Minnesota Legislature
SF 4
1st Engrossment - 82nd Legislature, 2001 1st Special Session (2001 - 2002) Posted on 12/15/2009 12:00am
KEY: stricken = removed, old language.
underscored = added, new language.
Bill Text Versions
| Engrossments | ||
|---|---|---|
| Introduction | Posted on 12/23/2002 | |
| 1st Engrossment | Posted on 12/23/2002 |
Current Version - 1st Engrossment
1.1 A bill for an act 1.2 relating to the operation of state government; 1.3 modifying provisions relating to health; health 1.4 department; health care; human services; human 1.5 services department; continuing care; consumer 1.6 information; long-term care; mental health and civil 1.7 commitment; assistance programs; nursing services 1.8 agencies; workforce and recruitment; child welfare and 1.9 foster care; child support licensing and licensing 1.10 background studies; vital statistics; patient 1.11 protection; criminal justice; driving while impaired; 1.12 appropriating money for health and human services and 1.13 criminal justice; amending Minnesota Statutes 2000, 1.14 sections 13.46, subdivision 4; 13.461, subdivision 17; 1.15 13B.06, subdivision 7; 15A.083, subdivision 4; 45.027, 1.16 subdivision 6; 62A.095, subdivision 1; 62A.48, 1.17 subdivision 4, by adding subdivisions; 62D.17, 1.18 subdivision 1; 62J.152, subdivision 8; 62J.38; 1.19 62J.451, subdivision 5; 62J.692, subdivision 7, by 1.20 adding a subdivision; 62M.02, subdivision 21; 62Q.56; 1.21 62Q.58; 62S.01, by adding subdivisions; 62S.26; 1.22 103I.101, subdivision 6; 103I.112; 103I.208, 1.23 subdivisions 1, 2; 103I.235, subdivision 1; 103I.525, 1.24 subdivisions 2, 6, 8, 9; 103I.531, subdivisions 2, 6, 1.25 8, 9; 103I.535, subdivisions 2, 6, 8, 9; 103I.541, 1.26 subdivisions 2b, 4, 5; 103I.545; 116L.11, subdivision 1.27 4; 116L.12, subdivisions 4, 5; 116L.13, subdivision 1; 1.28 121A.15, by adding subdivisions; 135A.14, by adding a 1.29 subdivision; 137.38, subdivision 1; 144.057; 144.0721, 1.30 subdivision 1; 144.1202, subdivision 4; 144.122; 1.31 144.1464; 144.148, subdivision 2; 144.1491, 1.32 subdivision 1; 144.212, subdivisions 2a, 3, 5, 7, 8, 1.33 9, 11; 144.214, subdivisions 1, 3, 4; 144.215, 1.34 subdivisions 1, 3, 4, 6, 7; 144.217; 144.218; 144.221, 1.35 subdivisions 1, 3; 144.222, subdivision 2; 144.223; 1.36 144.225, subdivisions 1, 2, 2a, 3, 7, as amended; 1.37 144.226, subdivisions 1, 3, 4; 144.227; 144.395, 1.38 subdivision 2; 144.551, subdivision 1; 144.98, 1.39 subdivision 3; 144A.071, subdivisions 1, 1a, 2, 4a; 1.40 144A.073, subdivisions 2, as amended, 4; 144A.44, 1.41 subdivision 1; 144A.4605, subdivision 4; 144D.03, 1.42 subdivision 2; 144D.04, subdivisions 2, 3; 144D.06; 1.43 145.881, subdivision 2; 145A.15, subdivision 1, by 1.44 adding a subdivision; 145A.16, subdivision 1, by 1.45 adding a subdivision; 148.212; 148.284; 148B.21, 1.46 subdivision 6a; 148B.22, subdivision 3; 150A.10, by 2.1 adding a subdivision; 157.16, subdivision 3; 157.22, 2.2 as amended; 169A.07; 169A.20, subdivision 3; 169A.25; 2.3 169A.26; 169A.27; 169A.275; 169A.283, subdivision 1; 2.4 169A.40, subdivision 3; 169A.63, subdivision 1; 2.5 171.29, subdivision 2; 214.104; 241.272, subdivision 2.6 6; 241.32, by adding a subdivision; 241.45; 242.192; 2.7 243.51, subdivisions 1, 3; 245.462, subdivisions 8, 2.8 18, by adding subdivisions; 245.474, by adding a 2.9 subdivision; 245.4871, subdivisions 10, 27, by adding 2.10 a subdivision; 245.4875, subdivision 2; 245.4876, 2.11 subdivision 1, by adding a subdivision; 245.488, by 2.12 adding a subdivision; 245.4885, subdivision 1; 2.13 245.4886, subdivision 1; 245.814, subdivision 1; 2.14 245.99, subdivision 4; 245A.02, subdivisions 1, 9, by 2.15 adding a subdivision; 245A.03, subdivisions 2, 2b, by 2.16 adding a subdivision; 245A.035, subdivision 1; 2.17 245A.04, subdivisions 3, 3a, 3b, 3c, 3d, 6, 11, by 2.18 adding a subdivision; 