 (2) the individual's disqualification has been set aside 478.3 for that agency as provided in subdivision 3b, paragraph (b); or 478.4 (3) the license holder has been granted a variance for the 478.5 disqualified individual under subdivision 3e. 478.6 (q) Termination of affiliation with persons in paragraph 478.7 (c), clauses (1) to (7), made in good faith reliance on a notice 478.8 of disqualification provided by the commissioner shall not 478.9 subject the applicant or license holder to civil liability. 478.10 (r) The commissioner may establish records to fulfill the 478.11 requirements of this section. 478.12 (s) The commissioner may not disqualify an individual 478.13 subject to a study under this section because that person has, 478.14 or has had, a mental illness as defined in section 245.462, 478.15 subdivision 20. 478.16 (t) An individual subject to disqualification under this 478.17 subdivision has the applicable rights in subdivision 3a, 3b, or 478.18 3c. 478.19 (u) For the purposes of background studies completed by 478.20 tribal organizations performing licensing activities otherwise 478.21 required of the commissioner under this chapter, after obtaining 478.22 consent from the background study subject, tribal licensing 478.23 agencies shall have access to criminal history data in the same 478.24 manner as county licensing agencies and private licensing 478.25 agencies under this chapter. 478.26 (v) County agencies shall have access to the criminal 478.27 history data in the same manner as county licensing agencies 478.28 under this chapter for purposes of background studies completed 478.29 by county agencies on legal nonlicensed child care providers to 478.30 determine eligibility for child care funds under chapter 119B. 478.31 Sec. 6. Minnesota Statutes 2002, section 245A.04, 478.32 subdivision 3b, is amended to read: 478.33 Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a) The 478.34 individual who is the subject of the disqualification may 478.35 request a reconsideration of the disqualification. 478.36 The individual must submit the request for reconsideration 479.1 to the commissioner in writing. A request for reconsideration 479.2 for an individual who has been sent a notice of disqualification 479.3 under subdivision 3a, paragraph (b), clause (1) or (2), must be 479.4 submitted within 30 calendar days of the disqualified 479.5 individual's receipt of the notice of disqualification. Upon 479.6 showing that the information in clause (1) or (2) cannot be 479.7 obtained within 30 days, the disqualified individual may request 479.8 additional time, not to exceed 30 days, to obtain that 479.9 information. A request for reconsideration for an individual 479.10 who has been sent a notice of disqualification under subdivision 479.11 3a, paragraph (b), clause (3), must be submitted within 15 479.12 calendar days of the disqualified individual's receipt of the 479.13 notice of disqualification. An individual who was determined to 479.14 have maltreated a child under section 626.556 or a vulnerable 479.15 adult under section 626.557, and who was disqualified under this 479.16 section on the basis of serious or recurring maltreatment, may 479.17 request reconsideration of both the maltreatment and the 479.18 disqualification determinations. The request for 479.19 reconsideration of the maltreatment determination and the 479.20 disqualification must be submitted within 30 calendar days of 479.21 the individual's receipt of the notice of disqualification. 479.22 Removal of a disqualified individual from direct contact shall 479.23 be ordered if the individual does not request reconsideration 479.24 within the prescribed time, and for an individual who submits a 479.25 timely request for reconsideration, if the disqualification is 479.26 not set aside. The individual must present information showing 479.27 that: 479.28 (1) the information the commissioner relied upon in 479.29 determining that the underlying conduct giving rise to the 479.30 disqualification occurred, and for maltreatment, that the 479.31 maltreatment was serious or recurring, is incorrect; or 479.32 (2) the subject of the study does not pose a risk of harm 479.33 to any person served by the applicant, license holder, or 479.34 registrant under section 144A.71, subdivision 1. 479.35 (b) The commissioner shall rescind the disqualification if 479.36 the commissioner finds that the information relied on to 480.1 disqualify the subject is incorrect. The commissioner may set 480.2 aside the disqualification under this section if the 480.3 commissioner finds that the individual does not pose a risk of 480.4 harm to any person served by the applicant, license holder, or 480.5 registrant under section 144A.71, subdivision 1. In determining 480.6 that an individual does not pose a risk of harm, the 480.7 commissioner shall consider the nature, severity, and 480.8 consequences of the event or events that lead to 480.9 disqualification, whether there is more than one disqualifying 480.10 event, the age and vulnerability of the victim at the time of 480.11 the event, the harm suffered by the victim, the similarity 480.12 between the victim and persons served by the program, the time 480.13 elapsed without a repeat of the same or similar event, 480.14 documentation of successful completion by the individual studied 480.15 of training or rehabilitation pertinent to the event, and any 480.16 other information relevant to reconsideration. In reviewing a 480.17 disqualification under this section, the commissioner shall give 480.18 preeminent weight to the safety of each person to be served by 480.19 the license holder, applicant, or registrant under section 480.20 144A.71, subdivision 1, over the interests of the license 480.21 holder, applicant, or registrant under section 144A.71, 480.22 subdivision 1. If the commissioner sets aside a 480.23 disqualification under this section, the disqualified individual 480.24 remains disqualified, but may hold a license and have direct 480.25 contact with or access to persons receiving services. The 480.26 commissioner's set aside of a disqualification is limited solely 480.27 to the licensed program, applicant, or agency specified in the 480.28 set aside notice, unless otherwise specified in the notice. The 480.29 commissioner may rescind a previous set aside of a 480.30 disqualification under this section based on new information 480.31 that indicates the individual may pose a risk of harm to persons 480.32 served by the applicant, license holder, or registrant. If the 480.33 commissioner rescinds a set aside of a disqualification under 480.34 this paragraph, the appeal rights under paragraphs (a) and (e) 480.35 shall apply. 480.36 (c) Unless the information the commissioner relied on in 481.1 disqualifying an individual is incorrect, the commissioner may 481.2 not set aside the disqualification of an individual in 481.3 connection with a license to provide family day care for 481.4 children, foster care for children in the provider's own home, 481.5 or foster care or day care services for adults in the provider's 481.6 own home if: 481.7 (1) less than ten years have passed since the discharge of 481.8 the sentence imposed for the offense; and the individual has 481.9 been convicted of a violation of any offense listed in sections 481.10 609.165 (felon ineligible to possess firearm), criminal 481.11 vehicular homicide under 609.21 (criminal vehicular homicide and 481.12 injury), 609.215 (aiding suicide or aiding attempted suicide), 481.13 felony violations under 609.223 or 609.2231 (assault in the 481.14 third or fourth degree), 609.713 (terroristic threats), 609.235 481.15 (use of drugs to injure or to facilitate crime), 609.24 (simple 481.16 robbery), 609.255 (false imprisonment), 609.562 (arson in the 481.17 second degree), 609.71 (riot), 609.498, subdivision 1 or1a1b 481.18 (aggravated first degree or first degree tampering with a 481.19 witness), burglary in the first or second degree under 609.582 481.20 (burglary), 609.66 (dangerous weapon), 609.665 (spring guns), 481.21 609.67 (machine guns and short-barreled shotguns), 609.749, 481.22 subdivision 2 (gross misdemeanor harassment; stalking), 152.021 481.23 or 152.022 (controlled substance crime in the first or second 481.24 degree), 152.023, subdivision 1, clause (3) or (4), or 481.25 subdivision 2, clause (4) (controlled substance crime in the 481.26 third degree), 152.024, subdivision 1, clause (2), (3), or (4) 481.27 (controlled substance crime in the fourth degree), 609.224, 481.28 subdivision 2, paragraph (c) (fifth-degree assault by a 481.29 caregiver against a vulnerable adult), 609.23 (mistreatment of 481.30 persons confined), 609.231 (mistreatment of residents or 481.31 patients), 609.2325 (criminal abuse of a vulnerable adult), 481.32 609.233 (criminal neglect of a vulnerable adult), 609.2335 481.33 (financial exploitation of a vulnerable adult), 609.234 (failure 481.34 to report), 609.265 (abduction), 609.2664 to 609.2665 481.35 (manslaughter of an unborn child in the first or second degree), 481.36 609.267 to 609.2672 (assault of an unborn child in the first, 482.1 second, or third degree), 609.268 (injury or death of an unborn 482.2 child in the commission of a crime), 617.293 (disseminating or 482.3 displaying harmful material to minors), a felony level 482.4 conviction involving alcohol or drug use, a gross misdemeanor 482.5 offense under 609.324, subdivision 1 (other prohibited acts), a 482.6 gross misdemeanor offense under 609.378 (neglect or endangerment 482.7 of a child), a gross misdemeanor offense under 609.377 482.8 (malicious punishment of a child), 609.72, subdivision 3 482.9 (disorderly conduct against a vulnerable adult); or an attempt 482.10 or conspiracy to commit any of these offenses, as each of these 482.11 offenses is defined in Minnesota Statutes; or an offense in any 482.12 other state, the elements of which are substantially similar to 482.13 the elements of any of the foregoing offenses; 482.14 (2) regardless of how much time has passed since the 482.15 involuntary termination of parental rights under section 482.16 260C.301 or the discharge of the sentence imposed for the 482.17 offense, the individual was convicted of a violation of any 482.18 offense listed in sections 609.185 to 609.195 (murder in the 482.19 first, second, or third degree), 609.20 (manslaughter in the 482.20 first degree), 609.205 (manslaughter in the second degree), 482.21 609.245 (aggravated robbery), 609.25 (kidnapping), 609.561 482.22 (arson in the first degree), 609.749, subdivision 3, 4, or 5 482.23 (felony-level harassment; stalking), 609.228 (great bodily harm 482.24 caused by distribution of drugs), 609.221 or 609.222 (assault in 482.25 the first or second degree), 609.66, subdivision 1e (drive-by 482.26 shooting), 609.855, subdivision 5 (shooting in or at a public 482.27 transit vehicle or facility), 609.2661 to 609.2663 (murder of an 482.28 unborn child in the first, second, or third degree), a felony 482.29 offense under 609.377 (malicious punishment of a child), a 482.30 felony offense under 609.324, subdivision 1 (other prohibited 482.31 acts), a felony offense under 609.378 (neglect or endangerment 482.32 of a child), 609.322 (solicitation, inducement, and promotion of 482.33 prostitution), 609.342 to 609.345 (criminal sexual conduct in 482.34 the first, second, third, or fourth degree), 609.352 482.35 (solicitation of children to engage in sexual conduct), 617.246 482.36 (use of minors in a sexual performance), 617.247 (possession of 483.1 pictorial representations of a minor), 609.365 (incest), a 483.2 felony offense under sections 609.2242 and 609.2243 (domestic 483.3 assault), a felony offense of spousal abuse, a felony offense of 483.4 child abuse or neglect, a felony offense of a crime against 483.5 children, or an attempt or conspiracy to commit any of these 483.6 offenses as defined in Minnesota Statutes, or an offense in any 483.7 other state, the elements of which are substantially similar to 483.8 any of the foregoing offenses; 483.9 (3) within the seven years preceding the study, the 483.10 individual committed an act that constitutes maltreatment of a 483.11 child under section 626.556, subdivision 10e, and that resulted 483.12 in substantial bodily harm as defined in section 609.02, 483.13 subdivision 7a, or substantial mental or emotional harm as 483.14 supported by competent psychological or psychiatric evidence; or 483.15 (4) within the seven years preceding the study, the 483.16 individual was determined under section 626.557 to be the 483.17 perpetrator of a substantiated incident of maltreatment of a 483.18 vulnerable adult that resulted in substantial bodily harm as 483.19 defined in section 609.02, subdivision 7a, or substantial mental 483.20 or emotional harm as supported by competent psychological or 483.21 psychiatric evidence. 483.22 In the case of any ground for disqualification under 483.23 clauses (1) to (4), if the act was committed by an individual 483.24 other than the applicant, license holder, or registrant under 483.25 section 144A.71, subdivision 1, residing in the applicant's or 483.26 license holder's home, or the home of a registrant under section 483.27 144A.71, subdivision 1, the applicant, license holder, or 483.28 registrant under section 144A.71, subdivision 1, may seek 483.29 reconsideration when the individual who committed the act no 483.30 longer resides in the home. 483.31 The disqualification periods provided under clauses (1), 483.32 (3), and (4) are the minimum applicable disqualification 483.33 periods. The commissioner may determine that an individual 483.34 should continue to be disqualified from licensure or 483.35 registration under section 144A.71, subdivision 1, because the 483.36 license holder, applicant, or registrant under section 144A.71, 484.1 subdivision 1, poses a risk of harm to a person served by that 484.2 individual after the minimum disqualification period has passed. 484.3 (d) The commissioner shall respond in writing or by 484.4 electronic transmission to all reconsideration requests for 484.5 which the basis for the request is that the information relied 484.6 upon by the commissioner to disqualify is incorrect or 484.7 inaccurate within 30 working days of receipt of a request and 484.8 all relevant information. If the basis for the request is that 484.9 the individual does not pose a risk of harm, the commissioner 484.10 shall respond to the request within 15 working days after 484.11 receiving the request for reconsideration and all relevant 484.12 information. If the request is based on both the correctness or 484.13 accuracy of the information relied on to disqualify the 484.14 individual and the risk of harm, the commissioner shall respond 484.15 to the request within 45 working days after receiving the 484.16 request for reconsideration and all relevant information. If 484.17 the disqualification is set aside, the commissioner shall notify 484.18 the applicant or license holder in writing or by electronic 484.19 transmission of the decision. 484.20 (e) Except as provided in subdivision 3c, if a 484.21 disqualification for which reconsideration was requested is not 484.22 set aside or is not rescinded, an individual who was 484.23 disqualified on the basis of a preponderance of evidence that 484.24 the individual committed an act or acts that meet the definition 484.25 of any of the crimes listed in subdivision 3d, paragraph (a), 484.26 clauses (1) to (4); for a determination under section 626.556 or 484.27 626.557 of substantiated maltreatment that was serious or 484.28 recurring under subdivision 3d, paragraph (a), clause (4); or 484.29 for failure to make required reports under section 626.556, 484.30 subdivision 3, or 626.557, subdivision 3, pursuant to 484.31 subdivision 3d, paragraph (a), clause (4), may request a fair 484.32 hearing under section 256.045. Except as provided under 484.33 subdivision 3c, the fair hearing is the only administrative 484.34 appeal of the final agency determination for purposes of appeal 484.35 by the disqualified individual, specifically, including a 484.36 challenge to the accuracy and completeness of data under section 485.1 13.04. If the individual was disqualified based on a conviction 485.2 or admission to any crimes listed in subdivision 3d, paragraph 485.3 (a), clauses (1) to (4), the reconsideration decision under this 485.4 subdivision is the final agency determination for purposes of 485.5 appeal by the disqualified individual and is not subject to a 485.6 hearing under section 256.045. 485.7 (f) Except as provided under subdivision 3c, if an 485.8 individual was disqualified on the basis of a determination of 485.9 maltreatment under section 626.556 or 626.557, which was serious 485.10 or recurring, and the individual has requested reconsideration 485.11 of the maltreatment determination under section 626.556, 485.12 subdivision 10i, or 626.557, subdivision 9d, and also requested 485.13 reconsideration of the disqualification under this subdivision, 485.14 reconsideration of the maltreatment determination and 485.15 reconsideration of the disqualification shall be consolidated 485.16 into a single reconsideration. For maltreatment and 485.17 disqualification determinations made by county agencies, the 485.18 consolidated reconsideration shall be conducted by the county 485.19 agency. If the county agency has disqualified an individual on 485.20 multiple bases, one of which is a county maltreatment 485.21 determination for which the individual has a right to request 485.22 reconsideration, the county shall conduct the reconsideration of 485.23 all disqualifications. Except as provided under subdivision 3c, 485.24 if an individual who was disqualified on the basis of serious or 485.25 recurring maltreatment requests a fair hearing on the 485.26 maltreatment determination under section 626.556, subdivision 485.27 10i, or 626.557, subdivision 9d, and requests a fair hearing on 485.28 the disqualification, which has not been set aside or rescinded 485.29 under this subdivision, the scope of the fair hearing under 485.30 section 256.045 shall include the maltreatment determination and 485.31 the disqualification. Except as provided under subdivision 3c, 485.32 a fair hearing is the only administrative appeal of the final 485.33 agency determination, specifically, including a challenge to the 485.34 accuracy and completeness of data under section 13.04. 485.35 (g) In the notice from the commissioner that a 485.36 disqualification has been set aside, the license holder must be 486.1 informed that information about the nature of the 486.2 disqualification and which factors under paragraph (b) were the 486.3 bases of the decision to set aside the disqualification is 486.4 available to the license holder upon request without consent of 486.5 the background study subject. With the written consent of a 486.6 background study subject, the commissioner may release to the 486.7 license holder copies of all information related to the 486.8 background study subject's disqualification and the 486.9 commissioner's decision to set aside the disqualification as 486.10 specified in the written consent. 486.11 Sec. 7. Minnesota Statutes 2002, section 245A.04, 486.12 subdivision 3d, is amended to read: 486.13 Subd. 3d. [DISQUALIFICATION.] (a) Upon receipt of 486.14 information showing, or when a background study completed under 486.15 subdivision 3 shows any of the following: a conviction of one 486.16 or more crimes listed in clauses (1) to (4); the individual has 486.17 admitted to or a preponderance of the evidence indicates the 486.18 individual has committed an act or acts that meet the definition 486.19 of any of the crimes listed in clauses (1) to (4); or an 486.20 investigation results in an administrative determination listed 486.21 under clause (4), the individual shall be disqualified from any 486.22 position allowing direct contact with persons receiving services 486.23 from the license holder, entity identified in subdivision 3, 486.24 paragraph (a), or registrant under section 144A.71, subdivision 486.25 1, and for individuals studied under section 245A.04, 486.26 subdivision 3, paragraph (c), clauses (2), (6), and (7), the 486.27 individual shall also be disqualified from access to a person 486.28 receiving services from the license holder: 486.29 (1) regardless of how much time has passed since the 486.30 involuntary termination of parental rights under section 486.31 260C.301 or the discharge of the sentence imposed for the 486.32 offense, and unless otherwise specified, regardless of the level 486.33 of the conviction, the individual was convicted of any of the 486.34 following offenses: sections 609.185 (murder in the first 486.35 degree); 609.19 (murder in the second degree); 609.195 (murder 486.36 in the third degree); 609.2661 (murder of an unborn child in the 487.1 first degree); 609.2662 (murder of an unborn child in the second 487.2 degree); 609.2663 (murder of an unborn child in the third 487.3 degree); 609.20 (manslaughter in the first degree); 609.205 487.4 (manslaughter in the second degree); 609.221 or 609.222 (assault 487.5 in the first or second degree); 609.228 (great bodily harm 487.6 caused by distribution of drugs); 609.245 (aggravated robbery); 487.7 609.25 (kidnapping); 609.561 (arson in the first degree); 487.8 609.749, subdivision 3, 4, or 5 (felony-level harassment; 487.9 stalking); 609.66, subdivision 1e (drive-by shooting); 609.855, 487.10 subdivision 5 (shooting at or in a public transit vehicle or 487.11 facility); 609.322 (solicitation, inducement, and promotion of 487.12 prostitution); 609.342 (criminal sexual conduct in the first 487.13 degree); 609.343 (criminal sexual conduct in the second degree); 487.14 609.344 (criminal sexual conduct in the third degree); 609.345 487.15 (criminal sexual conduct in the fourth degree); 609.352 487.16 (solicitation of children to engage in sexual conduct); 609.365 487.17 (incest); felony offense under 609.377 (malicious punishment of 487.18 a child); a felony offense under 609.378 (neglect or 487.19 endangerment of a child); a felony offense under 609.324, 487.20 subdivision 1 (other prohibited acts); 617.246 (use of minors in 487.21 sexual performance prohibited); 617.247 (possession of pictorial 487.22 representations of minors); a felony offense under sections 487.23 609.2242 and 609.2243 (domestic assault), a felony offense of 487.24 spousal abuse, a felony offense of child abuse or neglect, a 487.25 felony offense of a crime against children; or attempt or 487.26 conspiracy to commit any of these offenses as defined in 487.27 Minnesota Statutes, or an offense in any other state or country, 487.28 where the elements are substantially similar to any of the 487.29 offenses listed in this clause; 487.30 (2) if less than 15 years have passed since the discharge 487.31 of the sentence imposed for the offense; and the individual has 487.32 received a felony conviction for a violation of any of these 487.33 offenses: sections 609.21 (criminal vehicular homicide and 487.34 injury); 609.165 (felon ineligible to possess firearm); 609.215 487.35 (suicide); 609.223 or 609.2231 (assault in the third or fourth 487.36 degree); repeat offenses under 609.224 (assault in the fifth 488.1 degree); repeat offenses under 609.3451 (criminal sexual conduct 488.2 in the fifth degree); 609.498, subdivision 1 or1a488.3 1b (aggravated first degree or first degree tampering with a 488.4 witness); 609.713 (terroristic threats); 609.235 (use of drugs 488.5 to injure or facilitate crime); 609.24 (simple robbery); 609.255 488.6 (false imprisonment); 609.562 (arson in the second degree); 488.7 609.563 (arson in the third degree); repeat offenses under 488.8 617.23 (indecent exposure; penalties); repeat offenses under 488.9 617.241 (obscene materials and performances; distribution and 488.10 exhibition prohibited; penalty); 609.71 (riot); 609.66 488.11 (dangerous weapons); 609.67 (machine guns and short-barreled 488.12 shotguns); 609.2325 (criminal abuse of a vulnerable adult); 488.13 609.2664 (manslaughter of an unborn child in the first degree); 488.14 609.2665 (manslaughter of an unborn child in the second degree); 488.15 609.267 (assault of an unborn child in the first degree); 488.16 609.2671 (assault of an unborn child in the second degree); 488.17 609.268 (injury or death of an unborn child in the commission of 488.18 a crime); 609.52 (theft); 609.2335 (financial exploitation of a 488.19 vulnerable adult); 609.521 (possession of shoplifting gear); 488.20 609.582 (burglary); 609.625 (aggravated forgery); 609.63 488.21 (forgery); 609.631 (check forgery; offering a forged check); 488.22 609.635 (obtaining signature by false pretense); 609.27 488.23 (coercion); 609.275 (attempt to coerce); 609.687 (adulteration); 488.24 260C.301 (grounds for termination of parental rights); chapter 488.25 152 (drugs; controlled substance); and a felony level conviction 488.26 involving alcohol or drug use. An attempt or conspiracy to 488.27 commit any of these offenses, as each of these offenses is 488.28 defined in Minnesota Statutes; or an offense in any other state 488.29 or country, the elements of which are substantially similar to 488.30 the elements of the offenses in this clause. If the individual 488.31 studied is convicted of one of the felonies listed in this 488.32 clause, but the sentence is a gross misdemeanor or misdemeanor 488.33 disposition, the lookback period for the conviction is the 488.34 period applicable to the disposition, that is the period for 488.35 gross misdemeanors or misdemeanors; 488.36 (3) if less than ten years have passed since the discharge 489.1 of the sentence imposed for the offense; and the individual has 489.2 received a gross misdemeanor conviction for a violation of any 489.3 of the following offenses: sections 609.224 (assault in the 489.4 fifth degree); 609.2242 and 609.2243 (domestic assault); 489.5 violation of an order for protection under 518B.01, subdivision 489.6 14; 609.3451 (criminal sexual conduct in the fifth degree); 489.7 repeat offenses under 609.746 (interference with privacy); 489.8 repeat offenses under 617.23 (indecent exposure); 617.241 489.9 (obscene materials and performances); 617.243 (indecent 489.10 literature, distribution); 617.293 (harmful materials; 489.11 dissemination and display to minors prohibited); 609.71 (riot); 489.12 609.66 (dangerous weapons); 609.749, subdivision 2 (harassment; 489.13 stalking); 609.224, subdivision 2, paragraph (c) (assault in the 489.14 fifth degree by a caregiver against a vulnerable adult); 609.23 489.15 (mistreatment of persons confined); 609.231 (mistreatment of 489.16 residents or patients); 609.2325 (criminal abuse of a vulnerable 489.17 adult); 609.233 (criminal neglect of a vulnerable adult); 489.18 609.2335 (financial exploitation of a vulnerable adult); 609.234 489.19 (failure to report maltreatment of a vulnerable adult); 609.72, 489.20 subdivision 3 (disorderly conduct against a vulnerable adult); 489.21 609.265 (abduction); 609.378 (neglect or endangerment of a 489.22 child); 609.377 (malicious punishment of a child); 609.324, 489.23 subdivision 1a (other prohibited acts; minor engaged in 489.24 prostitution); 609.33 (disorderly house); 609.52 (theft); 489.25 609.582 (burglary); 609.631 (check forgery; offering a forged 489.26 check); 609.275 (attempt to coerce); or an attempt or conspiracy 489.27 to commit any of these offenses, as each of these offenses is 489.28 defined in Minnesota Statutes; or an offense in any other state 489.29 or country, the elements of which are substantially similar to 489.30 the elements of any of the offenses listed in this clause. If 489.31 the defendant is convicted of one of the gross misdemeanors 489.32 listed in this clause, but the sentence is a misdemeanor 489.33 disposition, the lookback period for the conviction is the 489.34 period applicable to misdemeanors; or 489.35 (4) if less than seven years have passed since the 489.36 discharge of the sentence imposed for the offense; and the 490.1 individual has received a misdemeanor conviction for a violation 490.2 of any of the following offenses: sections 609.224 (assault in 490.3 the fifth degree); 609.2242 (domestic assault); violation of an 490.4 order for protection under 518B.01 (Domestic Abuse Act); 490.5 violation of an order for protection under 609.3232 (protective 490.6 order authorized; procedures; penalties); 609.746 (interference 490.7 with privacy); 609.79 (obscene or harassing phone calls); 490.8 609.795 (letter, telegram, or package; opening; harassment); 490.9 617.23 (indecent exposure; penalties); 609.2672 (assault of an 490.10 unborn child in the third degree); 617.293 (harmful materials; 490.11 dissemination and display to minors prohibited); 609.66 490.12 (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 490.13 exploitation of a vulnerable adult); 609.234 (failure to report 490.14 maltreatment of a vulnerable adult); 609.52 (theft); 609.27 490.15 (coercion); or an attempt or conspiracy to commit any of these 490.16 offenses, as each of these offenses is defined in Minnesota 490.17 Statutes; or an offense in any other state or country, the 490.18 elements of which are substantially similar to the elements of 490.19 any of the offenses listed in this clause; a determination or 490.20 disposition of failure to make required reports under section 490.21 626.556, subdivision 3, or 626.557, subdivision 3, for incidents 490.22 in which: (i) the final disposition under section 626.556 or 490.23 626.557 was substantiated maltreatment, and (ii) the 490.24 maltreatment was recurring or serious; or a determination or 490.25 disposition of substantiated serious or recurring maltreatment 490.26 of a minor under section 626.556 or of a vulnerable adult under 490.27 section 626.557 for which there is a preponderance of evidence 490.28 that the maltreatment occurred, and that the subject was 490.29 responsible for the maltreatment. 490.30 For the purposes of this section, "serious maltreatment" 490.31 means sexual abuse; maltreatment resulting in death; or 490.32 maltreatment resulting in serious injury which reasonably 490.33 requires the care of a physician whether or not the care of a 490.34 physician was sought; or abuse resulting in serious injury. For 490.35 purposes of this section, "abuse resulting in serious injury" 490.36 means: bruises, bites, skin laceration or tissue damage; 491.1 fractures; dislocations; evidence of internal injuries; head 491.2 injuries with loss of consciousness; extensive second-degree or 491.3 third-degree burns and other burns for which complications are 491.4 present; extensive second-degree or third-degree frostbite, and 491.5 others for which complications are present; irreversible 491.6 mobility or avulsion of teeth; injuries to the eyeball; 491.7 ingestion of foreign substances and objects that are harmful; 491.8 near drowning; and heat exhaustion or sunstroke. For purposes 491.9 of this section, "care of a physician" is treatment received or 491.10 ordered by a physician, but does not include diagnostic testing, 491.11 assessment, or observation. For the purposes of this section, 491.12 "recurring maltreatment" means more than one incident of 491.13 maltreatment for which there is a preponderance of evidence that 491.14 the maltreatment occurred, and that the subject was responsible 491.15 for the maltreatment. For purposes of this section, "access" 491.16 means physical access to an individual receiving services or the 491.17 individual's personal property without continuous, direct 491.18 supervision as defined in section 245A.04, subdivision 3. 491.19 (b) Except for background studies related to child foster 491.20 care, adult foster care, or family child care licensure, when 491.21 the subject of a background study is regulated by a 491.22 health-related licensing board as defined in chapter 214, and 491.23 the regulated person has been determined to have been 491.24 responsible for substantiated maltreatment under section 626.556 491.25 or 626.557, instead of the commissioner making a decision 491.26 regarding disqualification, the board shall make a determination 491.27 whether to impose disciplinary or corrective action under 491.28 chapter 214. 491.29 (1) The commissioner shall notify the health-related 491.30 licensing board: 491.31 (i) upon completion of a background study that produces a 491.32 record showing that the individual was determined to have been 491.33 responsible for substantiated maltreatment; 491.34 (ii) upon the commissioner's completion of an investigation 491.35 that determined the individual was responsible for substantiated 491.36 maltreatment; or 492.1 (iii) upon receipt from another agency of a finding of 492.2 substantiated maltreatment for which the individual was 492.3 responsible. 492.4 (2) The commissioner's notice shall indicate whether the 492.5 individual would have been disqualified by the commissioner for 492.6 the substantiated maltreatment if the individual were not 492.7 regulated by the board. The commissioner shall concurrently 492.8 send this notice to the individual. 492.9 (3) Notwithstanding the exclusion from this subdivision for 492.10 individuals who provide child foster care, adult foster care, or 492.11 family child care, when the commissioner or a local agency has 492.12 reason to believe that the direct contact services provided by 492.13 the individual may fall within the jurisdiction of a 492.14 health-related licensing board, a referral shall be made to the 492.15 board as provided in this section. 492.16 (4) If, upon review of the information provided by the 492.17 commissioner, a health-related licensing board informs the 492.18 commissioner that the board does not have jurisdiction to take 492.19 disciplinary or corrective action, the commissioner shall make 492.20 the appropriate disqualification decision regarding the 492.21 individual as otherwise provided in this chapter. 492.22 (5) The commissioner has the authority to monitor the 492.23 facility's compliance with any requirements that the 492.24 health-related licensing board places on regulated persons 492.25 practicing in a facility either during the period pending a 492.26 final decision on a disciplinary or corrective action or as a 492.27 result of a disciplinary or corrective action. The commissioner 492.28 has the authority to order the immediate removal of a regulated 492.29 person from direct contact or access when a board issues an 492.30 order of temporary suspension based on a determination that the 492.31 regulated person poses an immediate risk of harm to persons 492.32 receiving services in a licensed facility. 492.33 (6) A facility that allows a regulated person to provide 492.34 direct contact services while not complying with the 492.35 requirements imposed by the health-related licensing board is 492.36 subject to action by the commissioner as specified under 493.1 sections 245A.06 and 245A.07. 493.2 (7) The commissioner shall notify a health-related 493.3 licensing board immediately upon receipt of knowledge of 493.4 noncompliance with requirements placed on a facility or upon a 493.5 person regulated by the board. 493.6 Sec. 8. Minnesota Statutes 2002, section 245A.09, 493.7 subdivision 7, is amended to read: 493.8 Subd. 7. [REGULATORY METHODS.] (a) Where appropriate and 493.9 feasible the commissioner shall identify and implement 493.10 alternative methods of regulation and enforcement to the extent 493.11 authorized in this subdivision. These methods shall include: 493.12 (1) expansion of the types and categories of licenses that 493.13 may be granted; 493.14 (2) when the standards of another state or federal 493.15 governmental agency or an independent accreditation body have 493.16 been shown topredict compliance with the rulesrequire the same 493.17 standards, methods, or alternative methods to achieve 493.18 substantially the same intended outcomes as the licensing 493.19 standards, the commissioner shall consider compliance with the 493.20 governmental or accreditation standards to be equivalent to 493.21 partial compliance with theruleslicensing standards; and 493.22 (3) use of an abbreviated inspection that employs key 493.23 standards that have been shown to predict full compliance with 493.24 the rules. 493.25 (b) If the commissioner accepts accreditation as 493.26 documentation of compliance with a licensing standard under 493.27 paragraph (a), the commissioner shall continue to investigate 493.28 complaints related to noncompliance with all licensing standards. 493.29 The commissioner may take a licensing action for noncompliance 493.30 under this chapter and shall recognize all existing appeal 493.31 rights regarding any licensing actions taken under this chapter. 493.32 (c) The commissioner shall work with the commissioners of 493.33 health, public safety, administration, and children, families, 493.34 and learning in consolidating duplicative licensing and 493.35 certification rules and standards if the commissioner determines 493.36 that consolidation is administratively feasible, would 494.1 significantly reduce the cost of licensing, and would not reduce 494.2 the protection given to persons receiving services in licensed 494.3 programs. Where administratively feasible and appropriate, the 494.4 commissioner shall work with the commissioners of health, public 494.5 safety, administration, and children, families, and learning in 494.6 conducting joint agency inspections of programs. 494.7(c)(d) The commissioner shall work with the commissioners 494.8 of health, public safety, administration, and children, 494.9 families, and learning in establishing a single point of 494.10 application for applicants who are required to obtain concurrent 494.11 licensure from more than one of the commissioners listed in this 494.12 clause. 494.13(d)(e) Unless otherwise specified in statute, the 494.14 commissioner mayspecify in rule periods of licensure up to two494.15yearsconduct routine inspections biennially. 494.16 Sec. 9. Minnesota Statutes 2002, section 245A.10, is 494.17 amended to read: 494.18 245A.10 [FEES.] 494.19 Subdivision 1. [APPLICATION OR LICENSE FEE REQUIRED, 494.20 PROGRAMS EXEMPT FROM FEE.] (a) Unless exempt under paragraph 494.21 (b), the commissioner shall charge a fee for evaluation of 494.22 applications and inspection of programs, other than family day494.23care and foster care,which are licensed under this chapter. 494.24The commissioner may charge a fee for the licensing of school494.25age child care programs, in an amount sufficient to cover the494.26cost to the state agency of processing the license.494.27 (b) Except as provided under subdivision 2, no application 494.28 or license fee shall be charged for child foster care, adult 494.29 foster care, family and group family child care or 494.30 state-operated programs, unless the state-operated program is an 494.31 intermediate care facility for persons with mental retardation 494.32 or related conditions (ICF/MR). 494.33 Subd. 2. [COUNTY FEES FOR BACKGROUND STUDIES AND LICENSING 494.34 INSPECTIONS IN FAMILY AND GROUP FAMILY CHILD CARE.] (a) For 494.35 purposes of family and group family child care licensing under 494.36 this chapter, a county agency may charge a fee to an applicant 495.1 or license holder to recover the actual cost of background 495.2 studies, but in any case not to exceed $100 annually. A county 495.3 agency may also charge a fee to an applicant or license holder 495.4 to recover the actual cost of licensing inspections, but in any 495.5 case not to exceed $150 annually. 495.6 (b) A county agency may charge a fee to a legal nonlicensed 495.7 child care provider or applicant for authorization to recover 495.8 the actual cost of background studies completed under section 495.9 119B.125, but in any case not to exceed $100 annually. 495.10 (c) Counties may elect to reduce or waive the fees in 495.11 paragraph (a) or (b): 495.12 (1) in cases of financial hardship; 495.13 (2) if the county has a shortage of providers in the 495.14 county's area; 495.15 (3) for new providers; or 495.16 (4) for providers who have attained at least 16 hours of 495.17 training before seeking initial licensure. 495.18 (d) Counties may allow providers to pay the applicant fees 495.19 in paragraph (a) or (b) on an installment basis for up to one 495.20 year. If the provider is receiving child care assistance 495.21 payments from the state, the provider may have the fees under 495.22 paragraph (a) or (b) deducted from the child care assistance 495.23 payments for up to one year and the state shall reimburse the 495.24 county for the county fees collected in this manner. 495.25 Subd. 3. [APPLICATION FEE FOR INITIAL LICENSE OR 495.26 CERTIFICATION.] (a) For fees required under subdivision 1, an 495.27 applicant for an initial license or certification issued by the 495.28 commissioner shall submit a $500 application fee with each new 495.29 application required under this subdivision. The application 495.30 fee shall not be prorated, is nonrefundable, and is in lieu of 495.31 the annual license or certification fee that expires on December 495.32 31. The commissioner shall not process an application until the 495.33 application fee is paid. 495.34 (b) Except as provided in clauses (1) to (3), an applicant 495.35 shall apply for a license to provide services at a specific 495.36 location. 496.1 (1) For a license to provide waivered services to persons 496.2 with developmental disabilities or related conditions, an 496.3 applicant shall submit an application for each county in which 496.4 the waivered services will be provided. 496.5 (2) For a license to provide semi-independent living 496.6 services to persons with developmental disabilities or related 496.7 conditions, an applicant shall submit a single application to 496.8 provide services statewide. 496.9 (3) For a license to provide independent living assistance 496.10 for youth under section 245A.22, an applicant shall submit a 496.11 single application to provide services statewide. 496.12 Subd. 4. [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS 496.13 WITH LICENSED CAPACITY.] (a) Child care centers and programs 496.14 with a licensed capacity shall pay an annual nonrefundable 496.15 license or certification fee based on the following schedule: 496.16 Licensed Capacity Child Care Residential 496.17 Center Program 496.18 License Fee License Fee 496.19 1 to 24 persons $200 $400 496.20 25 to 49 persons $300 $600 496.21 50 to 74 persons $400 $800 496.22 75 to 99 persons $500 $1,000 496.23 100 to 124 persons $600 $1,200 496.24 125 to 149 persons $700 $1,400 496.25 150 to 174 persons $900 $1,600 496.26 175 to 199 persons $1,200 $1,800 496.27 200 to 224 persons $1,400 $2,000 496.28 225 or more persons $1,600 $2,500 496.29 (b) A day training and habilitation program serving persons 496.30 with developmental disabilities or related conditions shall be 496.31 assessed a license fee based on the schedule in paragraph (a) 496.32 unless the license holder serves more than 50 percent of the 496.33 same persons at two or more locations in the community. When a 496.34 day training and habilitation program serves more than 50 496.35 percent of the same persons in two or more locations in a 496.36 community, the day training and habilitation program shall pay a 497.1 license fee based on the licensed capacity of the largest 497.2 facility and the other facility or facilities shall be charged a 497.3 license fee based on a licensed capacity of a residential 497.4 program serving one to 24 persons. 497.5 Subd. 5. [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS 497.6 WITHOUT A LICENSED CAPACITY.] (a) Except as provided in 497.7 paragraph (b), a program without a stated licensed capacity 497.8 shall pay a license or certification fee of $400. 497.9 (b) A mental health center or mental health clinic 497.10 requesting certification for purposes of insurance and 497.11 subscriber contract reimbursement under Minnesota Rules, parts 497.12 9520.0750 to 9520.0870 shall pay a certification fee of $1,000 497.13 per year. If the mental health center or mental health clinic 497.14 provides services at a primary location with satellite 497.15 facilities, the satellite facilities shall be certified with the 497.16 primary location without an additional charge. 497.17 Subd. 6. [LICENSE NOT ISSUED UNTIL LICENSE OR 497.18 CERTIFICATION FEE IS PAID.] The commissioner shall not issue a 497.19 license or certification until the license or certification fee 497.20 is paid. The commissioner shall send a bill for the license or 497.21 certification fee to the billing address identified by the 497.22 license holder. If the license holder does not submit the 497.23 license or certification fee payment by the due date, the 497.24 commissioner shall send the license holder a past due notice. 497.25 If the license holder fails to pay the license or certification 497.26 fee by the due date on the past due notice, the commissioner 497.27 shall send a final notice to the license holder informing the 497.28 license holder that the program license will expire on December 497.29 31 unless the license fee is paid before December 31. If a 497.30 license expires, the program is no longer licensed and, unless 497.31 exempt from licensure under section 245A.03, subdivision 2, must 497.32 not operate after the expiration date. After a license expires, 497.33 if the former license holder wishes to provide licensed 497.34 services, the former license holder must submit a new license 497.35 application and application fee under subdivision 3. 497.36 Sec. 10. Minnesota Statutes 2002, section 245A.11, 498.1 subdivision 2a, is amended to read: 498.2 Subd. 2a. [ADULT FOSTER CARE LICENSE CAPACITY.] (a) An 498.3 adult foster care license holder may have a maximum license 498.4 capacity of five if all persons in care are age 55 or over and 498.5 do not have a serious and persistent mental illness or a 498.6 developmental disability. 498.7 (b) The commissioner may grant variances to paragraph (a) 498.8 to allow a foster care provider with a licensed capacity of five 498.9 persons to admit an individual under the age of 55 if the 498.10 variance complies with section 245A.04, subdivision 9, and 498.11 approval of the variance is recommended by the county in which 498.12 the licensed foster care provider is located. 498.13 (c) The commissioner may grant variances to paragraph (a) 498.14 to allow the use of a fifth bed for emergency crisis services 498.15 for a person with serious and persistent mental illness or a 498.16 developmental disability, regardless of age, if the variance 498.17 complies with section 245A.04, subdivision 9, and approval of 498.18 the variance is recommended by the county in which the licensed 498.19 foster care provider is located. 498.20 (d) Notwithstanding paragraph (a), the commissioner may 498.21 issue an adult foster care license with a capacity of five or 498.22 six adults when the capacity is recommended by the county 498.23 licensing agency of the county in which the facility is located 498.24 and if the recommendation verifies that: 498.25 (1) the facility meets the physical environment 498.26 requirements in the adult foster care licensing rule; 498.27 (2) the five- or six-bed living arrangement is specified 498.28 for each resident in the resident's (i) individualized plan of 498.29 care; (ii) individual service plan under section 256B.092, 498.30 subdivision 1b, if required; or (iii) individual resident 498.31 placement agreement under Minnesota Rules, part 9555.5105, 498.32 subpart 19, if required; 498.33 (3) the license holder obtains written and signed informed 498.34 consent from each resident or resident's legal representative 498.35 documenting the resident's informed choice to living in the home 498.36 and that the resident's refusal to consent would not have 499.1 resulted in service termination; and 499.2 (4) the facility was licensed for adult foster care before 499.3 March 1, 2003. 499.4 (e) The commissioner shall not issue a new adult foster 499.5 care license under paragraph (d) after June 30, 2005. The 499.6 commissioner shall allow a facility with an adult foster care 499.7 license issued under paragraph (d) before June 30, 2005, to 499.8 continue with a capacity of five or six adults if the license 499.9 holder continues to comply with the requirements in paragraph 499.10 (d). 499.11 Sec. 11. Minnesota Statutes 2002, section 245A.11, 499.12 subdivision 2b, is amended to read: 499.13 Subd. 2b. [ADULT FOSTER CARE; FAMILY ADULT DAY CARE.] An 499.14 adult foster care license holder licensed under the conditions 499.15 in subdivision 2a may also provide family adult day care for 499.16 adults age 55 or over if no persons in the adult foster or adult 499.17 family day care program have a serious and persistent mental 499.18 illness or a developmental disability. The maximum combined 499.19 capacity for adult foster care and family adult day care is five 499.20 adults, except that the commissioner may grant a variance for a 499.21 family adult day care provider to admit up to seven individuals 499.22 for day care services and one individual for respite care 499.23 services, if all of the following requirements are met: (1) the 499.24 variance complies with section 245A.04, subdivision 9; (2) a 499.25 second caregiver is present whenever six or more clients are 499.26 being served; and (3) the variance is recommended by the county 499.27 social service agency in the county where the provider is 499.28 located. A separate license is not required to provide family 499.29 adult day care under this subdivision. Adult foster care homes 499.30 providing services to five adults under this section shall not 499.31 be subject to licensure by the commissioner of health under the 499.32 provisions of chapter 144, 144A, 157, or any other law requiring 499.33 facility licensure by the commissioner of health. 499.34 Sec. 12. Minnesota Statutes 2002, section 245A.11, is 499.35 amended by adding a subdivision to read: 499.36 Subd. 7. [ADULT FOSTER CARE; VARIANCE FOR ALTERNATE 500.1 OVERNIGHT SUPERVISION.] (a) The commissioner may grant a 500.2 variance under section 245A.04, subdivision 9, to rule parts 500.3 requiring a caregiver to be present in an adult foster care home 500.4 during normal sleeping hours to allow for alternative methods of 500.5 overnight supervision. The commissioner may grant the variance 500.6 if the local county licensing agency recommends the variance and 500.7 the county recommendation includes documentation verifying that: 500.8 (1) the county has approved the license holder's plan for 500.9 alternative methods of providing overnight supervision and 500.10 determined the plan protects the residents' health, safety, and 500.11 rights; 500.12 (2) the license holder has obtained written and signed 500.13 informed consent from each resident or each resident's legal 500.14 representative documenting the resident's or legal 500.15 representative's agreement with the alternative method of 500.16 overnight supervision; and 500.17 (3) the alternative method of providing overnight 500.18 supervision is specified for each resident in the resident's: 500.19 (i) individualized plan of care; (ii) individual service plan 500.20 under section 256B.092, subdivision 1b, if required; or (iii) 500.21 individual resident placement agreement under Minnesota Rules, 500.22 part 9555.5105, subpart 19, if required. 500.23 (b) To be eligible for a variance under paragraph (a), the 500.24 adult foster care license holder must not have had a licensing 500.25 action under section 245A.06 or 245A.07 during the prior 24 500.26 months based on failure to provide adequate supervision, health 500.27 care services, or resident safety in the adult foster care home. 500.28 Sec. 13. Minnesota Statutes 2002, section 245B.03, 500.29 subdivision 2, is amended to read: 500.30 Subd. 2. [RELATIONSHIP TO OTHER STANDARDS GOVERNING 500.31 SERVICES FOR PERSONS WITH MENTAL RETARDATION OR RELATED 500.32 CONDITIONS.] (a) ICFs/MR are exempt from: 500.33 (1) section 245B.04; 500.34 (2) section 245B.06, subdivisions 4 and 6; and 500.35 (3) section 245B.07, subdivisions 4, paragraphs (b) and 500.36 (c); 7; and 8, paragraphs (1), clause (iv), and (2). 501.1 (b) License holders also licensed under chapter 144 as a 501.2 supervised living facility are exempt from section 245B.04. 501.3 (c) Residential service sites controlled by license holders 501.4 licensed under chapter 245B for home and community-based 501.5 waivered services for four or fewer adults are exempt from 501.6 compliance with Minnesota Rules, parts 9543.0040, subpart 2, 501.7 item C; 9555.5505; 9555.5515, items B and G; 9555.5605; 501.8 9555.5705; 9555.6125, subparts 3, item C, subitem (2), and 4 to 501.9 6; 9555.6185; 9555.6225, subpart 8; 9555.6245; 9555.6255; and 501.10 9555.6265; and as provided under section 245B.06, subdivision 2, 501.11 the license holder is exempt from the program abuse prevention 501.12 plans and individual abuse prevention plans otherwise required 501.13 under sections 245A.65, subdivision 2, and 626.557, subdivision 501.14 14. The commissioner may approve alternative methods of 501.15 providing overnight supervision using the process and criteria 501.16 for granting a variance in section 245A.04, subdivision 9. This 501.17 chapter does not apply to foster care homes that do not provide 501.18 residential habilitation services funded under the home and 501.19 community-based waiver programs defined in section 256B.092. 501.20 (d) Residential service sites controlled by license holders 501.21 licensed under this chapter for home and community-based 501.22 waivered services for four or fewer children are exempt from 501.23 compliance with Minnesota Rules, parts 9545.0130; 9545.0140; 501.24 9545.0150; 9545.0170; 9545.0220, subparts 1, items C, F, and I, 501.25 and 3; and 9545.0230. 501.26 (e) The commissioner may exempt license holders from 501.27 applicable standards of this chapter when the license holder 501.28 meets the standards under section 245A.09, subdivision 7. 501.29 License holders that are accredited by an independent 501.30 accreditation body shall continue to be licensed under this 501.31 chapter. 501.32(e)(f) License holders governed by sections 245B.02 to 501.33 245B.07 must also meet the licensure requirements in chapter 501.34 245A. 501.35(f)(g) Nothing in this chapter prohibits license holders 501.36 from concurrently serving consumers with and without mental 502.1 retardation or related conditions provided this chapter's 502.2 standards are met as well as other relevant standards. 502.3(g)(h) The documentation that sections 245B.02 to 245B.07 502.4 require of the license holder meets the individual program plan 502.5 required in section 256B.092 or successor provisions. 502.6 Sec. 14. Minnesota Statutes 2002, section 245B.03, is 502.7 amended by adding a subdivision to read: 502.8 Subd. 3. [CONTINUITY OF CARE.] (a) When a consumer changes 502.9 service to the same type of service provided under a different 502.10 license held by the same license holder and the policies and 502.11 procedures under section 245B.07, subdivision 8, are 502.12 substantially similar, the license holder is exempt from the 502.13 requirements in sections 245B.06, subdivisions 2, paragraphs (e) 502.14 and (f), and 4; and 245B.07, subdivision 9, clause (2). 502.15 (b) When a direct service staff person begins providing 502.16 direct service under one or more licenses other than the license 502.17 for which the staff person initially received the staff 502.18 orientation requirements under section 245B.07, subdivision 5, 502.19 the license holder is exempt from all staff orientation 502.20 requirements under section 245B.07, subdivision 5, except that: 502.21 (1) if the service provision location changes, the staff 502.22 person must receive orientation regarding any policies or 502.23 procedures under section 245B.07, subdivision 8, that are 502.24 specific to the service provision location; and 502.25 (2) if the staff person provides direct service to one or 502.26 more consumers for whom the staff person has not previously 502.27 provided direct service, the staff person must review each 502.28 consumer's: (i) service plans and risk management plan in 502.29 accordance with section 245B.07, subdivision 5, paragraph (b), 502.30 clause (1); and (ii) medication administration in accordance 502.31 with section 245B.07, subdivision 5, paragraph (b), clause (6). 502.32 Sec. 15. Minnesota Statutes 2002, section 245B.04, 502.33 subdivision 2, is amended to read: 502.34 Subd. 2. [SERVICE-RELATED RIGHTS.] A consumer's 502.35 service-related rights include the right to: 502.36 (1) refuse or terminate services and be informed of the 503.1 consequences of refusing or terminating services; 503.2 (2) know, in advance, limits to the services available from 503.3 the license holder; 503.4 (3) know conditions and terms governing the provision of 503.5 services, including those related to initiation and termination; 503.6 (4) know what the charges are for services, regardless of 503.7 who will be paying for the services, and be notified upon 503.8 request of changes in those charges; 503.9 (5) know, in advance, whether services are covered by 503.10 insurance, government funding, or other sources, and be told of 503.11 any charges the consumer or other private party may have to pay; 503.12 and 503.13 (6) receive licensed services from individuals who are 503.14 competent and trained, who have professional certification or 503.15 licensure, as required, and who meet additional qualifications 503.16 identified in the individual service plan. 503.17 Sec. 16. Minnesota Statutes 2002, section 245B.06, 503.18 subdivision 2, is amended to read: 503.19 Subd. 2. [RISK MANAGEMENT PLAN.] (a) The license holder 503.20 must developand, document in writing, and implement a risk 503.21 management plan thatincorporates the individual abuse503.22prevention plan as required in section 245A.65meets the 503.23 requirements of this subdivision. License holders licensed 503.24 under this chapter are exempt from sections 245A.65, subdivision 503.25 2, and 626.557, subdivision 14, if the requirements of this 503.26 subdivision are met. 503.27 (b) The risk management plan must identify areas in which 503.28 the consumer is vulnerable, based on an assessment, at a 503.29 minimum, of the following areas: 503.30 (1) an adult consumer's susceptibility to physical, 503.31 emotional, and sexual abuse as defined in section 626.5572, 503.32 subdivision 2, and financial exploitation as defined in section 503.33 626.5572, subdivision 9; a minor consumer's susceptibility to 503.34 sexual and physical abuse as defined in section 626.556, 503.35 subdivision 2; and a consumer's susceptibility to self-abuse, 503.36 regardless of age; 504.1 (2) the consumer's health needs, considering the consumer's 504.2 physical disabilities; allergies; sensory impairments; seizures; 504.3 diet; need for medications; and ability to obtain medical 504.4 treatment; 504.5 (3) the consumer's safety needs, considering the consumer's 504.6 ability to take reasonable safety precautions; community 504.7 survival skills; water survival skills; ability to seek 504.8 assistance or provide medical care; and access to toxic 504.9 substances or dangerous items; 504.10 (4) environmental issues, considering the program's 504.11 location in a particular neighborhood or community; the type of 504.12 grounds and terrain surrounding the building; and the consumer's 504.13 ability to respond to weather-related conditions, open locked 504.14 doors, and remain alone in any environment; and 504.15 (5) the consumer's behavior, including behaviors that may 504.16 increase the likelihood of physical aggression between consumers 504.17 or sexual activity between consumers involving force or 504.18 coercion, as defined under section 245B.02, subdivision 10, 504.19 clauses (6) and (7). 504.20 (c) When assessing a consumer's vulnerability, the license 504.21 holder must consider only the consumer's skills and abilities, 504.22 independent of staffing patterns, supervision plans, the 504.23 environment, or other situational elements. 504.24 (d) License holders jointly providing services to a 504.25 consumer shall coordinate and use the resulting assessment of 504.26 risk areas for the development ofthiseach license holder's 504.27 risk management or the shared risk management plan.Upon504.28initiation of services, the license holder will have in place an504.29initial risk management plan that identifies areas in which the504.30consumer is vulnerable, including health, safety, and504.31environmental issues and the supports the provider will have in504.32place to protect the consumer and to minimize these risks. The504.33plan must be changed based on the needs of the individual504.34consumer and reviewed at least annually.The license holder's 504.35 plan must include the specific actions a staff person will take 504.36 to protect the consumer and minimize risks for the identified 505.1 vulnerability areas. The specific actions must include the 505.2 proactive measures being taken, training being provided, or a 505.3 detailed description of actions a staff person will take when 505.4 intervention is needed. 505.5 (e) Prior to or upon initiating services, a license holder 505.6 must develop an initial risk management plan that is, at a 505.7 minimum, verbally approved by the consumer or consumer's legal 505.8 representative and case manager. The license holder must 505.9 document the date the license holder receives the consumer's or 505.10 consumer's legal representative's and case manager's verbal 505.11 approval of the initial plan. 505.12 (f) As part of the meeting held within 45 days of 505.13 initiating service, as required under section 245B.06, 505.14 subdivision 4, the license holder must review the initial risk 505.15 management plan for accuracy and revise the plan if necessary. 505.16 The license holder must give the consumer or consumer's legal 505.17 representative and case manager an opportunity to participate in 505.18 this plan review. If the license holder revises the plan, or if 505.19 the consumer or consumer's legal representative and case manager 505.20 have not previously signed and dated the plan, the license 505.21 holder must obtain dated signatures to document the plan's 505.22 approval. 505.23 (g) After plan approval, the license holder must review the 505.24 plan at least annually and update the plan based on the 505.25 individual consumer's needs and changes to the environment. The 505.26 license holder must give the consumer or consumer's legal 505.27 representative and case manager an opportunity to participate in 505.28 the ongoing plan development. The license holder shall obtain 505.29 dated signatures from the consumer or consumer's legal 505.30 representative and case manager to document completion of the 505.31 annual review and approval of plan changes. 505.32 Sec. 17. Minnesota Statutes 2002, section 245B.06, 505.33 subdivision 5, is amended to read: 505.34 Subd. 5. [PROGRESS REVIEWS.] The license holder must 505.35 participate in progress review meetings following stated time 505.36 lines established in the consumer's individual service plan or 506.1 as requested in writing by the consumer, the consumer's legal 506.2 representative, or the case manager, at a minimum of once a 506.3 year. The license holder must summarize the progress toward 506.4 achieving the desired outcomes and make recommendations in a 506.5 written report sent to the consumer or the consumer's legal 506.6 representative and case manager prior to the review meeting. 506.7For consumers under public guardianship, the license holder is506.8required to provide quarterly written progress review reports to506.9the consumer, designated family member, and case manager.506.10 Sec. 18. Minnesota Statutes 2002, section 245B.07, 506.11 subdivision 6, is amended to read: 506.12 Subd. 6. [STAFF TRAINING.] (a) The license holder shall 506.13 ensure that direct service staff annually complete hours of 506.14 training equal to two percent of the number of hours the staff 506.15 person worked or one percent for license holders providing 506.16 semi-independent living services. Direct service staff who have 506.17 worked for the license holder for an average of at least 30 506.18 hours per week for 24 or more months must annually complete 506.19 hours of training equal to one percent of the number of hours 506.20 the staff person worked. If direct service staff has received 506.21 training from a license holder licensed under a program rule 506.22 identified in this chapter or completed course work regarding 506.23 disability-related issues from a post-secondary educational 506.24 institute, that training may also count toward training 506.25 requirements for other services and for other license holders. 506.26 (b) The license holder must document the training completed 506.27 by each employee. 506.28 (c) Training shall address staff competencies necessary to 506.29 address the consumer needs as identified in the consumer's 506.30 individual service plan and ensure consumer health, safety, and 506.31 protection of rights. Training may also include other areas 506.32 identified by the license holder. 506.33 (d) For consumers requiring a 24-hour plan of care, the 506.34 license holder shall provide training in cardiopulmonary 506.35 resuscitation, from a qualified source determined by the 506.36 commissioner, if the consumer's health needs as determined by 507.1 the consumer's physician indicate trained staff would be 507.2 necessary to the consumer. 507.3 Sec. 19. Minnesota Statutes 2002, section 245B.07, 507.4 subdivision 9, is amended to read: 507.5 Subd. 9. [AVAILABILITY OF CURRENT WRITTEN POLICIES AND 507.6 PROCEDURES.] The license holder shall: 507.7 (1) review and update, as needed, the written policies and 507.8 procedures in this chapterand inform all consumers or the507.9consumer's legal representatives, case managers, and employees507.10of the revised policies and procedures when they affect the507.11service provision; 507.12 (2) inform consumers or the consumer's legal 507.13 representatives of the written policies and procedures in this 507.14 chapter upon service initiation. Copies must be available to 507.15 consumers or the consumer's legal representatives, case 507.16 managers, the county where services are located, and the 507.17 commissioner upon request;and507.18 (3) provide all consumers or the consumers' legal 507.19 representatives and case managers a copy and explanation of 507.20 revisions to policies and procedures that affect consumers' 507.21 service-related or protection-related rights under section 507.22 245B.04. Unless there is reasonable cause, the license holder 507.23 must provide this notice at least 30 days before implementing 507.24 the revised policy and procedure. The license holder must 507.25 document the reason for not providing the notice at least 30 507.26 days before implementing the revisions; 507.27 (4) annually notify all consumers or the consumers' legal 507.28 representatives and case managers of any revised policies and 507.29 procedures under this chapter, other than those in clause (3). 507.30 Upon request, the license holder must provide the consumer or 507.31 consumer's legal representative and case manager copies of the 507.32 revised policies and procedures; 507.33 (5) before implementing revisions to policies and 507.34 procedures under this chapter, inform all employees of the 507.35 revised policies and procedures; and 507.36 (6) document and maintain relevant information related to 508.1 the policies and procedures in this chapter. 508.2 Sec. 20. Minnesota Statutes 2002, section 245B.08, 508.3 subdivision 1, is amended to read: 508.4 Subdivision 1. [ALTERNATIVE METHODS OF DETERMINING 508.5 COMPLIANCE.] (a) In addition to methods specified in chapter 508.6 245A, the commissioner may use alternative methods and new 508.7 regulatory strategies to determine compliance with this 508.8 section. The commissioner may use sampling techniques to ensure 508.9 compliance with this section. Notwithstanding section 245A.09, 508.10 subdivision 7, paragraph(d)(e), the commissioner may also 508.11 extend periods of licensure, not to exceed five years, for 508.12 license holders who have demonstrated substantial and consistent 508.13 compliance with sections 245B.02 to 245B.07 and have 508.14 consistently maintained the health and safety of consumers and 508.15 have demonstrated by alternative methods in paragraph (b) that 508.16 they meet or exceed the requirements of this section. For 508.17 purposes of this section, "substantial and consistent 508.18 compliance" means that during the current licensing period: 508.19 (1) the license holder's license has not been made 508.20 conditional, suspended, or revoked; 508.21 (2) there have been no substantiated allegations of 508.22 maltreatment against the license holder; 508.23 (3) there have been no program deficiencies that have been 508.24 identified that would jeopardize the health or safety of 508.25 consumers being served; and 508.26 (4) the license holder is in substantial compliance with 508.27 the other requirements of chapter 245A and other applicable laws 508.28 and rules. 508.29 (b) To determine the length of a license, the commissioner 508.30 shall consider: 508.31 (1) information from affected consumers, and the license 508.32 holder's responsiveness to consumers' concerns and 508.33 recommendations; 508.34 (2) self assessments and peer reviews of the standards of 508.35 this section, corrective actions taken by the license holder, 508.36 and sharing the results of the inspections with consumers, the 509.1 consumers' families, and others, as requested; 509.2 (3) length of accreditation by an independent accreditation 509.3 body, if applicable; 509.4 (4) information from the county where the license holder is 509.5 located; and 509.6 (5) information from the license holder demonstrating 509.7 performance that meets or exceeds the minimum standards of this 509.8 chapter. 509.9 (c) The commissioner may reduce the length of the license 509.10 if the license holder fails to meet the criteria in paragraph 509.11 (a) and the conditions specified in paragraph (b). 509.12 Sec. 21. Minnesota Statutes 2002, section 252.27, 509.13 subdivision 2a, is amended to read: 509.14 Subd. 2a. [CONTRIBUTION AMOUNT.] (a) The natural or 509.15 adoptive parents of a minor child, including a child determined 509.16 eligible for medical assistance without consideration of 509.17 parental income, must contribute monthly to the cost of 509.18 services, unless the child is married or has been married, 509.19 parental rights have been terminated, or the child's adoption is 509.20 subsidized according to section 259.67 or through title IV-E of 509.21 the Social Security Act. 509.22 (b) For households with adjusted gross income equal to or 509.23 greater than 100 percent of federal poverty guidelines, the 509.24 parental contribution shall bethe greater of a minimum monthly509.25fee of $25 for households with adjusted gross income of $30,000509.26and over, or an amount to becomputed by applying the following 509.27 schedule of rates to the adjusted gross income of the natural or 509.28 adoptive parentsthat exceeds 150 percent of the federal poverty509.29guidelines for the applicable household size, the following509.30schedule of rates: 509.31 (1)on the amount of adjusted gross income over 150 percent509.32of poverty, but not over $50,000, ten percentif the adjusted 509.33 gross income is equal to or greater than 100 percent of federal 509.34 poverty guidelines and less than 175 percent of federal poverty 509.35 guidelines, the parental contribution is $4 per month; 509.36 (2)onif theamount ofadjusted gross incomeover 150510.1percent of poverty and over $50,000 but not over $60,000, 12510.2percentis equal to or greater than 175 percent of federal 510.3 poverty guidelines and less than or equal to 975 percent of 510.4 federal poverty guidelines, the parental contribution shall be 510.5 determined using a sliding fee scale established by the 510.6 commissioner of human services which begins at one percent of 510.7 adjusted gross income at 175 percent of federal poverty 510.8 guidelines and increases to 16 percent of adjusted gross income 510.9 for those with adjusted gross income up to 975 percent of 510.10 federal poverty guidelines; 510.11(3) on the amount of adjusted gross income over 150 percent510.12of poverty, and over $60,000 but not over $75,000, 14 percent;510.13and510.14(4) on all adjusted gross income amounts over 150 percent510.15of poverty, and over $75,000, 15 percent.510.16 (3) if the adjusted gross income is equal to or greater 510.17 than 975 percent of federal poverty guidelines, the parental 510.18 contribution shall be 16 percent of adjusted gross income. 510.19 If the child lives with the parent, theparental510.20contributionannual adjusted gross income is reduced by$200,510.21except that the parent must pay the minimum monthly $25 fee510.22under this paragraph$4,800 prior to calculating the parental 510.23 contribution. If the child resides in an institution specified 510.24 in section 256B.35, the parent is responsible for the personal 510.25 needs allowance specified under that section in addition to the 510.26 parental contribution determined under this section. The 510.27 parental contribution is reduced by any amount required to be 510.28 paid directly to the child pursuant to a court order, but only 510.29 if actually paid. 510.30 (c) The household size to be used in determining the amount 510.31 of contribution under paragraph (b) includes natural and 510.32 adoptive parents and their dependents under age 21, including 510.33 the child receiving services. Adjustments in the contribution 510.34 amount due to annual changes in the federal poverty guidelines 510.35 shall be implemented on the first day of July following 510.36 publication of the changes. 511.1 (d) For purposes of paragraph (b), "income" means the 511.2 adjusted gross income of the natural or adoptive parents 511.3 determined according to the previous year's federal tax form. 511.4 (e) The contribution shall be explained in writing to the 511.5 parents at the time eligibility for services is being 511.6 determined. The contribution shall be made on a monthly basis 511.7 effective with the first month in which the child receives 511.8 services. Annually upon redetermination or at termination of 511.9 eligibility, if the contribution exceeded the cost of services 511.10 provided, the local agency or the state shall reimburse that 511.11 excess amount to the parents, either by direct reimbursement if 511.12 the parent is no longer required to pay a contribution, or by a 511.13 reduction in or waiver of parental fees until the excess amount 511.14 is exhausted. 511.15 (f) The monthly contribution amount must be reviewed at 511.16 least every 12 months; when there is a change in household size; 511.17 and when there is a loss of or gain in income from one month to 511.18 another in excess of ten percent. The local agency shall mail a 511.19 written notice 30 days in advance of the effective date of a 511.20 change in the contribution amount. A decrease in the 511.21 contribution amount is effective in the month that the parent 511.22 verifies a reduction in income or change in household size. 511.23 (g) Parents of a minor child who do not live with each 511.24 other shall each pay the contribution required under paragraph 511.25 (a), except that a. An amount equal to the annual court-ordered 511.26 child support payment actually paid on behalf of the child 511.27 receiving services shall be deducted from thecontribution511.28 adjusted gross income of the parent making the payment prior to 511.29 calculating the parental contribution under paragraph (b). 511.30 (h) The contribution under paragraph (b) shall be increased 511.31 by an additional five percent if the local agency determines 511.32 that insurance coverage is available but not obtained for the 511.33 child. For purposes of this section, "available" means the 511.34 insurance is a benefit of employment for a family member at an 511.35 annual cost of no more than five percent of the family's annual 511.36 income. For purposes of this section, "insurance" means health 512.1 and accident insurance coverage, enrollment in a nonprofit 512.2 health service plan, health maintenance organization, 512.3 self-insured plan, or preferred provider organization. 512.4 Parents who have more than one child receiving services 512.5 shall not be required to pay more than the amount for the child 512.6 with the highest expenditures. There shall be no resource 512.7 contribution from the parents. The parent shall not be required 512.8 to pay a contribution in excess of the cost of the services 512.9 provided to the child, not counting payments made to school 512.10 districts for education-related services. Notice of an increase 512.11 in fee payment must be given at least 30 days before the 512.12 increased fee is due. 512.13 (i) The contribution under paragraph (b) shall be reduced 512.14 by $300 per fiscal year if, in the 12 months prior to July 1: 512.15 (1) the parent applied for insurance for the child; 512.16 (2) the insurer denied insurance; 512.17 (3) the parents submitted a complaint or appeal, in writing 512.18 to the insurer, submitted a complaint or appeal, in writing, to 512.19 the commissioner of health or the commissioner of commerce, or 512.20 litigated the complaint or appeal; and 512.21 (4) as a result of the dispute, the insurer reversed its 512.22 decision and granted insurance. 512.23 For purposes of this section, "insurance" has the meaning 512.24 given in paragraph (h). 512.25 A parent who has requested a reduction in the contribution 512.26 amount under this paragraph shall submit proof in the form and 512.27 manner prescribed by the commissioner or county agency, 512.28 including, but not limited to, the insurer's denial of 512.29 insurance, the written letter or complaint of the parents, court 512.30 documents, and the written response of the insurer approving 512.31 insurance. The determinations of the commissioner or county 512.32 agency under this paragraph are not rules subject to chapter 14. 512.33 [EFFECTIVE DATE.] This section is effective July 1, 2003. 512.34 Sec. 22. Minnesota Statutes 2002, section 253B.04, 512.35 subdivision 1, is amended to read: 512.36 Subdivision 1. [VOLUNTARY ADMISSION AND TREATMENT.] (a) 513.1 Voluntary admission is preferred over involuntary commitment and 513.2 treatment. Any person 16 years of age or older may request to 513.3 be admitted to a treatment facility as a voluntary patient for 513.4 observation, evaluation, diagnosis, care and treatment without 513.5 making formal written application. Any person under the age of 513.6 16 years may be admitted as a patient with the consent of a 513.7 parent or legal guardian if it is determined by independent 513.8 examination that there is reasonable evidence that (1) the 513.9 proposed patient has a mental illness, or is mentally retarded 513.10 or chemically dependent; and (2) the proposed patient is 513.11 suitable for treatment. The head of the treatment facility 513.12 shall not arbitrarily refuse any person seeking admission as a 513.13 voluntary patient. In making decisions regarding admissions, 513.14 the facility shall use clinical admission criteria consistent 513.15 with the current applicable inpatient admission standards 513.16 established by the American Psychiatric Association or the 513.17 American Academy of Child and Adolescent Psychiatry. These 513.18 criteria must be no more restrictive than, and must be 513.19 consistent with, the requirements of section 62Q.53. The 513.20 facility may not refuse to admit a person voluntarily solely 513.21 because the person does not meet the criteria for involuntary 513.22 holds under section 253B.05 or the definition of mental illness 513.23 under section 253B.02, subdivision 13. 513.24 (b) In addition to the consent provisions of paragraph (a), 513.25 a person who is 16 or 17 years of age who refuses to consent 513.26 personally to admission may be admitted as a patient for mental 513.27 illness or chemical dependency treatment with the consent of a 513.28 parent or legal guardian if it is determined by an independent 513.29 examination that there is reasonable evidence that the proposed 513.30 patient is chemically dependent or has a mental illness and is 513.31 suitable for treatment. The person conducting the examination 513.32 shall notify the proposed patient and the parent or legal 513.33 guardian of this determination. 513.34 (c) A person who is voluntarily participating in treatment 513.35 for a mental illness is not subject to civil commitment under 513.36 this chapter if the person: 514.1 (1) has given informed consent or, if lacking capacity, is 514.2 a person for whom legally valid substitute consent has been 514.3 given; and 514.4 (2) is participating in a medically appropriate course of 514.5 treatment, including clinically appropriate and lawful use of 514.6 neuroleptic medication and electroconvulsive therapy. The 514.7 limitation on commitment in this paragraph does not apply if, 514.8 based on clinical assessment, the court finds that it is 514.9 unlikely that the person will remain in and cooperate with a 514.10 medically appropriate course of treatment absent commitment and 514.11 the standards for commitment are otherwise met. This paragraph 514.12 does not apply to a person for whom commitment proceedings are 514.13 initiated pursuant to rule 20.01 or 20.02 of the Rules of 514.14 Criminal Procedure, or a person found by the court to meet the 514.15 requirements under section 253B.02, subdivision 17. 514.16 Legally valid substitute consent may be provided by a proxy 514.17 under a health care directive, a guardian or conservator with 514.18 authority to consent to mental health treatment, or consent to 514.19 admission under subdivision 1a or 1b. 514.20 Sec. 23. Minnesota Statutes 2002, section 253B.05, 514.21 subdivision 3, is amended to read: 514.22 Subd. 3. [DURATION OF HOLD.] (a) Any person held pursuant 514.23 to this section may be held up to 72 hours, exclusive of 514.24 Saturdays, Sundays, and legal holidays after admission. If a 514.25 petition for the commitment of the person is filed in the 514.26 district court in the county of the person's residence or of the 514.27 county in which the treatment facility is located, the court may 514.28 issue a judicial hold order pursuant to section 253B.07, 514.29 subdivision 2b. 514.30 (b) During the 72-hour hold period, a court may not release 514.31 a person held under this section unless the court has received a 514.32 written petition for release and held a summary hearing 514.33 regarding the release. The petition must include the name of 514.34 the person being held, the basis for and location of the hold, 514.35 and a statement as to why the hold is improper. The petition 514.36 also must include copies of any written documentation under 515.1 subdivision 1 or 2 in support of the hold, unless the person 515.2 holding the petitioner refuses to supply the documentation. The 515.3 hearing must be held as soon as practicable and may be conducted 515.4 by means of a telephone conference call or similar method by 515.5 which the participants are able to simultaneously hear each 515.6 other. If the court decides to release the person, the court 515.7 shall direct the release and shall issue written findings 515.8 supporting the decision. The release may not be delayed pending 515.9 the written order. Before deciding to release the person, the 515.10 court shall make every reasonable effort to provide notice of 515.11 the proposed release to: 515.12 (1) any specific individuals identified in a statement 515.13 under subdivision 1 or 2 or individuals identified in the record 515.14 who might be endangered if the person was not held; 515.15 (2) the examiner whose written statement was a basis for a 515.16 hold under subdivision 1; and 515.17 (3) the peace or health officer who applied for a hold 515.18 under subdivision 2. 515.19 (c) If a person is intoxicated in public and held under 515.20 this section for detoxification, a treatment facility may 515.21 release the person without providing notice under paragraph (d) 515.22 as soon as the treatment facility determines the person is no 515.23 longer a danger to themselves or others. 515.24(c)(d) If a treatment facility releases a person during 515.25 the 72-hour hold period, the head of the treatment facility 515.26 shall immediately notify the agency which employs the peace or 515.27 health officer who transported the person to the treatment 515.28 facility under this section. 515.29 (e) A person held under a 72-hour emergency hold must be 515.30 released by the facility within 72 hours unless a court order to 515.31 hold the person is obtained. A consecutive emergency hold order 515.32 under this section may not be issued. 515.33 Sec. 24. Minnesota Statutes 2002, section 256.012, is 515.34 amended to read: 515.35 256.012 [MINNESOTA MERIT SYSTEM.] 515.36 Subdivision 1. [PERSONNEL STANDARDS.] The commissioner of 516.1 human services shall promulgate by rule personnel standards on a 516.2 merit basis in accordance with federal standards for a merit 516.3 system of personnel administration for all employees of county 516.4 boards engaged in the administration of community social 516.5 services or income maintenance programs, all employees of human 516.6 services boards that have adopted the rules of the Minnesota 516.7 merit system, and all employees of local social services 516.8 agencies. 516.9 Excluded from the rules are employees of institutions and 516.10 hospitals under the jurisdiction of the aforementioned boards 516.11 and agencies; employees of county personnel systems otherwise 516.12 provided for by law that meet federal merit system requirements; 516.13 duly appointed or elected members of the aforementioned boards 516.14 and agencies; and the director of community social services and 516.15 employees in positions that, upon the request of the appointing 516.16 authority, the commissioner chooses to exempt, provided the 516.17 exemption accords with the federal standards for a merit system 516.18 of personnel administration. 516.19 Subd. 2. [PAYMENT FOR SERVICES PROVIDED.] (a) The cost of 516.20 merit system operations shall be paid by counties and other 516.21 entities that utilize merit system services. Total costs shall 516.22 be determined by the commissioner annually and must be set at a 516.23 level that neither significantly over-recovers nor 516.24 under-recovers the costs of providing the service. The costs of 516.25 merit system services shall be prorated among participating 516.26 counties in accordance with an agreement between the 516.27 commissioner and these counties. Participating counties will be 516.28 billed quarterly in advance and shall pay their share of the 516.29 costs upon receipt of the billing. 516.30 (b) This subdivision does not apply to counties with 516.31 personnel systems otherwise provided by law that meet federal 516.32 merit system requirements. A county that applies to withdraw 516.33 from the merit system must notify the commissioner of the 516.34 county's intent to develop its own personnel system. This 516.35 notice must be provided in writing by December 31 of the year 516.36 preceding the year of final participation in the merit system. 517.1 The county may withdraw after the commissioner has certified 517.2 that its personnel system meets federal merit system 517.3 requirements. 517.4 (c) A county merit system operations account is established 517.5 in the special revenue fund. Payments received by the 517.6 commissioner for merit system costs must be deposited in the 517.7 merit system operations account and must be used for the purpose 517.8 of providing the services and administering the merit system. 517.9 (d) County payment of merit system costs is effective July 517.10 1, 2003, however payment for the period from July 1, 2003 517.11 through December 31, 2003, shall be made no later than January 517.12 31, 2004. 517.13 Subd. 3. [PARTICIPATING COUNTY CONSULTATION.] The 517.14 commissioner shall ensure that participating counties are 517.15 consulted regularly and offered the opportunity to provide input 517.16 on the management of the merit system to ensure effective use of 517.17 resources and to monitor system performance. 517.18 Sec. 25. Minnesota Statutes 2002, section 256.935, 517.19 subdivision 1, is amended to read: 517.20 Subdivision 1. [FUNERALBURIAL OR CREMATION EXPENSES.] On 517.21 the death of any person receiving public assistance through 517.22 MFIP, the county agency shall pay an amount forfuneralburial 517.23 or cremation expenses not exceeding the amount paid for 517.24 comparable services under section 261.035 plus actual cemetery 517.25 charges. The county agency may pay for cremation instead of 517.26 burial expenses being respectful of cultural and religious 517.27 preferences of the decedent or the decedent's next of kin. No 517.28funeralburial or cremation expenses shall be paid if the estate 517.29 of the deceased is sufficient to pay such expenses or if the 517.30 spouse, who was legally responsible for the support of the 517.31 deceased while living, is able to pay such expenses; provided,517.32that the additional payment or donation of the cost of cemetery517.33lot, interment, religious service, or for the transportation of517.34the body into or out of the community in which the deceased517.35resided, shall not limit payment by the county agency as herein517.36authorized. Freedom of choice in the selection of a funeral518.1director shall be granted to persons lawfully authorized to make518.2arrangements for the burial of any such deceased recipient. In 518.3 determining the sufficiency of such estate, due regard shall be 518.4 had for the nature and marketability of the assets of the 518.5 estate. The county agency may grantfuneralburial or cremation 518.6 expenses where the sale would cause undue loss to the estate. 518.7 Any amount paid forfuneralburial or cremation expenses shall 518.8 be a prior claim against the estate, as provided in section 518.9 524.3-805, and any amount recovered shall be reimbursed to the 518.10 agency which paid the expenses.The commissioner shall specify518.11requirements for reports, including fiscal reports, according to518.12section 256.01, subdivision 2, paragraph (17). The state share518.13shall pay the entire amount of county agency expenditures.518.14 Benefits shall be issued to recipients by thestate orcounty 518.15 subject to provisions of section 256.017. 518.16 Sec. 26. Minnesota Statutes 2002, section 256B.0911, 518.17 subdivision 3, is amended to read: 518.18 Subd. 3. [LONG-TERM CARE CONSULTATION TEAM.](a)A 518.19 long-term care consultation team shall be established by the 518.20 county board of commissioners. Each local consultation team 518.21 shall consist of at least one social worker and at least one 518.22 public health nurse from their respective county agencies. The 518.23 board may designate public health or social services as the lead 518.24 agency for long-term care consultation services. If a county 518.25 does not have a public health nurse available, it may request 518.26 approval from the commissioner to assign a county registered 518.27 nurse with at least one year experience in home care to 518.28 participate on the team. Two or more counties may collaborate 518.29 to establish a joint local consultation team or teams. 518.30(b) The team is responsible for providing long-term care518.31consultation services to all persons located in the county who518.32request the services, regardless of eligibility for Minnesota518.33health care programs.518.34 Sec. 27. Minnesota Statutes 2002, section 256F.13, 518.35 subdivision 1, is amended to read: 518.36 Subdivision 1. [FEDERAL REVENUE ENHANCEMENT.] (a) [DUTIES 519.1 OF COMMISSIONER OF HUMAN SERVICES.] The commissioner of human 519.2 services may enter into an agreement with one or more family 519.3 services collaboratives to enhance federal reimbursement under 519.4 Title IV-E of the Social Security Act and federal administrative 519.5 reimbursement under Title XIX of the Social Security Act. The 519.6 commissioner may contract with the department of children, 519.7 families, and learning for purposes of transferring the federal 519.8 reimbursement to the commissioner of children, families, and 519.9 learning to be distributed to the collaboratives according to 519.10 clause (2). The commissioner shall have the following authority 519.11 and responsibilities regarding family services collaboratives: 519.12 (1) the commissioner shall submit amendments to state plans 519.13 and seek waivers as necessary to implement the provisions of 519.14 this section; 519.15 (2) the commissioner shall pay the federal reimbursement 519.16 earned under this subdivision to each collaborative based on 519.17 their earnings. Payments to collaboratives for expenditures 519.18 under this subdivision will only be made of federal earnings 519.19 from services provided by the collaborative; 519.20 (3) the commissioner shall review expenditures of family 519.21 services collaboratives using reports specified in the agreement 519.22 with the collaborative to ensurethat the base level of519.23expenditures is continued andnew federal reimbursement is used 519.24 toexpandfund education, social, health, or health-related 519.25 services to young children and their families; 519.26 (4)the commissioner may reduce, suspend, or eliminate a519.27family services collaborative's obligations to continue the base519.28level of expenditures or expansion of services if the519.29commissioner determines that one or more of the following519.30conditions apply:519.31(i) imposition of levy limits that significantly reduce519.32available funds for social, health, or health-related services519.33to families and children;519.34(ii) reduction in the net tax capacity of the taxable519.35property eligible to be taxed by the lead county or519.36subcontractor that significantly reduces available funds for520.1education, social, health, or health-related services to520.2families and children;520.3(iii) reduction in the number of children under age 19 in520.4the county, collaborative service delivery area, subcontractor's520.5district, or catchment area when compared to the number in the520.6base year using the most recent data provided by the state520.7demographer's office; or520.8(iv) termination of the federal revenue earned under the520.9family services collaborative agreement;520.10(5)the commissioner shall not use the federal 520.11 reimbursement earned under this subdivision in determining the 520.12 allocation or distribution of other funds to counties or 520.13 collaboratives; 520.14(6)(5) the commissioner may suspend, reduce, or terminate 520.15 the federal reimbursement to a provider that does not meet the 520.16 reporting or other requirements of this subdivision; 520.17(7)(6) the commissioner shall recover from the family 520.18 services collaborative any federal fiscal disallowances or 520.19 sanctions for audit exceptions directly attributable to the 520.20 family services collaborative's actions in the integrated fund, 520.21 or the proportional share if federal fiscal disallowances or 520.22 sanctions are based on a statewide random sample; and 520.23(8)(7) the commissioner shall establish criteria for the 520.24 family services collaborative for the accounting and financial 520.25 management system that will support claims for federal 520.26 reimbursement. 