245A.05; 245A.06; 245A.07; 2.19 245A.08; 245A.13, subdivisions 7, 8; 245A.16, 2.20 subdivision 1; 245B.08, subdivision 3; 252.275, 2.21 subdivision 4b; 252A.02, subdivisions 12, 13, by 2.22 adding a subdivision; 252A.111, subdivision 6; 2.23 252A.16, subdivision 1; 252A.19, subdivision 2; 2.24 252A.20, subdivision 1; 253B.02, subdivisions 10, 13; 2.25 253B.03, subdivisions 5, 10, by adding a subdivision; 2.26 253B.04, subdivisions 1, 1a, by adding a subdivision; 2.27 253B.045, subdivision 6; 253B.05, subdivision 1; 2.28 253B.065, subdivision 5; 253B.066, subdivision 1; 2.29 253B.07, subdivisions 1, 2, 7; 253B.09, subdivision 1; 2.30 253B.10, subdivision 4; 254B.02, subdivision 3; 2.31 254B.03, subdivision 1; 254B.04, subdivision 1; 2.32 254B.09, by adding a subdivision; 256.01, subdivisions 2.33 2, as amended, 18, by adding a subdivision; 256.045, 2.34 subdivisions 3, 3b, 4; 256.476, subdivisions 1, 2, 3, 2.35 4, 5, 8, by adding a subdivision; 256.741, 2.36 subdivisions 1, 5, 8; 256.955, subdivisions 2a, 2b; 2.37 256.9657, subdivision 2; 256.969, subdivision 3a, by 2.38 adding a subdivision; 256.975, by adding subdivisions; 2.39 256.979, subdivisions 5, 6; 256.98, subdivision 8; 2.40 256B.04, by adding a subdivision; 256B.055, 2.41 subdivision 3a; 256B.056, subdivisions 1a, 3, 4, 4b, 2.42 5, by adding subdivisions; 256B.057, subdivisions 2, 2.43 3, 7, 9, by adding a subdivision; 256B.0625, 2.44 subdivisions 3b, 7, 13, 13a, 17, 17a, 18a, 19a, 19c, 2.45 20, 30, 34, by adding subdivisions; 256B.0627, 2.46 subdivisions 1, 2, 4, 5, 7, 8, 10, 11, by adding 2.47 subdivisions; 256B.0635, subdivisions 1, 2; 256B.0644; 2.48 256B.0911, subdivisions 1, 3, 5, 6, 7, by adding 2.49 subdivisions; 256B.0913, subdivisions 1, 2, 4, 5, 6, 2.50 7, 8, 9, 10, 11, 12, 13, 14; 256B.0915, subdivisions 2.51 1d, 3, 5; 256B.0916, subdivisions 7, 9, by adding a 2.52 subdivision; 256B.0917, subdivision 7, by adding a 2.53 subdivision; 256B.092, subdivision 5; 256B.093, 2.54 subdivision 3; 256B.095; 256B.0951, subdivisions 1, 3, 2.55 4, 5, 7, by adding subdivisions; 256B.0952, 2.56 subdivisions 1, 4; 256B.19, subdivision 1c; 256B.431, 2.57 subdivisions 2e, 17, by adding subdivisions; 256B.433, 2.58 subdivision 3a; 256B.434, subdivision 4, by adding 2.59 subdivisions; 256B.49, by adding subdivisions; 2.60 256B.5012, by adding a subdivision; 256B.69, 2.61 subdivisions 4, 5c, 23, by adding a subdivision; 2.62 256B.75; 256B.76; 256D.03, subdivision 3; 256D.053, 2.63 subdivision 1; 256D.35, by adding subdivisions; 2.64 256D.425, subdivision 1; 256D.44, subdivision 5; 2.65 256I.05, subdivisions 1d, 1e, by adding a subdivision; 2.66 256J.08, subdivision 55a, by adding a subdivision; 2.67 256J.09, subdivisions 1, 2, 3, by adding subdivisions; 2.68 256J.21, subdivision 2; 256J.24, subdivisions 2, 9, 2.69 10; 256J.26, subdivision 1; 256J.31, subdivisions 4, 2.70 12; 256J.32, subdivisions 4, 7a; 256J.37, subdivision 2.71 9; 256J.39, subdivision 2; 256J.42, subdivisions 1, 3, 3.1 4, by adding a subdivision; 256J.45, subdivisions 1, 3.2 2; 256J.46, subdivisions 1, 2a; 256J.48, by adding a 3.3 subdivision; 256J.49, subdivisions 2, 13, by adding a 3.4 subdivision; 256J.50, subdivisions 1, 7, 10, by adding 3.5 a subdivision; 256J.515; 256J.52, subdivisions 2, 6; 3.6 256J.53, subdivision 1; 256J.56; 256J.57, subdivision 3.7 2; 256J.62, subdivisions 2a, 9; 256J.625, subdivisions 3.8 1, 2, 4; 256J.645; 256J.751; 256K.03, subdivision 1; 3.9 256K.07; 256K.25, subdivisions 1, 3, 4, 5, 6; 256L.03, 3.10 by adding a subdivision; 256L.05, subdivision 2; 3.11 256L.06, subdivision 3; 256L.07, subdivision 2; 3.12 256L.12, by adding a subdivision; 256L.15, subdivision 3.13 1; 256L.16; 256L.17, subdivision 2; 257.0725; 3.14 260C.201, subdivision 1, as amended; 260C.301, 3.15 subdivision 3, as amended; 260C.317, subdivision 4; 3.16 261.062; 268.0122, subdivision 2; 