520.27 (b) [FAMILY SERVICES COLLABORATIVE RESPONSIBILITIES.] The 520.28 family services collaborative shall have the following authority 520.29 and responsibilities regarding federal revenue enhancement: 520.30 (1) the family services collaborative shall be the party 520.31 with which the commissioner contracts. A lead county shall be 520.32 designated as the fiscal agency for reporting, claiming, and 520.33 receiving payments; 520.34 (2) the family services collaboratives may enter into 520.35 subcontracts with other counties, school districts, special 520.36 education cooperatives, municipalities, and other public and 521.1 nonprofit entities for purposes of identifying and claiming 521.2 eligible expenditures to enhance federal reimbursement, or to 521.3 expand education, social, health, or health-related services to 521.4 families and children; 521.5 (3)the family services collaborative must continue the521.6base level of expenditures for education, social, health, or521.7health-related services to families and children from any state,521.8county, federal, or other public or private funding source521.9which, in the absence of the new federal reimbursement earned521.10under this subdivision, would have been available for those521.11services, except as provided in subdivision 1, paragraph (a),521.12clause (4). The base year for purposes of this subdivision521.13shall be the four-quarter calendar year ending at least two521.14calendar quarters before the first calendar quarter in which the521.15new federal reimbursement is earned;521.16 (4) the family services collaborative must use all new 521.17 federal reimbursement resulting from federal revenue enhancement 521.18 toexpandmake expenditures for education, social, health, or 521.19 health-related services to families and childrenbeyond the base521.20level, except as provided in subdivision 1, paragraph (a),521.21clause (4); 521.22 (5) the family services collaborative must ensure that 521.23 expenditures submitted for federal reimbursement are not made 521.24 from federal funds or funds used to match other federal funds. 521.25 Notwithstanding section 256B.19, subdivision 1, for the purposes 521.26 of family services collaborative expenditures under agreement 521.27 with the department, the nonfederal share of costs shall be 521.28 provided by the family services collaborative from sources other 521.29 than federal funds or funds used to match other federal funds; 521.30 (6) the family services collaborative must develop and 521.31 maintain an accounting and financial management system adequate 521.32 to support all claims for federal reimbursement, including a 521.33 clear audit trail and any provisions specified in the agreement; 521.34 and 521.35 (7) the family services collaborative shall submit an 521.36 annual report to the commissioner as specified in the agreement. 522.1 Sec. 28. Minnesota Statutes 2002, section 256F.13, 522.2 subdivision 2, is amended to read: 522.3 Subd. 2. [AGREEMENTS WITH FAMILY SERVICES COLLABORATIVES.] 522.4 At a minimum, the agreement between the commissioner and the 522.5 family services collaborative shall include the following 522.6 provisions: 522.7 (1) specific documentation of the expenditures eligible for 522.8 federal reimbursement; 522.9 (2) the process for developing and submitting claims to the 522.10 commissioner; 522.11 (3) specific identification of the education, social, 522.12 health, or health-related services to families and children 522.13 which areto be expandedfunded with the federal reimbursement; 522.14 (4) reporting and review proceduresensuring that the522.15family services collaborative must continue the base level of522.16expenditures for the education, social, health, or522.17health-related services for families and children as specified522.18in subdivision 2, clause (3)that emphasize the minimum number 522.19 of data elements necessary; 522.20 (5) reporting and review procedures to ensure that federal 522.21 revenue earned under this section is spent specifically to 522.22expandfund education, social, health, or health-related 522.23 services for families and children as specified in subdivision 522.24 2, clause (4); 522.25 (6) the period of time, not to exceed three years, 522.26 governing the terms of the agreement and provisions for 522.27 amendments to, and renewal of the agreement; and 522.28 (7) an annual report prepared by the family services 522.29 collaborative. 522.30 Sec. 29. Minnesota Statutes 2002, section 261.035, is 522.31 amended to read: 522.32 261.035 [FUNERALSBURIAL AT EXPENSE OF COUNTY.] 522.33 When a person dies in any county without apparent means to 522.34 provide for that person'sfuneral or final dispositionburial or 522.35 cremation, the county board shall first investigate to determine 522.36 whether that person had contracted for any prepaid funeral 523.1 arrangements. If arrangements have been made, the county shall 523.2 authorize arrangements to be implemented in accord with the 523.3 instructions of the deceased. If it is determined that the 523.4 person did not leave sufficient means to defray the necessary 523.5 expenses of afuneral and final dispositionburial or cremation, 523.6 nor any spouse of sufficient ability to procure the burial or 523.7 cremation, the county board shall provide for afuneral and523.8final dispositionburial or cremation, being respectful of 523.9 cultural and religious preferences, of the person's remains to 523.10 be made at the expense of the county. Anyfuneral and final523.11dispositionburial or cremation provided at the expense of the 523.12 county shall be in accordance with religious and moral beliefs 523.13 of the decedentor the decedent's spouse or the decedent's next523.14of kin. If the wishes of the decedent are not known and the 523.15 county has no information about the existence of or location of 523.16 any next of kin, the county may determine the method of final 523.17 disposition. 523.18 Sec. 30. Minnesota Statutes 2002, section 393.07, 523.19 subdivision 1, is amended to read: 523.20 Subdivision 1. [PUBLIC CHILD WELFARE PROGRAM.] (a) To 523.21 assist in carrying out the child protection, delinquency 523.22 prevention and family assistance responsibilities of the state, 523.23 the local social services agency shall administer a program of 523.24 social services and financial assistance to be known as the 523.25 public child welfare program. The public child welfare program 523.26 shall be supervised by the commissioner of human services and 523.27 administered by the local social services agency in accordance 523.28 with law and with rules of the commissioner. 523.29 (b) The purpose of the public child welfare program is to 523.30 assure protection for and financial assistance to children who 523.31 are confronted with social, physical, or emotional problems 523.32 requiring protection and assistance. These problems include, 523.33 but are not limited to the following: 523.34 (1) mental, emotional, or physical handicap; 523.35 (2) birth of a child to a mother who was not married to the 523.36 child's father when the child was conceived nor when the child 524.1 was born, including but not limited to costs of prenatal care, 524.2 confinement and other care necessary for the protection of a 524.3 child born to a mother who was not married to the child's father 524.4 at the time of the child's conception nor at the birth; 524.5 (3) dependency, neglect; 524.6 (4) delinquency; 524.7 (5) abuse or rejection of a child by its parents; 524.8 (6) absence of a parent or guardian able and willing to 524.9 provide needed care and supervision; 524.10 (7) need of parents for assistance with child rearing 524.11 problems, or in placing the child in foster care. 524.12 (c) A local social services agency shall make the services 524.13 of its public child welfare program available as required by 524.14 law, by the commissioner, or by the courts and shall cooperate 524.15 with other agencies, public or private, dealing with the 524.16 problems of children and their parents as provided in this 524.17 subdivision. 524.18The public child welfare program shall be available in524.19divorce cases for investigations of children and home conditions524.20and for supervision of children when directed by the court524.21hearing the divorce.524.22 (d) A local social services agency may rent, lease, or 524.23 purchase property, or in any other way approved by the 524.24 commissioner, contract with individuals or agencies to provide 524.25 needed facilities for foster care of children. It may purchase 524.26 services or child care from duly authorized individuals, 524.27 agencies or institutions when in its judgment the needs of a 524.28 child or the child's family can best be met in this way. 524.29 Sec. 31. Minnesota Statutes 2002, section 393.07, 524.30 subdivision 5, is amended to read: 524.31 Subd. 5. [COMPLIANCE WITH FEDERAL SOCIAL SECURITY ACT; 524.32 MERIT SYSTEM.] The commissioner of human services shall have 524.33 authority to require such methods of administration as are 524.34 necessary for compliance with requirements of the federal Social 524.35 Security Act, as amended, and for the proper and efficient 524.36 operation of all welfare programs. This authority to require 525.1 methods of administration includes methods relating to the 525.2 establishment and maintenance of personnel standards on a merit 525.3 basis as concerns all employees of local social services 525.4 agencies except those employed in an institution, sanitarium, or 525.5 hospital. The commissioner of human services shall exercise no 525.6 authority with respect to the selection, tenure of office, and 525.7 compensation of any individual employed in accordance with such 525.8 methods. The adoption of methods relating to the establishment 525.9 and maintenance of personnel standards on a merit basis of all 525.10 such employees of the local social services agencies and the 525.11 examination thereof, and the administration thereof shall be 525.12 directed and controlled exclusively by the commissioner of human 525.13 services. 525.14 Notwithstanding the provisions of any other law to the 525.15 contrary, every employee of every local social services agency 525.16 who occupies a position which requires as prerequisite to 525.17 eligibility therefor graduation from an accredited four year 525.18 college or a certificate of registration as a registered nurse 525.19 under section 148.231, must be employed in such position under 525.20 the merit system established under authority of this 525.21 subdivision. Every such employee now employed by a local social 525.22 services agency and who is not under said merit system is 525.23 transferred, as of January 1, 1962, to a position of comparable 525.24 classification in the merit system with the same status therein 525.25 as the employee had in the county of employment prior thereto 525.26 and every such employee shall be subject to and have the benefit 525.27 of the merit system, including seniority within the local social 525.28 services agency, as though the employee had served thereunder 525.29 from the date of entry into the service of the local social 525.30 services agency. 525.31By March 1, 1996, the commissioner of human services shall525.32report to the chair of the senate health care and family525.33services finance division and the chair of the house health and525.34human services finance division on options for the delivery of525.35merit-based employment services by entities other than the525.36department of human services in order to reduce the526.1administrative costs to the state while maintaining compliance526.2with applicable federal regulations.526.3 Sec. 32. Minnesota Statutes 2002, section 518.167, 526.4 subdivision 1, is amended to read: 526.5 Subdivision 1. [COURT ORDER.] In contested custody 526.6 proceedings, and in other custody proceedings if a parent or the 526.7 child's custodian requests, the court may order an investigation 526.8 and report concerning custodial arrangements for the child. If 526.9 the county elects to conduct an investigation, the county may 526.10 charge a fee. The investigation and report may be made by the 526.11 county welfare agency or department of court services or a 526.12 private vendor. 526.13 Sec. 33. Minnesota Statutes 2002, section 518.551, 526.14 subdivision 7, is amended to read: 526.15 Subd. 7. [SERVICE FEEFEES AND COST RECOVERY FEES FOR IV-D 526.16 SERVICES.]When the public agency responsible for child support526.17enforcement provides child support collection services either to526.18a public assistance recipient or to a party who does not receive526.19public assistance, the public agency may upon written notice to526.20the obligor charge a monthly collection fee equivalent to the526.21full monthly cost to the county of providing collection526.22services, in addition to the amount of the child support which526.23was ordered by the court. The fee shall be deposited in the526.24county general fund. The service fee assessed is limited to ten526.25percent of the monthly court ordered child support and shall not526.26be assessed to obligors who are current in payment of the526.27monthly court ordered child support.(a) When a recipient of 526.28 IV-D services is no longer receiving assistance under the 526.29 state's title IV-A, IV-E foster care, medical assistance, or 526.30 MinnesotaCare programs, the public authority responsible for 526.31 child support enforcement must notify the recipient, within five 526.32 working days of the notification of ineligibility, that IV-D 526.33 services will be continued unless the public authority is 526.34 notified to the contrary by the recipient. The notice must 526.35 include the implications of continuing to receive IV-D services, 526.36 including the available services and fees, cost recovery fees, 527.1 and distribution policies relating to fees. 527.2 (b) An application fee of $25 shall be paid by the person 527.3 who applies for child support and maintenance collection 527.4 services, except persons who are receiving public assistance as 527.5 defined in section 256.741 and, if enacted, the diversionary 527.6 work program under section 256J.95, persons who transfer from 527.7 public assistance to nonpublic assistance status, and minor 527.8 parents and parents enrolled in a public secondary school, area 527.9 learning center, or alternative learning program approved by the 527.10 commissioner of children, families, and learning. 527.11 (c) When the public authority provides full IV-D services 527.12 to an obligee who has applied for those services, upon written 527.13 notice to the obligee, the public authority must charge a cost 527.14 recovery fee of two percent of the amount collected. This fee 527.15 must be deducted from the amount of the child support and 527.16 maintenance collected and not assigned under section 256.741, 527.17 before disbursement to the obligee. This fee does not apply to 527.18 an obligee who: 527.19 (1) is currently receiving assistance under the state's 527.20 title IV-A, IV-E foster care, medical assistance, or 527.21 MinnesotaCare programs; or 527.22 (2) has received assistance under the state's title IV-A or 527.23 IV-E foster care programs, until the person has not received 527.24 this assistance for 24 consecutive months. 527.25 (d) When the public authority provides full IV-D services 527.26 to an obligor who has applied for such services, upon written 527.27 notice to the obligor, the public authority must charge a cost 527.28 recovery fee of two percent of the monthly court ordered child 527.29 support and maintenance obligation. The fee may be collected 527.30 through income withholding, as well as by any other enforcement 527.31 remedy available to the public authority responsible for child 527.32 support enforcement. 527.33 (e) Fees assessed by state and federal tax agencies for 527.34 collection of overdue support owed to or on behalf of a person 527.35 not receiving public assistance must be imposed on the person 527.36 for whom these services are provided. The public authority upon 528.1 written notice to the obligee shall assess a fee of $25 to the 528.2 person not receiving public assistance for each successful 528.3 federal tax interception. The fee must be withheld prior to the 528.4 release of the funds received from each interception and 528.5 deposited in the general fund. 528.6 (f) Cost recovery fees collected under paragraphs (c) and 528.7 (d) shall be considered child support program income according 528.8 to Code of Federal Regulations, title 45, section 304.50, and 528.9 shall be deposited in the cost recovery fee account established 528.10 under paragraph (h). The commissioner of human services must 528.11 elect to recover costs based on either actual or standardized 528.12 costs. 528.13However,(g) The limitations of this subdivision on the 528.14 assessment of fees shall not apply to the extent inconsistent 528.15 with the requirements of federal law for receiving funds for the 528.16 programs under Title IV-A and Title IV-D of the Social Security 528.17 Act, United States Code, title 42, sections 601 to 613 and 528.18 United States Code, title 42, sections 651 to 662. 528.19 (h) The commissioner of human services is authorized to 528.20 establish a special revenue fund account to receive child 528.21 support cost recovery fees. A portion of the nonfederal share 528.22 of these fees may be retained for expenditures necessary to 528.23 administer the fee, and must be transferred to the child support 528.24 system special revenue account. The remaining nonfederal share 528.25 of the cost recovery fee must be retained by the commissioner 528.26 and dedicated to the child support general fund county 528.27 performance based grant account authorized under sections 528.28 256.979 and 256.9791. 528.29 [EFFECTIVE DATE.] This section is effective July 1, 2004, 528.30 except paragraph (d) is effective July 1, 2005. 528.31 Sec. 34. Minnesota Statutes 2002, section 518.6111, 528.32 subdivision 2, is amended to read: 528.33 Subd. 2. [APPLICATION.] This section applies to all 528.34 support orders issued by a court or an administrative tribunal 528.35 and orders for or notices of withholding issued by the public 528.36 authorityaccording to section 518.5513, subdivision 5,529.1paragraph (a), clause (5). 529.2 [EFFECTIVE DATE.] This section is effective July 1, 2004. 529.3 Sec. 35. Minnesota Statutes 2002, section 518.6111, 529.4 subdivision 3, is amended to read: 529.5 Subd. 3. [ORDER.] Every support order must address income 529.6 withholding. Whenever a support order is initially entered or 529.7 modified, the full amount of the support order must be 529.8withheldsubject to income withholding from the income of the 529.9 obligor. If the obligee or obligor applies for either full IV-D 529.10 services or for income withholding only services from the public 529.11 authority responsible for child support enforcement, the full 529.12 amount of the support order must be withheld from the income of 529.13 the obligor and forwarded to the public authority. Every order 529.14 for support or maintenance shall provide for a conspicuous 529.15 notice of the provisions of this section that complies with 529.16 section 518.68, subdivision 2. An order without this notice 529.17 remains subject to this section. This section applies 529.18 regardless of the source of income of the person obligated to 529.19 pay the support or maintenance. 529.20 A payor of funds shall implement income withholding 529.21 according to this section upon receipt of an order for or notice 529.22 of withholding. The notice of withholding shall be on a form 529.23 provided by the commissioner of human services. 529.24 [EFFECTIVE DATE.] This section is effective July 1, 2004. 529.25 Sec. 36. Minnesota Statutes 2002, section 518.6111, 529.26 subdivision 4, is amended to read: 529.27 Subd. 4. [COLLECTION SERVICES.] (a) The commissioner of 529.28 human services shall prepare and make available to the courts a 529.29 notice of services that explains child support and maintenance 529.30 collection services available through the public authority, 529.31 including income withholding, and the fees for such services. 529.32 Upon receiving a petition for dissolution of marriage or legal 529.33 separation, the court administrator shall promptly send the 529.34 notice of services to the petitioner and respondent at the 529.35 addresses stated in the petition. 529.36 (b) Either the obligee or obligor may at any time apply to 530.1 the public authority for either full IV-D services or for income 530.2 withholding only services. 530.3Upon receipt of a support order requiring income530.4withholding, a petitioner or respondent, who is not a recipient530.5of public assistance and does not receive child support services530.6from the public authority, shall apply to the public authority530.7for either full child support collection services or for income530.8withholding only services.530.9 (c) For those persons applying for income withholding only 530.10 services, a monthly service fee of $15 must be charged to the 530.11 obligor. This fee is in addition to the amount of the support 530.12 order and shall be withheld through income withholding. The 530.13 public authority shall explain the service options in this 530.14 section to the affected parties and encourage the application 530.15 for full child support collection services. 530.16 (d) If the obligee is not a current recipient of public 530.17 assistance as defined in section 256.741, the person who applied 530.18 for services may at any time choose to terminate either full 530.19 IV-D services or income withholding only services regardless of 530.20 whether income withholding is currently in place. The obligee 530.21 or obligor may reapply for either full IV-D services or income 530.22 withholding only services at any time. Unless the applicant is 530.23 a recipient of public assistance as defined in section 256.741, 530.24 a $25 application fee shall be charged at the time of each 530.25 application. 530.26 (e) When a person terminates IV-D services, if an arrearage 530.27 for public assistance as defined in section 256.741 exists, the 530.28 public authority may continue income withholding, as well as use 530.29 any other enforcement remedy for the collection of child 530.30 support, until all public assistance arrears are paid in full. 530.31 Income withholding shall be in an amount equal to 20 percent of 530.32 the support order in effect at the time the services terminated. 530.33 [EFFECTIVE DATE.] This section is effective July 1, 2004. 530.34 Sec. 37. Minnesota Statutes 2002, section 518.6111, 530.35 subdivision 16, is amended to read: 530.36 Subd. 16. [WAIVER.] (a) If the public authority is 531.1 providing child support and maintenance enforcement services and 531.2 child support or maintenance is not assigned under section 531.3 256.741, the court may waive the requirements of this section if 531.4the court finds there is no arrearage in child support and531.5maintenance as of the date of the hearing and: 531.6 (1) one party demonstrates and the courtfindsdetermines 531.7 there is good cause to waive the requirements of this section or 531.8 to terminate an order for or notice of income withholding 531.9 previously entered under this section. The court must make 531.10 written findings to include the reasons income withholding would 531.11 not be in the best interests of the child. In cases involving a 531.12 modification of support, the court must also make a finding that 531.13 support payments have been timely made; or 531.14 (2)all parties reach anthe obligee and obligor sign a 531.15 written agreementand the agreementproviding for an alternative 531.16 payment arrangement which isapprovedreviewed and entered in 531.17 the record by the courtafter a finding that the agreement is531.18likely to result in regular and timely payments. The court's531.19findings waiving the requirements of this paragraph shall531.20include a written explanation of the reasons why income531.21withholding would not be in the best interests of the child. 531.22In addition to the other requirements in this subdivision,531.23if the case involves a modification of support, the court shall531.24make a finding that support has been timely made.531.25 (b) If the public authority is not providing child support 531.26 and maintenance enforcement services and child support or 531.27 maintenance is not assigned under section 256.741, the court may 531.28 waive the requirements of this section if the parties sign a 531.29 written agreement. 531.30 (c) If the court waives income withholding, the obligee or 531.31 obligor may at any time request income withholding under 531.32 subdivision 7. 531.33 [EFFECTIVE DATE.] This section is effective July 1, 2004. 531.34 Sec. 38. [MANDATE IDENTIFICATION; REPORT TO LEGISLATURE.] 531.35 The commissioners of health and human services must 531.36 identify required state services or programs in law or rule that 532.1 are under each agency's respective jurisdictions, the 532.2 administration or provision of which the state has delegated to 532.3 the counties. For each state-mandated service or program, the 532.4 commissioner must describe: 532.5 (1) the year enacted and the scope of the service or 532.6 program; 532.7 (2) the funding sources for the service or program; and 532.8 (3) related federal requirements and support. 532.9 The commissioners must seek the advice of the county officials 532.10 knowledgeable about the state-mandated services and programs, 532.11 county associations, consumer representatives, and service or 532.12 program providers. Each commissioner must submit a report to 532.13 the house and senate committees with jurisdiction over the 532.14 budget of departments of health and human services by January 532.15 15, 2004. 532.16 [EFFECTIVE DATE; EXPIRATION DATE.] This section is 532.17 effective the day following final enactment and expires June 30, 532.18 2005. 532.19 Sec. 39. [STATE-OPERATED SERVICES STUDY.] 532.20 (a) Before restructuring state-operated services, 532.21 redesigning the mental health safety net, or reducing reliance 532.22 on large institutions, the commissioner shall review and study 532.23 the President's New Freedom Commission on Mental Health final 532.24 report. The commissioner shall report on whether the 532.25 commissioner's plan to restructure state-operated services is 532.26 consistent with the recommendations in the final report and how 532.27 the state can implement the recommendations in the final report. 532.28 (b) The commissioner of human services shall study 532.29 alternate methods of providing services to persons with 532.30 developmental disabilities served by state-operated community 532.31 services (SOCS) and other providers, including, but not limited 532.32 to, the needs of the persons served, the cost effectiveness of 532.33 the services provided, whether alternate populations can be 532.34 served in SOCS, and if the services could be privatized. The 532.35 commissioner shall also study the Minnesota extended treatment 532.36 options, including an analysis of the population served by the 533.1 program and the effectiveness of the program. The commissioner 533.2 shall report on the results of the study under this section to 533.3 the chairs of the house and senate committees with jurisdiction 533.4 over state-operated services by January 15, 2004. 533.5 Sec. 40. [STATE-OPERATED SERVICES REFINANCING STRATEGY.] 533.6 Subdivision 1. [REDESIGN OF MENTAL HEALTH SAFETY NET.] (a) 533.7 Pursuant to Minnesota Statutes, sections 246.0135, 251.011, and 533.8 251.013, when implementing any proposal to restructure 533.9 state-operated services, redesign the mental health safety net, 533.10 relocate a program located at a regional treatment center or 533.11 state-operated nursing home, or reduce reliance on large 533.12 institutions, the commissioner of human services must seek 533.13 specific legislative authorization to close any regional 533.14 treatment center or state-operated nursing home or any program 533.15 at a regional treatment center or state-operated nursing home. 533.16 (b) In developing and seeking legislative authorization for 533.17 any proposals to restructure state-operated services under this 533.18 subdivision, the commissioner must consider: 533.19 (1) the needs and preferences of the individuals served by 533.20 affected state-operated services programs and their families; 533.21 (2) the location of necessary support services, as 533.22 identified in the service or treatment plans of individuals 533.23 served by affected state-operated services programs; 533.24 (3) the appropriate grouping of individuals served by a 533.25 community-based state-operated services program; 533.26 (4) the availability of qualified staff to provide services 533.27 in community-based state-operated services programs; 533.28 (5) the need for state-operated services programs in 533.29 certain geographical regions in the state; and 533.30 (6) whether commuting distance to the program for staff and 533.31 families is reasonable. 533.32 (c) The commissioner's proposals to restructure 533.33 state-operated services under this subdivision must not result 533.34 in a net reduction in the total number of services in any 533.35 catchment area in the state. The commissioner's proposals under 533.36 this subdivision also must ensure that any new community-based 534.1 state-operated services programs are located in areas that are 534.2 convenient to the individuals receiving services and their 534.3 families. 534.4 Subd. 2. [REDEVELOPMENT PLAN.] (a) Before seeking 534.5 legislative authorization for any proposal to restructure 534.6 state-operated services, redesign the mental health safety net, 534.7 or reduce reliance on large institutions, the commissioner shall 534.8 develop a comprehensive redevelopment plan for any facilities or 534.9 land vacated as a result of the proposal. If a local government 534.10 entity cannot be secured for facility redevelopment, then the 534.11 commissioner shall develop the plan in collaboration with 534.12 affected residents, family members, employees, providers, and 534.13 communities. The plan must include specific information on the 534.14 redevelopment of the affected facilities or land, specific 534.15 information about the implementation schedule for the plan, 534.16 proposed legislation, and letters of commitment regarding the 534.17 reuse and redevelopment of the facilities or land vacated as a 534.18 result of the proposal. 534.19 (b) The commissioner shall not implement a redevelopment 534.20 plan under this subdivision until the county board of 534.21 commissioners in any regional treatment center domiciled county 534.22 affected by the commissioner's redevelopment plan approves the 534.23 plan. 534.24 Subd. 3. [STAFFING.] To the extent permitted by applicable 534.25 collective bargaining agreements, the commissioner must offset 534.26 any staff position reductions that result from restructuring 534.27 state-operated services, redesigning the mental health safety 534.28 net, or reducing reliance on large institutions, by creating new 534.29 positions at community-based state-operated services programs. 534.30 A state employee whose job is eliminated as a result of the 534.31 restructuring of state-operated services shall have the option 534.32 of transferring to a community-based state-operated services 534.33 program, a position of comparable classification in another 534.34 regional treatment center setting, or a position in another 534.35 state agency. State employees affected by the restructuring of 534.36 state-operated services shall have the rights available under 535.1 the memorandum of understanding between the commissioner, the 535.2 state negotiator, and the bargaining representatives of state 535.3 employees. 535.4 Subd. 4. [STATE-OPERATED SERVICES COSTS.] (a) Programs 535.5 that remain at a regional treatment center campus during and 535.6 after the restructuring of state-operated services shall not be 535.7 assessed any disproportional increase in fees, charges, or other 535.8 costs associated with operating and maintaining the campus. 535.9 Increased costs associated with inflation are permissible. 535.10 (b) Effective January 2, 2004, there shall be no increase 535.11 in the county share of the cost of care provided in 535.12 state-operated services. 535.13 Subd. 5. [REQUEST FOR FEDERAL WAIVER.] By January 1, 2004, 535.14 the commissioner of human services shall apply to the federal 535.15 government for a waiver from Medicaid requirements to permit 535.16 medical assistance coverage for mental health treatment services 535.17 provided by an existing program located at a regional treatment 535.18 center with a capacity of more than 15 beds. 535.19 Sec. 41. [REDUCING DUPLICATIVE HEALTH AND HUMAN SERVICES 535.20 LICENSING ACTIVITIES; REPORT TO LEGISLATURE.] 535.21 (a) The commissioners of health and human services shall 535.22 submit a report to the chairs of the house and senate committees 535.23 with jurisdiction over health and human services licensing by 535.24 December 15, 2003, regarding how to reduce duplicative licensing 535.25 activities by the departments of health and human services. 535.26 (b) The report must include draft legislation providing for: 535.27 (1) the licensure of intermediate care facilities for 535.28 persons with mental retardation or related conditions or ICFs/MR 535.29 by either the commissioner of health or human services. In 535.30 developing the draft legislation, the commissioners, in 535.31 consultation with provider and advocacy organizations, shall 535.32 review: 535.33 (i) current state regulations enforced by the commissioner 535.34 of human services under Minnesota Statutes, chapter 245B; the 535.35 psychotropic medication use checklist under Minnesota Statutes, 535.36 section 245B.02, subdivision 19; and Minnesota Rules, parts 536.1 9525.2700 to 9525.2810, governing the use of aversive and 536.2 deprivation procedures; and 536.3 (ii) current state regulations enforced by the commissioner 536.4 of health under Minnesota Statutes, chapter 144, and Minnesota 536.5 Rules, chapter 4665. 536.6 The draft legislation must codify the regulations and 536.7 provisions listed in items (i) and (ii) in Minnesota Statutes, 536.8 chapter 144 or 245B, depending upon which commissioner is 536.9 recommended to license ICFs/MR. The draft legislation also must 536.10 repeal all rules made obsolete by the proposed codification of 536.11 the regulations; and 536.12 (2) the licensure of residential adult mental illness 536.13 treatment programs and chemical dependency treatment programs by 536.14 the commissioner of human services. The commissioners, in 536.15 consultation with provider and advocacy organizations, shall 536.16 review current regulations enforced by the commissioner of 536.17 health in nonhospital-based residential adult mental illness and 536.18 chemical dependency treatment programs to determine whether the 536.19 commissioner of human services should enforce the regulations. 536.20 If the commissioners determine that the commissioner of human 536.21 services should enforce the regulations, the draft legislation 536.22 must address how the provisions in the regulations should be 536.23 codified in Minnesota Statutes, chapter 245A. 536.24 (c) The report also must include an analysis of: 536.25 (1) whether the international fire and building codes, 536.26 effective in calendar year 2003, provide comparable and adequate 536.27 physical plant safeguards when compared to the supervised living 536.28 facility class B licensing standards. The commissioner must 536.29 analyze whether a board and lodging license combined with a 536.30 human services program license will maintain at least the 536.31 current safety levels in supervised living facility class B 536.32 facilities. If the commissioners determine that there is likely 536.33 no adverse effect on the health and safety of persons receiving 536.34 services from the adult mental illness or chemical dependency 536.35 programs or ICFs/MR, the draft legislation must repeal the 536.36 supervised living facility regulations and require board and 537.1 lodging licensure for these programs; and 537.2 (2) the funding implications for any proposed change to the 537.3 commissioners' responsibilities for licensing activities, 537.4 including the impact on the general fund and the state 537.5 government special revenue fund. 537.6 Sec. 42. [REVISOR'S INSTRUCTION.] 537.7 For sections in Minnesota Statutes and Minnesota Rules 537.8 affected by the repealed sections in this article, the revisor 537.9 shall delete internal cross-references where appropriate and 537.10 make changes necessary to correct the punctuation, grammar, or 537.11 structure of the remaining text and preserve its meaning. 537.12 Sec. 43. [REPEALER.] 537.13 (a) Minnesota Statutes 2002, sections 145A.17, subdivision 537.14 9; 245.478; 245.4888; 245.714; 256B.0945, subdivisions 6, 7, 8, 537.15 and 10; 256B.83; and 256F.10, subdivision 7, are repealed. 537.16 (b) Minnesota Rules, parts 9545.2000; 9545.2010; 9545.2020; 537.17 9545.2030; and 9545.2040, are repealed. 537.18 ARTICLE 8 537.19 HEALTH DEPARTMENT MISCELLANEOUS 537.20 Section 1. Minnesota Statutes 2002, section 62A.65, 537.21 subdivision 7, is amended to read: 537.22 Subd. 7. [SHORT-TERM COVERAGE.] (a) For purposes of this 537.23 section, "short-term coverage" means an individual health plan 537.24 that: 537.25 (1) is issued to provide coverage for a period of 185 days 537.26 or less, except that the health plan may permit coverage to 537.27 continue until the end of a period of hospitalization for a 537.28 condition for which the covered person was hospitalized on the 537.29 day that coverage would otherwise have ended; 537.30 (2) is nonrenewable, provided that the health carrier may 537.31 provide coverage for one or more subsequent periods that satisfy 537.32 clause (1), if the total of the periods of coverage do not 537.33 exceed a total of185555 days out of any365-day730-day 537.34 period, plus any additional days covered as a result of 537.35 hospitalization on the day that a period of coverage would 537.36 otherwise have ended; 538.1 (3) does not cover any preexisting conditions, including 538.2 ones that originated during a previous identical policy or 538.3 contract with the same health carrier where coverage was 538.4 continuous between the previous and the current policy or 538.5 contract; and 538.6 (4) is available with an immediate effective date without 538.7 underwriting upon receipt of a completed application indicating 538.8 eligibility under the health carrier's eligibility requirements, 538.9 provided that coverage that includes optional benefits may be 538.10 offered on a basis that does not meet this requirement. 538.11 (b) Short-term coverage is not subject to subdivisions 2 538.12 and 5. Short-term coverage may exclude as a preexisting 538.13 condition any injury, illness, or condition for which the 538.14 covered person had medical treatment, symptoms, or any 538.15 manifestations before the effective date of the coverage, but 538.16 dependent children born or placed for adoption during the policy 538.17 period must not be subject to this provision. 538.18 (c) Notwithstanding subdivision 3, and section 62A.021, a 538.19 health carrier may combine short-term coverage with its most 538.20 commonly sold individual qualified plan, as defined in section 538.21 62E.02, other than short-term coverage, for purposes of 538.22 complying with the loss ratio requirement. 538.23 (d) The185555 day coverage limitation provided in 538.24 paragraph (a) applies to the total number of days of short-term 538.25 coverage that covers a person, regardless of the number of 538.26 policies, contracts, or health carriers that provide the 538.27 coverage. A written application for short-term coverage must 538.28 ask the applicant whether the applicant has been covered by 538.29 short-term coverage by any health carrier within the365730 538.30 days immediately preceding the effective date of the coverage 538.31 being applied for. Short-term coverage issued in violation of 538.32 the185-day555-day limitation is valid until the end of its 538.33 term and does not lose its status as short-term coverage, in 538.34 spite of the violation. A health carrier that knowingly issues 538.35 short-term coverage in violation of the185-day555-day 538.36 limitation is subject to the administrative penalties otherwise 539.1 available to the commissioner of commerce or the commissioner of 539.2 health, as appropriate. 539.3 (e) Time spent under short-term coverage counts as time 539.4 spent under a preexisting condition limitation for purposes of 539.5 group or individual health plans, other than short-term 539.6 coverage, subsequently issued to that person, or to cover that 539.7 person, by any health carrier, if the person maintains 539.8 continuous coverage as defined in section 62L.02. Short-term 539.9 coverage is a health plan and is qualifying coverage as defined 539.10 in section 62L.02. Notwithstanding any other law to the 539.11 contrary, a health carrier is not required under any 539.12 circumstances to provide a person covered by short-term coverage 539.13 the right to obtain coverage on a guaranteed issue basis under 539.14 another health plan offered by the health carrier, as a result 539.15 of the person's enrollment in short-term coverage. 539.16 [EFFECTIVE DATE.] This section is effective the day 539.17 following final enactment and applies to policies issued on or 539.18 after that date. 539.19 Sec. 2. Minnesota Statutes 2002, section 62D.095, 539.20 subdivision 2, is amended to read: 539.21 Subd. 2. [CO-PAYMENTS.] (a) A health maintenance contract 539.22 may impose a co-payment as authorized under Minnesota Rules, 539.23 part 4685.0801, or under this section. 539.24 (b) A health maintenance contract may impose a flat fee 539.25 co-payment on outpatient office visits and prescription drugs 539.26 not to exceed 50 percent of the median provider's charges for 539.27 similar services or goods received by enrollees as calculated 539.28 under Minnesota Rules, part 4685.0801, subparts 3 and 4. 539.29 (c) If a health maintenance contract is permitted to impose 539.30 a co-payment for preexisting health status under sections 62D.01 539.31 to 62D.30, these provisions may vary with respect to length of 539.32 enrollment in the health plan. 539.33 Sec. 3. Minnesota Statutes 2002, section 62D.095, is 539.34 amended by adding a subdivision to read: 539.35 Subd. 6. [PUBLIC PROGRAMS.] This section does not apply to 539.36 the prepaid medical assistance program, the MinnesotaCare 540.1 program, the prepaid general assistance program, the federal 540.2 Medicare program, or the health plans provided through any of 540.3 those programs. 540.4 Sec. 4. Minnesota Statutes 2002, section 62J.692, 540.5 subdivision 4, is amended to read: 540.6 Subd. 4. [DISTRIBUTION OF FUNDS.] (a) The commissioner 540.7 shall annually distribute medical education funds to all 540.8 qualifying applicants based on the following criteria: 540.9 (1) total medical education funds available for 540.10 distribution; 540.11 (2) total number of eligible trainee FTEs in each clinical 540.12 medical education program; and 540.13 (3) the statewide average cost per trainee as determined by 540.14 the application information provided in the first year of the 540.15 biennium, by type of trainee, in each clinical medical education 540.16 program. 540.17 (b) Funds distributed shall not be used to displace current 540.18 funding appropriations from federal or state sources. 540.19 (c) Funds shall be distributed to the sponsoring 540.20 institutions indicating the amount to be distributed to each of 540.21 the sponsor's clinical medical education programs based on the 540.22 criteria in this subdivision and in accordance with the 540.23 commissioner's approval letter. Each clinical medical education 540.24 program must distribute funds to the training sites as specified 540.25 in the commissioner's approval letter. Sponsoring institutions, 540.26 which are accredited through an organization recognized by the 540.27 department of education or the Centers for Medicare and Medicaid 540.28 Services, may contract directly with training sites to provide 540.29 clinical training. To ensure the quality of clinical training, 540.30 those accredited sponsoring institutions must: 540.31 (1) develop contracts specifying the terms, expectations, 540.32 and outcomes of the clinical training conducted at sites; and 540.33 (2) take necessary action if the contract requirements are 540.34 not met. Action may include the withholding of payments under 540.35 this section or the removal of students from the site. 540.36 (d) Any funds not distributed in accordance with the 541.1 commissioner's approval letter must be returned to the medical 541.2 education and research fund within 30 days of receiving notice 541.3 from the commissioner. The commissioner shall distribute 541.4 returned funds to the appropriate training sites in accordance 541.5 with the commissioner's approval letter. 541.6 (e) The commissioner shall distribute by June 30 of each 541.7 year an amount equal to the funds transferred undersection541.862J.694, subdivision 2a, paragraph (b)subdivision 10, plus five 541.9 percent interest to the University of Minnesota board of regents 541.10 for thecosts of the academic health center as specified under541.11section 62J.694, subdivision 2a, paragraph (a).instructional 541.12 costs of health professional programs at the academic health 541.13 center and for interdisciplinary academic initiatives within the 541.14 academic health center. 541.15 (f) A maximum of $150,000 of the funds dedicated to the 541.16 commissioner under section 297F.10, subdivision 1, paragraph 541.17 (b), clause (2), may be used by the commissioner for 541.18 administrative expenses associated with implementing this 541.19 section. 541.20 Sec. 5. Minnesota Statutes 2002, section 62J.692, is 541.21 amended by adding a subdivision to read: 541.22 Subd. 10. [TRANSFERS FROM UNIVERSITY OF MINNESOTA.] Of the 541.23 funds dedicated to the academic health center under section 541.24 297F.10, subdivision 1, paragraph (b), clause (1), $4,850,000 541.25 shall be transferred annually to the commissioner of health no 541.26 later than April 15 of each year for distribution under 541.27 subdivision 4, paragraph (e). 541.28 Sec. 6. Minnesota Statutes 2002, section 62Q.19, 541.29 subdivision 1, is amended to read: 541.30 Subdivision 1. [DESIGNATION.] (a) The commissioner shall 541.31 designate essential community providers. The criteria for 541.32 essential community provider designation shall be the following: 541.33 (1) a demonstrated ability to integrate applicable 541.34 supportive and stabilizing services with medical care for 541.35 uninsured persons and high-risk and special needs populations, 541.36 underserved, and other special needs populations; and 542.1 (2) a commitment to serve low-income and underserved 542.2 populations by meeting the following requirements: 542.3 (i) has nonprofit status in accordance with chapter 317A; 542.4 (ii) has tax exempt status in accordance with the Internal 542.5 Revenue Service Code, section 501(c)(3); 542.6 (iii) charges for services on a sliding fee schedule based 542.7 on current poverty income guidelines; and 542.8 (iv) does not restrict access or services because of a 542.9 client's financial limitation; 542.10 (3) status as a local government unit as defined in section 542.11 62D.02, subdivision 11, a hospital district created or 542.12 reorganized under sections 447.31 to 447.37, an Indian tribal 542.13 government, an Indian health service unit, or a community health 542.14 board as defined in chapter 145A; 542.15 (4) a former state hospital that specializes in the 542.16 treatment of cerebral palsy, spina bifida, epilepsy, closed head 542.17 injuries, specialized orthopedic problems, and other disabling 542.18 conditions; or 542.19 (5)a rural hospital that has qualified fora sole 542.20 community hospitalfinancial assistance grant in the past three542.21years under section 144.1484, subdivision 1. For these rural 542.22 hospitals, the essential community provider designation applies 542.23 to all health services provided, including both inpatient and 542.24 outpatient services. For purposes of this section, "sole 542.25 community hospital" means a rural hospital that: 542.26 (i) is eligible to be classified as a sole community 542.27 hospital according to Code of Federal Regulations, title 42, 542.28 section 412.92, or is located in a community with a population 542.29 of less than 5,000 and located more than 25 miles from a like 542.30 hospital currently providing acute short-term services; 542.31 (ii) has experienced net operating income losses in two of 542.32 the previous three most recent consecutive hospital fiscal years 542.33 for which audited financial information is available; and 542.34 (iii) consists of 40 or fewer licensed beds. 542.35 (b) Prior to designation, the commissioner shall publish 542.36 the names of all applicants in the State Register. The public 543.1 shall have 30 days from the date of publication to submit 543.2 written comments to the commissioner on the application. No 543.3 designation shall be made by the commissioner until the 30-day 543.4 period has expired. 543.5 (c) The commissioner may designate an eligible provider as 543.6 an essential community provider for all the services offered by 543.7 that provider or for specific services designated by the 543.8 commissioner. 543.9 (d) For the purpose of this subdivision, supportive and 543.10 stabilizing services include at a minimum, transportation, child 543.11 care, cultural, and linguistic services where appropriate. 543.12 Sec. 7. Minnesota Statutes 2002, section 144.1222, is 543.13 amended by adding a subdivision to read: 543.14 Subd. 1a. [FEES.] All plans and specifications for public 543.15 swimming pool and spa construction, installation, or alteration 543.16 or requests for a variance that are submitted to the 543.17 commissioner according to Minnesota Rules, part 4717.3975, shall 543.18 be accompanied by the appropriate fees. If the commissioner 543.19 determines, upon review of the plans, that inadequate fees were 543.20 paid, the necessary additional fees shall be paid before plan 543.21 approval. For purposes of determining fees, a project is 543.22 defined as a proposal to construct or install a public pool, 543.23 spa, special purpose pool, or wading pool and all associated 543.24 water treatment equipment and drains, gutters, decks, water 543.25 recreation features, spray pads, and those design and safety 543.26 features that are within five feet of any pool or spa. The 543.27 commissioner shall charge the following fees for plan review and 543.28 inspection of public pools and spas and for requests for 543.29 variance from the public pool and spa rules: 543.30 (1) each spa pool, $500; 543.31 (2) projects valued at $250,000 or less, a minimum of $800 543.32 per pool plus: 543.33 (i) for each slide, an additional $400; and 543.34 (ii) for each spa pool, an additional $500; 543.35 (3) projects valued at $250,000 or more, 0.5 percent of 543.36 documented estimated project cost to a maximum fee of $10,000; 544.1 (4) alterations to an existing pool without changing the 544.2 size or configuration of the pool, $400; 544.3 (5) removal or replacement of pool disinfection equipment 544.4 only, $75; and 544.5 (6) request for variance from the public pool and spa 544.6 rules, $500. 544.7 Sec. 8. Minnesota Statutes 2002, section 144.125, is 544.8 amended to read: 544.9 144.125 [TESTS OF INFANTS FORINBORN METABOLIC ERRORS544.10 HERITABLE AND CONGENITAL DISORDERS.] 544.11 Subdivision 1. [DUTY TO PERFORM TESTING.] It is the duty 544.12 of (1) the administrative officer or other person in charge of 544.13 each institution caring for infants 28 days or less of age, (2) 544.14 the person required in pursuance of the provisions of section 544.15 144.215, to register the birth of a child, or (3) the nurse 544.16 midwife or midwife in attendance at the birth, to arrange to 544.17 have administered to every infant or child in its care tests for 544.18inborn errors of metabolism in accordance withheritable and 544.19 congenital disorders according to subdivision 2 and rules 544.20 prescribed by the state commissioner of health.In determining544.21which tests must be administered, the commissioner shall take544.22into consideration the adequacy of laboratory methods to detect544.23the inborn metabolic error, the ability to treat or prevent544.24medical conditions caused by the inborn metabolic error, and the544.25severity of the medical conditions caused by the inborn544.26metabolic error.Testing and the recording and reporting of 544.27 test results shall be performed at the times and in the manner 544.28 prescribed by the commissioner of health. The commissioner 544.29 shall charge laboratory service fees so that the total of fees 544.30 collected will approximate the costs of conducting the tests and 544.31 implementing and maintaining a system to follow-up infants with 544.32inborn metabolic errorsheritable or congenital disorders. The 544.33 laboratory service fee is $61 per specimen. Costs associated 544.34 with capital expenditures and the development of new procedures 544.35 may be prorated over a three-year period when calculating the 544.36 amount of the fees. 545.1 Subd. 2. [DETERMINATION OF TESTS TO BE ADMINISTERED.] The 545.2 commissioner shall periodically revise the list of tests to be 545.3 administered for determining the presence of a heritable or 545.4 congenital disorder. Revisions to the list shall reflect 545.5 advances in medical science, new and improved testing methods, 545.6 or other factors that will improve the public health. In 545.7 determining whether a test must be administered, the 545.8 commissioner shall take into consideration the adequacy of 545.9 laboratory methods to detect the heritable or congenital 545.10 disorder, the ability to treat or prevent medical conditions 545.11 caused by the heritable or congenital disorder, and the severity 545.12 of the medical conditions caused by the heritable or congenital 545.13 disorder. The list of tests to be performed may be revised if 545.14 the changes are recommended by the advisory committee 545.15 established under section 144.1255, approved by the 545.16 commissioner, and published in the State Register. The revision 545.17 is exempt from the rulemaking requirements in chapter 14 and 545.18 sections 14.385 and 14.386 do not apply. 545.19 Subd. 3. [OBJECTION OF PARENTS TO TEST.] Persons with a 545.20 duty to perform testing under subdivision 1 shall advise parents 545.21 of infants (1) that the blood or tissue samples used to perform 545.22 testing thereunder as well as the results of such testing may be 545.23 retained by the department of health and (2) that the following 545.24 options are available to them with respect to the testing: 545.25 (i) to decline to have the tests, or 545.26 (ii) to elect to have the tests but to require that all 545.27 blood samples and records of test results be destroyed within 24 545.28 months of the testing. If the parents of an infant object in 545.29 writing to testing for heritable and congenital disorders or 545.30 elect to require that blood samples and test results be 545.31 destroyed, the objection or election shall be recorded on a form 545.32 that is signed by a parent or legal guardian and made part of 545.33 the infant's medical record. A written objection exempts an 545.34 infant from the requirements of this section and section 144.128. 545.35 Sec. 9. [144.1255] [ADVISORY COMMITTEE ON HERITABLE AND 545.36 CONGENITAL DISORDERS.] 546.1 Subdivision 1. [CREATION AND MEMBERSHIP.] (a) By July 1, 546.2 2003, the commissioner of health shall appoint an advisory 546.3 committee to provide advice and recommendations to the 546.4 commissioner concerning tests and treatments for heritable and 546.5 congenital disorders found in newborn children. Membership of 546.6 the committee shall include, but not be limited to, at least one 546.7 member from each of the following representative groups: 546.8 (1) parents and other consumers; 546.9 (2) primary care providers; 546.10 (3) clinicians and researchers specializing in newborn 546.11 diseases and disorders; 546.12 (4) genetic counselors; 546.13 (5) birth hospital representatives; 546.14 (6) newborn screening laboratory professionals; 546.15 (7) nutritionists; and 546.16 (8) other experts as needed representing related fields 546.17 such as emerging technologies and health insurance. 546.18 (b) The terms and removal of members are governed by 546.19 section 15.059. Members shall not receive per diems but shall 546.20 be compensated for expenses. Notwithstanding section 15.059, 546.21 subdivision 5, the advisory committee does not expire. 546.22 Subd. 2. [FUNCTION AND OBJECTIVES.] The committee's 546.23 activities include, but are not limited to: 546.24 (1) collection of information on the efficacy and 546.25 reliability of various tests for heritable and congenital 546.26 disorders; 546.27 (2) collection of information on the availability and 546.28 efficacy of treatments for heritable and congenital disorders; 546.29 (3) collection of information on the severity of medical 546.30 conditions caused by heritable and congenital disorders; 546.31 (4) discussion and assessment of the benefits of performing 546.32 tests for heritable or congenital disorders as compared to the 546.33 costs, treatment limitations, or other potential disadvantages 546.34 of requiring the tests; 546.35 (5) discussion and assessment of ethical considerations 546.36 surrounding the testing, treatment, and handling of data and 547.1 specimens generated by the testing requirements of sections 547.2 144.125 to 144.128; and 547.3 (6) providing advice and recommendations to the 547.4 commissioner concerning tests and treatments for heritable and 547.5 congenital disorders found in newborn children. 547.6 [EFFECTIVE DATE.] This section is effective the day 547.7 following final enactment. 547.8 Sec. 10. Minnesota Statutes 2002, section 144.128, is 547.9 amended to read: 547.10 144.128 [TREATMENT FOR POSITIVE DIAGNOSIS, REGISTRY OF547.11CASESCOMMISSIONER'S DUTIES.] 547.12 The commissioner shall: 547.13 (1) notify the physicians of newborns tested of the results 547.14 of the tests performed; 547.15(1)(2) makearrangementsreferrals for the necessary 547.16 treatment of diagnosed cases ofhemoglobinopathy,547.17phenylketonuria, and other inborn errors of metabolismheritable 547.18 or congenital disorders when treatment is indicatedand the547.19family is uninsured and, because of a lack of available income,547.20is unable to pay the cost of the treatment; 547.21(2)(3) maintain a registry of the cases of 547.22hemoglobinopathy, phenylketonuria, and other inborn errors of547.23metabolismheritable and congenital disorders detected by the 547.24 screening program for the purpose of follow-up services; and 547.25(3)(4) adopt rules to carry outsection 144.126 and this547.26sectionsections 144.125 to 144.128. 547.27 Sec. 11. Minnesota Statutes 2002, section 144.1483, is 547.28 amended to read: 547.29 144.1483 [RURAL HEALTH INITIATIVES.] 547.30 The commissioner of health, through the office of rural 547.31 health, and consulting as necessary with the commissioner of 547.32 human services, the commissioner of commerce, the higher 547.33 education services office, and other state agencies, shall: 547.34 (1) develop a detailed plan regarding the feasibility of 547.35 coordinating rural health care services by organizing individual 547.36 medical providers and smaller hospitals and clinics into 548.1 referral networks with larger rural hospitals and clinics that 548.2 provide a broader array of services; 548.3 (2) develop and implement a program to assist rural 548.4 communities in establishing community health centers, as 548.5 required by section 144.1486; 548.6 (3)administer the program of financial assistance548.7established under section 144.1484 for rural hospitals in548.8isolated areas of the state that are in danger of closing548.9without financial assistance, and that have exhausted local548.10sources of support;548.11(4)develop recommendations regarding health education and 548.12 training programs in rural areas, including but not limited to a 548.13 physician assistants' training program, continuing education 548.14 programs for rural health care providers, and rural outreach 548.15 programs for nurse practitioners within existing training 548.16 programs; 548.17(5)(4) develop a statewide, coordinated recruitment 548.18 strategy for health care personnel and maintain a database on 548.19 health care personnel as required under section 144.1485; 548.20(6)(5) develop and administer technical assistance 548.21 programs to assist rural communities in: (i) planning and 548.22 coordinating the delivery of local health care services; and 548.23 (ii) hiring physicians, nurse practitioners, public health 548.24 nurses, physician assistants, and other health personnel; 548.25(7)(6) study and recommend changes in the regulation of 548.26 health care personnel, such as nurse practitioners and physician 548.27 assistants, related to scope of practice, the amount of on-site 548.28 physician supervision, and dispensing of medication, to address 548.29 rural health personnel shortages; 548.30(8)(7) support efforts to ensure continued funding for 548.31 medical and nursing education programs that will increase the 548.32 number of health professionals serving in rural areas; 548.33(9)(8) support efforts to secure higher reimbursement for 548.34 rural health care providers from the Medicare and medical 548.35 assistance programs; 548.36(10)(9) coordinate the development of a statewide plan for 549.1 emergency medical services, in cooperation with the emergency 549.2 medical services advisory council; 549.3(11)(10) establish a Medicare rural hospital flexibility 549.4 program pursuant to section 1820 of the federal Social Security 549.5 Act, United States Code, title 42, section 1395i-4, by 549.6 developing a state rural health plan and designating, consistent 549.7 with the rural health plan, rural nonprofit or public hospitals 549.8 in the state as critical access hospitals. Critical access 549.9 hospitals shall include facilities that are certified by the 549.10 state as necessary providers of health care services to 549.11 residents in the area. Necessary providers of health care 549.12 services are designated as critical access hospitals on the 549.13 basis of being more than 20 miles, defined as official mileage 549.14 as reported by the Minnesota department of transportation, from 549.15 the next nearest hospital, being the sole hospital in the 549.16 county, being a hospital located in a county with a designated 549.17 medically underserved area or health professional shortage area, 549.18 or being a hospital located in a county contiguous to a county 549.19 with a medically underserved area or health professional 549.20 shortage area. A critical access hospital located in a county 549.21 with a designated medically underserved area or a health 549.22 professional shortage area or in a county contiguous to a county 549.23 with a medically underserved area or health professional 549.24 shortage area shall continue to be recognized as a critical 549.25 access hospital in the event the medically underserved area or 549.26 health professional shortage area designation is subsequently 549.27 withdrawn; and 549.28(12)(11) carry out other activities necessary to address 549.29 rural health problems. 549.30 Sec. 12. Minnesota Statutes 2002, section 144.1488, 549.31 subdivision 4, is amended to read: 549.32 Subd. 4. [ELIGIBLE HEALTH PROFESSIONALS.] (a) To be 549.33 eligible to apply to the commissioner for the loan repayment 549.34 program, health professionals must be citizens or nationals of 549.35 the United States, must not have any unserved obligations for 549.36 service to a federal, state, or local government, or other 550.1 entity, must have a current and unrestricted Minnesota license 550.2 to practice, and must be ready to begin full-time clinical 550.3 practice upon signing a contract for obligated service. 550.4 (b) Eligible providers are those specified by the federal 550.5 Bureau ofPrimary Health CareHealth Professions in the policy 550.6 information notice for the state's current federal grant 550.7 application. A health professional selected for participation 550.8 is not eligible for loan repayment until the health professional 550.9 has an employment agreement or contract with an eligible loan 550.10 repayment site and has signed a contract for obligated service 550.11 with the commissioner. 550.12 Sec. 13. Minnesota Statutes 2002, section 144.1491, 550.13 subdivision 1, is amended to read: 550.14 Subdivision 1. [PENALTIES FOR BREACH OF CONTRACT.] A 550.15 program participant who fails to completetwothe required years 550.16 of obligated service shall repay the amount paid, as well as a 550.17 financial penaltybased upon the length of the service550.18obligation not fulfilled. If the participant has served at550.19least one year, the financial penalty is the number of unserved550.20months multiplied by $1,000. If the participant has served less550.21than one year, the financial penalty is the total number of550.22obligated months multiplied by $1,000specified by the federal 550.23 Bureau of Health Professions in the policy information notice 550.24 for the state's current federal grant application. The 550.25 commissioner shall report to the appropriate health-related 550.26 licensing board a participant who fails to complete the service 550.27 obligation and fails to repay the amount paid or fails to pay 550.28 any financial penalty owed under this subdivision. 550.29 Sec. 14. [144.1501] [HEALTH PROFESSIONAL EDUCATION LOAN 550.30 FORGIVENESS PROGRAM.] 550.31 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 550.32 section, the following definitions apply. 550.33 (b) "Designated rural area" means: 550.34 (1) an area in Minnesota outside the counties of Anoka, 550.35 Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, 550.36 excluding the cities of Duluth, Mankato, Moorhead, Rochester, 551.1 and St. Cloud; or 551.2 (2) a municipal corporation, as defined under section 551.3 471.634, that is physically located, in whole or in part, in an 551.4 area defined as a designated rural area under clause (1). 551.5 (c) "Emergency circumstances" means those conditions that 551.6 make it impossible for the participant to fulfill the service 551.7 commitment, including death, total and permanent disability, or 551.8 temporary disability lasting more than two years. 551.9 (d) "Medical resident" means an individual participating in 551.10 a medical residency in family practice, internal medicine, 551.11 obstetrics and gynecology, pediatrics, or psychiatry. 551.12 (e) "Midlevel practitioner" means a nurse practitioner, 551.13 nurse-midwife, nurse anesthetist, advanced clinical nurse 551.14 specialist, or physician assistant. 551.15 (f) "Nurse" means an individual who has completed training 551.16 and received all licensing or certification necessary to perform 551.17 duties as a licensed practical nurse or registered nurse. 551.18 (g) "Nurse-midwife" means a registered nurse who has 551.19 graduated from a program of study designed to prepare registered 551.20 nurses for advanced practice as nurse-midwives. 551.21 (h) "Nurse practitioner" means a registered nurse who has 551.22 graduated from a program of study designed to prepare registered 551.23 nurses for advanced practice as nurse practitioners. 551.24 (i) "Physician" means an individual who is licensed to 551.25 practice medicine in the areas of family practice, internal 551.26 medicine, obstetrics and gynecology, pediatrics, or psychiatry. 551.27 (j) "Physician assistant" means a person registered under 551.28 chapter 147A. 551.29 (k) "Qualified educational loan" means a government, 551.30 commercial, or foundation loan for actual costs paid for 551.31 tuition, reasonable education expenses, and reasonable living 551.32 expenses related to the graduate or undergraduate education of a 551.33 health care professional. 551.34 (l) "Underserved urban community" means a Minnesota urban 551.35 area or population included in the list of designated primary 551.36 medical care health professional shortage areas (HPSAs), 552.1 medically underserved areas (MUAs), or medically underserved 552.2 populations (MUPs) maintained and updated by the United States 552.3 Department of Health and Human Services. 552.4 Subd. 2. [CREATION OF ACCOUNT.] A health professional 552.5 education loan forgiveness program account is established. The 552.6 commissioner of health shall use money from the account to 552.7 establish a loan forgiveness program for medical residents 552.8 agreeing to practice in designated rural areas or underserved 552.9 urban communities, for midlevel practitioners agreeing to 552.10 practice in designated rural areas, and for nurses who agree to 552.11 practice in a Minnesota nursing home or intermediate care 552.12 facility for persons with mental retardation or related 552.13 conditions. Appropriations made to the account do not cancel 552.14 and are available until expended, except that at the end of each 552.15 biennium, any remaining balance in the account that is not 552.16 committed by contract and not needed to fulfill existing 552.17 commitments shall cancel to the fund. 552.18 Subd. 3. [ELIGIBILITY.] (a) To be eligible to participate 552.19 in the loan forgiveness program, an individual must: 552.20 (1) be a medical resident or be enrolled in a midlevel 552.21 practitioner, registered nurse, or a licensed practical nurse 552.22 training program; and 552.23 (2) submit an application to the commissioner of health. 552.24 (b) An applicant selected to participate must sign a 552.25 contract to agree to serve a minimum three-year full-time 552.26 service obligation according to subdivision 2, which shall begin 552.27 no later than March 31 following completion of required training. 552.28 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 552.29 may select applicants each year for participation in the loan 552.30 forgiveness program, within the limits of available funding. 552.31 The commissioner shall distribute available funds for loan 552.32 forgiveness proportionally among the eligible professions 552.33 according to the vacancy rate for each profession in the 552.34 required geographic area or facility type specified in 552.35 subdivision 2. The commissioner shall allocate funds for 552.36 physician loan forgiveness so that 75 percent of the funds 553.1 available are used for rural physician loan forgiveness and 25 553.2 percent of the funds available are used for underserved urban 553.3 communities loan forgiveness. If the commissioner does not 553.4 receive enough qualified applicants each year to use the entire 553.5 allocation of funds for urban underserved communities, the 553.6 remaining funds may be allocated for rural physician loan 553.7 forgiveness. Applicants are responsible for securing their own 553.8 qualified educational loans. The commissioner shall select 553.9 participants based on their suitability for practice serving the 553.10 required geographic area or facility type specified in 553.11 subdivision 2, as indicated by experience or training. The 553.12 commissioner shall give preference to applicants closest to 553.13 completing their training. For each year that a participant 553.14 meets the service obligation required under subdivision 3, up to 553.15 a maximum of four years, the commissioner shall make annual 553.16 disbursements directly to the participant equivalent to 15 553.17 percent of the average educational debt for indebted graduates 553.18 in their profession in the year closest to the applicant's 553.19 selection for which information is available, not to exceed the 553.20 balance of the participant's qualifying educational loans. 553.21 Before receiving loan repayment disbursements and as requested, 553.22 the participant must complete and return to the commissioner an 553.23 affidavit of practice form provided by the commissioner 553.24 verifying that the participant is practicing as required under 553.25 subdivisions 2 and 3. The participant must provide the 553.26 commissioner with verification that the full amount of loan 553.27 repayment disbursement received by the participant has been 553.28 applied toward the designated loans. After each disbursement, 553.29 verification must be received by the commissioner and approved 553.30 before the next loan repayment disbursement is made. 553.31 Participants who move their practice remain eligible for loan 553.32 repayment as long as they practice as required under subdivision 553.33 2. 553.34 Subd. 5. [PENALTY FOR NONFULFILLMENT.] If a participant 553.35 does not fulfill the required minimum commitment of service 553.36 according to subdivision 3, the commissioner of health shall 554.1 collect from the participant the total amount paid to the 554.2 participant under the loan forgiveness program plus interest at 554.3 a rate established according to section 270.75. The 554.4 commissioner shall deposit the money collected in the health 554.5 care access fund to be credited to the health professional 554.6 education loan forgiveness program account established in 554.7 subdivision 2. The commissioner shall allow waivers of all or 554.8 part of the money owed the commissioner as a result of a 554.9 nonfulfillment penalty if emergency circumstances prevented 554.10 fulfillment of the minimum service commitment. 554.11 Subd. 6. [RULES.] The commissioner may adopt rules to 554.12 implement this section. 554.13 Sec. 15. Minnesota Statutes 2002, section 144.1502, 554.14 subdivision 4, is amended to read: 554.15 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 554.16 may acceptup to 14applicantspereach year for participation 554.17 in the loan forgiveness program, within the limits of available 554.18 funding. Applicants are responsible for securing their own 554.19 loans. The commissioner shall select participants based on 554.20 their suitability for practice serving public program patients, 554.21 as indicated by experience or training. The commissioner shall 554.22 give preference to applicants who have attended a Minnesota 554.23 dentistry educational institution and to applicants closest to 554.24 completing their training. For each year that a participant 554.25 meets the service obligation required under subdivision 3, up to 554.26 a maximum of four years, the commissioner shall make annual 554.27 disbursements directly to the participant equivalent to$10,000554.28per year of service, not to exceed $40,00015 percent of the 554.29 average educational debt for indebted dental school graduates in 554.30 the year closest to the applicant's selection for which 554.31 information is available or the balance of the qualifying 554.32 educational loans, whichever is less. Before receiving loan 554.33 repayment disbursements and as requested, the participant must 554.34 complete and return to the commissioner an affidavit of practice 554.35 form provided by the commissioner verifying that the participant 554.36 is practicing as required under subdivision 3. The participant 555.1 must provide the commissioner with verification that the full 555.2 amount of loan repayment disbursement received by the 555.3 participant has been applied toward the designated loans. After 555.4 each disbursement, verification must be received by the 555.5 commissioner and approved before the next loan repayment 555.6 disbursement is made. Participants who move their practice 555.7 remain eligible for loan repayment as long as they practice as 555.8 required under subdivision 3. 555.9 Sec. 16. Minnesota Statutes 2002, section 144.343, 555.10 subdivision 1, is amended to read: 555.11 Subdivision 1. [MINOR'S CONSENT VALID.] Any minor may give 555.12 effective consent for medical, mental and other health services 555.13 to determine the presence of or to treat pregnancy and 555.14 conditions associated therewith, venereal disease, alcohol and 555.15 other drug abuse, and the consent of no other person is 555.16 required. This section does not preclude parents from having 555.17 access to the medical records of their unemancipated minor 555.18 children. 555.19 Sec. 17. Minnesota Statutes 2002, section 144.551, 555.20 subdivision 1, is amended to read: 555.21 Subdivision 1. [RESTRICTED CONSTRUCTION OR MODIFICATION.] 555.22 (a) The following construction or modification may not be 555.23 commenced: 555.24 (1) any erection, building, alteration, reconstruction, 555.25 modernization, improvement, extension, lease, or other 555.26 acquisition by or on behalf of a hospital that increases the bed 555.27 capacity of a hospital, relocates hospital beds from one 555.28 physical facility, complex, or site to another, or otherwise 555.29 results in an increase or redistribution of hospital beds within 555.30 the state; and 555.31 (2) the establishment of a new hospital. 555.32 (b) This section does not apply to: 555.33 (1) construction or relocation within a county by a 555.34 hospital, clinic, or other health care facility that is a 555.35 national referral center engaged in substantial programs of 555.36 patient care, medical research, and medical education meeting 556.1 state and national needs that receives more than 40 percent of 556.2 its patients from outside the state of Minnesota; 556.3 (2) a project for construction or modification for which a 556.4 health care facility held an approved certificate of need on May 556.5 1, 1984, regardless of the date of expiration of the 556.6 certificate; 556.7 (3) a project for which a certificate of need was denied 556.8 before July 1, 1990, if a timely appeal results in an order 556.9 reversing the denial; 556.10 (4) a project exempted from certificate of need 556.11 requirements by Laws 1981, chapter 200, section 2; 556.12 (5) a project involving consolidation of pediatric 556.13 specialty hospital services within the Minneapolis-St. Paul 556.14 metropolitan area that would not result in a net increase in the 556.15 number of pediatric specialty hospital beds among the hospitals 556.16 being consolidated; 556.17 (6) a project involving the temporary relocation of 556.18 pediatric-orthopedic hospital beds to an existing licensed 556.19 hospital that will allow for the reconstruction of a new 556.20 philanthropic, pediatric-orthopedic hospital on an existing site 556.21 and that will not result in a net increase in the number of 556.22 hospital beds. Upon completion of the reconstruction, the 556.23 licenses of both hospitals must be reinstated at the capacity 556.24 that existed on each site before the relocation; 556.25 (7) the relocation or redistribution of hospital beds 556.26 within a hospital building or identifiable complex of buildings 556.27 provided the relocation or redistribution does not result in: 556.28 (i) an increase in the overall bed capacity at that site; (ii) 556.29 relocation of hospital beds from one physical site or complex to 556.30 another; or (iii) redistribution of hospital beds within the 556.31 state or a region of the state; 556.32 (8) relocation or redistribution of hospital beds within a 556.33 hospital corporate system that involves the transfer of beds 556.34 from a closed facility site or complex to an existing site or 556.35 complex provided that: (i) no more than 50 percent of the 556.36 capacity of the closed facility is transferred; (ii) the 557.1 capacity of the site or complex to which the beds are 557.2 transferred does not increase by more than 50 percent; (iii) the 557.3 beds are not transferred outside of a federal health systems 557.4 agency boundary in place on July 1, 1983; and (iv) the 557.5 relocation or redistribution does not involve the construction 557.6 of a new hospital building; 557.7 (9) a construction project involving up to 35 new beds in a 557.8 psychiatric hospital in Rice county that primarily serves 557.9 adolescents and that receives more than 70 percent of its 557.10 patients from outside the state of Minnesota; 557.11 (10) a project to replace a hospital or hospitals with a 557.12 combined licensed capacity of 130 beds or less if: (i) the new 557.13 hospital site is located within five miles of the current site; 557.14 and (ii) the total licensed capacity of the replacement 557.15 hospital, either at the time of construction of the initial 557.16 building or as the result of future expansion, will not exceed 557.17 70 licensed hospital beds, or the combined licensed capacity of 557.18 the hospitals, whichever is less; 557.19 (11) the relocation of licensed hospital beds from an 557.20 existing state facility operated by the commissioner of human 557.21 services to a new or existing facility, building, or complex 557.22 operated by the commissioner of human services; from one 557.23 regional treatment center site to another; or from one building 557.24 or site to a new or existing building or site on the same 557.25 campus; 557.26 (12) the construction or relocation of hospital beds 557.27 operated by a hospital having a statutory obligation to provide 557.28 hospital and medical services for the indigent that does not 557.29 result in a net increase in the number of hospital beds; 557.30 (13) a construction project involving the addition of up to 557.31 31 new beds in an existing nonfederal hospital in Beltrami 557.32 county;or557.33 (14) a construction project involving the addition of up to 557.34 eight new beds in an existing nonfederal hospital in Otter Tail 557.35 county with 100 licensed acute care beds; 557.36 (15) a construction project involving the addition of 20 558.1 new hospital beds used for rehabilitation services in an 558.2 existing hospital in Carver county serving the southwest 558.3 suburban metropolitan area; or 558.4 (16) a project for the construction or relocation of up to 558.5 20 hospital beds for the operation of up to two psychiatric 558.6 facilities or units for children provided that the operation of 558.7 the facilities or units have received the approval of the 558.8 commissioner of human services. 558.9 Sec. 18. [144.706] [CITATION.] 558.10 Sections 144.706 to 144.7069 may be cited as the Minnesota 558.11 Adverse Health Care Events Reporting Act of 2003. 558.12 [EFFECTIVE DATE.] This section is effective July 1, 2005, 558.13 contingent upon obtaining independent funding. 558.14 Sec. 19. [144.7063] [DEFINITIONS.] 558.15 Subdivision 1. [SCOPE.] Unless the context clearly 558.16 indicates otherwise, for the purposes of sections 144.706 to 558.17 144.7069, the terms defined in this section have the meanings 558.18 given them. 558.19 Subd. 2. [COMMISSIONER.] "Commissioner" means the 558.20 commissioner of health. 558.21 Subd. 3. [FACILITY.] "Facility" means a hospital licensed 558.22 under sections 144.50 to 144.58. 558.23 Subd. 4. [SERIOUS DISABILITY.] "Serious disability" means 558.24 (1) a physical or mental impairment that substantially limits 558.25 one or more of the major life activities of an individual or a 558.26 loss of bodily function, if the impairment or loss lasts more 558.27 than seven days or is still present at the time of discharge 558.28 from an inpatient health care facility or (2) loss of a body 558.29 part. 558.30 Subd. 5. [SURGERY.] "Surgery" means the treatment of 558.31 disease, injury, or deformity by manual or operative methods. 558.32 Surgery includes endoscopies and other invasive procedures. 558.33 [EFFECTIVE DATE.] This section is effective July 1, 2005, 558.34 contingent upon obtaining independent funding. 558.35 Sec. 20. [144.7065] [FACILITY REQUIREMENTS TO REPORT, 558.36 ANALYZE, AND CORRECT.] 559.1 Subdivision 1. [REPORTS OF ADVERSE HEALTH CARE EVENTS 559.2 REQUIRED.] Each facility shall report to the commissioner the 559.3 occurrence of any of the adverse health care events described in 559.4 subdivisions 2 to 7 as soon as is reasonably and practically 559.5 possible, but no later than 15 working days after discovery of 559.6 the event. The report shall be filed in a format specified by 559.7 the commissioner and shall identify the facility but shall not 559.8 identify any of the health care professionals, facility 559.9 employees, or patients involved. The report shall not contain 559.10 the name, address, social security number, date of birth, 559.11 telephone number, federal patient identification number, 559.12 subscriber number, medical record number, or any other 559.13 identifying information of the patient involved. The report 559.14 shall not contain the name, social security number, federal 559.15 provider identification number, license number, or other 559.16 identifying information of the health care professionals 559.17 involved. The report shall not contain the name, employee 559.18 number, social security number, or any other identifying 559.19 information of the facility employee involved. The commissioner 559.20 may consult with experts and organizations familiar with patient 559.21 safety when developing the format for reporting and in further 559.22 defining events in order to be consistent with industry 559.23 standards. 559.24 Subd. 2. [SURGICAL EVENTS.] Events reportable under this 559.25 subdivision are: 559.26 (1) surgery performed on a wrong body part that is not 559.27 consistent with the documented informed consent for that 559.28 patient. Reportable events under this clause do not include 559.29 situations requiring prompt action that occur in the course of 559.30 surgery or situations whose urgency precludes obtaining informed 559.31 consent; 559.32 (2) surgery performed on the wrong patient; 559.33 (3) the wrong surgical procedure performed on a patient 559.34 that is not consistent with the documented informed consent for 559.35 that patient. Reportable events under this clause do not 559.36 include situations requiring prompt action that occur in the 560.1 course of surgery or situations whose urgency precludes 560.2 obtaining informed consent; 560.3 (4) retention of a foreign object in a patient after 560.4 surgery or other procedure, excluding objects intentionally 560.5 implanted as part of a planned intervention and objects present 560.6 prior to surgery that are intentionally retained; and 560.7 (5) death during or immediately after surgery of a normal, 560.8 healthy patient who has no organic, physiologic, biochemical, or 560.9 psychiatric disturbance and for whom the pathologic processes 560.10 for which the operation is to be performed are localized and do 560.11 not entail a systemic disturbance. 560.12 Subd. 3. [PRODUCT OR DEVICE EVENTS.] Events reportable 560.13 under this subdivision are: 560.14 (1) patient death or serious disability associated with the 560.15 use of contaminated drugs, devices, or biologics provided by the 560.16 facility when the contamination is the result of generally 560.17 detectable contaminants in drugs, devices, or biologics 560.18 regardless of the source of the contamination or the product; 560.19 (2) patient death or serious disability associated with the 560.20 use or function of a device in patient care in which the device 560.21 is used or functions other than as intended. "Device" includes, 560.22 but is not limited to, catheters, drains, and other specialized 560.23 tubes, infusion pumps, and ventilators; and 560.24 (3) patient death or serious disability associated with 560.25 intravascular air embolism that occurs while being cared for in 560.26 a facility, excluding deaths associated with neurosurgical 560.27 procedures known to present a high risk of intravascular air 560.28 embolism. 560.29 Subd. 4. [PATIENT PROTECTION EVENTS.] Events reportable 560.30 under this subdivision are: 560.31 (1) an infant discharged to the wrong person; 560.32 (2) patient death or serious disability associated with 560.33 patient disappearance for more than four hours, excluding events 560.34 involving adults who have decision making capacity; and 560.35 (3) patient suicide or attempted suicide resulting in 560.36 serious disability while being cared for in a facility due to 561.1 patient actions after admission to the facility, excluding 561.2 deaths resulting from self-inflicted injuries that were the 561.3 reason for admission to the facility. 561.4 Subd. 5. [CARE MANAGEMENT EVENTS.] Events reportable under 561.5 this subdivision are: 561.6 (1) patient death or serious disability associated with a 561.7 medication error, including, but not limited to, errors 561.8 involving the wrong drug, the wrong dose, the wrong patient, the 561.9 wrong time, the wrong rate, the wrong preparation, or the wrong 561.10 route of administration, excluding reasonable differences in 561.11 clinical judgment on drug selection and dose; 561.12 (2) patient death or serious disability associated with a 561.13 hemolytic reaction due to the administration of ABO-incompatible 561.14 blood or blood products; 561.15 (3) maternal death or serious disability associated with 561.16 labor or delivery in a low-risk pregnancy while being cared for 561.17 in a facility, including events that occur within 42 days 561.18 postdelivery and excluding deaths from pulmonary or amniotic 561.19 fluid embolism, acute fatty liver of pregnancy, or 561.20 cardiomyopathy; 561.21 (4) patient death or serious disability directly related to 561.22 hypoglycemia, the onset of which occurs while the patient is 561.23 being cared for in a facility; 561.24 (5) death or serious disability, including kernicterus, 561.25 associated with failure to identify and treat hyperbilirubinemia 561.26 in neonates during the first 28 days of life. 561.27 "Hyperbilirubinemia" means bilirubin levels greater than 30 561.28 milligrams per deciliter; 561.29 (6) stage 3 or 4 ulcers acquired after admission to a 561.30 facility, excluding progression from stage 2 to stage 3 if stage 561.31 2 was recognized upon admission; and 561.32 (7) patient death or serious disability due to spinal 561.33 manipulative therapy. 561.34 Subd. 6. [ENVIRONMENTAL EVENTS.] Events reportable under 561.35 this subdivision are: 561.36 (1) patient death or serious disability associated with an 562.1 electric shock while being cared for in a facility, excluding 562.2 events involving planned treatments such as electric 562.3 countershock; 562.4 (2) any incident in which a line designated for oxygen or 562.5 other gas to be delivered to a patient contains the wrong gas or 562.6 is contaminated by toxic substances; 562.7 (3) patient death or serious disability associated with a 562.8 burn incurred from any source while being cared for in a 562.9 facility; 562.10 (4) patient death associated with a fall while being cared 562.11 for in a facility; and 562.12 (5) patient death or serious disability associated with the 562.13 use or lack of restraints or bedrails while being cared for in a 562.14 facility. 562.15 Subd. 7. [CRIMINAL EVENTS.] Events reportable under this 562.16 subdivision are: 562.17 (1) any instance of care ordered by or provided by someone 562.18 impersonating a physician, nurse, pharmacist, or other licensed 562.19 health care provider; 562.20 (2) abduction of a patient of any age; 562.21 (3) sexual assault on a patient within or on the grounds of 562.22 a facility; and 562.23 (4) death or significant injury of a patient or staff 562.24 member resulting from a physical assault that occurs within or 562.25 on the grounds of a facility. 562.26 Subd. 8. [ROOT CAUSE ANALYSIS; CORRECTIVE ACTION 562.27 PLAN.] Following the occurrence of an adverse health care event, 562.28 the facility must conduct a root cause analysis of the event. 562.29 Following the analysis, the facility must: (1) implement a 562.30 corrective action plan to implement the findings of the 562.31 analysis, or (2) report to the commissioner any reasons for not 562.32 taking corrective action. If the root cause analysis and the 562.33 implementation of a corrective action plan are complete at the 562.34 time an event must be reported, the findings of the analysis and 562.35 the corrective action plan must be included in the report of the 562.36 event. The findings of the root cause analysis and a copy of 563.1 the corrective action plan must otherwise be filed with the 563.2 commissioner within 60 days of the event. 