326.38; 357.021, 3.17 subdivisions 6, 7; 393.07, by adding a subdivision; 3.18 518.5513, subdivision 5; 518.575, subdivision 1; 3.19 518.5851, by adding a subdivision; 518.5853, by adding 3.20 a subdivision; 518.6111, subdivision 5; 518.6195; 3.21 518.64, subdivision 2, as amended; 518.641, 3.22 subdivisions 1, 2, 3, by adding a subdivision; 3.23 548.091, subdivision 1a; 611.23; 626.556, subdivisions 3.24 10, as amended, 10b, 10d, as amended, 10e, 10f, 10i, 3.25 as amended, 11, 12; 626.557, subdivisions 3, 9d, 12b; 3.26 626.5572, subdivision 17; 626.559, subdivision 2; Laws 3.27 1995, chapter 178, article 2, section 36; Laws 1995, 3.28 chapter 207, article 3, section 21, as amended; Laws 3.29 1997, chapter 203, article 9, section 21, as amended; 3.30 Laws 1999, chapter 152, section 1; Laws 1999, chapter 3.31 152, section 4; Laws 1999, chapter 245, article 3, 3.32 section 45, as amended; Laws 1999, chapter 245, 3.33 article 4, section 110; Laws 1999, chapter 245, 3.34 article 10, section 10, as amended; Laws 2000, chapter 3.35 364, section 2; Laws 2001, chapter 154, section 1, 3.36 subdivision 1; Laws 2001, chapter 161, section 45; 3.37 proposing coding for new law in Minnesota Statutes, 3.38 chapters 62D; 62Q; 62S; 116L; 144; 144A; 145; 145A; 3.39 169A; 214; 244; 245A; 246; 256; 256B; 256I; 256J; 3.40 299A; 325F; repealing Minnesota Statutes 2000, 3.41 sections 116L.12, subdivisions 2, 7; 121A.15, 3.42 subdivision 6; 144.148, subdivision 8; 144.1761; 3.43 144.217, subdivision 4; 144.219; 144A.16; 145.9245; 3.44 145.927; 252A.111, subdivision 3; 256.476, subdivision 3.45 7; 256B.0635, subdivision 3; 256B.0911, subdivisions 3.46 2, 2a, 4, 9; 256B.0912; 256B.0913, subdivisions 3, 3.47 15a, 15b, 15c, 16; 256B.0915, subdivisions 3a, 3b, 3c; 3.48 256B.0951, subdivision 6; 256B.19, subdivision 1b; 3.49 256B.434, subdivision 5; 256B.49, subdivisions 1, 2, 3.50 3, 4, 5, 6, 7, 8, 9, 10; 256D.066; 256J.08, 3.51 subdivision 50a; 256J.12, subdivision 3; 256J.43; 3.52 256J.44; 256J.46, subdivision 1a; 256J.49, subdivision 3.53 11; 256J.53, subdivision 4; 256L.02, subdivision 4; 3.54 518.641, subdivisions 4, 5; Laws 1995, chapter 178, 3.55 article 2, section 48, subdivision 6; Minnesota Rules, 3.56 parts 4655.6810; 4655.6820; 4655.6830; 4658.1600; 3.57 4658.1605; 4658.1610; 4658.1690; 9505.2390; 9505.2395; 3.58 9505.2396; 9505.2400; 9505.2405; 9505.2410; 9505.2413; 3.59 9505.2415; 9505.2420; 9505.2425; 9505.2426; 9505.2430; 3.60 9505.2435; 9505.2440; 9505.2445; 9505.2450; 9505.2455; 3.61 9505.2458; 9505.2460; 9505.2465; 9505.2470; 9505.2473; 3.62 9505.2475; 9505.2480; 9505.2485; 9505.2486; 9505.2490; 3.63 9505.2495; 9505.2496; 9505.2500; 9505.3010; 9505.3015; 3.64 9505.3020; 9505.3025; 9505.3030; 9505.3035; 9505.3040; 3.65 9505.3065; 9505.3085; 9505.3135; 9505.3500; 9505.3510; 3.66 9505.3520; 9505.3530; 9505.3535; 9505.3540; 9505.3545; 3.67 9505.3550; 9505.3560; 9505.3570; 9505.3575; 9505.3580; 3.68 9505.3585; 9505.3600; 9505.3610; 9505.3620; 9505.3622; 3.69 9505.3624; 9505.3626; 9505.3630; 9505.3635; 9505.3640; 3.70 9505.3645; 9505.3650; 9505.3660; 9505.3670; 9543.3000; 3.71 9543.3010; 9543.3020; 9543.3030; 9543.3040; 9543.3050; 4.1 9543.3060; 9543.3080; 9543.3090; 9546.0010; 9546.0020; 4.2 9546.0030; 9546.0040; 9546.0050; 9546.0060. 4.3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 4.4 ARTICLE 1 4.5 DEPARTMENT OF HEALTH 4.6 Section 1. Minnesota Statutes 2000, section 62J.152, 4.7 subdivision 8, is amended to read: 4.8 Subd. 8. [REPEALER.] This section and sections 62J.15 and 4.9 62J.156 are repealed effective July 1,20012005. 4.10 Sec. 2. Minnesota Statutes 2000, section 62J.451, 4.11 subdivision 5, is amended to read: 4.12 Subd. 5. [HEALTH CARE ELECTRONIC DATA INTERCHANGE 4.13 SYSTEM.](a)The health data institute shall establish an 4.14 electronic data interchange system that electronically 4.15 transmits, collects, archives, and provides users of data with 4.16 the data necessary for their specific interests, in order to 4.17 promote a high quality, cost-effective, consumer-responsive 4.18 health care system. This public-private information system 4.19 shall be developed to make health care claims processing and 4.20 financial settlement transactions more efficient and to provide 4.21 an efficient, unobtrusive method for meeting the shared 4.22 electronic data interchange needs of consumers, group 4.23 purchasers, providers, and the state. 4.24(b) The health data institute shall operate the Minnesota4.25center for health care electronic data interchange established4.26in section 62J.57, and shall integrate the goals, objectives,4.27and activities of the center with those of the health data4.28institute's electronic data interchange system.4.29 Sec. 3. Minnesota Statutes 2000, section 103I.101, 4.30 subdivision 6, is amended to read: 4.31 Subd. 6. [FEES FOR VARIANCES.] The commissioner shall 4.32 charge a nonrefundable application fee of$120$150 to cover the 4.33 administrative cost of processing a request for a variance or 4.34 modification of rules adopted by the commissioner under this 4.35 chapter. 4.36 [EFFECTIVE DATE.] This section is effective July 1, 2002. 5.1 Sec. 4. Minnesota Statutes 2000, section 103I.112, is 5.2 amended to read: 5.3 103I.112 [FEE EXEMPTIONS FOR STATE AND LOCAL GOVERNMENT.] 5.4 (a) The commissioner of health may not charge fees required 5.5 under this chapter to a federal agency, state agency, or a local 5.6 unit of government or to a subcontractor performing work for the 5.7 state agency or local unit of government. 5.8 (b) "Local unit of government" means a statutory or home 5.9 rule charter city, town, county, or soil and water conservation 5.10 district, watershed district, an organization formed for the 5.11 joint exercise of powers under section 471.59, a board of health 5.12 or community health board, or other special purpose district or 5.13 authority with local jurisdiction in water and related land 5.14 resources management. 5.15 [EFFECTIVE DATE.] This section is effective July 1, 2002. 5.16 Sec. 5. Minnesota Statutes 2000, section 103I.208, 5.17 subdivision 1, is amended to read: 5.18 Subdivision 1. [WELL NOTIFICATION FEE.] The well 5.19 notification fee to be paid by a property owner is: 5.20 (1) for a new well,$120$150, which includes the state 5.21 core function fee; 5.22 (2) for a well sealing,$20$30 for each well, which 5.23 includes the state core function fee, except that for monitoring 5.24 wells constructed on a single property, having depths within a 5.25 25 foot range, and sealed within 48 hours of start of 5.26 construction, a single fee of$20$30; and 5.27 (3) for construction of a dewatering well,$120$150, which 5.28 includes the state core function fee, for each well except a 5.29 dewatering project comprising five or more wells shall be 5.30 assessed a single fee of$600$750 for the wells recorded on the 5.31 notification. 5.32 [EFFECTIVE DATE.] This section is effective July 1, 2002. 5.33 Sec. 6. Minnesota Statutes 2000, section 103I.208, 5.34 subdivision 2, is amended to read: 5.35 Subd. 2. [PERMIT FEE.] The permit fee to be paid by a 5.36 property owner is: 6.1 (1) for a well that is not in use under a maintenance 6.2 permit,$100$125 annually; 6.3 (2) for construction of a monitoring well,$120$150, which 6.4 includes the state core function fee; 6.5 (3) for a monitoring well that is unsealed under a 6.6 maintenance permit,$100$125 annually; 6.7 (4) for monitoring wells used as a leak detection device at 6.8 a single motor fuel retail outlet, a single petroleum bulk 6.9 storage site excluding tank farms, or a single agricultural 6.10 chemical facility site, the construction permit fee 6.11 is$120$150, which includes the state core function fee, per 