563.3 Subd. 9. [ELECTRONIC REPORTING.] The commissioner must 563.4 design the reporting system so that a facility may file by 563.5 electronic means the reports required under this section. The 563.6 commissioner shall encourage a facility to use the electronic 563.7 filing option when that option is feasible for the facility. 563.8 Subd. 10. [RELATION TO OTHER LAW.] (a) Adverse health 563.9 events described in subdivisions 2 to 6 do not constitute 563.10 "maltreatment" or "a physical injury that is not reasonably 563.11 explained" under section 626.557 and are excluded from the 563.12 reporting requirements of section 626.557, provided the facility 563.13 makes a determination within 24 hours of the discovery of the 563.14 event that this section is applicable and the facility files the 563.15 reports required under this section in a timely fashion. 563.16 (b) A facility that has determined that an event described 563.17 in subdivisions 2 to 6 has occurred must inform persons who are 563.18 mandated reporters under section 626.5572, subdivision 16, of 563.19 that determination. A mandated reporter otherwise required to 563.20 report under section 626.557, subdivision 3, paragraph (e), is 563.21 relieved of the duty to report an event that the facility 563.22 determines under paragraph (a) to be reportable under 563.23 subdivisions 2 to 6. 563.24 (c) The protections and immunities applicable to voluntary 563.25 reports under section 626.557 are not affected by this section. 563.26 (d) Notwithstanding section 626.557, a lead agency under 563.27 section 626.5572, subdivision 13, is not required to conduct an 563.28 investigation of an event described in subdivisions 2 to 6. 563.29 [EFFECTIVE DATE.] This section is effective July 1, 2005, 563.30 contingent upon obtaining independent funding. 563.31 Sec. 21. [144.7067] [COMMISSIONER DUTIES AND 563.32 RESPONSIBILITIES.] 563.33 Subdivision 1. [ESTABLISHMENT OF REPORTING SYSTEM.] (a) 563.34 The commissioner shall establish an adverse health event 563.35 reporting system designed to facilitate quality improvement in 563.36 the health care system. The reporting system shall not be 564.1 designed to punish errors by health care practitioners or health 564.2 care facility employees. 564.3 (b) The reporting system shall consist of: 564.4 (1) mandatory reporting by facilities of 27 adverse health 564.5 care events; 564.6 (2) mandatory completion of a root cause analysis and a 564.7 corrective action plan by the facility and reporting of the 564.8 findings of the analysis and the plan to the commissioner or 564.9 reporting of reasons for not taking corrective action; 564.10 (3) analysis of reported information by the commissioner to 564.11 determine patterns of systemic failure in the health care system 564.12 and successful methods to correct these failures; 564.13 (4) sanctions against facilities for failure to comply with 564.14 reporting system requirements; and 564.15 (5) communication from the commissioner to facilities, 564.16 health care purchasers, and the public to maximize the use of 564.17 the reporting system to improve health care quality. 564.18 (c) Reports, analyses, and corrective action plans 564.19 submitted under section 144.7065, subdivisions 1 and 8, shall be 564.20 considered aggregate data as contemplated by section 145.64, 564.21 subdivision 1, paragraph (b), and afforded the protections and 564.22 immunities provided in section 145.64. 564.23 (d) Nothing in this section shall authorize the 564.24 commissioner to select from or between competing alternative 564.25 medical practices. 564.26 Subd. 2. [DUTY TO ANALYZE REPORTS; COMMUNICATE 564.27 FINDINGS.] The commissioner shall: 564.28 (1) analyze adverse event reports, corrective action plans, 564.29 and the findings of the root cause analyses, to determine 564.30 patterns of systemic failure in the health care system and 564.31 successful methods to correct these failures; 564.32 (2) communicate to individual facilities the commissioner's 564.33 conclusions, if any, regarding an adverse event reported by the 564.34 facility; 564.35 (3) communicate with relevant health care facilities any 564.36 recommendations for corrective action resulting from the 565.1 commissioner's analysis of submissions from facilities; and 565.2 (4) publish an annual report: 565.3 (i) describing, by institution, adverse events reported; 565.4 (ii) outlining, in aggregate, corrective action plans, and 565.5 the findings of the root cause analyses; and 565.6 (iii) making recommendations for modifications of state 565.7 health care operations. 565.8 Subd. 3. [SANCTIONS.] (a) The commissioner shall take 565.9 steps necessary to determine if adverse event reports, the 565.10 findings of the root cause analyses, and corrective action plans 565.11 are filed in a timely manner. The commissioner may sanction a 565.12 facility for: 565.13 (1) failure to file a timely adverse event report under 565.14 section 144.7065, subdivision 1; or 565.15 (2) failure to conduct a root cause analysis, to implement 565.16 a corrective action plan, or to provide the findings of a root 565.17 cause analysis or corrective action plan in a timely fashion 565.18 under section 144.7065, subdivision 8. 565.19 (b) If a facility fails to develop and implement a 565.20 corrective action plan or report to the commissioner why 565.21 corrective action is not needed, the commissioner may suspend, 565.22 revoke, fail to renew, or place conditions on the license under 565.23 which the facility operates. 565.24 [EFFECTIVE DATE.] This section is effective July 1, 2005, 565.25 contingent upon obtaining independent funding. 565.26 Sec. 22. [144.7069] [INTERSTATE COORDINATION; REPORTS.] 565.27 The commissioner shall report the definitions and the list 565.28 of reportable events adopted in this act to the National Quality 565.29 Forum and, working in coordination with the National Quality 565.30 Forum, to the other states. The commissioner shall monitor 565.31 discussions by the National Quality Forum of amendments to the 565.32 forum's list of reportable events and shall report to the 565.33 legislature whenever the list is modified. The commissioner 565.34 shall also monitor implementation efforts in other states to 565.35 establish a list of reportable events and shall make 565.36 recommendations to the legislature as necessary for 566.1 modifications in the Minnesota list or in the other components 566.2 of the Minnesota reporting system to keep the system as nearly 566.3 uniform as possible with similar systems in other states. 566.4 Sec. 23. Minnesota Statutes 2002, section 147A.08, is 566.5 amended to read: 566.6 147A.08 [EXEMPTIONS.] 566.7 (a) This chapter does not apply to, control, prevent, or 566.8 restrict the practice, service, or activities of persons listed 566.9 in section 147.09, clauses (1) to (6) and (8) to (13), persons 566.10 regulated under section 214.01, subdivision 2, or persons 566.11 defined in section144.1495144.1501, subdivision 1, 566.12 paragraphs(a) to (d)(e), (g), and (h). 566.13 (b) Nothing in this chapter shall be construed to require 566.14 registration of: 566.15 (1) a physician assistant student enrolled in a physician 566.16 assistant or surgeon assistant educational program accredited by 566.17 the Committee on Allied Health Education and Accreditation or by 566.18 its successor agency approved by the board; 566.19 (2) a physician assistant employed in the service of the 566.20 federal government while performing duties incident to that 566.21 employment; or 566.22 (3) technicians, other assistants, or employees of 566.23 physicians who perform delegated tasks in the office of a 566.24 physician but who do not identify themselves as a physician 566.25 assistant. 566.26 Sec. 24. Minnesota Statutes 2002, section 148.5194, 566.27 subdivision 1, is amended to read: 566.28 Subdivision 1. [FEE PRORATION.] The commissioner shall 566.29 prorate the registration fee for clinical fellowship, temporary, 566.30 and first time registrants according to the number of months 566.31 that have elapsed between the date registration is issued and 566.32 the date registration expires or must be renewed under section 566.33 148.5191, subdivision 4. 566.34 Sec. 25. Minnesota Statutes 2002, section 148.5194, 566.35 subdivision 2, is amended to read: 566.36 Subd. 2. [BIENNIAL REGISTRATION FEE.] The fee for initial 567.1 registration and biennial registration, clinical fellowship 567.2 registration, temporary registration, or renewal is $200. 567.3 Sec. 26. Minnesota Statutes 2002, section 148.5194, 567.4 subdivision 3, is amended to read: 567.5 Subd. 3. [BIENNIAL REGISTRATION FEE FOR DUAL 567.6 REGISTRATION.] The fee for initial registration and biennial 567.7 registration, clinical fellowship registration, temporary 567.8 registration, or renewal is $200. 567.9 Sec. 27. Minnesota Statutes 2002, section 148.5194, is 567.10 amended by adding a subdivision to read: 567.11 Subd. 6. [VERIFICATION OF CREDENTIAL.] The fee for written 567.12 verification of credentialed status is $25. 567.13 Sec. 28. Minnesota Statutes 2002, section 148.6445, 567.14 subdivision 7, is amended to read: 567.15 Subd. 7. [CERTIFICATIONVERIFICATION TO OTHER STATES.] The 567.16 fee forcertificationverification of licensure to other states 567.17 is $25. 567.18 Sec. 29. [148C.12] [FEES.] 567.19 Subdivision 1. [APPLICATION.] The application fee for a 567.20 license to practice alcohol and drug counseling is $295. 567.21 Subd. 2. [BIENNIAL RENEWAL.] The license renewal fee is 567.22 $295. If the commissioner changes the renewal schedule and the 567.23 expiration date is less than two years, the fee must be prorated. 567.24 Subd. 3. [TEMPORARY PRACTICE STATUS.] The initial fee for 567.25 applicants under section 148C.04, subdivision 6, paragraph (a), 567.26 clause (1), item (i), is $100. The initial fee for applicants 567.27 under section 148C.04, subdivision 6, paragraph (a), clause (1), 567.28 item (ii) or (iii), is the license application fee under 567.29 subdivision 1. The fee for annual renewal of temporary practice 567.30 status is $100. 567.31 Subd. 4. [EXAMINATION.] The examination fee is $95 for the 567.32 written examination and $200 for the oral examination. 567.33 Subd. 5. [INACTIVE RENEWAL.] The inactive renewal fee is 567.34 $150. 567.35 Subd. 6. [LATE FEE.] The late fee is 25 percent of the 567.36 biennial renewal fee, the inactive renewal fee, or the annual 568.1 fee for renewal of temporary practice status. 568.2 Subd. 7. [RENEWAL AFTER EXPIRATION.] The fee for renewal 568.3 of a license that has expired is the total of the biennial 568.4 renewal fee, the late fee, and a fee of $100 for review and 568.5 approval of the continuing education report. 568.6 Subd. 8. [LICENSE VERIFICATION.] The fee for license 568.7 verification to institutions and other jurisdictions is $25. 568.8 Subd. 9. [SURCHARGE.] Notwithstanding section 16A.1285, 568.9 subdivision 2, a surcharge of $172 shall be paid at the time of 568.10 application for or renewal of an alcohol and drug counseling 568.11 license until June 30, 2009. 568.12 Subd. 10. [NONREFUNDABLE FEES.] All fees are nonrefundable. 568.13 Sec. 30. Minnesota Statutes 2002, section 153A.17, is 568.14 amended to read: 568.15 153A.17 [EXPENSES; FEES.] 568.16 The expenses for administering the certification 568.17 requirements including the complaint handling system for hearing 568.18 aid dispensers in sections 153A.14 and 153A.15 and the consumer 568.19 information center under section 153A.18 must be paid from 568.20 initial application and examination fees, renewal fees, 568.21 penalties, and fines. All fees are nonrefundable. The 568.22 certificate application fee is$165 for audiologists registered568.23under section 148.511 and $490 for all others$350, the 568.24 examination fee is$200$250 for the written portion and 568.25$200$250 for the practical portion each time one or the other 568.26 is taken, and the trainee application fee 568.27 is$100$200.Notwithstanding the policy set forth in section568.2816A.1285, subdivision 2, a surcharge of $165 for audiologists568.29registered under section 148.511 and $330 for all others shall568.30be paid at the time of application or renewal until June 30,568.312003, to recover the commissioner's accumulated direct568.32expenditures for administering the requirements of this568.33chapter.The penalty fee for late submission of a renewal 568.34 application is $200. The fee for verification of certification 568.35 to other jurisdictions or entities is $25. All fees, penalties, 568.36 and fines received must be deposited in the state government 569.1 special revenue fund. The commissioner may prorate the 569.2 certification fee for new applicants based on the number of 569.3 quarters remaining in the annual certification period. 569.4 Sec. 31. Minnesota Statutes 2002, section 179A.03, 569.5 subdivision 7, is amended to read: 569.6 Subd. 7. [ESSENTIAL EMPLOYEE.] "Essential employee" means 569.7 firefighters, peace officers subject to licensure under sections 569.8 626.84 to 626.863, 911 system and police and fire department 569.9 public safety dispatchers, guards at correctional facilities, 569.10 confidential employees, supervisory employees, assistant county 569.11 attorneys, assistant city attorneys, principals, and assistant 569.12 principals. However, for state employees, "essential employee" 569.13 means all employees in law enforcement, health care 569.14 professionals, health care nonprofessionals, correctional 569.15 guards, professional engineering, and supervisory collective 569.16 bargaining units, irrespective of severance, and no other 569.17 employees. For University of Minnesota employees, "essential 569.18 employee" means all employees in law enforcement, nursing 569.19 professional and supervisory units, irrespective of severance, 569.20 and no other employees. "Firefighters" means salaried employees 569.21 of a fire department whose duties include, directly or 569.22 indirectly, controlling, extinguishing, preventing, detecting, 569.23 or investigating fires. Employees for whom the state court 569.24 administrator is the negotiating employer are not essential 569.25 employees. 569.26 Sec. 32. Minnesota Statutes 2002, section 295.55, 569.27 subdivision 2, is amended to read: 569.28 Subd. 2. [ESTIMATED TAX; HOSPITALS; SURGICAL CENTERS.] (a) 569.29 Each hospital or surgical center must make estimated payments of 569.30 the taxes for the calendar year in monthly installments to the 569.31 commissioner within 15 days after the end of the month. 569.32 (b) Estimated tax payments are not required of hospitals or 569.33 surgical centers if: (1) the tax for the current calendar year 569.34 is less than $500; or (2) the tax for the previous calendar year 569.35 is less than $500, if the taxpayer had a tax liability and was 569.36 doing business the entire year; or (3) if a hospital has been570.1allowed a grant under section 144.1484, subdivision 2, for the570.2year. 570.3 (c) Underpayment of estimated installments bear interest at 570.4 the rate specified in section 270.75, from the due date of the 570.5 payment until paid or until the due date of the annual return 570.6 whichever comes first. An underpayment of an estimated 570.7 installment is the difference between the amount paid and the 570.8 lesser of (1) 90 percent of one-twelfth of the tax for the 570.9 calendar year or (2) one-twelfth of the total tax for the 570.10 previous calendar year if the taxpayer had a tax liability and 570.11 was doing business the entire year. 570.12 Sec. 33. Minnesota Statutes 2002, section 326.42, is 570.13 amended to read: 570.14 326.42 [APPLICATIONS, FEES.] 570.15 Subdivision 1. [APPLICATION.] Applications for plumber's 570.16 license shall be made to the state commissioner of health, with 570.17 fee. Unless the applicant is entitled to a renewal, the 570.18 applicant shall be licensed by the state commissioner of health 570.19 only after passing a satisfactory examination by the examiners 570.20 showing fitness. Examination fees for both journeyman and 570.21 master plumbers shall be in an amount prescribed by the state 570.22 commissioner of health pursuant to section 144.122. Upon being 570.23 notified that of having successfully passed the examination for 570.24 original license the applicant shall submit an application, with 570.25 the license fee herein provided. License fees shall be in an 570.26 amount prescribed by the state commissioner of health pursuant 570.27 to section 144.122. Licenses shall expire and be renewed as 570.28 prescribed by the commissioner pursuant to section 144.122. 570.29 Subd. 2. [FEES.] Plumbing system plans and specifications 570.30 that are submitted to the commissioner for review shall be 570.31 accompanied by the appropriate plan examination fees. If the 570.32 commissioner determines, upon review of the plans, that 570.33 inadequate fees were paid, the necessary additional fees shall 570.34 be paid prior to plan approval. The commissioner shall charge 570.35 the following fees for plan reviews and audits of plumbing 570.36 installations for public, commercial, and industrial buildings: 571.1 (1) systems with both water distribution and drain, waste, 571.2 and vent systems and having: 571.3 (i) 25 or fewer drainage fixture units, $150; 571.4 (ii) 26 to 50 drainage fixture units, $250; 571.5 (iii) 51 to 150 drainage fixture units, $350; 571.6 (iv) 151 to 249 drainage fixture units, $500; 571.7 (v) 250 or more drainage fixture units, $3 per drainage 571.8 fixture unit to a maximum of $4,000; and 571.9 (vi) interceptors, separators, or catch basins, $70 per 571.10 interceptor, separator, or catch basin; 571.11 (2) building sewer service only, $150; 571.12 (3) building water service only, $150; 571.13 (4) building water distribution system only, no drainage 571.14 system, $5 per supply fixture unit or $150, whichever is 571.15 greater; 571.16 (5) storm drainage system, a minimum fee of $150 or: 571.17 (i) $50 per drain opening, up to a maximum of $500; and 571.18 (ii) $70 per interceptor, separator, or catch basin; 571.19 (6) manufactured home park or campground, 1 to 25 sites, 571.20 $300; 571.21 (7) manufactured home park or campground, 26 to 50 sites, 571.22 $350; 571.23 (8) manufactured home park or campground, 51 to 125 sites, 571.24 $400; 571.25 (9) manufactured home park or campground, more than 125 571.26 sites, $500; 571.27 (10) accelerated review, double the regular fee, one-half 571.28 to be refunded if no response from the commissioner within 15 571.29 business days; and 571.30 (11) revision to previously reviewed or incomplete plans: 571.31 (i) review of plans for which commissioner has issued two 571.32 or more requests for additional information, per review, $100 or 571.33 ten percent of the original fee, whichever is greater; 571.34 (ii) proposer-requested revision with no increase in 571.35 project scope, $50 or ten percent of original fee, whichever is 571.36 greater; and 572.1 (iii) proposer-requested revision with an increase in 572.2 project scope, $50 plus the difference between the original 572.3 project fee and the revised project fee. 572.4 Sec. 34. [AUTHORITY TO COLLECT CERTAIN FEES SUSPENDED.] 572.5 (a) The commissioner's authority to collect the certificate 572.6 application fee from hearing instrument dispensers under 572.7 Minnesota Statutes, section 153A.17, is suspended for certified 572.8 hearing instrument dispensers renewing certification in fiscal 572.9 year 2004. 572.10 (b) The commissioner's authority to collect the license 572.11 renewal fee from occupational therapy practitioners under 572.12 Minnesota Statutes, section 148.6445, subdivision 2, is 572.13 suspended for fiscal years 2004 and 2005. 572.14 Sec. 35. [TRANSITION PERIOD.] 572.15 From July 1, 2003, through June 30, 2005, facilities are 572.16 required to report any adverse health care events as defined in 572.17 Minnesota Statutes, section 144.7067, to the incident reporting 572.18 system currently maintained by the Minnesota Hospital 572.19 Association. The commissioner of health will work with the 572.20 Minnesota Hospital Association to obtain access to, or receive 572.21 reports of, adverse health care events by category only. The 572.22 commissioner will not receive any identifying information from 572.23 such access or reports. The commissioner will work with 572.24 organizations and experts familiar with patient safety to review 572.25 reporting categories in Minnesota Statutes, section 144.7067, 572.26 and will monitor discussions of the National Quality Forum, 572.27 other states and the federal government in the area of patient 572.28 safety. The commissioner of health will submit reports to the 572.29 legislature by January 15, 2004, and January 15, 2005, including 572.30 a listing of the number of reported events by type and 572.31 recommendations, if any, of additional categories of events that 572.32 should be included. From July 1, 2003, through June 30, 2005, 572.33 the department of health shall not make a final disposition as 572.34 defined in Minnesota Statutes, section 626.5572, subdivision 8, 572.35 for investigations conducted in licensed hospitals under the 572.36 provisions of Minnesota Statutes, section 626.557. The 573.1 department of health's findings in these cases shall identify 573.2 noncompliance with federal certification or state licensure 573.3 rules or laws. From July 1, 2003, through June 30, 2005, the 573.4 commissioner will solicit funds to provide for full 573.5 implementation of the Minnesota Adverse Health Care Reporting 573.6 Act of 2003 on a pilot or demonstration basis. If funds are 573.7 available, the commissioner will advise the legislature and 573.8 recommend full implementation of the Act on an earlier date. 573.9 [EFFECTIVE DATE.] This section is effective to the extent 573.10 independent funds are obtained. 573.11 Sec. 36. [HOSPITAL MORATORIUM STUDY.] 573.12 (a) Utilizing existing resources, the commissioner of 573.13 health, working with the Minnesota Hospital Association and 573.14 other affected parties, shall study and report to the 573.15 legislature by January 1, 2005, on the moratorium on hospital 573.16 beds. The study and report shall: 573.17 (1) evaluate the moratorium's impact on access, cost, and 573.18 quality of care; 573.19 (2) recommend appropriate criteria to be considered by the 573.20 legislature in judging applications for moratorium exceptions; 573.21 (3) assess the impact of "niche" and ambulatory services on 573.22 a system of controlling capacity; 573.23 (4) identify demographic and health care delivery changes 573.24 that have occurred since the inception of the moratorium, 573.25 projected future trends in technology, and their impact on 573.26 future inpatient hospitals' utilization and future demand for 573.27 inpatient services; and 573.28 (5) include a comprehensive national survey of inpatient 573.29 and outpatient capacity controls. 573.30 (b) As an outcome of the study, the commissioner shall 573.31 recommend: 573.32 (1) criteria for judging exception requests; 573.33 (2) processes to be used in considering exception requests; 573.34 and 573.35 (3) other changes in the moratorium law needed to work with 573.36 future trends and demographic changes. 574.1 (c) A progress report shall be presented to the legislature 574.2 by March 15, 2004. 574.3 Sec. 37. [REVISOR'S INSTRUCTION.] 574.4 (a) The revisor of statutes shall delete the reference to 574.5 "144.1495" in Minnesota Statutes, section 62Q.145, and insert 574.6 "144.1501." 574.7 (b) For sections in Minnesota Statutes and Minnesota Rules 574.8 affected by the repealed sections in this article, the revisor 574.9 shall delete internal cross-references where appropriate and 574.10 make changes necessary to correct the punctuation, grammar, or 574.11 structure of the remaining text and preserve its meaning. 574.12 Sec. 38. [REPEALER; EXPENDITURE REPORTING.] 574.13 Minnesota Statutes 2002, sections 16A.151, subdivision 5, 574.14 and 62J.17, are repealed effective the day following final 574.15 enactment. Notwithstanding the repeal of section 62J.17, any 574.16 prospective review imposed on a provider for violation of 574.17 section 62J.17 shall continue until its scheduled expiration. 574.18 Sec. 39. [REPEALER.] 574.19 (a) Minnesota Statutes 2002, sections 16A.87; 62J.694; 574.20 144.126; 144.1484; 144.1494; 144.1495; 144.1496; 144.1497; 574.21 144.395; 144.396; 144A.36; 144A.38; 148.5194, subdivision 3a; 574.22 and 148.6445, subdivision 9, are repealed. 574.23 (b) Minnesota Rules, parts 4763.0100; 4763.0110; 4763.0125; 574.24 4763.0135; 4763.0140; 4763.0150; 4763.0160; 4763.0170; 574.25 4763.0180; 4763.0190; 4763.0205; 4763.0215; 4763.0220; 574.26 4763.0230; 4763.0240; 4763.0250; 4763.0260; 4763.0270; 574.27 4763.0285; 4763.0295; and 4763.0300, are repealed. 574.28 ARTICLE 9 574.29 LOCAL PUBLIC HEALTH GRANTS 574.30 Section 1. Minnesota Statutes 2002, section 144E.11, 574.31 subdivision 6, is amended to read: 574.32 Subd. 6. [REVIEW CRITERIA.] When reviewing an application 574.33 for licensure, the board and administrative law judge shall 574.34 consider the following factors: 574.35 (1)the relationship of the proposed service or expansion574.36in primary service area to the current community health plan as575.1approved by the commissioner of health under section 145A.12,575.2subdivision 4;575.3(2)the recommendations or comments of the governing bodies 575.4 of the counties, municipalities, community health boards as 575.5 defined under section 145A.09, subdivision 2, and regional 575.6 emergency medical services system designated under section 575.7 144E.50 in which the service would be provided; 575.8(3)(2) the deleterious effects on the public health from 575.9 duplication, if any, of ambulance services that would result 575.10 from granting the license; 575.11(4)(3) the estimated effect of the proposed service or 575.12 expansion in primary service area on the public health; and 575.13(5)(4) whether any benefit accruing to the public health 575.14 would outweigh the costs associated with the proposed service or 575.15 expansion in primary service area. The administrative law judge 575.16 shall recommend that the board either grant or deny a license or 575.17 recommend that a modified license be granted. The reasons for 575.18 the recommendation shall be set forth in detail. The 575.19 administrative law judge shall make the recommendations and 575.20 reasons available to any individual requesting them. 575.21 Sec. 2. Minnesota Statutes 2002, section 145.88, is 575.22 amended to read: 575.23 145.88 [PURPOSE.] 575.24The legislature finds that it is in the public interest to575.25assure:575.26(a) statewide planning and coordination of maternal and575.27child health services through the acquisition and analysis of575.28population-based health data, provision of technical support and575.29training, and coordination of the various public and private575.30maternal and child health efforts; and575.31(b) support for targeted maternal and child health services575.32in communities with significant populations of high risk, low575.33income families through a grants process.575.34 Federal money received by the Minnesota department of 575.35 health, pursuant to United States Code, title 42, sections 701 575.36 to 709, shall be expended to: 576.1 (1) assure access to quality maternal and child health 576.2 services for mothers and children, especially those of low 576.3 income and with limited availability to health services and 576.4 those children at risk of physical, neurological, emotional, and 576.5 developmental problems arising from chemical abuse by a mother 576.6 during pregnancy; 576.7 (2) reduce infant mortality and the incidence of 576.8 preventable diseases and handicapping conditions among children; 576.9 (3) reduce the need for inpatient and long-term care 576.10 services and to otherwise promote the health of mothers and 576.11 children, especially by providing preventive and primary care 576.12 services for low-income mothers and children and prenatal, 576.13 delivery and postpartum care for low-income mothers; 576.14 (4) provide rehabilitative services for blind and disabled 576.15 children under age 16 receiving benefits under title XVI of the 576.16 Social Security Act; and 576.17 (5) provide and locate medical, surgical, corrective and 576.18 other service for children who are crippled or who are suffering 576.19 from conditions that lead to crippling. 576.20 Sec. 3. Minnesota Statutes 2002, section 145.881, 576.21 subdivision 2, is amended to read: 576.22 Subd. 2. [DUTIES.] The advisory task force shall meet on a 576.23 regular basis to perform the following duties: 576.24 (a) review and report on the health care needs of mothers 576.25 and children throughout the state of Minnesota; 576.26 (b) review and report on the type, frequency and impact of 576.27 maternal and child health care services provided to mothers and 576.28 children under existing maternal and child health care programs, 576.29 including programs administered by the commissioner of health; 576.30 (c) establish, review, and report to the commissioner a 576.31 list of program guidelines and criteria which the advisory task 576.32 force considers essential to providing an effective maternal and 576.33 child health care program to low income populations and high 576.34 risk persons and fulfilling the purposes defined in section 576.35 145.88; 576.36 (d)review staff recommendations of the department of577.1health regarding maternal and child health grant awards before577.2the awards are made;577.3(e)make recommendations to the commissioner for the use of 577.4 other federal and state funds available to meet maternal and 577.5 child health needs; 577.6(f)(e) make recommendations to the commissioner of health 577.7 on priorities for funding the following maternal and child 577.8 health services: (1) prenatal, delivery and postpartum care, (2) 577.9 comprehensive health care for children, especially from birth 577.10 through five years of age, (3) adolescent health services, (4) 577.11 family planning services, (5) preventive dental care, (6) 577.12 special services for chronically ill and handicapped children 577.13 and (7) any other services which promote the health of mothers 577.14 and children; and 577.15(g) make recommendations to the commissioner of health on577.16the process to distribute, award and administer the maternal and577.17child health block grant funds; and577.18(h) review the measures that are used to define the577.19variables of the funding distribution formula in section577.20145.882, subdivision 4, every two years and make recommendations577.21to the commissioner of health for changes based upon principles577.22established by the advisory task force for this purpose.577.23 (f) establish, in consultation with the commissioner and 577.24 the state community health advisory committee established under 577.25 section 145A.10, subdivision 10, paragraph (a), statewide 577.26 outcomes that will improve the health status of mothers and 577.27 children as required in section 145A.12, subdivision 7. 577.28 Sec. 4. Minnesota Statutes 2002, section 145.882, 577.29 subdivision 1, is amended to read: 577.30 Subdivision 1. [FUNDINGLEVELS AND ADVISORY TASK FORCE577.31REVIEW.] Any decrease in the amount of federal funding to the 577.32 state for the maternal and child health block grant must be 577.33 apportioned to reflect a proportional decrease for each 577.34 recipient. Any increase in the amount of federal funding to the 577.35 state must be distributed under subdivisions 2,and 3, and 4. 577.36The advisory task force shall review and recommend the578.1proportion of maternal and child health block grant funds to be578.2expended for indirect costs, direct services and special578.3projects.578.4 Sec. 5. Minnesota Statutes 2002, section 145.882, 578.5 subdivision 2, is amended to read: 578.6 Subd. 2. [ALLOCATION TO THE COMMISSIONER OF HEALTH.] 578.7 Beginning January 1, 1986, up to one-third of the total maternal 578.8 and child health block grant money may be retained by the 578.9 commissioner of healthfor administrative and technical578.10assistance services, projects of regional or statewide578.11significance, direct services to children with handicaps, and578.12other activities of the commissioner.to: 578.13 (1) meet federal maternal and child block grant 578.14 requirements of a statewide needs assessment every five years 578.15 and prepare the annual federal block grant application and 578.16 report; 578.17 (2) collect and disseminate statewide data on the health 578.18 status of mothers and children within one year of the end of the 578.19 year; 578.20 (3) provide technical assistance to community health boards 578.21 in meeting statewide outcomes under section 145A.12, subdivision 578.22 7; 578.23 (4) evaluate the impact of maternal and child health 578.24 activities on the health status of mothers and children; 578.25 (5) provide services to children under age 16 receiving 578.26 benefits under title XVI of the Social Security Act; and 578.27 (6) perform other maternal and child health activities 578.28 listed in section 145.88 and as deemed necessary by the 578.29 commissioner. 578.30 Sec. 6. Minnesota Statutes 2002, section 145.882, 578.31 subdivision 3, is amended to read: 578.32 Subd. 3. [ALLOCATION TO COMMUNITY HEALTHSERVICES578.33AREASBOARDS.](a)The maternal and child health block grant 578.34 money remaining after distributions made under subdivision 2 578.35 must be allocated according to the formula insubdivision 4 to578.36community health services areassection 145A.131, subdivision 2, 579.1 for distributionbyto community health boards.as defined in579.2section 145A.02, subdivision 5, to qualified programs that579.3provide essential services within the community health services579.4area as long as:579.5(1) the Minneapolis community health service area is579.6allocated at least $1,626,215 per year;579.7(2) the St. Paul community health service area is allocated579.8at least $822,931 per year; and579.9(3) all other community health service areas are allocated579.10at least $30,000 per county per year or their 1988-1989 funding579.11cycle award, whichever is less.579.12(b) Notwithstanding paragraph (a), if the total amount of579.13maternal and child health block grant funding decreases, the579.14decrease must be apportioned to reflect a proportional decrease579.15for each recipient, including recipients who would otherwise579.16receive a guaranteed minimum allocation under paragraph (a).579.17 Sec. 7. Minnesota Statutes 2002, section 145.882, is 579.18 amended by adding a subdivision to read: 579.19 Subd. 5a. [NONPARTICIPATING COMMUNITY HEALTH BOARDS.] If a 579.20 community health board decides not to participate in maternal 579.21 and child health block grant activities under subdivision 3 or 579.22 the commissioner determines under section 145A.131, subdivision 579.23 7, not to fund the community health board, the commissioner is 579.24 responsible for directing maternal and child health block grant 579.25 activities in that community health board's geographic area. 579.26 The commissioner may elect to directly provide public health 579.27 activities to meet the statewide outcomes or to contract with 579.28 other governmental units or nonprofit organizations. 579.29 Sec. 8. Minnesota Statutes 2002, section 145.882, 579.30 subdivision 7, is amended to read: 579.31 Subd. 7. [USE OF BLOCK GRANT MONEY.](a)Maternal and 579.32 child health block grant money allocated to a community health 579.33 boardor community health services areaunder this section must 579.34 be used for qualified programs for high risk and low-income 579.35 individuals. Block grant money must be used for programs that: 579.36 (1) specifically address the highest risk populations, 580.1 particularly low-income and minority groups with a high rate of 580.2 infant mortality and children with low birth weight, by 580.3 providing services, including prepregnancy family planning 580.4 services, calculated to produce measurable decreases in infant 580.5 mortality rates, instances of children with low birth weight, 580.6 and medical complications associated with pregnancy and 580.7 childbirth, including infant mortality, low birth rates, and 580.8 medical complications arising from chemical abuse by a mother 580.9 during pregnancy; 580.10 (2) specifically target pregnant women whose age, medical 580.11 condition, maternal history, or chemical abuse substantially 580.12 increases the likelihood of complications associated with 580.13 pregnancy and childbirth or the birth of a child with an 580.14 illness, disability, or special medical needs; 580.15 (3) specifically address the health needs of young children 580.16 who have or are likely to have a chronic disease or disability 580.17 or special medical needs, including physical, neurological, 580.18 emotional, and developmental problems that arise from chemical 580.19 abuse by a mother during pregnancy; 580.20 (4) provide family planning and preventive medical care for 580.21 specifically identified target populations, such as minority and 580.22 low-income teenagers, in a manner calculated to decrease the 580.23 occurrence of inappropriate pregnancy and minimize the risk of 580.24 complications associated with pregnancy and childbirth;or580.25 (5) specifically address the frequency and severity of 580.26 childhood and adolescent health issues, including injuries in 580.27 high risk target populations by providing services calculated to 580.28 produce measurable decreases in mortality and morbidity.; 580.29However, money may be used for this purpose only if the580.30community health board's application includes program components580.31for the purposes in clauses (1) to (4) in the proposed580.32geographic service area and the total expenditure for580.33injury-related programs under this clause does not exceed ten580.34percent of the total allocation under subdivision 3.580.35(b) Maternal and child health block grant money may be used580.36for purposes other than the purposes listed in this subdivision581.1only under the following conditions:581.2(1) the community health board or community health services581.3area can demonstrate that existing programs fully address the581.4needs of the highest risk target populations described in this581.5subdivision; or581.6(2) the money is used to continue projects that received581.7funding before creation of the maternal and child health block581.8grant in 1981.581.9(c) Projects that received funding before creation of the581.10maternal and child health block grant in 1981, must be allocated581.11at least the amount of maternal and child health special project581.12grant funds received in 1989, unless (1) the local board of581.13health provides equivalent alternative funding for the project581.14from another source; or (2) the local board of health581.15demonstrates that the need for the specific services provided by581.16the project has significantly decreased as a result of changes581.17in the demographic characteristics of the population, or other581.18factors that have a major impact on the demand for services. If581.19the amount of federal funding to the state for the maternal and581.20child health block grant is decreased, these projects must581.21receive a proportional decrease as required in subdivision 1.581.22Increases in allocation amounts to local boards of health under581.23subdivision 4 may be used to increase funding levels for these581.24projects.581.25 (6) specifically address preventing child abuse and 581.26 neglect, reducing juvenile delinquency, promoting positive 581.27 parenting and resiliency in children, and promoting family 581.28 health and economic sufficiency through public health nurse home 581.29 visits under section 145A.17; or 581.30 (7) specifically address nutritional issues of women, 581.31 infants, and young children through WIC clinic services. 581.32 Sec. 9. [145.8821] [ACCOUNTABILITY.] 581.33 (a) Coordinating with the statewide outcomes established 581.34 under section 145A.12, subdivision 7, and with accountability 581.35 measures outlined in section 145A.131, subdivision 7, each 581.36 community health board that receives money under section 582.1 145.882, subdivision 3, shall select by February 1, 2005, and 582.2 every five years thereafter, up to two statewide maternal and 582.3 child health outcomes. 582.4 (b) For the period January 1, 2004, to December 31, 2005, 582.5 each community health board must work toward the Healthy People 582.6 2010 goal to reduce the state's percentage of low birth weight 582.7 infants. 582.8 (c) The commissioner shall monitor and evaluate whether 582.9 each community health board has made sufficient progress toward 582.10 the selected outcomes established in paragraph (b) and under 582.11 section 145A.12, subdivision 7. 582.12 (d) Community health boards shall provide the commissioner 582.13 with annual information necessary to evaluate progress toward 582.14 selected statewide outcomes and to meet federal reporting 582.15 requirements. 582.16 Sec. 10. Minnesota Statutes 2002, section 145.883, 582.17 subdivision 1, is amended to read: 582.18 Subdivision 1. [SCOPE.] For purposes of sections 145.881 582.19 to145.888145.883, the terms defined in this section shall have 582.20 the meanings given them. 582.21 Sec. 11. Minnesota Statutes 2002, section 145.883, 582.22 subdivision 9, is amended to read: 582.23 Subd. 9. [COMMUNITY HEALTHSERVICES AREABOARD.] 582.24 "Community healthservices areaboard" meansa city, county, or582.25multicounty area that is organized as a community health board582.26under section 145A.09 and for which a state subsidy is received582.27under sections 145A.09 to 145A.13a board of health established, 582.28 operating, and eligible for a local public health grant under 582.29 sections 145A.09 to 145A.131. 582.30 Sec. 12. Minnesota Statutes 2002, section 145A.02, 582.31 subdivision 5, is amended to read: 582.32 Subd. 5. [COMMUNITY HEALTH BOARD.] "Community health 582.33 board" means a board of health established, operating, and 582.34 eligible for asubsidylocal public health grant under sections 582.35 145A.09 to145A.13145A.131. 582.36 Sec. 13. Minnesota Statutes 2002, section 145A.02, 583.1 subdivision 6, is amended to read: 583.2 Subd. 6. [COMMUNITY HEALTH SERVICES.] "Community health 583.3 services" means activities designed to protect and promote the 583.4 health of the general population within a community health 583.5 service area by emphasizing the prevention of disease, injury, 583.6 disability, and preventable death through the promotion of 583.7 effective coordination and use of community resources, and by 583.8 extending health services into the community.Program583.9categories of community health services include disease583.10prevention and control, emergency medical care, environmental583.11health, family health, health promotion, and home health care.583.12 Sec. 14. Minnesota Statutes 2002, section 145A.02, 583.13 subdivision 7, is amended to read: 583.14 Subd. 7. [COMMUNITY HEALTH SERVICE AREA.] "Community 583.15 health service area" means a city, county, or multicounty area 583.16 that is organized as a community health board under section 583.17 145A.09 and for which asubsidylocal public health grant is 583.18 received under sections 145A.09 to145A.13145A.131. 583.19 Sec. 15. Minnesota Statutes 2002, section 145A.06, 583.20 subdivision 1, is amended to read: 583.21 Subdivision 1. [GENERALLY.] In addition to other powers 583.22 and duties provided by law, the commissioner has the powers 583.23 listed in subdivisions 2 to45. 583.24 Sec. 16. Minnesota Statutes 2002, section 145A.09, 583.25 subdivision 2, is amended to read: 583.26 Subd. 2. [COMMUNITY HEALTH BOARD; ELIGIBILITY.] A board of 583.27 health that meets the requirements of sections 145A.09 583.28 to145A.13145A.131 is a community health board and is eligible 583.29 for acommunity health subsidylocal public health grant under 583.30 section145A.13145A.131. 583.31 Sec. 17. Minnesota Statutes 2002, section 145A.09, 583.32 subdivision 4, is amended to read: 583.33 Subd. 4. [CITIES.] A city that received a subsidy under 583.34 section 145A.13 and that meets the requirements of sections 583.35 145A.09 to145A.13145A.131 is eligible for acommunity health583.36subsidylocal public health grant under section 584.1145A.13145A.131. 584.2 Sec. 18. Minnesota Statutes 2002, section 145A.09, 584.3 subdivision 7, is amended to read: 584.4 Subd. 7. [WITHDRAWAL.] (a) A county or city that has 584.5 established or joined a community health board may withdraw from 584.6 thesubsidylocal public health grant program authorized by 584.7 sections 145A.09 to145A.13145A.131 by resolution of its 584.8 governing body in accordance with section 145A.03, subdivision 584.9 3, and this subdivision. 584.10 (b) A county or city may not withdraw from a joint powers 584.11 community health board during the first two calendar years 584.12 following that county's or city's initial adoption of the joint 584.13 powers agreement. 584.14 (c) The withdrawal of a county or city from a community 584.15 health board does not affect the eligibility for thecommunity584.16health subsidylocal public health grant of any remaining county 584.17 or city for one calendar year following the effective date of 584.18 withdrawal. 584.19 (d)The amount of additional annual payment for calendar584.20year 1985 made pursuant to Minnesota Statutes 1984, section584.21145.921, subdivision 4, must be subtracted from the subsidy for584.22a county that, due to withdrawal from a community health board,584.23ceases to meet the terms and conditions under which that584.24additional annual payment was madeThe local public health grant 584.25 for a county that chooses to withdraw from a multicounty 584.26 community health board shall be reduced by the amount of the 584.27 local partnership incentive under section 145A.131, subdivision 584.28 2, paragraph (c). 584.29 Sec. 19. Minnesota Statutes 2002, section 145A.10, 584.30 subdivision 2, is amended to read: 584.31 Subd. 2. [PREEMPTION.] (a) Not later than 365 days after 584.32 theapproval of a community health plan by the584.33commissionerformation of a community health board, any other 584.34 board of health within the community health service area for 584.35 which the plan has been prepared must cease operation, except as 584.36 authorized in a joint powers agreement under section 145A.03, 585.1 subdivision 2, or delegation agreement under section 145A.07, 585.2 subdivision 2, or as otherwise allowed by this subdivision. 585.3 (b) This subdivision does not preempt or otherwise change 585.4 the powers and duties of any city or county eligible forsubsidy585.5 a local public health grant under section 145A.09. 