6.12 site regardless of the number of wells constructed on the site, 6.13 and the annual fee for a maintenance permit for unsealed 6.14 monitoring wells is$100$125 per site regardless of the number 6.15 of monitoring wells located on site; 6.16 (5) for a groundwater thermal exchange device, in addition 6.17 to the notification fee for wells,$120$150, which includes the 6.18 state core function fee; 6.19 (6) for a vertical heat exchanger,$120$150; 6.20 (7) for a dewatering well that is unsealed under a 6.21 maintenance permit,$100$125 annually for each well, except a 6.22 dewatering project comprising more than five wells shall be 6.23 issued a single permit for$500$625 annually for wells recorded 6.24 on the permit; and 6.25 (8) for excavating holes for the purpose of installing 6.26 elevator shafts,$120$150 for each hole. 6.27 [EFFECTIVE DATE.] This section is effective July 1, 2002. 6.28 Sec. 7. Minnesota Statutes 2000, section 103I.235, 6.29 subdivision 1, is amended to read: 6.30 Subdivision 1. [DISCLOSURE OF WELLS TO BUYER.] (a) Before 6.31 signing an agreement to sell or transfer real property, the 6.32 seller must disclose in writing to the buyer information about 6.33 the status and location of all known wells on the property, by 6.34 delivering to the buyer either a statement by the seller that 6.35 the seller does not know of any wells on the property, or a 6.36 disclosure statement indicating the legal description and 7.1 county, and a map drawn from available information showing the 7.2 location of each well to the extent practicable. In the 7.3 disclosure statement, the seller must indicate, for each well, 7.4 whether the well is in use, not in use, or sealed. 7.5 (b) At the time of closing of the sale, the disclosure 7.6 statement information, name and mailing address of the buyer, 7.7 and the quartile, section, township, and range in which each 7.8 well is located must be provided on a well disclosure 7.9 certificate signed by the seller or a person authorized to act 7.10 on behalf of the seller. 7.11 (c) A well disclosure certificate need not be provided if 7.12 the seller does not know of any wells on the property and the 7.13 deed or other instrument of conveyance contains the statement: 7.14 "The Seller certifies that the Seller does not know of any wells 7.15 on the described real property." 7.16 (d) If a deed is given pursuant to a contract for deed, the 7.17 well disclosure certificate required by this subdivision shall 7.18 be signed by the buyer or a person authorized to act on behalf 7.19 of the buyer. If the buyer knows of no wells on the property, a 7.20 well disclosure certificate is not required if the following 7.21 statement appears on the deed followed by the signature of the 7.22 grantee or, if there is more than one grantee, the signature of 7.23 at least one of the grantees: "The Grantee certifies that the 7.24 Grantee does not know of any wells on the described real 7.25 property." The statement and signature of the grantee may be on 7.26 the front or back of the deed or on an attached sheet and an 7.27 acknowledgment of the statement by the grantee is not required 7.28 for the deed to be recordable. 7.29 (e) This subdivision does not apply to the sale, exchange, 7.30 or transfer of real property: 7.31 (1) that consists solely of a sale or transfer of severed 7.32 mineral interests; or 7.33 (2) that consists of an individual condominium unit as 7.34 described in chapters 515 and 515B. 7.35 (f) For an area owned in common under chapter 515 or 515B 7.36 the association or other responsible person must report to the 8.1 commissioner by July 1, 1992, the location and status of all 8.2 wells in the common area. The association or other responsible 8.3 person must notify the commissioner within 30 days of any change 8.4 in the reported status of wells. 8.5 (g) For real property sold by the state under section 8.6 92.67, the lessee at the time of the sale is responsible for 8.7 compliance with this subdivision. 8.8 (h) If the seller fails to provide a required well 8.9 disclosure certificate, the buyer, or a person authorized to act 8.10 on behalf of the buyer, may sign a well disclosure certificate 8.11 based on the information provided on the disclosure statement 8.12 required by this section or based on other available information. 8.13 (i) A county recorder or registrar of titles may not record 8.14 a deed or other instrument of conveyance dated after October 31, 8.15 1990, for which a certificate of value is required under section 8.16 272.115, or any deed or other instrument of conveyance dated 8.17 after October 31, 1990, from a governmental body exempt from the 8.18 payment of state deed tax, unless the deed or other instrument 8.19 of conveyance contains the statement made in accordance with 8.20 paragraph (c) or (d) or is accompanied by the well disclosure 8.21 certificate containing all the information required by paragraph 8.22 (b) or (d). The county recorder or registrar of titles must not 8.23 accept a certificate unless it contains all the required 8.24 information. The county recorder or registrar of titles shall 8.25 note on each deed or other instrument of conveyance accompanied 8.26 by a well disclosure certificate that the well disclosure 8.27 certificate was received. The notation must include the 8.28 statement "No wells on property" if the disclosure certificate 8.29 states there are no wells on the property. The well disclosure 8.30 certificate shall not be filed or recorded in the records 8.31 maintained by the county recorder or registrar of titles. After 8.32 noting "No wells on property" on the deed or other instrument of 8.33 conveyance, the county recorder or registrar of titles shall 8.34 destroy or return to the buyer the well disclosure certificate. 8.35 The county recorder or registrar of titles shall collect from 8.36 the buyer or the person seeking to record a deed or other 9.1 instrument of conveyance, a fee of$20$30 for receipt of a 9.2 completed well disclosure certificate. By the tenth day of each 9.3 month, the county recorder or registrar of titles shall transmit 9.4 the well disclosure certificates to the commissioner of health. 9.5 By the tenth day after the end of each calendar quarter, the 9.6 county recorder or registrar of titles shall transmit to the 9.7 commissioner of health$17.50$27.50 of the fee for each well 9.8 disclosure certificate received during the quarter. The 9.9 commissioner shall maintain the well disclosure certificate for 9.10 at least six years. The commissioner may store the certificate 9.11 as an electronic image. A copy of that image shall be as valid 9.12 as the original. 9.13 (j) No new well disclosure certificate is required under 9.14 this subdivision if the buyer or seller, or a person authorized 9.15 to act on behalf of the buyer or seller, certifies on the deed 9.16 or other instrument of conveyance that the status and number of 9.17 wells on the property have not changed since the last previously 9.18 filed well disclosure certificate. The following statement, if 9.19 followed by the signature of the person making the statement, is 9.20 sufficient to comply with the certification requirement of this 9.21 paragraph: "I am familiar with the property described in this 9.22 instrument and I certify that the status and number of wells on 9.23 the described real property have not changed since the last 9.24 previously filed well disclosure certificate." The 9.25 certification and signature may be on the front or back of the 9.26 deed or on an attached sheet and an acknowledgment of the 9.27 statement is not required for the deed or other instrument of 9.28 conveyance to be recordable. 