585.6 (c) This subdivision does not preempt the authority to 585.7 operate a community health services program of any city of the 585.8 first or second class operating an existing program of community 585.9 health services located within a county with a population of 585.10 300,000 or more persons until the city council takes action to 585.11 allow the county to preempt the city's powers and duties. 585.12 Sec. 20. Minnesota Statutes 2002, section 145A.10, is 585.13 amended by adding a subdivision to read: 585.14 Subd. 5a. [DUTIES.] (a) Consistent with the guidelines and 585.15 standards established under section 145A.12, and with input from 585.16 the community, the community health board shall: 585.17 (1) establish local public health priorities based on an 585.18 assessment of community health needs and assets; and 585.19 (2) determine the mechanisms by which the community health 585.20 board will address the local public health priorities 585.21 established under clause (1) and achieve the statewide outcomes 585.22 established under sections 145.8821 and 145A.12, subdivision 7, 585.23 within the limits of available funding. In determining the 585.24 mechanisms to address local public health priorities and achieve 585.25 statewide outcomes, the community health board shall seek public 585.26 input or consider the recommendations of the community health 585.27 advisory committee and the following essential public health 585.28 services: 585.29 (i) monitor health status to identify community health 585.30 problems; 585.31 (ii) diagnose and investigate problems and health hazards 585.32 in the community; 585.33 (iii) inform, educate, and empower people about health 585.34 issues; 585.35 (iv) mobilize community partnerships to identify and solve 585.36 health problems; 586.1 (v) develop policies and plans that support individual and 586.2 community health efforts; 586.3 (vi) enforce laws and regulations that protect health and 586.4 ensure safety; 586.5 (vii) link people to needed personal health care services; 586.6 (viii) ensure a competent public health and personal health 586.7 care workforce; 586.8 (ix) evaluate effectiveness, accessibility, and quality of 586.9 personal and population-based health services; and 586.10 (x) research for new insights and innovative solutions to 586.11 health problems. 586.12 (b) By February 1, 2005, and every five years thereafter, 586.13 each community health board that receives a local public health 586.14 grant under section 145A.131 shall notify the commissioner in 586.15 writing of the statewide outcomes established under sections 586.16 145.8821 and 145A.12, subdivision 7, that the board will address 586.17 and the local priorities established under paragraph (a) that 586.18 the board will address. 586.19 (c) Each community health board receiving a local public 586.20 health grant under section 145A.131 must submit an annual report 586.21 to the commissioner documenting progress towards the achievement 586.22 of statewide outcomes established under sections 145.8821 and 586.23 145A.12, subdivision 7, and the local public health priorities 586.24 established under paragraph (a), using reporting standards and 586.25 procedures established by the commissioner and in compliance 586.26 with all applicable federal requirements. If a community health 586.27 board has identified additional local priorities for use of the 586.28 local public health grant since the last notification of 586.29 outcomes and priorities under paragraph (b), the community 586.30 health board shall notify the commissioner of the additional 586.31 local public health priorities in the annual report. 586.32 Sec. 21. Minnesota Statutes 2002, section 145A.10, 586.33 subdivision 10, is amended to read: 586.34 Subd. 10. [STATE AND LOCAL ADVISORY COMMITTEES.] (a) A 586.35 state community health advisory committee is established to 586.36 advise, consult with, and make recommendations to the 587.1 commissioner on the development, maintenance, funding, and 587.2 evaluation of community health services. Each community health 587.3 board may appoint a member to serve on the committee. The 587.4 committee must meet at least quarterly, and special meetings may 587.5 be called by the committee chair or a majority of the members. 587.6 Members or their alternates mayreceive a per diem and mustbe 587.7 reimbursed for travel and other necessary expenses while engaged 587.8 in their official duties. 587.9 (b) The city councils or county boards that have 587.10 established or are members of a community health boardmustmay 587.11 appoint a community health advisory committee to advise, consult 587.12 with, and make recommendations to the community health board on 587.13matters relating to the development, maintenance, funding, and587.14evaluation of community health services. The committee must587.15consist of at least five members and must be generally587.16representative of the population and health care providers of587.17the community health service area. The committee must meet at587.18least three times a year and at the call of the chair or a587.19majority of the members. Members may receive a per diem and587.20reimbursement for travel and other necessary expenses while587.21engaged in their official duties.587.22(c) State and local advisory committees must adopt bylaws587.23or operating procedures that specify the length of terms of587.24membership, procedures for assuring that no more than half of587.25these terms expire during the same year, and other matters587.26relating to the conduct of committee business. Bylaws or587.27operating procedures may allow one alternate to be appointed for587.28each member of a state or local advisory committee. Alternates587.29may be given full or partial powers and duties of membersthe 587.30 duties under subdivision 5a. 587.31 Sec. 22. Minnesota Statutes 2002, section 145A.11, 587.32 subdivision 2, is amended to read: 587.33 Subd. 2. [CONSIDERATION OFCOMMUNITY HEALTH PLANLOCAL 587.34 PUBLIC HEALTH PRIORITIES AND STATEWIDE OUTCOMES IN TAX LEVY.] In 587.35 levying taxes authorized under section 145A.08, subdivision 3, a 587.36 city council or county board that has formed or is a member of a 588.1 community health board must consider the income and expenditures 588.2 required to meetthe objectives of the community health plan for588.3its arealocal public health priorities established under 588.4 section 145A.10, subdivision 5a, and statewide outcomes 588.5 established under section 145A.12, subdivision 7. 588.6 Sec. 23. Minnesota Statutes 2002, section 145A.11, 588.7 subdivision 4, is amended to read: 588.8 Subd. 4. [ORDINANCES RELATING TO COMMUNITY HEALTH 588.9 SERVICES.] A city council or county board that has established 588.10 or is a member of a community health board may by ordinance 588.11 adopt and enforce minimum standards for services provided 588.12 according to sections 145A.02 and 145A.10, subdivision 5. An 588.13 ordinance must not conflict with state law or with more 588.14 stringent standards established either by rule of an agency of 588.15 state government or by the provisions of the charter or 588.16 ordinances of any city organized under section 145A.09, 588.17 subdivision 4. 588.18 Sec. 24. Minnesota Statutes 2002, section 145A.12, 588.19 subdivision 1, is amended to read: 588.20 Subdivision 1. [ADMINISTRATIVE AND PROGRAM SUPPORT.] The 588.21 commissioner must assist community health boards in the 588.22 development, administration, and implementation of community 588.23 health services. This assistance may consist of but is not 588.24 limited to: 588.25 (1) informational resources, consultation, and training to 588.26 help community health boards plan, develop, integrate, provide 588.27 and evaluate community health services; and 588.28 (2) administrative and program guidelines and standards, 588.29 developed with the advice of the state community health advisory 588.30 committee.Adoption of these guidelines by a community health588.31board is not a prerequisite for plan approval as prescribed in588.32subdivision 4.588.33 Sec. 25. Minnesota Statutes 2002, section 145A.12, 588.34 subdivision 2, is amended to read: 588.35 Subd. 2. [PERSONNEL STANDARDS.] In accordance with chapter 588.36 14, and in consultation with the state community health advisory 589.1 committee, the commissioner may adopt rules to set standards for 589.2 administrative and program personnel to ensure competence in 589.3 administration and planningand in each program area defined in589.4section 145A.02. 589.5 Sec. 26. Minnesota Statutes 2002, section 145A.12, is 589.6 amended by adding a subdivision to read: 589.7 Subd. 7. [STATEWIDE OUTCOMES.] (a) The commissioner, in 589.8 consultation with the state community health advisory committee 589.9 established under section 145A.10, subdivision 10, paragraph 589.10 (a), shall establish statewide outcomes for local public health 589.11 grant funds allocated to community health boards between January 589.12 1, 2004, and December 31, 2005. 589.13 (b) At least one statewide outcome must be established in 589.14 each of the following public health areas: 589.15 (1) preventing diseases; 589.16 (2) protecting against environmental hazards; 589.17 (3) preventing injuries; 589.18 (4) promoting healthy behavior; 589.19 (5) responding to disasters; and 589.20 (6) ensuring access to health services. 589.21 (c) The commissioner shall use Minnesota's public health 589.22 goals established under section 62J.212 and the essential public 589.23 health services under section 145A.10, subdivision 5a, as a 589.24 basis for the development of statewide outcomes. 589.25 (d) The statewide maternal and child health outcomes 589.26 established under section 145.8821 shall be included as 589.27 statewide outcomes under this section. 589.28 (e) By December 31, 2004, and every five years thereafter, 589.29 the commissioner, in consultation with the state community 589.30 health advisory committee established under section 145A.10, 589.31 subdivision 10, paragraph (a), and the maternal and child health 589.32 advisory task force established under section 145.881, shall 589.33 develop statewide outcomes for the local public health grant 589.34 established under section 145A.131, based on state and local 589.35 assessment data regarding the health of Minnesota residents, the 589.36 essential public health services under section 145A.10, and 590.1 current Minnesota public health goals established under section 590.2 62J.212. 590.3 Sec. 27. Minnesota Statutes 2002, section 145A.13, is 590.4 amended by adding a subdivision to read: 590.5 Subd. 4. [EXPIRATION.] This section expires January 1, 590.6 2004. 590.7 Sec. 28. [145A.131] [LOCAL PUBLIC HEALTH GRANT.] 590.8 Subdivision 1. [FUNDING FORMULA FOR COMMUNITY HEALTH 590.9 BOARDS] (a) The state community health advisory committee shall 590.10 recommend a formula to the commissioner to use in distributing 590.11 state and federal funds to community health boards organized and 590.12 operating under sections 145A.09 to 145A.131 to achieve locally 590.13 identified priorities under section 145A.10, subdivision 5a, and 590.14 selected statewide outcomes under section 145A.12, subdivision 590.15 7, by July 1, 2004, for use of distributing funds to community 590.16 health boards beginning January 1, 2006, and thereafter. 590.17 (b) This paragraph and paragraph (c) create base funding 590.18 for the local public health grant formula. A community health 590.19 board eligible for a local public health grant under section 590.20 145A.09, subdivision 2, shall receive no less for any calendar 590.21 year than 50 percent of the board's 2002-2003 fiscal year 590.22 allocations, prior to unallotment in fiscal year 2003, of the 590.23 following awards: community health services subsidy; maternal 590.24 and child health special projects grants; and state allocations 590.25 of women, infants, and children. 590.26 (c) A community health board eligible for a local public 590.27 health grant under section 145A.09, subdivision 2, shall receive 590.28 no less for any calendar year than a combination of 50 percent 590.29 of the board's 2002-2003 fiscal year award for family home 590.30 visiting and 50 percent of the board's anticipated 2004-2005 590.31 fiscal year award for family home visiting. 590.32 (d) Base funding for a community health board eligible for 590.33 a local public health grant under section 145A.09, subdivision 590.34 2, shall be reduced or increased equally among all community 590.35 health boards. 590.36 (e) Multicounty community health boards shall receive a 591.1 local partnership base of up to $15,000 per year for each county 591.2 included in the community health board. The multicounty base 591.3 will be limited in fiscal years 2004 and 2005 so as not to 591.4 exceed a community health board's allocations as defined in 591.5 paragraphs (b) and (c). 591.6 Subd. 2. [LOCAL MATCH.] (a) A community health board that 591.7 receives a local public health grant shall provide a 50 percent 591.8 match for the local public health grant funds described in 591.9 paragraph (b), subject to paragraphs (b) to (e). 591.10 (b) Eligible funds must be used to meet match requirements. 591.11 Eligible funds include funds from local property taxes, 591.12 reimbursements from third parties, fees, other state funds, and 591.13 donations or nonfederal grants that are used for community 591.14 health services described in section 145A.02, subdivision 6. 591.15 (c) Community health boards must provide documentation that 591.16 the 50 percent match for funds received under United States 591.17 Code, title 42, sections 701 to 709, is used for maternal and 591.18 child health activities as described in section 145.882, 591.19 subdivision 7. 591.20 (d) When the amount of local matching funds for a community 591.21 health board is less than the amount required under paragraph 591.22 (a), the local public health grant provided for that community 591.23 health board under this section shall be reduced proportionally. 591.24 (e) A city organized under the provision of sections 591.25 145A.09 to 145A.131 that levies a tax for provision of community 591.26 health services is exempt from any county levy for the same 591.27 services to the extent of the levy imposed by the city. 591.28 Subd. 3. [ADDITIONAL FUNDS.] Additional state or federal 591.29 funds distributed to community health boards to achieve specific 591.30 outcomes shall be distributed as part of the local public health 591.31 grant established in subdivision 1. Additional outcomes for 591.32 these funds, if not specified by federal or state law, shall be 591.33 developed by the commissioner in consultation with the state 591.34 community health advisory committee established under section 591.35 145A.10, subdivision 10, and the maternal and child health 591.36 advisory task force established under section 145.881. 592.1 Subd. 4. [SPECIAL PROJECT GRANTS.] Notwithstanding other 592.2 requirements of this section, the commissioner in consultation 592.3 with the state community health advisory committee may choose to 592.4 fund noncompetitive special project grants for projects by 592.5 select community health boards, according to state or federal 592.6 law. These special project grant funds shall be distributed as 592.7 a part of a community health board's local public health grant 592.8 established in subdivision 1. 592.9 Subd. 5. [RESPONSIBILITY OF COMMISSIONER TO ENSURE A 592.10 STATEWIDE PUBLIC HEALTH SYSTEM.] If a county withdraws from a 592.11 community health board and operates as a board of health or if a 592.12 community health board elects not to accept the local public 592.13 health grant, the commissioner may retain the amount of funding 592.14 that would have been allocated to the community health board 592.15 using the formula described in subdivision 1 and assume 592.16 responsibility for public health activities to meet the 592.17 statewide outcomes in the geographic area served by the board of 592.18 health or community health board. The commissioner may elect to 592.19 directly provide public health activities to meet the statewide 592.20 outcomes or contract with other units of government or with 592.21 community-based organizations. If a city that is currently a 592.22 community health board withdraws from a community health board 592.23 or elects not to accept the local public health grant, the local 592.24 public health grant funds that would have been allocated to that 592.25 city shall be distributed to the county in which the city is 592.26 located, if the county is part of a community health board. 592.27 Subd. 6. [ACCOUNTABILITY.] (a) Community health boards 592.28 accepting local public health grants must document progress 592.29 towards the selected statewide outcomes established in section 592.30 145A.12, subdivision 7, to maintain eligibility to receive the 592.31 local public health grant. 592.32 (b) If the commissioner determines that a community health 592.33 board has not by the applicable deadline documented progress in 592.34 one or more of the statewide outcomes established under section 592.35 145.8821 or 145A.12, subdivision 7, then the commissioner may 592.36 determine not to distribute future funds to the community health 593.1 board under subdivision 1. If the commissioner determines not 593.2 to distribute future funds, the commissioner must give the 593.3 community health board written notice of this determination. In 593.4 determining whether or not to distribute future funds to the 593.5 community health board, the commissioner shall consider the 593.6 following factors with respect to the statewide outcomes for 593.7 which the community health board did not demonstrate sufficient 593.8 progress: 593.9 (1) the difficulty of meeting the statewide outcome; 593.10 (2) the effort put forth by the community health board to 593.11 meet the statewide outcome; 593.12 (3) the number of statewide outcomes that the community 593.13 health board did not meet; 593.14 (4) whether the community health board has previously 593.15 failed to meet statewide outcomes under this section; 593.16 (5) the amount of funding received by the community health 593.17 board to address the statewide outcomes; and 593.18 (6) other factors as justice may require, if the 593.19 commissioner specifically identifies the additional factors in 593.20 the commissioner's written notice of determination. 593.21 (c) If a community health board does not document progress 593.22 towards the selected statewide outcomes, the commissioner may 593.23 retain local public health grant funds and assume responsibility 593.24 for directly carrying out activities to meet the statewide 593.25 outcomes or contract with other units of government or 593.26 community-based organizations to assume responsibility for the 593.27 statewide outcomes. If the community health board that does not 593.28 document progress towards the selected statewide outcomes is a 593.29 city, the commissioner shall distribute the local public health 593.30 grant funds that would have been allocated to that city to the 593.31 county in which the city is located, if the county is part of a 593.32 community health board. 593.33 (d) The commissioner shall establish a reporting system for 593.34 community health boards to report their progress. The system 593.35 shall be developed in consultation with the state community 593.36 health advisory committee established under section 145A.10, 594.1 subdivision 10, paragraph (a), and the maternal and child health 594.2 advisory task force established under section 145.881. 594.3 Subd. 7. [LOCAL PUBLIC HEALTH PRIORITIES.] Community 594.4 health boards may use their local public health grant to address 594.5 local public health priorities identified under section 145A.10, 594.6 subdivision 5a. 594.7 Sec. 29. Minnesota Statutes 2002, section 145A.14, 594.8 subdivision 2, is amended to read: 594.9 Subd. 2. [INDIAN HEALTH GRANTS.] (a) The commissioner may 594.10 make special grants tocommunity health boards toestablish, 594.11 operate, or subsidize clinic facilities and services to furnish 594.12 health services for American Indians who reside off reservations. 594.13 (b)To qualify for a grant under this subdivision the594.14community health plan submitted by the community health board594.15must contain a proposal for the delivery of the services and594.16documentation that representatives of the Indian community594.17affected by the plan were involved in its development.594.18(c)Applicants must submit for approval a plan and budget 594.19 for the use of the funds in the form and detail specified by the 594.20 commissioner. 594.21(d)(c) Applicants must keep records, including records of 594.22 expenditures to be audited, as the commissioner specifies. 594.23 Sec. 30. Minnesota Statutes 2002, section 145A.14, is 594.24 amended by adding a subdivision to read: 594.25 Subd. 2a. [TRIBAL GOVERNMENTS.] (a) Of the funding 594.26 available for local public health grants, $2,000,000 per year is 594.27 available to tribal governments for: 594.28 (1) maternal and child health activities under section 594.29 145.882, subdivision 7; 594.30 (2) activities to reduce health disparities under section 594.31 145.928, subdivision 10; and 594.32 (3) emergency preparedness. 594.33 (b) The commissioner, in consultation with tribal 594.34 governments, shall establish a formula for distributing the 594.35 funds and developing the outcomes to be measured. 594.36 Sec. 31. [REVISOR'S INSTRUCTION.] 595.1 (a) The revisor of statutes shall delete "145A.13" and 595.2 insert "145A.131" in Minnesota Statutes, sections 145A.03, 595.3 subdivision 1; 145A.04, subdivision 4; 145A.10, subdivision 1; 595.4 256E.03, subdivision 2; 383B.221, subdivision 2; and 402.02, 595.5 subdivision 2. 595.6 (b) For sections in Minnesota Statutes and Minnesota Rules 595.7 affected by the repealed sections in this article, the revisor 595.8 shall delete internal cross-references where appropriate and 595.9 make changes necessary to correct the punctuation, grammar, or 595.10 structure of the remaining text and preserve its meaning. 595.11 Sec. 32. [REPEALER.] 595.12 (a) Minnesota Statutes 2002, sections 144.401; 144.9507, 595.13 subdivision 3; 145.56, subdivision 2; 145.882, subdivisions 4, 595.14 5, 6, and 8; 145.883, subdivisions 4 and 7; 145.884; 145.885; 595.15 145.886; 145.888; 145.889; 145.890; 145.9266, subdivisions 2, 4, 595.16 5, 6, and 7; 145.928, subdivision 9; 145A.02, subdivisions 9, 595.17 10, 11, 12, 13, and 14; 145A.09, subdivision 6; 145A.10, 595.18 subdivisions 5, 6, and 8; 145A.11, subdivision 3; 145A.12, 595.19 subdivisions 3, 4, and 5; 145A.14, subdivisions 3 and 4; and 595.20 145A.17, subdivision 2, are repealed. 595.21 (b) Minnesota Rules, parts 4736.0010; 4736.0020; 4736.0030; 595.22 4736.0040; 4736.0050; 4736.0060; 4736.0070; 4736.0080; 595.23 4736.0090; 4736.0120; and 4736.0130, are repealed effective 595.24 January 1, 2004. 595.25 (c) Minnesota Rules, parts 4705.0100; 4705.0200; 4705.0300; 595.26 4705.0400; 4705.0500; 4705.0600; 4705.0700; 4705.0800; 595.27 4705.0900; 4705.1000; 4705.1100; 4705.1200; 4705.1300; 595.28 4705.1400; 4705.1500; and 4705.1600, are repealed effective June 595.29 30, 2004. 595.30 ARTICLE 10 595.31 CHILD CARE AND MISCELLANEOUS PROVISIONS 595.32 Section 1. Minnesota Statutes 2002, section 119B.011, 595.33 subdivision 5, is amended to read: 595.34 Subd. 5. [CHILD CARE.] "Child care" means the care of a 595.35 child by someone other than a parentor, stepparent, legal 595.36 guardian, eligible relative caregiver, or the spouses of any of 596.1 the foregoing in or outside the child's own home for gain or 596.2 otherwise, on a regular basis, for any part of a 24-hour day. 596.3 Sec. 2. Minnesota Statutes 2002, section 119B.011, 596.4 subdivision 6, is amended to read: 596.5 Subd. 6. [CHILD CARE FUND.] "Child care fund" means a 596.6 program under this chapter providing: 596.7 (1) financial assistance for child care to parents engaged 596.8 in employment, job search, or education and training leading to 596.9 employment, or an at-home infant care subsidy; and 596.10 (2) grants to develop, expand, and improve the access and 596.11 availability of child care services statewide. 596.12 Sec. 3. Minnesota Statutes 2002, section 119B.011, 596.13 subdivision 15, is amended to read: 596.14 Subd. 15. [INCOME.] "Income" means earned or unearned 596.15 income received by all family members, including public 596.16 assistance cash benefitsand at-home infant care subsidy596.17payments, unless specifically excluded and child support and 596.18 maintenance distributed to the family under section 256.741, 596.19 subdivision 15. The following are excluded from income: funds 596.20 used to pay for health insurance premiums for family members, 596.21 Supplemental Security Income, scholarships, work-study income, 596.22 and grants that cover costs or reimbursement for tuition, fees, 596.23 books, and educational supplies; student loans for tuition, 596.24 fees, books, supplies, and living expenses; state and federal 596.25 earned income tax credits; assistance specifically excluded as 596.26 income by law; in-kind income such as food stamps, energy 596.27 assistance, foster care assistance, medical assistance, child 596.28 care assistance, and housing subsidies; earned income of 596.29 full-time or part-time students up to the age of 19, who have 596.30 not earned a high school diploma or GED high school equivalency 596.31 diploma including earnings from summer employment; grant awards 596.32 under the family subsidy program; nonrecurring lump sum income 596.33 only to the extent that it is earmarked and used for the purpose 596.34 for which it is paid; and any income assigned to the public 596.35 authority according to section 256.741. 596.36 Sec. 4. Minnesota Statutes 2002, section 119B.011, 597.1 subdivision 19, is amended to read: 597.2 Subd. 19. [PROVIDER.] "Provider" means: (1) an individual 597.3 or child care center or facility, either licensed or unlicensed, 597.4 providing legal child care services as defined under section 597.5 245A.03; or (2) an individual or child care center or facility 597.6 holding a valid child care license issued by another state or a 597.7 tribe and providing child care services in the licensing state 597.8 or in the area under the licensing tribe's jurisdiction. A 597.9 legally unlicensedregisteredfamily child care provider must be 597.10 at least 18 years of age, and not a member of the MFIP 597.11 assistance unit or a member of the family receiving child care 597.12 assistance to be authorized under this chapter. 597.13 Sec. 5. Minnesota Statutes 2002, section 119B.011, is 597.14 amended by adding a subdivision to read: 597.15 Subd. 19a. [REGISTRATION.] "Registration" means the 597.16 process used by a county to determine whether the provider 597.17 selected by a family applying for or receiving child care 597.18 assistance to care for that family's children meets the 597.19 requirements necessary for payment of child care assistance for 597.20 care provided by that provider. 597.21 Sec. 6. Minnesota Statutes 2002, section 119B.011, 597.22 subdivision 21, is amended to read: 597.23 Subd. 21. [RECOUPMENT OF OVERPAYMENTS.] "Recoupment of 597.24 overpayments" means the reduction of child care assistance 597.25 payments to an eligible family or a child care provider in order 597.26 to correct an overpaymentto the family even when the597.27overpayment is due to agency error or other circumstances597.28outside the responsibility or control of the familyof child 597.29 care assistance. 597.30 Sec. 7. Minnesota Statutes 2002, section 119B.011, is 597.31 amended by adding a subdivision to read: 597.32 Subd. 23. [FEDERAL POVERTY GUIDELINES.] "Federal poverty 597.33 guidelines" means the annual poverty guidelines for a family of 597.34 four, adjusted for family size, published annually by the United 597.35 States Department of Health and Human Services in the Federal 597.36 Register. 598.1 Sec. 8. Minnesota Statutes 2002, section 119B.011, is 598.2 amended by adding a subdivision to read: 598.3 Subd. 24. [UNSAFE CARE.] "Unsafe care" means any provider 598.4 or care arrangement that meets any of the criteria listed in 598.5 sections 119B.125, subdivision 2, 245A.04, subdivisions 3b and 598.6 3d, or any other conduct or condition determined to be injurious 598.7 or potentially harmful to a child. 598.8 Sec. 9. Minnesota Statutes 2002, section 119B.02, 598.9 subdivision 1, is amended to read: 598.10 Subdivision 1. [CHILD CARE SERVICES.] The commissioner 598.11 shall develop standards for county and human services boards to 598.12 provide child care services to enable eligible families to 598.13 participate in employment, training, or education programs. 598.14 Within the limits of available appropriations, the commissioner 598.15 shall distribute money to counties to reduce the costs of child 598.16 care for eligible families. The commissioner shall adopt rules 598.17 to govern the program in accordance with this section. The 598.18 rules must establish a sliding schedule of fees for parents 598.19 receiving child care services. The rules shall provide that 598.20 funds received as a lump sum payment of child support arrearages 598.21 shall not be counted as income to a family in the month received 598.22 but shall be prorated over the 12 months following receipt and 598.23 added to the family income during those months.In the rules598.24adopted under this section, county and human services boards598.25shall be authorized to establish policies for payment of child598.26care spaces for absent children, when the payment is required by598.27the child's regular provider. The rules shall not set a maximum598.28number of days for which absence payments can be made, but598.29instead shall direct the county agency to set limits and pay for598.30absences according to the prevailing market practice in the598.31county. County policies for payment of absences shall be598.32subject to the approval of the commissioner.The commissioner 598.33 shall maximize the use of federal money under title I and title 598.34 IV of Public Law Number 104-193, the Personal Responsibility and 598.35 Work Opportunity Reconciliation Act of 1996, and other programs 598.36 that provide federal or state reimbursement for child care 599.1 services for low-income families who are in education, training, 599.2 job search, or other activities allowed under those programs. 599.3 Money appropriated under this section must be coordinated with 599.4 the programs that provide federal reimbursement for child care 599.5 services to accomplish this purpose. Federal reimbursement 599.6 obtained must be allocated to the county that spent money for 599.7 child care that is federally reimbursable under programs that 599.8 provide federal reimbursement for child care services. The 599.9 counties shall use the federal money to expand child care 599.10 services. The commissioner may adopt rules under chapter 14 to 599.11 implement and coordinate federal program requirements. 599.12 Sec. 10. [119B.025] [DUTIES OF COUNTIES.] 599.13 Subdivision 1. [FACTORS WHICH MUST BE VERIFIED.] (a) The 599.14 county shall verify the following at all initial child care 599.15 applications using the universal application: 599.16 (1) identity of adults; 599.17 (2) presence of the minor child in the home, if 599.18 questionable; 599.19 (3) relationship of minor child to caregivers; 599.20 (4) age; 599.21 (5) immigration status, if related to eligibility; 599.22 (6) social security number, if given; 599.23 (7) income; 599.24 (8) spousal support and child support payments made to 599.25 persons outside the household; 599.26 (9) residence; 599.27 (10) inconsistent information, if related to eligibility; 599.28 and 599.29 (11) any other information the county deems necessary to 599.30 determine eligibility. 599.31 (b) If a family did not use the universal application to 599.32 apply for child care assistance, the family must complete the 599.33 universal application at its next eligibility redetermination 599.34 and the county must verify the factors listed in paragraph (a) 599.35 as part of that redetermination. Once a family has completed a 599.36 universal application, the county shall use the redetermination 600.1 form described in paragraph (c) for that family's subsequent 600.2 redeterminations. 600.3 (c) The commissioner shall develop a recertification form 600.4 to redetermine eligibility that minimizes paperwork for the 600.5 county and the participant. 600.6 Subd. 2. [SOCIAL SECURITY NUMBERS.] The county must 600.7 request social security numbers from all applicants for child 600.8 care assistance under this chapter. A county may not deny child 600.9 care assistance solely on the basis of failure of an applicant 600.10 to report a social security number. 600.11 Sec. 11. Minnesota Statutes 2002, section 119B.03, 600.12 subdivision 9, is amended to read: 600.13 Subd. 9. [PORTABILITY POOL.] (a) The commissioner shall 600.14 establish a pool of up to five percent of the annual 600.15 appropriation for the basic sliding fee program to provide 600.16 continuous child care assistance for eligible families who move 600.17 between Minnesota counties. At the end of each allocation 600.18 period, any unspent funds in the portability pool must be used 600.19 for assistance under the basic sliding fee program. If 600.20 expenditures from the portability pool exceed the amount of 600.21 money available, the reallocation pool must be reduced to cover 600.22 these shortages. 600.23 (b) To be eligible for portable basic sliding fee 600.24 assistance, a family that has moved from a county in which it 600.25 was receiving basic sliding fee assistance to a county with a 600.26 waiting list for the basic sliding fee program must: 600.27 (1) meet the income and eligibility guidelines for the 600.28 basic sliding fee program; and 600.29 (2) notify the new county of residence within3060 days of 600.30 moving andapply for basic sliding fee assistance insubmit 600.31 information to the new county of residence to verify eligibility 600.32 for the basic sliding fee program. 600.33 (c) The receiving county must: 600.34 (1) accept administrative responsibility for applicants for 600.35 portable basic sliding fee assistance at the end of the two 600.36 months of assistance under the Unitary Residency Act; 601.1 (2) continue basic sliding fee assistance for the lesser of 601.2 six months or until the family is able to receive assistance 601.3 under the county's regular basic sliding program; and 601.4 (3) notify the commissioner through the quarterly reporting 601.5 process of any family that meets the criteria of the portable 601.6 basic sliding fee assistance pool. 601.7 Sec. 12. Minnesota Statutes 2002, section 119B.05, 601.8 subdivision 1, is amended to read: 601.9 Subdivision 1. [ELIGIBLE PARTICIPANTS.] Families eligible 601.10 for child care assistance under the MFIP child care program are: 601.11 (1) MFIP participants who are employed or in job search and 601.12 meet the requirements of section 119B.10; 601.13 (2) persons who are members of transition year families 601.14 under section 119B.011, subdivision 20, and meet the 601.15 requirements of section 119B.10; 601.16 (3) families who are participating in employment 601.17 orientation or job search, or other employment or training 601.18 activities that are included in an approved employability 601.19 development plan under chapter 256K; 601.20 (4) MFIP families who are participating in work job search, 601.21 job support, employment, or training activities as required in 601.22 their job search support or employment plan, or in appeals, 601.23 hearings, assessments, or orientations according to chapter 601.24 256J; 601.25 (5) MFIP families who are participating in social services 601.26 activities under chapter 256J or 256K as required in their 601.27 employment plan approved according to chapter 256J or 256K; and 601.28 (6) families who are participating in programs as required 601.29 in tribal contracts under section 119B.02, subdivision 2, or 601.30 256.01, subdivision 2. 601.31 Sec. 13. Minnesota Statutes 2002, section 119B.08, 601.32 subdivision 3, is amended to read: 601.33 Subd. 3. [CHILD CARE FUND PLAN.] The county and designated 601.34 administering agency shall submit a biennial child care fund 601.35 plan to the commissioneran annual child care fund plan in its601.36biennial community social services plan. The commissioner shall 602.1 establish the dates by which the county must submit the plans. 602.2 The plan shall include: 602.3 (1)a narrative of the total program for child care602.4services, including all policies and procedures that affect602.5eligible families and are used to administer the child care602.6funds;602.7(2) the methods used by the county to inform eligible602.8families of the availability of child care assistance and602.9related services;602.10(3) the provider rates paid for all children with special602.11needs by provider type;602.12(4) the county prioritization policy for all eligible602.13families under the basic sliding fee program; and602.14(5) othera description of strategies to coordinate and 602.15 maximize public and private community resources, including 602.16 school districts, health care facilities, government agencies, 602.17 neighborhood organizations, and other resources knowledgeable in 602.18 early childhood development, in particular to coordinate child 602.19 care assistance with existing community-based programs and 602.20 service providers including child care resource and referral 602.21 programs, early childhood family education, school readiness, 602.22 Head Start, local interagency early intervention committees, 602.23 special education services, early childhood screening, and other 602.24 early childhood care and education services and programs to the 602.25 extent possible, to foster collaboration among agencies and 602.26 other community-based programs that provide flexible, 602.27 family-focused services to families with young children and to 602.28 facilitate transition into kindergarten. The county must 602.29 describe a method by which to share information, responsibility, 602.30 and accountability among service and program providers; 602.31 (2) a description of procedures and methods to be used to 602.32 make copies of the proposed state plan reasonably available to 602.33 the public, including members of the public particularly 602.34 interested in child care policies such as parents, child care 602.35 providers, culturally specific service organizations, child care 602.36 resource and referral programs, interagency early intervention 603.1 committees, potential collaborative partners and agencies 603.2 involved in the provision of care and education to young 603.3 children, and allowing sufficient time for public review and 603.4 comment; and 603.5 (3) information as requested by the department to ensure 603.6 compliance with the child care fund statutes and rules 603.7 promulgated by the commissioner. 603.8 The commissioner shall notify counties within6090 days of 603.9 the date the plan is submitted whether the plan is approved or 603.10 the corrections or information needed to approve the plan. The 603.11 commissioner shall withhold a county's allocation until it has 603.12 an approved plan. Plans not approved by the end of the second 603.13 quarter after the plan is due may result in a 25 percent 603.14 reduction in allocation. Plans not approved by the end of the 603.15 third quarter after the plan is due may result in a 100 percent 603.16 reduction in the allocation to the county. Counties are to 603.17 maintain services despite any reduction in their allocation due 603.18 to plans not being approved. 603.19 Sec. 14. Minnesota Statutes 2002, section 119B.09, 603.20 subdivision 1, is amended to read: 603.21 Subdivision 1. [GENERAL ELIGIBILITY REQUIREMENTS FOR ALL 603.22 APPLICANTS FOR CHILD CARE ASSISTANCE.] (a) Child care services 603.23 must be available to families who need child care to find or 603.24 keep employment or to obtain the training or education necessary 603.25 to find employment and who: 603.26 (1) meet the requirements of section 119B.05; receive MFIP 603.27 assistance; and are participating in employment and training 603.28 services under chapter 256J or 256K; 603.29 (2) have household income below the eligibility levels for 603.30 MFIP; or 603.31 (3) have household incomewithin a range established by the603.32commissionerless than 250 percent of the federal poverty 603.33 guidelines, adjusted for family size. 603.34 (b) Child care services must be made available as in-kind 603.35 services. 603.36 (c) All applicants for child care assistance and families 604.1 currently receiving child care assistance must be assisted and 604.2 required to cooperate in establishment of paternity and 604.3 enforcement of child support obligations for all children in the 604.4 family as a condition of program eligibility. For purposes of 604.5 this section, a family is considered to meet the requirement for 604.6 cooperation when the family complies with the requirements of 604.7 section 256.741. 604.8 Sec. 15. Minnesota Statutes 2002, section 119B.09, 604.9 subdivision 2, is amended to read: 604.10 Subd. 2. [SLIDING FEE.] Child care services to 604.11 familieswith incomes in the commissioner's established range604.12 must be made available on a sliding fee basis.The upper limit604.13of the range must be neither less than 70 percent nor more than604.1490 percent of the state median income for a family of four,604.15adjusted for family size.604.16 Sec. 16. Minnesota Statutes 2002, section 119B.09, 604.17 subdivision 7, is amended to read: 604.18 Subd. 7. [DATE OF ELIGIBILITY FOR ASSISTANCE.] (a) The 604.19 date of eligibility for child care assistance under this chapter 604.20 is the later of the date the application was signed; the 604.21 beginning date of employment, education, or training; or the 604.22 date a determination has been made that the applicant is a 604.23 participant in employment and training services under Minnesota 604.24 Rules, part 3400.0080, subpart 2a, or chapter 256J or 256K.The604.25date of eligibility for the basic sliding fee at-home infant604.26child care program is the later of the date the infant is born604.27or, in a county with a basic sliding fee waiting list, the date604.28the family applies for at-home infant child care.604.29 (b)Payment ceases for a family under the at-home infant604.30child care program when a family has used a total of 12 months604.31of assistance as specified under section 119B.061.Payment of 604.32 child care assistance for employed persons on MFIP is effective 604.33 the date of employment or the date of MFIP eligibility, 604.34 whichever is later. Payment of child care assistance for MFIP 604.35 or work first participants in employment and training services 604.36 is effective the date of commencement of the services or the 605.1 date of MFIP or work first eligibility, whichever is later. 605.2 Payment of child care assistance for transition year child care 605.3 must be made retroactive to the date of eligibility for 605.4 transition year child care. 605.5 Sec. 17. Minnesota Statutes 2002, section 119B.09, is 605.6 amended by adding a subdivision to read: 605.7 Subd. 9. [LICENSED AND LEGAL NONLICENSED FAMILY CHILD CARE 605.8 PROVIDERS; ASSISTANCE.] Licensed and legal nonlicensed family 605.9 child care providers are not eligible to receive child care 605.10 assistance subsidies under this chapter for their own children 605.11 or children in their custody. 605.12 Sec. 18. Minnesota Statutes 2002, section 119B.09, is 605.13 amended by adding a subdivision to read: 605.14 Subd. 10. [PAYMENT OF FUNDS.] All federal, state, and 605.15 local child care funds must be paid directly to the parent when 605.16 a provider cares for children in the children's own home. In 605.17 all other cases, all federal, state, and local child care funds 605.18 must be paid directly to the child care provider, either 605.19 licensed or legal nonlicensed, on behalf of the eligible family. 605.20 Sec. 19. Minnesota Statutes 2002, section 119B.11, 605.21 subdivision 2a, is amended to read: 605.22 Subd. 2a. [RECOVERY OF OVERPAYMENTS.] (a) An amount of 605.23 child care assistance paid to a recipient in excess of the 605.24 payment due is recoverable by the county agency under paragraphs 605.25 (b) and (c), even when the overpayment was caused by agency 605.26 error or circumstances outside the responsibility and control of 605.27 the family or provider. 605.28 (b) An overpayment must be recouped or recovered from the 605.29 family if the overpayment benefited the family by causing the 605.30 family to pay less for child care expenses than the family 605.31 otherwise would have been required to pay under child care 605.32 assistance program requirements. If the family remains eligible 605.33 for child care assistance, the overpayment must be recovered 605.34 through recoupment as identified in Minnesota Rules, 605.35 part3400.0140, subpart 193400.0187, except that the 605.36 overpayments must be calculated and collected on a service 606.1 period basis. If the family no longer remains eligible for 606.2 child care assistance, the county may choose to initiate efforts 606.3 to recover overpayments from the family for overpayment less 606.4 than $50. If the overpayment is greater than or equal to $50, 606.5 the county shall seek voluntary repayment of the overpayment 606.6 from the family. If the county is unable to recoup the 606.7 overpayment through voluntary repayment, the county shall 606.8 initiate civil court proceedings to recover the overpayment 606.9 unless the county's costs to recover the overpayment will exceed 606.10 the amount of the overpayment. A family with an outstanding 606.11 debt under this subdivision is not eligible for child care 606.12 assistance until: (1) the debt is paid in full; or (2) 606.13 satisfactory arrangements are made with the county to retire the 606.14 debt consistent with the requirements of this chapter and 606.15 Minnesota Rules, chapter 3400, and the family is in compliance 606.16 with the arrangements. 606.17 (c) The county must recover an overpayment from a provider 606.18 if the overpayment did not benefit the family by causing it to 606.19 receive more child care assistance or to pay less for child care 606.20 expenses than the family otherwise would have been eligible to 606.21 receive or required to pay under child care assistance program 606.22 requirements, and benefited the provider by causing the provider 606.23 to receive more child care assistance than otherwise would have 606.24 been paid on the family's behalf under child care assistance 606.25 program requirements. If the provider continues to care for 606.26 children receiving child care assistance, the overpayment must 606.27 be recovered through reductions in child care assistance 606.28 payments for services as described in an agreement with the 606.29 county. The provider may not charge families using that 606.30 provider more to cover the cost of recouping the overpayment. 606.31 If the provider no longer cares for children receiving child 606.32 care assistance, the county may choose to initiate efforts to 606.33 recover overpayments of less than $50 from the provider. If the 606.34 overpayment is greater than or equal to $50, the county shall 606.35 seek voluntary repayment of the overpayment from the provider. 606.36 If the county is unable to recoup the overpayment through 607.1 voluntary repayment, the county shall initiate civil court 607.2 proceedings to recover the overpayment unless the county's costs 607.3 to recover the overpayment will exceed the amount of the 607.4 overpayment. A provider with an outstanding debt under this 607.5 subdivision is not eligible to care for children receiving child 607.6 care assistance until: (1) the debt is paid in full; or (2) 607.7 satisfactory arrangements are made with the county to retire the 607.8 debt consistent with the requirements of this chapter and 607.9 Minnesota Rules, chapter 3400, and the provider is in compliance 607.10 with the arrangements. 607.11 (d) When both the family and the provider acted together to 607.12 intentionally cause the overpayment, both the family and the 607.13 provider are jointly liable for the overpayment regardless of 607.14 who benefited from the overpayment. The county must recover the 607.15 overpayment as provided in paragraphs (b) and (c). When the 607.16 family or the provider is in compliance with a repayment 607.17 agreement, the party in compliance is eligible to receive child 607.18 care assistance or to care for children receiving child care 607.19 assistance despite the other party's noncompliance with 607.20 repayment arrangements. 607.21 Sec. 20. Minnesota Statutes 2002, section 119B.12, 607.22 subdivision 2, is amended to read: 607.23 Subd. 2. [PARENT FEE.] A family must be assessed a parent 607.24 fee for each service period. A family'smonthlyparent fee must 607.25 be a fixed percentage of its annual gross income. Parent fees 607.26 must apply to families eligible for child care assistance under 607.27 sections 119B.03 and 119B.05. Income must be as defined in 607.28 section 119B.011, subdivision 15. The fixed percent is based on 607.29 the relationship of the family's annual gross income to100250 607.30 percent ofstate median incomethe federal poverty 607.31 guidelines.Beginning January 1, 1998, parent fees must begin607.32at 75 percent of the poverty level. The minimum parent fees for607.33families between 75 percent and 100 percent of poverty level607.34must be $5 per month.Parent fees must be established in rule 607.35 and must provide for graduated movement to full payment. 607.36 Sec. 21. [119B.125] [PROVIDER REQUIREMENTS.] 608.1 Subdivision 1. [AUTHORIZATION.] Except as provided in 608.2 subdivision 5, a county must authorize a provider to receive 608.3 child care assistance payments before the county makes payment 608.4 for care provided by that provider. The commissioner must 608.5 establish the requirements necessary for authorization of 608.6 providers. 608.7 Subd. 2. [PERSONS WHO CANNOT BE AUTHORIZED.] (a) A person 608.8 who meets any of the conditions under paragraphs (b) to (n) must 608.9 not be authorized as a legal nonlicensed family child care 608.10 provider. For purposes of this subdivision, a finding that a 608.11 delinquency petition is proven in juvenile court must be 608.12 considered a conviction in state district court. 608.13 (b) The person has been convicted of one of the following 608.14 offenses or has admitted to committing or a preponderance of the 608.15 evidence indicates that the person has committed an act that 608.16 meets the definition of one of the following offenses: sections 608.17 609.185 to 609.195, murder in the first, second, or third 608.18 degree; 609.2661 to 609.2663, murder of an unborn child in the 608.19 first, second, or third degree; 609.322, solicitation, 608.20 inducement, or promotion of prostitution; 609.323, receiving 608.21 profit from prostitution; 609.342 to 609.345, criminal sexual 608.22 conduct in the first, second, third, or fourth degree; 609.352, 608.23 solicitation of children to engage in sexual conduct; 609.365, 608.24 incest; 609.377, felony malicious punishment of a child; 608.25 617.246, use of minors in sexual performance; 617.247, 608.26 possession of pictorial representation of a minor; 609.2242 to 608.27 609.2243, felony domestic assault; a felony offense of spousal 608.28 abuse; a felony offense of child abuse or neglect; a felony 608.29 offense of a crime against children; or an attempt or conspiracy 608.30 to commit any of these offenses as defined in Minnesota 608.31 Statutes; or an offense in any other state or country where the 608.32 elements are substantially similar to any of the offenses listed 608.33 in this paragraph. 608.34 (c) Less than 15 years have passed since the discharge of 608.35 the sentence imposed for the offense and the person has received 608.36 a felony conviction for one of the following offenses, or the 609.1 person has admitted to committing or a preponderance of the 609.2 evidence indicates that the person has committed an act that 609.3 meets the definition of a felony conviction for one of the 609.4 following offenses: sections 609.20 to 609.205, manslaughter in 609.5 the first or second degree; 609.21, criminal vehicular homicide; 609.6 609.215, aiding suicide or aiding attempted suicide; 609.221 to 609.7 609.2231, assault in the first, second, third, or fourth degree; 609.8 609.224, repeat offenses of fifth degree assault; 609.228, great 609.9 bodily harm caused by distribution of drugs; 609.2325, criminal 609.10 abuse of a vulnerable adult; 609.2335, financial exploitation of 609.11 a vulnerable adult; 609.235, use of drugs to injure or 609.12 facilitate a crime; 609.24, simple robbery; 617.241, repeat 609.13 offenses of obscene materials and performances; 609.245, 609.14 aggravated robbery; 609.25, kidnapping; 609.255, false 609.15 imprisonment; 609.2664 to 609.2665, manslaughter of an unborn 609.16 child in the first or second degree; 609.267 to 609.2672, 609.17 assault of an unborn child in the first, second, or third 609.18 degree; 609.268, injury or death of an unborn child in the 609.19 commission of a crime; 609.27, coercion; 609.275, attempt to 609.20 coerce; 609.324, subdivision 1, other prohibited acts, minor 609.21 engaged in prostitution; 609.3451, repeat offenses of criminal 609.22 sexual conduct in the fifth degree; 609.378, neglect or 609.23 endangerment of a child; 609.52, theft; 609.521, possession of 609.24 shoplifting gear; 609.561 to 609.563, arson in the first, 609.25 second, or third degree; 609.582, burglary in the first, second, 609.26 third, or fourth degree; 609.625, aggravated forgery; 609.63, 609.27 forgery; 609.631, check forgery, offering a forged check; 609.28 609.635, obtaining signature by false pretenses; 609.66, 609.29 dangerous weapon; 609.665, setting a spring gun; 609.67, 609.30 unlawfully owning, possessing, or operating a machine gun; 609.31 609.687, adulteration; 609.71, riot; 609.713, terrorist threats; 609.32 609.749, harassment, stalking; 260.221, grounds for termination 609.33 of parental rights; 152.021 to 152.022, controlled substance 609.34 crime in the first or second degree; 152.023, subdivision 1, 609.35 clause (3) or (4), or 152.023, subdivision 2, clause (4), 609.36 controlled substance crime in third degree; 152.024, subdivision 610.1 1, clause (2), (3), or (4), controlled substance crime in fourth 610.2 degree; 617.23, repeat offenses of indecent exposure; an attempt 610.3 or conspiracy to commit any of these offenses as defined in 610.4 Minnesota Statutes; or an offense in any other state or country 610.5 where the elements are substantially similar to any of the 610.6 offenses listed in this paragraph. 610.7 (d) Less than ten years have passed since the discharge of 610.8 the sentence imposed for the offense and the person has received 610.9 a gross misdemeanor conviction for one of the following offenses 610.10 or the person has admitted to committing or a preponderance of 610.11 the evidence indicates that the person has committed an act that 610.12 meets the definition of a gross misdemeanor conviction for one 610.13 of the following offenses: sections 609.224, fifth degree 610.14 assault; 609.2242 to 609.2243, domestic assault; 518B.01, 610.15 subdivision 14, violation of an order for protection; 609.3451, 610.16 fifth degree criminal sexual conduct; 609.746, repeat offenses 610.17 of interference with privacy; 617.23, repeat offenses of 610.18 indecent exposure; 617.241, obscene materials and performances; 610.19 617.243, indecent literature, distribution; 617.293, 610.20 disseminating or displaying harmful material to minors; 609.71, 610.21 riot; 609.66, dangerous weapons; 609.749, harassment, stalking; 610.22 609.224, subdivision 2, paragraph (c), fifth degree assault 610.23 against a vulnerable adult by a caregiver; 609.23, mistreatment 610.24 of persons confined; 609.231, mistreatment of residents or 610.25 patients; 609.2325, criminal abuse of a vulnerable adult; 610.26 609.2335, financial exploitation of a vulnerable adult; 609.233, 610.27 criminal neglect of a vulnerable adult; 609.234, failure to 610.28 report maltreatment of a vulnerable adult; 609.72, subdivision 610.29 3, disorderly conduct against a vulnerable adult; 609.265, 610.30 abduction; 609.378, neglect or endangerment of a child; 609.377, 610.31 malicious punishment of a child; 609.324, subdivision 1a, other 610.32 prohibited acts, minor engaged in prostitution; 609.33, 610.33 disorderly house; 609.52, theft; 609.582, burglary in the first, 610.34 second, third, or fourth degree; 609.631, check forgery, 610.35 offering a forged check; 609.275, attempt to coerce; an attempt 610.36 or conspiracy to commit any of these offenses as defined in 611.1 Minnesota Statutes; or an offense in any other state or country 611.2 where the elements are substantially similar to any of the 611.3 offenses listed in this paragraph. 611.4 (e) Less than seven years have passed since the discharge 611.5 of the sentence imposed for the offense and the person has 611.6 received a misdemeanor conviction for one of the following 611.7 offenses or the person has admitted to committing or a 611.8 preponderance of the evidence indicates that the person has 611.9 committed an act that meets the definition of a misdemeanor 611.10 conviction for one of the following offenses: sections 609.224, 611.11 fifth degree assault; 609.2242, domestic assault; 518B.01, 611.12 violation of an order for protection; 609.3232, violation of an 611.13 order for protection; 609.746, interference with privacy; 611.14 609.79, obscene or harassing telephone calls; 609.795, letter, 611.15 telegram, or package, opening, harassment; 617.23, indecent 611.16 exposure; 609.2672, assault of an unborn child, third degree; 611.17 617.293, dissemination and display of harmful materials to 611.18 minors; 609.66, dangerous weapons; 609.665, spring guns; an 611.19 attempt or conspiracy to commit any of these offenses as defined 611.20 in Minnesota Statutes; or an offense in any other state or 611.21 country where the elements are substantially similar to any of 611.22 the offenses listed in this paragraph. 611.23 (f) The person has been identified by the county's child 611.24 protection agency or by the statewide child protection database 611.25 as the person allegedly responsible for physical or sexual abuse 611.26 of a child within the last seven years. 611.27 (g) The person has been identified by the county's adult 611.28 protection agency or by the statewide adult protection database 611.29 as the person responsible for abuse or neglect of a vulnerable 611.30 adult within the last seven years. 611.31 (h) The person has refused to give written consent for 611.32 disclosure of criminal history records. 611.33 (i) The person has been denied a family child care license 611.34 or has received a fine or a sanction as a licensed child care 611.35 provider that has not been reversed on appeal. 611.36 (j) The person has a family child care licensing 612.1 disqualification that has not been set aside. 612.2 (k) The person has admitted or a county has found that 612.3 there is a preponderance of evidence that fraudulent information 612.4 was given to the county for application purposes or was used in 612.5 submitting bills for payment. 612.6 (l) The person has been convicted or there is a 612.7 preponderance of evidence of the crime of theft by wrongfully 612.8 obtaining public assistance. 612.9 (m) The person has a household member age 13 or older who 612.10 has access to children during the hours that care is provided 612.11 and who meets one of the conditions listed in paragraphs (b) to 612.12 (l). 612.13 (n) The person has a household member ages ten to 12 who 612.14 has access to children during the hours that care is provided; 612.15 information or circumstances exist which provide the county with 612.16 articulable suspicion that further pertinent information may 612.17 exist showing the household member meets one of the conditions 612.18 listed in paragraphs (b) to (l); and the household member 612.19 actually meets one of the conditions listed in paragraphs (b) to 612.20 (l). 612.21 Subd. 3. [AUTHORIZATION EXCEPTION.] When a county denies a 612.22 person authorization as a legal nonlicensed family child care 612.23 provider under subdivision 2, the county later may authorize 612.24 that person as a provider if the following conditions are met: 612.25 (1) after receiving notice of the denial of the 612.26 authorization, the person applies for and obtains a valid child 612.27 care license issued under chapter 245A, issued by a tribe, or 612.28 issued by another state; 612.29 (2) the person maintains the valid child care license; and 612.30 (3) the person is providing child care in the state of 612.31 licensure or in the area under the jurisdiction of the licensing 612.32 tribe. 612.33 Subd. 4. [UNSAFE CARE.] A county may deny authorization as 612.34 a child care provider to any applicant or rescind authorization 612.35 of any provider when the county knows or has reason to believe 612.36 that the provider is unsafe or that the circumstances of the 613.1 chosen child care arrangement are unsafe, even when the grounds 613.2 supporting this determination are not listed in subdivision 2. 613.3 Subd. 5. [RETROACTIVE PAYMENT.] Once a provider receives 613.4 county authorization, the county may issue retroactive payment 613.5 to the provider for child care services provided during the time 613.6 between the county's receipt of the completed application and 613.7 final authorization of the provider. 613.8 Subd. 6. [RECORD KEEPING REQUIREMENT.] All providers must 613.9 keep daily attendance records for children receiving child care 613.10 assistance and must make those records available immediately to 613.11 the county upon request. The daily attendance records must be 613.12 retained for six years after the date of service. A county may 613.13 deny authorization as a child care provider to any applicant or 613.14 rescind authorization of any provider when the county knows or 613.15 has reason to believe that the provider has not complied with 613.16 the record keeping requirement in this subdivision. 613.17 Sec. 22. Minnesota Statutes 2002, section 119B.13, 613.18 subdivision 1, is amended to read: 613.19 Subdivision 1. [SUBSIDY RESTRICTIONS.] The maximum rate 613.20 paid for child care assistance under the child care fund may not 613.21 exceed the75th60th percentile rate for like-care arrangements 613.22 in the county as surveyed by the commissioner. A rate which 613.23 includes a provider bonus paid under subdivision 2 or a special 613.24 needs rate paid under subdivision 3 may be in excess of the 613.25 maximum rate allowed under this subdivision. The department 613.26 shall monitor the effect of this paragraph on provider rates. 613.27 The county shall pay the provider's full charges for every child 613.28 in care up to the maximum established. The commissioner shall 613.29 determine the maximum rate for each type of care on an hourly, 613.30 full-day, and weekly basis, including special needs and 613.31 handicapped care. Not less than once every two years, the 613.32 commissioner shall evaluate market practices for payment of 613.33 absences and shall establish policies for payment of absent days 613.34 that reflect current market practice. 613.35 When the provider charge is greater than the maximum 613.36 provider rate allowed, the parentis responsible for payment of614.1the difference in the rates in addition tomust pay any family 614.2 copayment fee but the provider cannot require the parent to pay 614.3 the difference between the maximum rate allowed and the provider 614.4 charge. 614.5 Sec. 23. Minnesota Statutes 2002, section 119B.13, is 614.6 amended by adding a subdivision to read: 614.7 Subd. 1a. [CHILD CARE PROVIDERS; HOURLY RATES.] When a 614.8 family receiving child care assistance is authorized to receive 614.9 seven hours of care or less per day, child care assistance 614.10 payments for that care must be made on an hourly basis but may 614.11 not exceed the maximum full-day rate. 614.12 Sec. 24. Minnesota Statutes 2002, section 119B.13, is 614.13 amended by adding a subdivision to read: 614.14 Subd. 1b. [LEGAL NONLICENSED FAMILY CHILD CARE PROVIDER 614.15 RATES.] (a) Legal nonlicensed family child care providers 614.16 receiving reimbursement under this chapter must be paid on an 614.17 hourly basis for care provided to families receiving assistance. 614.18 (b) The maximum rate paid to legal nonlicensed family child 614.19 care providers must be 90 percent of the county maximum hourly 614.20 rate for licensed family child care providers. In counties 614.21 where the maximum hourly rate for licensed family child care 614.22 providers is higher than the maximum weekly rate for those 614.23 providers divided by 50, the maximum hourly rate that may be 614.24 paid to legal nonlicensed family child care providers is the 614.25 rate equal to the maximum weekly rate for licensed family child 614.26 care providers divided by 50 and then multiplied by 0.90. 614.27 (c) A rate which includes a provider bonus paid under 614.28 subdivision 2 or a special needs rate paid under subdivision 3 614.29 may be in excess of the maximum rate allowed under this 614.30 subdivision. 614.31 (d) Legal nonlicensed family child care providers receiving 614.32 reimbursement under this chapter may not be paid registration 614.33 fees for families receiving assistance. 614.34 Sec. 25. Minnesota Statutes 2002, section 119B.13, 614.35 subdivision 2, is amended to read: 614.36 Subd. 2. [PROVIDER RATE BONUS FOR ACCREDITATION.] A family 615.1 child care provider or child care center shall be paid a 615.2tenfive percent bonus above the maximum rate established in 615.3 subdivision 1, 1a, or 1b, if the provider or center holds a 615.4 current early childhood development credential approved by the 615.5 commissioner, up to the actual provider rate. 615.6 Sec. 26. Minnesota Statutes 2002, section 119B.13, 615.7 subdivision 6, is amended to read: 615.8 Subd. 6. [PROVIDER PAYMENTS.] (a) Counties or the state 615.9 shall make vendor payments to the child care provideror pay the615.10parent directlyfor eligible child care expenses, except when a 615.11 provider cares for children in the children's own home. When a 615.12 provider cares for children in the children's own home, the 615.13 county or the state shall make child care assistance payments 615.14 directly to the parent. 615.15 (b) Ifpayments for child care assistance are made to615.16providers,the child care facility is a center and has the 615.17 ability to bill electronically or keeps a detailed sign in/sign 615.18 out log, then the parent or guardian is not required to sign the 615.19 bill. If the provider does not keep detailed log sheets, both 615.20 the parent or guardian and the provider must sign the bill for 615.21 services rendered before payment is issued. For licensed family 615.22 child care and legal nonlicensed child care providers, both the 615.23 parent or guardian and the provider must sign the bill. The 615.24 provider shall bill the county for services provided within ten 615.25 days of the end of themonth ofservice period. If bills are 615.26 submittedin accordance with the provisions of this615.27subdivisionwithin ten days of the end of the service period, a 615.28 county or the state shall issue payment to the provider of child 615.29 care under the child care fund within 30 days of receivingan615.30invoicea bill from the provider. Counties or the state may 615.31 establish policies that make payments on a more frequent basis. 615.32 (c) All bills must be submitted within 90 days of the last 615.33 date of service on the bill. A county may pay a bill submitted 615.34 more than 90 days after the last date of service if the provider 615.35 shows good cause why the bill was not submitted within 90 days. 615.36 Good cause must be defined in the county's child care fund plan 616.1 under section 119B.08, subdivision 3, and the definition of good 616.2 cause must include county error. A county may not pay any bill 616.3 submitted more than one year after the last date of service on 616.4 the bill, unless the delay in payment is due to county error. 616.5 (d) A county may stop payment issued to a provider or may 616.6 refuse to pay a bill submitted by a provider if: 616.7 (1) the provider admits to intentionally providing the 616.8 county with false information on the provider's billing forms; 616.9 or 616.10 (2) a county finds by a preponderance of the evidence that 616.11 the provider intentionally gave the county false information on 616.12 the provider's billing forms. 616.13 (e) A county's payment policies must be included in the 616.14 county's child care plan under section 119B.08, subdivision 3. 616.15 If payments are made by the state, in addition to being in 616.16 compliance with this subdivision, the payments must be made in 616.17 compliance with section 16A.124. 616.18 Sec. 27. Minnesota Statutes 2002, section 119B.16, is 616.19 amended by adding a subdivision to read: 616.20 Subd. 1a. [FAIR HEARING ALLOWED FOR PROVIDERS.] (a) This 616.21 subdivision applies to providers caring for children receiving 616.22 child care assistance. 616.23 (b) A provider to whom a county agency has assigned 616.24 responsibility for an overpayment may request a fair hearing in 616.25 accordance with section 256.045 for the limited purpose of 616.26 challenging the assignment of responsibility for the overpayment 616.27 and the amount of the overpayment. The scope of the fair 616.28 hearing does not include the issues of whether the provider 616.29 wrongfully obtained public assistance in violation of section 616.30 256.98 or was properly disqualified under section 256.98, 616.31 subdivision 8, paragraph (c), unless the fair hearing has been 616.32 combined with an administrative disqualification hearing brought 616.33 against the provider under section 256.046. 616.34 Sec. 28. Minnesota Statutes 2002, section 119B.16, is 616.35 amended by adding a subdivision to read: 616.36 Subd. 1b. [JOINT FAIR HEARINGS.] When a provider requests 617.1 a fair hearing under subdivision 1a, the family in whose case 617.2 the overpayment was created must be made a party to the fair 617.3 hearing. All other issues raised by the family must be resolved 617.4 in the same proceeding. When a family requests a fair hearing 617.5 and claims that the county should have assigned responsibility 617.6 for an overpayment to a provider, the provider must be made a 617.7 party to the fair hearing. The referee assigned to a fair 617.8 hearing may join a family or a provider as a party to the fair 617.9 hearing whenever joinder of that party is necessary to fully and 617.10 fairly resolve overpayment issues raised in the appeal. 617.11 Sec. 29. Minnesota Statutes 2002, section 119B.16, 617.12 subdivision 2, is amended to read: 617.13 Subd. 2. [INFORMAL CONFERENCE.] The county agency shall 617.14 offer an informal conference to applicants and recipients 617.15 adversely affected by an agency action to attempt to resolve the 617.16 dispute. The county agency shall offer an informal conference 617.17 to providers to whom the county agency has assigned 617.18 responsibility for an overpayment in an attempt to resolve the 617.19 dispute. The county agency or the provider may ask the family 617.20 in whose case the overpayment arose to participate in the 617.21 informal conference, but the family may refuse to do so. The 617.22 county agency shall advise adversely affected applicantsand, 617.23 recipients, and providers that a request for a conference with 617.24 the agency is optional and does not delay or replace the right 617.25 to a fair hearing. 617.26 Sec. 30. Minnesota Statutes 2002, section 119B.19, 617.27 subdivision 7, is amended to read: 617.28 Subd. 7. [CHILD CARE RESOURCE AND REFERRAL PROGRAMS.] 617.29 Within each region, a child care resource and referral program 617.30 must: 617.31 (1) maintain one database of all existing child care 617.32 resources and services and one database of family referrals; 617.33 (2) provide a child care referral service for families; 617.34 (3) develop resources to meet the child care service needs 617.35 of families; 617.36 (4) increase the capacity to provide culturally responsive 618.1 child care services; 618.2 (5) coordinate professional development opportunities for 618.3 child care and school-age care providers; 618.4 (6) administer and award child care services grants; 618.5 (7) administer and provide loans for child development 618.6 education and training;and618.7 (8) cooperate with the Minnesota Child Care Resource and 618.8 Referral Network and its member programs to develop effective 618.9 child care services and child care resources; and 618.10 (9) assist in fostering coordination, collaboration, and 618.11 planning among child care programs and community programs such 618.12 as school readiness, Head Start, early childhood family 618.13 education, local interagency early intervention committees, 618.14 early childhood screening, special education services, and other 618.15 early childhood care and education services and programs that 618.16 provide flexible, family-focused services to families with young 618.17 children to the extent possible. 618.18 Sec. 31. Minnesota Statutes 2002, section 119B.21, 618.19 subdivision 11, is amended to read: 618.20 Subd. 11. [STATEWIDE ADVISORY TASK FORCE.] The 618.21 commissioner may convene a statewide advisory task force to 618.22 advise the commissioner on statewide grants or other child care 618.23 issues. The following groups must be represented: family child 618.24 care providers, child care center programs, school-age care 618.25 providers, parents who use child care services, health services, 618.26 social services, Head Start, public schools, school-based early 618.27 childhood programs, special education programs, employers, and 618.28 other citizens with demonstrated interest in child care issues. 618.29 Additional members may be appointed by the commissioner. The 618.30 commissioner may compensate members for their travel, child 618.31 care, and child care provider substitute expenses for attending 618.32 task force meetings. The commissioner may also pay a stipend to 618.33 parent representatives for participating in task force meetings. 618.34 Sec. 32. Minnesota Statutes 2002, section 119B.23, 618.35 subdivision 3, is amended to read: 618.36 Subd. 3. [BIENNIAL PLAN.] The county board shall 619.1 biennially develop a plan for the distribution of money for 619.2 child care services as part of thecommunity social services619.3plan described in section 256E.09child care fund plan under 619.4 section 119B.08. All licensed child care programs shall be 619.5 given written notice concerning the availability of money and 619.6 the application process. 619.7 Sec. 33. Minnesota Statutes 2002, section 256.046, 619.8 subdivision 1, is amended to read: 619.9 Subdivision 1. [HEARING AUTHORITY.] A local agency must 619.10 initiate an administrative fraud disqualification hearing for 619.11 individuals, including child care providers caring for children 619.12 receiving child care assistance, accused of wrongfully obtaining 619.13 assistance or intentional program violations, in lieu of a 619.14 criminal action when it has not been pursued, in the aid to 619.15 families with dependent children program formerly codified in 619.16 sections 256.72 to 256.87, MFIP, child care assistance programs, 619.17 general assistance, family general assistance program formerly 619.18 codified in section 256D.05, subdivision 1, clause (15), 619.19 Minnesota supplemental aid, medical care, or food stamp 619.20 programs. The hearing is subject to the requirements of section 619.21 256.045 and the requirements in Code of Federal Regulations, 619.22 title 7, section 273.16, for the food stamp program and title 619.23 45, section 235.112, as of September 30, 1995, for the cash 619.24 grantand, medical care programs, and child care assistance 619.25 under chapter 119B. 619.26 Sec. 34. Minnesota Statutes 2002, section 256.0471, 619.27 subdivision 1, is amended to read: 619.28 Subdivision 1. [QUALIFYING OVERPAYMENT.] Any overpayment 619.29 for assistance granted undersection 119B.05chapter 119B, the 619.30 MFIP program formerly codified under sections 256.031 to 619.31 256.0361, and the AFDC program formerly codified under sections 619.32 256.72 to 256.871; chapters 256B, 256D, 256I, 256J, and 256K; 619.33 and the food stamp program, except agency error claims, become a 619.34 judgment by operation of law 90 days after the notice of 619.35 overpayment is personally served upon the recipient in a manner 619.36 that is sufficient under rule 4.03(a) of the Rules of Civil 620.1 Procedure for district courts, or by certified mail, return 620.2 receipt requested. This judgment shall be entitled to full 620.3 faith and credit in this and any other state. 620.4 Sec. 35. Minnesota Statutes 2002, section 256.98, 620.5 subdivision 8, is amended to read: 620.6 Subd. 8. [DISQUALIFICATION FROM PROGRAM.] (a) Any person 620.7 found to be guilty of wrongfully obtaining assistance by a 620.8 federal or state court or by an administrative hearing 620.9 determination, or waiver thereof, through a disqualification 620.10 consent agreement, or as part of any approved diversion plan 620.11 under section 401.065, or any court-ordered stay which carries 620.12 with it any probationary or other conditions, in the Minnesota 620.13 family investment program, the food stamp program, the general 620.14 assistance program, the group residential housing program, or 620.15 the Minnesota supplemental aid program shall be disqualified 620.16 from that program. In addition, any person disqualified from 620.17 the Minnesota family investment program shall also be 620.18 disqualified from the food stamp program. The needs of that 620.19 individual shall not be taken into consideration in determining 620.20 the grant level for that assistance unit: 620.21 (1) for one year after the first offense; 620.22 (2) for two years after the second offense; and 620.23 (3) permanently after the third or subsequent offense. 620.24 The period of program disqualification shall begin on the 620.25 date stipulated on the advance notice of disqualification 620.26 without possibility of postponement for administrative stay or 620.27 administrative hearing and shall continue through completion 620.28 unless and until the findings upon which the sanctions were 620.29 imposed are reversed by a court of competent jurisdiction. The 620.30 period for which sanctions are imposed is not subject to 620.31 review. The sanctions provided under this subdivision are in 620.32 addition to, and not in substitution for, any other sanctions 620.33 that may be provided for by law for the offense involved. A 620.34 disqualification established through hearing or waiver shall 620.35 result in the disqualification period beginning immediately 620.36 unless the person has become otherwise ineligible for 621.1 assistance. If the person is ineligible for assistance, the 621.2 disqualification period begins when the person again meets the 621.3 eligibility criteria of the program from which they were 621.4 disqualified and makes application for that program. 621.5 (b) A family receiving assistance through child care 621.6 assistance programs under chapter 119B with a family member who 621.7 is found to be guilty of wrongfully obtaining child care 621.8 assistance by a federal court, state court, or an administrative 621.9 hearing determination or waiver, through a disqualification 621.10 consent agreement, as part of an approved diversion plan under 621.11 section 401.065, or a court-ordered stay with probationary or 621.12 other conditions, is disqualified from child care assistance 621.13 programs. The disqualifications must be for periods of three 621.14 months, six months, and two years for the first, second, and 621.15 third offenses respectively. Subsequent violations must result 621.16 in permanent disqualification. During the disqualification 621.17 period, disqualification from any child care program must extend 621.18 to all child care programs and must be immediately applied. 621.19 (c) A provider caring for children receiving assistance 621.20 through child care assistance programs under chapter 119B is 621.21 disqualified from receiving payment for child care services from 621.22 the child care assistance program under chapter 119B when the 621.23 provider is found to have wrongfully obtained child care 621.24 assistance by a federal court, state court, or an administrative 621.25 hearing determination or waiver under section 256.046, through a 621.26 disqualification consent agreement, as part of an approved 621.27 diversion plan under section 401.065, or a court-ordered stay 621.28 with probationary or other conditions. The disqualifications 621.29 must be for periods of one year and two years for the first and 621.30 second offenses respectively. Any subsequent violation must 621.31 result in permanent disqualification. The disqualification 621.32 period must be imposed immediately after a determination is made 621.33 under this paragraph. During the disqualification period, the 621.34 provider is disqualified from receiving payment from any child 621.35 care assistance program under chapter 119B. 621.36 Sec. 36. Minnesota Statutes 2002, section 466.03, 622.1 subdivision 6d, is amended to read: 622.2 Subd. 6d. [LICENSING AND AUTHORIZATION OF PROVIDERS.] A 622.3 claim against a municipality based on the failure of a provider 622.4 to meet the standards needed for a license to operate a day care 622.5 facility under chapter 245A for children, unless the622.6municipality had actual knowledge of a failure to meet licensing622.7standards that resulted in a dangerous condition that622.8foreseeably threatened the plaintiffor to meet the standards 622.9 needed for authorization as a provider for the child care 622.10 assistance program under chapter 119B. A municipality shall be 622.11 immune from liability for a claim arising out of a provider's 622.12 use of a swimming pool located at a family day care or group 622.13 family day care home under section 245A.14, subdivision 10, 622.14 unless the municipality had actual knowledge of a provider's 622.15 failure to meet the licensing standards under section 245A.14, 622.16 subdivision 10, paragraph (a), clauses (1) to (3), that resulted 622.17 in a dangerous condition that foreseeably threatened the 622.18 plaintiff. 622.19 Sec. 37. [DIRECTION TO COMMISSIONER; PROVIDER RATES.] 622.20 The provider rates determined under Minnesota Statutes, 622.21 section 119B.13, for fiscal year 2003 and implemented on July 1, 622.22 2002, are to be continued in effect through June 30, 2005. The 622.23 commissioner of human services is directed to evaluate the costs 622.24 of child care in Minnesota, to examine the differences in the 622.25 cost of child care in rural and metropolitan areas, and to make 622.26 recommendations to the legislature for containing future cost 622.27 increases in the child care program under Minnesota Statutes, 622.28 chapter 119B, in a manner that complies with federal child care 622.29 and development block grant requirements for promoting parental 622.30 choice and permits the department to track the effect of rate 622.31 changes on child care assistance program costs, the availability 622.32 of different types of care throughout the state, the length of 622.33 waiting lists, and the care options available to program 622.34 participants. The commissioner shall also examine the 622.35 allocation formula under Minnesota Statutes, section 119B.03, 622.36 and make recommendations to the legislature in order to create a 623.1 more equitable formula. The commissioner shall consider the 623.2 impact any recommendations might have on work incentives for low 623.3 and middle income families and possible changes to MFIP child 623.4 care, basic sliding fee child care, and the dependent care tax 623.5 credit. The commissioner shall make recommendations to the 623.6 legislature by January 15, 2005. 623.7 Sec. 38. [CHILD CARE WAITING LIST.] 623.8 Notwithstanding Minnesota Statutes, section 119B.03, 623.9 subdivision 6, the commissioner may manage the child care 623.10 assistance waiting list under Minnesota Statutes, section 623.11 119B.03, subdivision 2, on a regional or statewide basis in 623.12 order to ensure that families listed under higher priority 623.13 categories, as determined by Minnesota Statutes, section 623.14 119B.03, subdivision 4, are served before families listed under 623.15 lower priority categories. 623.16 Sec. 39. [CHILD CARE ASSISTANCE PARENT FEE SCHEDULE.] 623.17 Notwithstanding Minnesota Rules, part 3400.0100, subpart 4, 623.18 the parent fee schedule is as follows: 623.19 Income Range Co-payment (as a percentage of 623.20 (as a percentage of the adjusted gross income) 623.21 federal poverty guidelines) 623.22 0-74.99% $15/month 623.23 75.00-99.99% $25/month 623.24 100.00-104.99% 2.50% 623.25 105.00-109.99% 2.60% 623.26 110.00-114.99% 3.00% 623.27 115.00-119.99% 4.25% 623.28 120.00-124.99% 6.00% 623.29 125.00-139.99% 8.00% 623.30 140.00-144.99% 8.50% 623.31 145.00-149.99% 9.00% 623.32 150.00-154.99% 9.25% 623.33 155.00-159.99% 9.50% 623.34 160.00-164.99% 10.00% 623.35 165.00-169.99% 10.25% 623.36 170.00-174.99% 10.50% 624.1 175.00-179.99% 10.75% 624.2 180.00-184.99% 11.00% 624.3 185.00-189.99% 11.25% 624.4 190.00-194.99% 12.00% 624.5 195.00-199.99% 12.50% 624.6 200.00-209.99% 13.20% 624.7 210.00-224.99% 13.30% 624.8 225.00-229.99% 13.40% 624.9 230.00-234.99% 13.70% 624.10 235.00-239.99% 14.10% 624.11 240.00-244.99% 14.20% 624.12 245.00-249.99% 15.40% 624.13 250% ineligible 624.14 A family's monthly co-payment fee is the fixed percentage 624.15 established for the income range multiplied by the highest 624.16 possible income within that income range. 624.17 Sec. 40. [REPEALER.] 624.18 (a) Minnesota Statutes 2002, section 119B.061, is repealed. 624.19 (b) Laws 2001, First Special Session chapter 3, article 1, 624.20 section 16, is repealed. 624.21 ARTICLE 11A 624.22 HEALTH AND HUMAN SERVICES FORECAST ADJUSTMENTS 624.23 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 624.24 The dollar amounts shown in the columns marked 624.25 "APPROPRIATIONS" are added to or, if shown in parentheses, are 624.26 subtracted from the appropriations in Laws 2001, First Special 624.27 Session chapter 9, as amended by Laws 2002, chapter 220, and 624.28 Laws 2002, chapter 374, and are appropriated from the general 624.29 fund, or any other fund named, to the agencies and for the 624.30 purposes specified in this article, to be available for the 624.31 fiscal year indicated for each purpose. The figure "2003" used 624.32 in this article means that the appropriation or appropriations 624.33 listed under them are available for the fiscal year ending June 624.34 30, 2003. 624.35 SUMMARY BY FUND 624.36 2003 625.1 General $103,756,000 625.2 Health Care Access (1,492,000) 625.3 Federal TANF 20,419,000 625.4 APPROPRIATIONS 625.5 Available for the Year 625.6 Ending June 30, 2003 625.7 Sec. 2. COMMISSIONER OF 625.8 HUMAN SERVICES 625.9 Subdivision 1. Total 625.10 Appropriation $128,203,000 625.11 Summary by Fund 625.12 General 109,276,000 625.13 Health Care Access (1,492,000) 625.14 Federal TANF 20,419,000 625.15 Subd. 2. Administrative 625.16 Reimbursement/Pass-through 1,180,000 625.17 Subd. 3. Basic Health Care 625.18 Grants 625.19 General 59,364,000 625.20 Health Care Access (1,492,000) 625.21 The amounts that may be spent from this 625.22 appropriation for each purpose are as 625.23 follows: 625.24 (a) MinnesotaCare Grants 625.25 Health Care Access (1,492,000) 625.26 (b) MA Basic Health Care Grants - 625.27 Families and Children 625.28 General 14,708,000 625.29 (c) MA Basic Health Care Grants - 625.30 Elderly and Disabled 625.31 General 15,137,000 625.32 (d) General Assistance Medical Care 625.33 Grants 625.34 General 29,519,000 625.35 Subd. 4. Continuing Care Grants 625.36 General 56,615,000 625.37 The amounts that may be spent from this 625.38 appropriation for each purpose are as 625.39 follows: 625.40 (a) Medical Assistance Long-Term Care 625.41 Waivers and Home Care Grants 625.42 General 57,388,000 625.43 (b) Medical Assistance Long-Term Care 626.1 Facilities Grants 626.2 General 678,000 626.3 (c) Group Residential Housing Grants 626.4 General (1,451,000) 626.5 Subd. 5. Economic Support Grants 626.6 General (6,703,000) 626.7 Federal TANF 19,239,000 626.8 The amounts that may be spent from the 626.9 appropriation for each purpose are as 626.10 follows: 626.11 (a) Assistance to Families Grants 626.12 General (9,306,000) 626.13 Federal TANF 19,239,000 626.14 (b) General Assistance Grants 626.15 General 3,491,000 626.16 (c) Minnesota Supplemental Aid Grants 626.17 General (888,000) 626.18 Sec. 3. COMMISSIONER OF HEALTH 626.19 Subdivision 1. Total Appropriation (5,520,000) 626.20 Summary by Fund 626.21 General (5,520,000) 626.22 Subd. 2. Access and Quality Improvement (5,520,000) 626.23 Sec. 4. [EFFECTIVE DATE.] 626.24 Sections 1 to 3 are effective the day following final 626.25 enactment. 626.26 ARTICLE 11B 626.27 DEPARTMENT OF CHILDREN, FAMILIES, AND LEARNING 626.28 FORECAST ADJUSTMENT 626.29 Section 1. The dollar amounts shown are added to or, if shown 626.30 in parentheses, are subtracted from the appropriations in Laws 626.31 2001, First Special Session chapter 6, as amended by Laws 2002, 626.32 chapter 220, and Laws 2002, chapter 374, or other law, and are 626.33 appropriated from the general fund to the department of 626.34 children, families, and learning for the purposes specified in 626.35 this article, to be available for the fiscal year indicated for 626.36 each purpose. The figure "2003" used in this article means that 626.37 the appropriation or appropriations listed are available for the 627.1 fiscal year ending June 30, 2003. 627.2 2003 627.3 APPROPRIATION CHANGE 627.4 Sec. 2. APPROPRIATIONS; EARLY CHILDHOOD 627.5 AND FAMILY EDUCATION 627.6 MFIP Child Care 6,817,000 627.9 ARTICLE 11C 627.10 APPROPRIATIONS 627.11 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 627.12 The sums shown in the columns marked "APPROPRIATIONS" are 627.13 appropriated from the general fund, or any other fund named, to 627.14 the agencies and for the purposes specified in the sections of 627.15 this article, to be available for the fiscal years indicated for 627.16 each purpose. The figures "2004" and "2005" where used in this 627.17 article, mean that the appropriation or appropriations listed 627.18 under them are available for the fiscal year ending June 30, 627.19 2004, or June 30, 2005, respectively. Where a dollar amount 627.20 appears in parentheses, it means a reduction of an appropriation. 627.21 SUMMARY BY FUND 627.22 BIENNIAL 627.23 2004 2005 TOTAL 627.24 General $3,747,774,000 $3,668,129,000 $7,415,903,000 627.25 State Government 627.26 Special Revenue 45,162,000 44,899,000 90,061,000 627.27 Health Care 627.28 Access 260,262,000 326,325,000 586,587,000 627.29 Federal TANF 267,482,000 267,161,000 534,643,000 627.30 Lottery Prize 627.31 Fund 1,306,000 1,306,000 2,612,000 627.32 TOTAL $4,321,986,000 $4,307,820,000 $8,629,806,000 627.33 APPROPRIATIONS 627.34 Available for the Year 627.35 Ending June 30 627.36 2004 2005 627.37 Sec. 2. COMMISSIONER OF 627.38 HUMAN SERVICES 627.39 Subdivision 1. Total 627.40 Appropriation $4,074,880,000 $4,064,216,000 627.41 Summary by Fund 628.1 General 3,557,569,000 3,481,163,000 628.2 State Government 628.3 Special Revenue 534,000 534,000 628.4 Health Care 628.5 Access 253,989,000 320,052,000 628.6 Federal TANF 261,482,000 261,161,000 628.7 Lottery Cash 628.8 Flow 1,306,000 1,306,000 628.9 [RECEIPTS FOR SYSTEMS PROJECTS.] 628.10 Appropriations and federal receipts for 628.11 information system projects for MAXIS, 628.12 PRISM, MMIS, and SSIS must be deposited 628.13 in the state system account authorized 628.14 in Minnesota Statutes, section 628.15 256.014. Money appropriated for 628.16 computer projects approved by the 628.17 Minnesota office of technology, funded 628.18 by the legislature, and approved by the 628.19 commissioner of finance may be 628.20 transferred from one project to another 628.21 and from development to operations as 628.22 the commissioner of human services 628.23 considers necessary. Any unexpended 628.24 balance in the appropriation for these 628.25 projects does not cancel but is 628.26 available for ongoing development and 628.27 operations. 628.28 [GIFTS.] Notwithstanding Minnesota 628.29 Statutes, chapter 7, the commissioner 628.30 may accept on behalf of the state 628.31 additional funding from sources other 628.32 than state funds for the purpose of 628.33 financing the cost of assistance 628.34 program grants or nongrant 628.35 administration. All additional funding 628.36 is appropriated to the commissioner for 628.37 use as designated by the grantor of 628.38 funding. 628.39 [SYSTEMS CONTINUITY.] In the event of 628.40 disruption of technical systems or 628.41 computer operations, the commissioner 628.42 may use available grant appropriations 628.43 to ensure continuity of payments for 628.44 maintaining the health, safety, and 628.45 well-being of clients served by 628.46 programs administered by the department 628.47 of human services. Grant funds must be 628.48 used in a manner consistent with the 628.49 original intent of the appropriation. 628.50 [NONFEDERAL SHARE TRANSFERS.] The 628.51 nonfederal share of activities for 628.52 which federal administrative 628.53 reimbursement is appropriated to the 628.54 commissioner may be transferred to the 628.55 special revenue fund. 628.56 [TANF FUNDS APPROPRIATED TO OTHER 628.57 ENTITIES.] Any expenditures from the 628.58 TANF block grant shall be expended in 628.59 accordance with the requirements and 628.60 limitations of part A of title IV of 628.61 the Social Security Act, as amended, 628.62 and any other applicable federal 629.1 requirement or limitation. Prior to 629.2 any expenditure of these funds, the 629.3 commissioner shall assure that funds 629.4 are expended in compliance with the 629.5 requirements and limitations of federal 629.6 law and that any reporting requirements 629.7 of federal law are met. It shall be 629.8 the responsibility of any entity to 629.9 which these funds are appropriated to 629.10 implement a memorandum of understanding 629.11 with the commissioner that provides the 629.12 necessary assurance of compliance prior 629.13 to any expenditure of funds. The 629.14 commissioner shall receipt TANF funds 629.15 appropriated to other state agencies 629.16 and coordinate all related interagency 629.17 accounting transactions necessary to 629.18 implement these appropriations. 629.19 Unexpended TANF funds appropriated to 629.20 any state, local, or nonprofit entity 629.21 cancel at the end of the state fiscal 629.22 year unless appropriating language 629.23 permits otherwise. 629.24 [TANF FUNDS TRANSFERRED TO OTHER 629.25 FEDERAL GRANTS.] The commissioner must 629.26 authorize transfers from TANF to other 629.27 federal block grants so that funds are 629.28 available to meet the annual 629.29 expenditure needs as appropriated. 629.30 Transfers may be authorized prior to 629.31 the expenditure year with the agreement 629.32 of the receiving entity. Transferred 629.33 funds must be expended in the year for 629.34 which the funds were appropriated 629.35 unless appropriation language permits 629.36 otherwise. In accelerating transfer 629.37 authorizations, the commissioner must 629.38 aim to preserve the future potential 629.39 transfer capacity from TANF to other 629.40 block grants. 629.41 [TANF MAINTENANCE OF EFFORT.] (a) In 629.42 order to meet the basic maintenance of 629.43 effort (MOE) requirements of the TANF 629.44 block grant specified under Code of 629.45 Federal Regulations, title 45, section 629.46 263.1, the commissioner may only report 629.47 nonfederal money expended for allowable 629.48 activities listed in the following 629.49 clauses as TANF/MOE expenditures: 629.50 (1) MFIP cash, diversionary work 629.51 program, and food assistance benefits 629.52 under Minnesota Statutes, chapter 256J; 629.53 (2) the child care assistance programs 629.54 under Minnesota Statutes, sections 629.55 119B.03 and 119B.05, and county child 629.56 care administrative costs under 629.57 Minnesota Statutes, section 119B.15; 629.58 (3) state and county MFIP 629.59 administrative costs under Minnesota 629.60 Statutes, chapters 256J and 256K; 629.61 (4) state, county, and tribal MFIP 629.62 employment services under Minnesota 629.63 Statutes, chapters 256J and 256K; 629.64 (5) expenditures made on behalf of 630.1 noncitizen MFIP recipients who qualify 630.2 for the medical assistance without 630.3 federal financial participation program 630.4 under Minnesota Statutes, section 630.5 256B.06, subdivision 4, paragraphs (d), 630.6 (e), and (j). 630.7 (6) qualifying working family credit 630.8 expenditures under Minnesota Statutes, 630.9 section 290.0671. 630.10 (b) The commissioner shall ensure that 630.11 sufficient qualified nonfederal 630.12 expenditures are made each year to meet 630.13 the state's TANF/MOE requirements. For 630.14 the activities listed in paragraph (a), 630.15 clauses (2) to (6), the commissioner 630.16 may only report expenditures that are 630.17 excluded from the definition of 630.18 assistance under Code of Federal 630.19 Regulations, title 45, section 260.31. 630.20 (c) By August 31 of each year, the 630.21 commissioner shall make a preliminary 630.22 calculation to determine the likelihood 630.23 that the state will meet its annual 630.24 federal work participation requirement 630.25 under Code of Federal Regulations, 630.26 title 45, sections 261.21 and 261.23, 630.27 after adjustment for any caseload 630.28 reduction credit under Code of Federal 630.29 Regulations, title 45, section 261.41. 630.30 If the commissioner determines that the 630.31 state will meet its federal work 630.32 participation rate for the federal 630.33 fiscal year ending that September, the 630.34 commissioner may reduce the expenditure 630.35 under paragraph (a), clause (1), to the 630.36 extent allowed under Code of Federal 630.37 Regulations, title 45, section 630.38 263.1(a)(2). 630.39 (d) For fiscal years beginning with 630.40 state fiscal year 2003, the 630.41 commissioner shall assure that the 630.42 maintenance of effort used by the 630.43 commissioner of finance for the 630.44 February and November forecasts 630.45 required under Minnesota Statutes, 630.46 section 16A.103, contains expenditures 630.47 under paragraph (a), clause (1), equal 630.48 to at least 25 percent of the total 630.49 required under Code of Federal 630.50 Regulations, title 45, section 263.1. 630.51 (e) If nonfederal expenditures for the 630.52 programs and purposes listed in 630.53 paragraph (a) are insufficient to meet 630.54 the state's TANF/MOE requirements, the 630.55 commissioner shall recommend additional 630.56 allowable sources of nonfederal 630.57 expenditures to the legislature, if the 630.58 legislature is or will be in session to 630.59 take action to specify additional 630.60 sources of nonfederal expenditures for 630.61 TANF/MOE before a federal penalty is 630.62 imposed. The commissioner shall 630.63 otherwise provide notice to the 630.64 legislative commission on planning and 630.65 fiscal policy under paragraph (g). 631.1 (f) If the commissioner uses authority 631.2 granted under section 11, or similar 631.3 authority granted by a subsequent 631.4 legislature, to meet the state's 631.5 TANF/MOE requirement in a reporting 631.6 period, the commissioner shall inform 631.7 the chairs of the appropriate 631.8 legislative committees about all 631.9 transfers made under that authority for 631.10 this purpose. 631.11 (g) If the commissioner determines that 631.12 nonfederal expenditures under paragraph 631.13 (a) are insufficient to meet TANF/MOE 631.14 expenditure requirements, and if the 631.15 legislature is not or will not be in 631.16 session to take timely action to avoid 631.17 a federal penalty, the commissioner may 631.18 report nonfederal expenditures from 631.19 other allowable sources as TANF/MOE 631.20 expenditures after the requirements of 631.21 this paragraph are met. The 631.22 commissioner may report nonfederal 631.23 expenditures in addition to those 631.24 specified under paragraph (a) as 631.25 nonfederal TANF/MOE expenditures, but 631.26 only ten days after the commissioner of 631.27 finance has first submitted the 631.28 commissioner's recommendations for 631.29 additional allowable sources of 631.30 nonfederal TANF/MOE expenditures to the 631.31 members of the legislative commission 631.32 on planning and fiscal policy for their 631.33 review. 631.34 (h) The commissioner of finance shall 631.35 not incorporate any changes in federal 631.36 TANF expenditures or nonfederal 631.37 expenditures for TANF/MOE that may 631.38 result from reporting additional 631.39 allowable sources of nonfederal 631.40 TANF/MOE expenditures under the interim 631.41 procedures in paragraph (g) into the 631.42 February or November forecasts required 631.43 under Minnesota Statutes, section 631.44 16A.103, unless the commissioner of 631.45 finance has approved the additional 631.46 sources of expenditures under paragraph 631.47 (g). 631.48 (i) Minnesota Statutes, section 631.49 256.011, subdivision 3, which requires 631.50 that federal grants or aids secured or 631.51 obtained under that subdivision be used 631.52 to reduce any direct appropriations 631.53 provided by law, do not apply if the 631.54 grants or aids are federal TANF funds. 631.55 (j) Notwithstanding section 14, 631.56 paragraph (a), clauses (1) to (5), and 631.57 paragraphs (b) to (j) expire June 30, 631.58 2007. 631.59 [SHIFT COUNTY PAYMENT.] The 631.60 commissioner shall make up to 100 631.61 percent of the calendar year 2005 631.62 payments to counties for developmental 631.63 disabilities semi-independent living 631.64 services grants, developmental 631.65 disabilities family support grants, and 631.66 adult mental health grants from fiscal 632.1 year 2006 appropriations. This is a 632.2 onetime payment shift. Calendar year 632.3 2006 and future payments for these 632.4 grants are not affected by this shift. 632.5 This provision expires June 30, 2006. 632.6 [CAPITATION RATE INCREASE.] Of the 632.7 health care access fund appropriations 632.8 to the University of Minnesota in the 632.9 higher education omnibus appropriation 632.10 bill, $2,157,000 in fiscal year 2004 632.11 and $2,157,000 in fiscal year 2005 are 632.12 to be used to increase the capitation 632.13 payments under Minnesota Statutes, 632.14 section 256B.69. Notwithstanding the 632.15 provisions of section 14, this 632.16 provision shall not expire. 632.17 Subd. 2. Agency Management 632.18 Summary by Fund 632.19 General 41,534,000 27,868,000 632.20 State Government 632.21 Special Revenue 415,000 415,000 632.22 Health Care Access 3,673,000 3,673,000 632.23 Federal TANF 320,000 320,000 632.24 The amounts that may be spent from the 632.25 appropriation for each purpose are as 632.26 follows: 632.27 (a) Financial Operations 632.28 General 8,751,000 9,056,000 632.29 Health Care Access 828,000 828,000 632.30 Federal TANF 220,000 220,000 632.31 (b) Legal and 632.32 Regulation Operations 632.33 General 7,957,000 8,168,000 632.34 State Government 632.35 Special Revenue 415,000 415,000 632.36 Health Care Access 244,000 244,000 632.37 Federal TANF 100,000 100,000 632.38 (c) Management Operations 632.39 General 17,373,000 3,076,000 632.40 Health Care Access 1,623,000 1,623,000 632.41 (d) Information Technology 632.42 Operations 632.43 General 7,453,000 7,568,000 632.44 Health Care Access 978,000 978,000 632.45 Subd. 3. Revenue and Pass-Through 632.46 Federal TANF 54,978,000 51,345,000 633.1 [TANF TRANSFER TO SOCIAL SERVICES BLOCK 633.2 GRANT.] $6,000,000 in fiscal year 2004 633.3 and $9,272,000 in fiscal year 2005 are 633.4 appropriated to the commissioner for 633.5 the purposes of providing services for 633.6 families with children whose incomes 633.7 are at or below 200 percent of the 633.8 federal poverty guidelines. The 633.9 commissioner shall authorize a 633.10 sufficient transfer of funds from the 633.11 state's federal TANF block grant to the 633.12 state's federal social services block 633.13 grant to meet this appropriation. The 633.14 funds shall be distributed to counties 633.15 for the children and community services 633.16 grant according to the formula for the 633.17 state appropriations in Minnesota 633.18 Statutes, chapter 256M. 633.19 [TANF FUNDS FOR FISCAL YEAR 2006 AND 633.20 FISCAL YEAR 2007 REFINANCING.] 633.21 $16,724,000 in fiscal year 2006 and 633.22 $16,827,000 in fiscal year 2007 in TANF 633.23 funds are available to the commissioner 633.24 to replace general funds in the amount 633.25 of $16,724,000 in fiscal year 2006 and 633.26 $16,827,000 in fiscal year 2007 in 633.27 expenditures that may be counted toward 633.28 TANF maintenance of effort requirements 633.29 or as an allowable TANF expenditure. 633.30 [REDUCTION IN TANF TRANSFER TO CHILD 633.31 CARE AND DEVELOPMENT FUND.] Transfers 633.32 of TANF to the child care development 633.33 fund for the purposes of MFIP child 633.34 care assistance shall be reduced by 633.35 $993,000 in fiscal year 2004 and shall 633.36 be increased by $6,000 in fiscal year 633.37 2005. 633.38 Subd. 4. Children's Services Grants 633.39 Summary by Fund 633.40 General 105,760,000 92,165,000 633.41 Federal TANF 6,000,000 9,272,000 633.42 [ADOPTION ASSISTANCE INCENTIVE GRANTS.] 633.43 Federal funds available during fiscal 633.44 year 2004 and fiscal year 2005, for 633.45 adoption incentive grants are 633.46 appropriated to the commissioner for 633.47 these purposes. 633.48 [ADOPTION ASSISTANCE AND RELATIVE 633.49 CUSTODY ASSISTANCE.] The commissioner 633.50 may transfer unencumbered appropriation 633.51 balances for adoption assistance and 633.52 relative custody assistance between 633.53 fiscal years and between programs. 633.54 Subd. 5. Children's Services Management 633.55 General 5,221,000 5,283,000 633.56 Subd. 6. Basic Health Care Grants 633.57 Summary by Fund 633.58 General 1,505,760,000 1,462,747,000 634.1 Health Care Access 236,638,000 303,184,000 634.2 [UPDATING FEDERAL POVERTY GUIDELINES.] 634.3 Annual updates to the federal poverty 634.4 guidelines are effective each July 1, 634.5 following publication by the United 634.6 States Department of Health and Human 634.7 Services for health care programs under 634.8 Minnesota Statutes, chapters 256, 256B, 634.9 256D, and 256L. 634.10 [PHARMACY REIMBURSEMENT.] The 634.11 commissioner may adjust the discount 634.12 from the average wholesale price used 634.13 to estimate the actual acquisition cost 634.14 of a drug in Minnesota Statutes, 634.15 section 256B.0625, subdivision 13f, to 634.16 allow the spending to match the 634.17 allocation and tracking for that 634.18 provision. 634.19 The amounts that may be spent from this 634.20 appropriation for each purpose are as 634.21 follows: 634.22 (a) MinnesotaCare Grants 634.23 Health Care Access 232,634,000 299,083,000 634.24 [MINNESOTACARE FEDERAL RECEIPTS.] 634.25 Receipts received as a result of 634.26 federal participation pertaining to 634.27 administrative costs of the Minnesota 634.28 health care reform waiver shall be 634.29 deposited as nondedicated revenue in 634.30 the health care access fund. Receipts 634.31 received as a result of federal 634.32 participation pertaining to grants 634.33 shall be deposited in the federal fund 634.34 and shall offset health care access 634.35 funds for payments to providers. 634.36 [MINNESOTACARE FUNDING.] The 634.37 commissioner may expend money 634.38 appropriated from the health care 634.39 access fund for MinnesotaCare in either 634.40 fiscal year of the biennium. 634.41 [MINNESOTACARE NOT AN ENTITLEMENT.] The 634.42 MinnesotaCare program is not an 634.43 entitlement. Enrollment in the 634.44 program, eligibility criteria, and 634.45 covered services are subject to the 634.46 availability of funding, and may be 634.47 modified by the commissioner of human 634.48 services to maintain program 634.49 expenditures within the level of 634.50 funding. Notwithstanding section 14, 634.51 this provision does not expire. 634.52 (b) MA Basic Health Care Grants - 634.53 Families and Children 634.54 General 560,492,000 575,494,000 634.55 (c) MA Basic Health Care Grants - Elderly 634.56 and Disabled 634.57 General 700,407,000 754,349,000 634.58 [DELAY MA FEE FOR SERVICE - ACUTE 635.1 CARE.] The last payment in fiscal year 635.2 2005 from the Medicaid Management 635.3 Information System that would otherwise 635.4 have been made to providers for medical 635.5 assistance and general assistance 635.6 medical care services shall be delayed 635.7 and included in the first payment in 635.8 fiscal year 2006. This payment delay 635.9 shall not include payments to skilled 635.10 nursing facilities, intermediate care 635.11 facilities for mental retardation, 635.12 prepaid health plans, home health 635.13 agencies, personal care nursing 635.14 providers, and providers of only waiver 635.15 services. The provisions of Minnesota 635.16 Statutes, section 16A.124, shall not 635.17 apply to these delayed payments. 635.18 Notwithstanding section 14, this 635.19 provision shall not expire. 635.20 (d) General Assistance Medical Care 635.21 Grants 635.22 General 232,211,000 120,034,000 635.23 (e) Health Care Grants - Other 635.24 Assistance 635.25 General 3,067,000 3,123,000 635.26 Health Care Access 4,004,000 4,101,000 635.27 (f) Prescription Drug Program 635.28 General 9,583,000 9,747,000 635.29 [TRANSFER FOR THE PRESCRIPTION DRUG 635.30 ASSISTANCE PROGRAM.] Of the 635.31 appropriation from the general fund for 635.32 the prescription drug program under 635.33 Minnesota Statutes, section 256.955, 635.34 for the biennium beginning July 1, 2003 635.35 $1,739,000 is for the commissioner of 635.36 human services to establish and 635.37 administer the prescription drug 635.38 assistance program through the 635.39 Minnesota board on aging. 635.40 [MINNESOTA PRESCRIPTION DRUG DEDICATED 635.41 FUND.] Of this appropriation, $284,000 635.42 is appropriated from the health care 635.43 access fund to the commissioner of 635.44 human services for the fiscal year 635.45 beginning January 1, 2005, for the 635.46 Minnesota prescription drug dedicated 635.47 fund established under the prescription 635.48 drug discount program. This is a 635.49 onetime appropriation. 635.50 Subd. 7. Health Care Management 635.51 Summary by Fund 635.52 General 24,733,000 25,292,000 635.53 Health Care Access 12,329,000 11,846,000 635.54 The amounts that may be spent from this 635.55 appropriation for each purpose are as 635.56 follows: 636.1 (a) Health Care Policy Administration 636.2 General 4,472,000 5,216,000 636.3 Health Care Access 846,000 846,000 636.4 [MINNESOTACARE OUTREACH REIMBURSEMENT.] 636.5 Federal administrative reimbursement 636.6 resulting from MinnesotaCare outreach 636.7 is appropriated to the commissioner for 636.8 this activity. 636.9 [MINNESOTA SENIOR HEALTH OPTIONS 636.10 REIMBURSEMENT.] Federal administrative 636.11 reimbursement resulting from the 636.12 Minnesota senior health options project 636.13 is appropriated to the commissioner for 636.14 this activity. 636.15 [UTILIZATION REVIEW.] Federal 636.16 administrative reimbursement resulting 636.17 from prior authorization and inpatient 636.18 admission certification by a 636.19 professional review organization shall 636.20 be dedicated to the commissioner for 636.21 these purposes. A portion of these 636.22 funds must be used for activities to 636.23 decrease unnecessary pharmaceutical 636.24 costs in medical assistance. 636.25 (b) Health Care Operations 636.26 General 20,261,000 20,076,000 636.27 Health Care Access 11,483,000 11,000,000 636.28 [PREPAID MEDICAL PROGRAMS.] For all 636.29 counties in which the PMAP program has 636.30 been operating for 12 or more months, 636.31 state funding for the nonfederal share 636.32 of prepaid medical assistance program 636.33 administration costs for county managed 636.34 care advocacy and enrollment operations 636.35 is eliminated. State funding will 636.36 continue for these activities for 636.37 counties and tribes establishing new 636.38 PMAP programs for a maximum of 16 636.39 months (four months prior to beginning 636.40 PMAP enrollment and through the first 636.41 12 months of their PMAP program 636.42 operation). Those counties operating 636.43 PMAP programs for less than 12 months 636.44 can continue to receive state funding 636.45 for advocacy and enrollment activities 636.46 through their first year of operation. 636.47 Subd. 8. State-operated Services 636.48 General 195,062,000 186,775,000 636.49 [MITIGATION RELATED TO STATE-OPERATED 636.50 SERVICES RESTRUCTURING.] Money 636.51 appropriated to finance mitigation 636.52 expenses related to restructuring 636.53 state-operated services programs and 636.54 administrative services may be 636.55 transferred between fiscal years within 636.56 the biennium. 636.57 [STATE-OPERATED SERVICES 636.58 RESTRUCTURING.] For purposes of 637.1 restructuring state-operated services, 637.2 any state-operated services employee 637.3 whose position is to be eliminated 637.4 shall be afforded the options provided 637.5 in applicable collective bargaining 637.6 agreements. All salary and mitigation 637.7 allocations from fiscal year 2004 shall 637.8 be carried forward into fiscal year 637.9 2005. Provided there is no conflict 637.10 with any collective bargaining 637.11 agreement, any state-operated services 637.12 position reduction must only be 637.13 accomplished through mitigation, 637.14 attrition, transfer, and other measures 637.15 as provided in state or applicable 637.16 collective bargaining agreements and in 637.17 Minnesota Statutes, section 252.50, 637.18 subdivision 11, and not through layoff. 637.19 [REPAIRS AND BETTERMENTS.] The 637.20 commissioner may transfer unencumbered 637.21 appropriation balances between fiscal 637.22 years within the biennium for the state 637.23 residential facilities repairs and 637.24 betterments account and special 637.25 equipment. 637.26 Subd. 9. Continuing Care Grants 637.27 Summary by Fund 637.28 General 1,505,622,000 1,503,961,000 637.29 Lottery Prize Fund 1,158,000 1,158,000 637.30 The amounts that may be spent from this 637.31 appropriation for each purpose are as 637.32 follows: 637.33 (a) Aging and Adult Service Grant 637.34 General 12,960,000 13,913,000 637.35 [LONG-TERM CARE PROGRAM REDUCTIONS.] 637.36 For the biennium ending June 30, 2005, 637.37 state funding for the following state 637.38 long-term care programs is reduced by 637.39 15 percent from the level of state 637.40 funding provided on June 30, 2003: 637.41 SAIL project grants under Minnesota 637.42 Statutes, section 256B.0917; 637.43 independent living demonstration 637.44 project for persons with epilepsy 637.45 established under Laws 1988, chapter 637.46 689, article 2, section 251; senior 637.47 nutrition programs under Minnesota 637.48 Statutes, section 256.9752; foster 637.49 grandparents program under Minnesota 637.50 Statutes, section 256.976; retired 637.51 senior volunteer program under 637.52 Minnesota Statutes, section 256.9753; 637.53 and the senior companion program under 637.54 Minnesota Statutes, section 256.977. 637.55 (b) Deaf and Hard-of-hearing 637.56 Service Grants 637.57 General 1,725,000 1,498,000 637.58 (c) Mental Health Grants 638.1 General 53,744,000 34,955,000 638.2 Lottery Prize Fund 1,158,000 1,158,000 638.3 [RESTRUCTURING OF ADULT MENTAL HEALTH 638.4 SERVICES.] The commissioner may make 638.5 budget neutral transfers to effectively 638.6 implement the restructuring of adult 638.7 mental health services. "Budget 638.8 neutral transfers" means transfers 638.9 which do not increase the state share 638.10 of costs. 638.11 (d) Community Support Grants 638.12 General 13,022,000 10,091,000 638.13 (e) Medical Assistance Long-Term 638.14 Care Waivers and Home Care Grants 638.15 General 666,766,000 729,737,000 638.16 [REDUCE GROWTH IN MR/RC WAIVER.] The 638.17 commissioner shall reduce the growth in 638.18 the MR/RC waiver by not allocating the 638.19 300 additional diversion allocations 638.20 that are included in the February 2003 638.21 forecast for the fiscal years that 638.22 begin on July 1, 2003, and July 1, 2004. 638.23 [MANAGE THE GROWTH IN THE TBI WAIVER.] 638.24 During the fiscal years beginning on 638.25 July 1, 2003, and July 1, 2004, the 638.26 commissioner shall allocate money for 638.27 home and community-based programs 638.28 covered under Minnesota Statutes, 638.29 section 256B.49, to assure a reduction 638.30 in state spending that is equivalent to 638.31 limiting the caseload growth of the TBI 638.32 waiver to 150 in each year of the 638.33 biennium. Priorities for the 638.34 allocation of funds shall be for 638.35 individuals anticipated to be 638.36 discharged from institutional settings 638.37 or who are at imminent risk of a 638.38 placement in an institutional setting. 638.39 [TARGETED CASE MANAGEMENT FOR HOME CARE 638.40 RECIPIENTS.] Implementation of the 638.41 targeted case management benefit for 638.42 home care recipients, according to 638.43 Minnesota Statutes, section 256B.0621, 638.44 subdivisions 2, 3, 5, 6, 7, 9, and 10, 638.45 will be delayed until July 1, 2005. 638.46 [COMMON SERVICE MENU.] Implementation 638.47 of the common service menu option 638.48 within the home and community-based 638.49 waivers, according to Minnesota 638.50 Statutes, section 256B.49, subdivision 638.51 16, will be delayed until July 1, 2005. 638.52 (f) Medical Assistance Long-term 638.53 Care Facilities Grants 638.54 General 540,712,000 521,251,000 638.55 (g) Alternative Care Grants 638.56 General 71,382,000 59,885,000 639.1 [ALTERNATIVE CARE TRANSFER.] Any money 639.2 allocated to the alternative care 639.3 program that is not spent for the 639.4 purposes indicated does not cancel but 639.5 shall be transferred to the medical 639.6 assistance account. 639.7 [ALTERNATIVE CARE APPROPRIATION.] The 639.8 commissioner may expend the money 639.9 appropriated for the alternative care 639.10 program for that purpose in either year 639.11 of the biennium. 639.12 [ALTERNATIVE CARE IMPLEMENTATION OF 639.13 CHANGES TO PREMIUMS AND ELIGIBILITY.] 639.14 Changes to Minnesota Statutes, section 639.15 256B.0913, subdivision 4, paragraph 639.16 (d), and subdivision 12, are effective 639.17 July 1, 2003, for all persons found 639.18 eligible for the alternative care 639.19 program on or after July 1, 2003. All 639.20 recipients of alternative care funding 639.21 as of June 30, 2003, shall be subject 639.22 to Minnesota Statutes, section 639.23 256B.0913, subdivision 4, paragraph 639.24 (d), and subdivision 12, on the annual 639.25 reassessment and review of their 639.26 eligibility after July 1, 2003, but no 639.27 later than January 1, 2004. 639.28 (h) Group Residential Housing Grants 639.29 General 94,583,000 80,728,000 639.30 [GROUP RESIDENTIAL HOUSING COSTS 639.31 REFINANCED.] Effective July 1, 2004, 639.32 the commissioner shall increase the 639.33 home and community-based service rates 639.34 and county allocations provided to 639.35 programs established under section 639.36 1915(c) of the Social Security Act to 639.37 the extent that these programs will be 639.38 paying for the costs above the rate 639.39 established in Minnesota Statutes, 639.40 section 256I.05, subdivision 1. 639.41 (i) Chemical Dependency 639.42 Entitlement Grants 639.43 General 49,673,000 50,848,000 639.44 (j) Chemical Dependency Nonentitlement 639.45 Grants 639.46 General 1,055,000 1,055,000 639.47 Subd. 10. Continuing Care Management 639.48 Summary by Fund 639.49 General 21,427,000 21,258,000 639.50 State Government 639.51 Special Revenue 119,000 119,000 639.52 Lottery Prize Fund 148,000 148,000 639.53 Subd. 11. Economic Support Grants 639.54 Summary by Fund 640.1 General 113,422,000 116,511,000 640.2 Federal TANF 199,816,000 199,856,000 640.3 The amounts that may be spent from this 640.4 appropriation for each purpose are as 640.5 follows: 640.6 (a) Minnesota Family Investment Program 640.7 General 50,947,000 38,938,000 640.8 Federal TANF 104,756,000 98,170,000 640.9 (b) Work Grants 640.10 General 666,000 14,678,000 640.11 Federal TANF 95,060,000 101,686,000 640.12 [MFIP SUPPORT SERVICES COUNTY AND 640.13 TRIBAL ALLOCATION.] When determining 640.14 the funds available for the 640.15 consolidated MFIP support services 640.16 grant in the 18-month period ending 640.17 December 31, 2004, the commissioner 640.18 shall apportion the funds appropriated 640.19 for fiscal year 2005 in such manner as 640.20 necessary to provide $14,000,000 more 640.21 to counties and tribes for the period 640.22 ending December 31, 2004, than would 640.23 have been available had the funds been 640.24 evenly divided within the fiscal year 640.25 between the period before December 31, 640.26 2004, and the period after December 31, 640.27 2004. 640.28 For allocations for the calendar years 640.29 starting January 1, 2005, the 640.30 commissioner shall apportion the funds 640.31 appropriated for each fiscal year in 640.32 such manner as necessary to provide 640.33 $14,000,000 more to counties and tribes 640.34 for the period ending December 31 of 640.35 that year than would have been 640.36 available had the funds been evenly 640.37 divided within the fiscal year between 640.38 the period before December 31 and the 640.39 period after December 31. 640.40 (c) Economic Support Grants - Other 640.41 Assistance 640.42 General 3,358,000 3,463,000 640.43 (d) Child Support Enforcement Grants 640.44 General 3,571,000 3,503,000 640.45 (e) General Assistance Grants 640.46 General 24,651,000 24,482,000 640.47 [GENERAL ASSISTANCE STANDARD.] The 640.48 commissioner shall set the monthly 640.49 standard of assistance for general 640.50 assistance units consisting of an adult 640.51 recipient who is childless and 640.52 unmarried or living apart from parents 640.53 or a legal guardian at $203. The 640.54 commissioner may reduce this amount 641.1 according to Laws 1997, chapter 85, 641.2 article 3, section 54. 641.3 [EMERGENCY GENERAL ASSISTANCE.] The 641.4 amount appropriated for emergency 641.5 general assistance funds is limited to 641.6 no more than $7,889,812 in each fiscal 641.7 year of 2004 and 2005. Funds to 641.8 counties shall be allocated by the 641.9 commissioner using the allocation 641.10 method specified in Minnesota Statutes, 641.11 section 256D.06. 641.12 (f) Minnesota Supplemental Aid Grants 641.13 General 30,229,000 31,447,000 641.14 [EMERGENCY MINNESOTA SUPPLEMENTAL AID 641.15 FUNDS.] The amount appropriated for 641.16 emergency Minnesota supplemental aid 641.17 funds is limited to no more than 641.18 $1,138,707 in fiscal year 2004 and 641.19 $1,017,000 in fiscal year 2005. Funds 641.20 to counties shall be allocated by the 641.21 commissioner using the allocation 641.22 method specified in Minnesota Statutes, 641.23 section 256D.46. 641.24 Subd. 12. Economic Support 641.25 Management 641.26 Summary by Fund 641.27 General 39,028,000 39,303,000 641.28 Health Care Access 1,349,000 1,349,000 641.29 Federal TANF 368,000 368,000 641.30 The amounts that may be spent from this 641.31 appropriation for each purpose are as 641.32 follows: 641.33 (a) Economic Support 641.34 Policy Administration 641.35 General 5,360,000 5,587,000 641.36 Federal TANF 368,000 368,000 641.37 (b) Economic Support 641.38 Operations 641.39 General 33,668,000 33,716,000 641.40 Health Care Access 1,349,000 1,349,000 641.41 [CHILD SUPPORT PAYMENT CENTER.] 641.42 Payments to the commissioner from other 641.43 governmental units, private 641.44 enterprises, and individuals for 641.45 services performed by the child support 641.46 payment center must be deposited in the 641.47 state systems account authorized under 641.48 Minnesota Statutes, section 256.014. 641.49 These payments are appropriated to the 641.50 commissioner for the operation of the 641.51 child support payment center or system, 641.52 according to Minnesota Statutes, 641.53 section 256.014. 642.1 [CHILD SUPPORT COST RECOVERY FEES.] The 642.2 commissioner shall transfer $247,000 of 642.3 child support cost recovery fees 642.4 collected in fiscal year 2005 to the 642.5 PRISM special revenue account to offset 642.6 PRISM system costs of implementing the 642.7 fee. 642.8 [FINANCIAL INSTITUTION DATA MATCH AND 642.9 PAYMENT OF FEES.] The commissioner is 642.10 authorized to allocate up to $310,000 642.11 each year in fiscal year 2004 and 642.12 fiscal year 2005 from the PRISM special 642.13 revenue account to make payments to 642.14 financial institutions in exchange for 642.15 performing data matches between account 642.16 information held by financial 642.17 institutions and the public authority's 642.18 database of child support obligors as 642.19 authorized by Minnesota Statutes, 642.20 section 13B.06, subdivision 7. 642.21 Sec. 3. COMMISSIONER OF HEALTH 642.22 Subdivision 1. Total 642.23 Appropriation 101,714,000 101,980,000 642.24 Summary by Fund 642.25 General 56,561,000 57,090,000 642.26 State Government 642.27 Special Revenue 32,880,000 32,617,000 642.28 Health Care Access 6,273,000 6,273,000 642.29 Federal TANF 6,000,000 6,000,000 642.30 Subd. 2. Health Improvement 642.31 Summary by Fund 642.32 General 42,584,000 42,178,000 642.33 State Government 642.34 Special Revenue 1,987,000 1,987,000 642.35 Health Care Access 3,510,000 3,510,000 642.36 Federal TANF 6,000,000 6,000,000 642.37 [TOBACCO PREVENTION ENDOWMENT FUND 642.38 TRANSFERS.] (a) On July 1, 2003, the 642.39 commissioner of finance shall transfer 642.40 $4,000,000 from the tobacco use 642.41 prevention and local public health 642.42 endowment expendable trust fund to the 642.43 general fund. 642.44 (b) Notwithstanding Minnesota Statutes, 642.45 section 16A.62, any remaining 642.46 unexpended balance in the fund after 642.47 the transfer in paragraph (a) shall be 642.48 transferred to the miscellaneous 642.49 special revenue fund and dedicated to 642.50 the commissioner of health for a youth 642.51 tobacco prevention program. These 642.52 funds are available until expended. 642.53 [TANF APPROPRIATIONS.] TANF funds 642.54 appropriated to the commissioner are 643.1 available for home visiting and 643.2 nutritional activities listed under 643.3 Minnesota Statutes, section 145.882, 643.4 subdivision 7, clauses (6) and (7), and 643.5 eliminating health disparities 643.6 activities under Minnesota Statutes, 643.7 section 145.928, subdivision 10. 643.8 Funding shall be distributed to 643.9 community health boards and tribal 643.10 governments based on the formula in 643.11 Minnesota Statutes, section 145A.131, 643.12 subdivisions 1 and 2. 643.13 [TANF CARRYFORWARD.] Any unexpended 643.14 balance of the TANF appropriation in 643.15 the first year of the biennium does not 643.16 cancel but is available for the second 643.17 year. 643.18 [IGT MEDICARE UPPER PAYMENT LIMIT.] If 643.19 variations in intergovernmental 643.20 transfer revenue occur resulting from 643.21 adjustments to medical assistance and 643.22 general assistance medical care 643.23 payments for inpatient and outpatient 643.24 hospital services, then appropriations 643.25 for community clinic grants and rural 643.26 hospital capital improvement grants 643.27 shall be adjusted accordingly. 643.28 [FAMILY PLANNING GRANTS.] On June 30, 643.29 2005, family planning grants are 643.30 reduced by $4,478,000. Base level 643.31 funding in each year of the fiscal year 643.32 2006-2007 biennium is $2,618,000. 643.33 Subd. 3. Health Quality and 643.34 Access 643.35 Summary by Fund 643.36 General 873,000 814,000 643.37 State Government 643.38 Special Revenue 8,888,000 8,888,000 643.39 Health Care Access 2,763,000 2,763,000 643.40 [STATE GOVERNMENT SPECIAL REVENUE FUND 643.41 TRANSFERS.] On July 1, 2003, the 643.42 commissioner of finance shall transfer 643.43 $3,000,000 from the state government 643.44 special revenue fund to the general 643.45 fund. On July 1, 2004, the 643.46 commissioner of finance shall transfer 643.47 $1,000,000 from the state government 643.48 special revenue fund to the general 643.49 fund. 643.50 [NURSING PROVIDERS WORK GROUP.] 643.51 Notwithstanding the provisions of 643.52 Minnesota Statutes, section 144A.10, 643.53 during the next biennium, the 643.54 commissioner of health shall not 643.55 conduct surveys under the provisions of 643.56 Minnesota Rules, chapter 4655, and 643.57 chapter 4658, parts 4658.0010 to 643.58 4658.2090 in nursing homes or boarding 643.59 care homes that are certified for 643.60 participation in the federal Medicaid 643.61 or Medicare program. During the next 644.1 biennium, the commissioner of health 644.2 shall establish a working group 644.3 consisting of nursing home and boarding 644.4 care home providers, representatives of 644.5 nursing home residents, and other 644.6 health care providers to review current 644.7 licensure provisions and evaluate the 644.8 continued appropriateness of these 644.9 provisions. The commissioner shall 644.10 present recommendations to the 644.11 legislature by January 1, 2005. 644.12 [MEDICAL EDUCATION ENDOWMENT FUND 644.13 TRANSFERS.] Notwithstanding Minnesota 644.14 Statutes, section 16A.62, any remaining 644.15 unexpended balances in the medical 644.16 education expendable trust fund shall 644.17 be transferred to the miscellaneous 644.18 special revenue fund and dedicated to 644.19 the commissioner for the purposes 644.20 identified in Minnesota Statutes, 644.21 section 62J.692. These funds are 644.22 available until expended. 644.23 [MEDICAL EDUCATION AND RESEARCH COSTS.] 644.24 $8,660,000 in fiscal year 2004 and 644.25 $8,616,000 in fiscal year 2005 are 644.26 appropriated from the medical education 644.27 and research costs account in the 644.28 special revenue fund for medical 644.29 education and research funding. In the 644.30 event that the balance in the account 644.31 is less than the appropriation, the 644.32 appropriation is reduced accordingly. 644.33 Subd. 4. Health Protection 644.34 Summary by Fund 644.35 General 8,855,000 8,855,000 644.36 State Government 644.37 Special Revenue 22,005,000 21,742,000 644.38 Subd. 5. Management and Support 644.39 Services 644.40 General 5,249,000 5,243,000 644.41 [STATE GOVERNMENT SPECIAL REVENUE FUND 644.42 TRANSFERS.] On July 1, 2003, the 644.43 commissioner of finance shall transfer 644.44 $4,000,000 from the state government 644.45 special revenue fund to the general 644.46 fund. 644.47 Sec. 4. VETERANS HOME BOARD 644.48 General 30,030,000 30,030,000 644.49 [VETERANS HOMES SPECIAL REVENUE 644.50 ACCOUNT.] The general fund 644.51 appropriations made to the board may be 644.52 transferred to a veterans homes special 644.53 revenue account in the special revenue 644.54 fund in the same manner as other 644.55 receipts are deposited according to 644.56 Minnesota Statutes, section 198.34, and 644.57 are appropriated to the board for the 644.58 operation of board facilities and 644.59 programs. 645.1 Sec. 5. HEALTH-RELATED BOARDS 645.2 Subdivision 1. Total 645.3 Appropriation 11,266,000 11,266,000 645.4 [STATE GOVERNMENT SPECIAL REVENUE 645.5 FUND.] The appropriations in this 645.6 section are from the state government 645.7 special revenue fund, except where 645.8 noted. 645.9 [NO SPENDING IN EXCESS OF REVENUES.] 645.10 The commissioner of finance shall not 645.11 permit the allotment, encumbrance, or 645.12 expenditure of money appropriated in 645.13 this section in excess of the 645.14 anticipated biennial revenues or 645.15 accumulated surplus revenues from fees 645.16 collected by the boards. Neither this 645.17 provision nor Minnesota Statutes, 645.18 section 214.06, applies to transfers 645.19 from the general contingent account. 645.20 [STATE GOVERNMENT SPECIAL REVENUE FUND 645.21 TRANSFERS.] On July 1, 2003, the 645.22 commissioner of finance shall transfer 645.23 $3,500,000 from the state government 645.24 special revenue fund to the general 645.25 fund. 645.26 Subd. 2. Board of Chiropractic 645.27 Examiners 384,000 384,000 645.28 Subd. 3. Board of Dentistry 645.29 State Government Special 645.30 Revenue Fund 858,000 858,000 645.31 Health Care 645.32 Access Fund 64,000 64,000 645.33 Subd. 4. Board of Dietetic and 645.34 Nutrition Practice 101,000 101,000 645.35 Subd. 5. Board of Marriage and 645.36 Family Therapy 118,000 118,000 645.37 Subd. 6. Board of Medical 645.38 Practice 3,498,000 3,498,000 645.39 Subd. 7. Board of Nursing 2,405,000 2,405,000 645.40 Subd. 8. Board of Nursing 645.41 Home Administrators 198,000 198,000 645.42 Subd. 9. Board of Optometry 96,000 96,000 645.43 Subd. 10. Board of Pharmacy 1,386,000 1,386,000 645.44 [ADMINISTRATIVE SERVICES UNIT.] Of this 645.45 appropriation, $359,000 the first year 645.46 and $359,000 the second year are for 645.47 the health boards administrative 645.48 services unit. The administrative 645.49 services unit may receive and expend 645.50 reimbursements for services performed 645.51 for other agencies. 645.52 Subd. 11. Board of Physical 645.53 Therapy 197,000 197,000 646.1 Subd. 12. Board of Podiatry 45,000 45,000 646.2 Subd. 13. Board of Psychology 680,000 680,000 646.3 Subd. 14. Board of Social 646.4 Work 1,073,000 1,073,000 646.5 Subd. 15. Board of Veterinary 646.6 Medicine 163,000 163,000 646.7 Sec. 6. EMERGENCY MEDICAL SERVICES BOARD 646.8 Subdivision 1. Total 646.9 Appropriation 2,850,000 2,850,000 646.10 Summary by Fund 646.11 General 2,304,000 2,304,000 646.12 State Government 646.13 Special Revenue 546,000 546,000 646.14 [HEALTH PROFESSIONAL SERVICES 646.15 ACTIVITY.] $546,000 each year from the 646.16 state government special revenue fund 646.17 is for the health professional services 646.18 activity. 646.19 Sec. 7. COUNCIL ON DISABILITY 646.20 General 500,000 500,000 646.21 Sec. 8. OMBUDSMAN FOR MENTAL HEALTH 646.22 AND MENTAL RETARDATION 646.23 General 1,243,000 1,242,000 646.24 Sec. 9. OMBUDSMAN FOR 646.25 FAMILIES 646.26 General 170,000 170,000 646.27 Sec. 10. DEPARTMENT OF CHILDREN, 646.28 FAMILIES, AND LEARNING 646.29 Subdivision 1. Total 646.30 Appropriation $ 122,906,000 $ 117,307,000 646.31 Summary by Fund 646.32 General 95,431,000 93,318,000 646.33 Federal TANF 24,135,000 20,649,000 646.34 State Special 646.35 Revenue 3,340,000 3,340,000 646.36 Subd. 2. Child Care 646.37 [BASIC SLIDING FEE CHILD CARE.] Of this 646.38 appropriation, $23,561,000 in fiscal 646.39 year 2004, and $18,984,000 in fiscal 646.40 year 2005 are for child care assistance 646.41 according to Minnesota Statutes, 646.42 section 119B.03. These appropriations 646.43 are available to be spent either year. 646.44 [MFIP CHILD CARE.] Of this 646.45 appropriation, $66,752,000 in fiscal 646.46 year 2004, and $67,416,000 in fiscal 646.47 year 2005 are for MFIP child care. 647.1 [CHILD CARE PROGRAM INTEGRITY.] Of this 647.2 appropriation, $425,000 in fiscal year 647.3 2004, and $376,000 in fiscal year 2005 647.4 are for the administrative costs of 647.5 program integrity and fraud prevention 647.6 for child care assistance under 647.7 Minnesota Statutes, chapter 119B. 647.8 [CHILD CARE DEVELOPMENT.] Of this 647.9 appropriation, $1,115,000 in fiscal 647.10 year 2004, and $1,164,000 in fiscal 647.11 year 2005 are for child care 647.12 development grants according to 647.13 Minnesota Statutes, section 119B.21. 647.14 Subd. 3. Child Care Assistance 647.15 Special Revenue Account 3,340,000 $ 3,340,000 647.16 [CHILD SUPPORT SPECIAL REVENUE 647.17 ACCOUNT.] Appropriations and transfers 647.18 in this subdivision are from the child 647.19 support collection payments in the 647.20 special revenue fund, pursuant to 647.21 Minnesota Statutes, section 119B.074. 647.22 The sums indicated are appropriated to 647.23 the department of children, families, 647.24 and learning for the fiscal years 647.25 designated. 647.26 [CHILD CARE ASSISTANCE.] Of this 647.27 appropriation, $3,340,000 in fiscal 647.28 year 2004, and $3,340,000 in fiscal 647.29 year 2005 are for child care assistance 647.30 according to Minnesota Statutes, 647.31 section 119B.03. 647.32 [SPECIAL REVENUE ACCOUNT UNOBLIGATED 647.33 FUND TRANSFER.] On July 1, 2003, the 647.34 commissioner of finance shall transfer 647.35 $1,800,000 from the special revenue 647.36 fund to the general fund. 647.37 Subd. 4. Child Care 647.38 Assistance TANF Funds 647.39 [FEDERAL TANF TRANSFERS.] The sums 647.40 indicated in this section are 647.41 transferred from the federal TANF fund 647.42 to the child care and development fund 647.43 and are appropriated to the department 647.44 of children, families, and learning for 647.45 the fiscal years indicated. The 647.46 commissioner shall ensure that all 647.47 transferred funds are expended 647.48 according to the child care and 647.49 development fund regulations and that 647.50 maximum allowable transferred funds are 647.51 used for the following programs: 647.52 (a) For basic sliding fee child care, 647.53 $17,819,000 in fiscal year 2004 and 647.54 $17,824,000 in fiscal year 2005, are 647.55 for child care assistance under 647.56 Minnesota Statutes, section 119B.03. 647.57 (b) For MFIP/TY, $6,302,000 in fiscal 647.58 year 2004 and $2,825,000 in fiscal year 647.59 2005 are for child care assistance 647.60 under Minnesota Statutes, section 647.61 119B.05. 648.1 (c) For child care development grants 648.2 under Minnesota Statutes, section 648.3 119B.21, $14,000 is available in fiscal 648.4 year 2004. 648.5 Subd. 5. Self-Sufficiency Programs 648.6 General 5,378,000 5,378,000 648.7 [MINNESOTA ECONOMIC OPPORTUNITY 648.8 GRANTS.] Of this appropriation, 648.9 $4,000,000 in fiscal year 2004 and 648.10 $4,000,000 in fiscal year 2005 are for 648.11 Minnesota economic opportunity grants. 648.12 [FOOD SHELF PROGRAMS.] Of this 648.13 appropriation, $1,278,000 in fiscal 648.14 year 2004 and $1,278,000 in fiscal year 648.15 2005 are for food shelf programs under 648.16 Minnesota Statutes, section 119A.44. 648.17 [LEAD ABATEMENT.] Of this 648.18 appropriation, $100,000 in fiscal year 648.19 2004 and $100,000 in fiscal year 2005 648.20 are for lead abatement according to 648.21 Minnesota Statutes, section 119A.46. 648.22 Any balance in the first year does not 648.23 cancel but is available in the second 648.24 year. 648.25 Sec. 11. [TRANSFERS.] 648.26 Subdivision 1. [GRANTS.] The commissioner of human 648.27 services, with the approval of the commissioner of finance, and 648.28 after notification of the chair of the senate health, human 648.29 services and corrections budget division and the chair of the 648.30 house health and human services finance committee, may transfer 648.31 unencumbered appropriation balances for the biennium ending June 648.32 30, 2005, within fiscal years among the MFIP, general 648.33 assistance, general assistance medical care, medical assistance, 648.34 Minnesota supplemental aid, and group residential housing 648.35 programs, and the entitlement portion of the chemical dependency 648.36 consolidated treatment fund, and between fiscal years of the 648.37 biennium. 648.38 Subd. 2. [ADMINISTRATION.] Positions, salary money, and 648.39 nonsalary administrative money may be transferred within the 648.40 departments of human services and health and within the programs 648.41 operated by the veterans nursing homes board as the 648.42 commissioners and the board consider necessary, with the advance 648.43 approval of the commissioner of finance. The commissioner or 648.44 the board shall inform the chairs of the house health and human 648.45 services finance committee and the senate health, human services 649.1 and corrections budget division quarterly about transfers made 649.2 under this provision. 649.3 Subd. 3. [PROHIBITED TRANSFERS.] Grant money shall not be 649.4 transferred to operations within the departments of human 649.5 services and health and within the programs operated by the 649.6 veterans nursing homes board without the approval of the 649.7 legislature. 649.8 Sec. 12. [INDIRECT COSTS NOT TO FUND PROGRAMS.] 649.9 The commissioners of health and of human services shall not 649.10 use indirect cost allocations to pay for the operational costs 649.11 of any program for which they are responsible. 649.12 Sec. 13. [CARRYOVER LIMITATION.] 649.13 The appropriations in this article which are allowed to be 649.14 carried forward from fiscal year 2004 to fiscal year 2005 shall 649.15 not become part of the base level funding for the 2006-2007 649.16 biennial budget, unless specifically directed by the legislature. 649.17 Sec. 14. [SUNSET OF UNCODIFIED LANGUAGE.] 649.18 All uncodified language contained in this article expires 649.19 on June 30, 2005, unless a different expiration date is explicit. 649.20 Sec. 15. [REPEALER.] 649.21 Laws 2002, chapter 374, article 9, section 8, is repealed 649.22 effective upon final enactment. 649.23 Sec. 16. [EFFECTIVE DATE.] 649.24 The provisions in this article are effective July 1, 2003, 649.25 unless a different effective date is specified.