9.29 (k) The commissioner in consultation with county recorders 9.30 shall prescribe the form for a well disclosure certificate and 9.31 provide well disclosure certificate forms to county recorders 9.32 and registrars of titles and other interested persons. 9.33 (l) Failure to comply with a requirement of this 9.34 subdivision does not impair: 9.35 (1) the validity of a deed or other instrument of 9.36 conveyance as between the parties to the deed or instrument or 10.1 as to any other person who otherwise would be bound by the deed 10.2 or instrument; or 10.3 (2) the record, as notice, of any deed or other instrument 10.4 of conveyance accepted for filing or recording contrary to the 10.5 provisions of this subdivision. 10.6 [EFFECTIVE DATE.] This section is effective July 1, 2002. 10.7 Sec. 8. Minnesota Statutes 2000, section 103I.525, 10.8 subdivision 2, is amended to read: 10.9 Subd. 2. [APPLICATION FEE.] The application fee for a well 10.10 contractor's license is$50$75. The commissioner may not act 10.11 on an application until the application fee is paid. 10.12 [EFFECTIVE DATE.] This section is effective July 1, 2002. 10.13 Sec. 9. Minnesota Statutes 2000, section 103I.525, 10.14 subdivision 6, is amended to read: 10.15 Subd. 6. [LICENSE FEE.] The fee for a well contractor's 10.16 license is $250, except the fee for an individual well 10.17 contractor's license is$50$75. 10.18 [EFFECTIVE DATE.] This section is effective July 1, 2002. 10.19 Sec. 10. Minnesota Statutes 2000, section 103I.525, 10.20 subdivision 8, is amended to read: 10.21 Subd. 8. [RENEWAL.] (a) A licensee must file an 10.22 application and a renewal application fee to renew the license 10.23 by the date stated in the license. 10.24 (b) The renewal application feeshall be set by the10.25commissioner under section 16A.1285for a well contractor's 10.26 license is $250. 10.27 (c) The renewal application must include information that 10.28 the applicant has met continuing education requirements 10.29 established by the commissioner by rule. 10.30 (d) At the time of the renewal, the commissioner must have 10.31 on file all properly completed well reports, well sealing 10.32 reports, reports of excavations to construct elevator shafts, 10.33 well permits, and well notifications for work conducted by the 10.34 licensee since the last license renewal. 10.35 [EFFECTIVE DATE.] This section is effective July 1, 2002. 10.36 Sec. 11. Minnesota Statutes 2000, section 103I.525, 11.1 subdivision 9, is amended to read: 11.2 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 11.3 to submit all information required for renewal in subdivision 8 11.4 or submits the application and information after the required 11.5 renewal date: 11.6 (1) the licensee must includean additionala late feeset11.7by the commissionerof $75; and 11.8 (2) the licensee may not conduct activities authorized by 11.9 the well contractor's license until the renewal application, 11.10 renewal application fee, late fee, and all other information 11.11 required in subdivision 8 are submitted. 11.12 [EFFECTIVE DATE.] This section is effective July 1, 2002. 11.13 Sec. 12. Minnesota Statutes 2000, section 103I.531, 11.14 subdivision 2, is amended to read: 11.15 Subd. 2. [APPLICATION FEE.] The application fee for a 11.16 limited well/boring contractor's license is$50$75. The 11.17 commissioner may not act on an application until the application 11.18 fee is paid. 11.19 [EFFECTIVE DATE.] This section is effective July 1, 2002. 11.20 Sec. 13. Minnesota Statutes 2000, section 103I.531, 11.21 subdivision 6, is amended to read: 11.22 Subd. 6. [LICENSE FEE.] The fee for a limited well/boring 11.23 contractor's license is$50$75. 11.24 [EFFECTIVE DATE.] This section is effective July 1, 2002. 11.25 Sec. 14. Minnesota Statutes 2000, section 103I.531, 11.26 subdivision 8, is amended to read: 11.27 Subd. 8. [RENEWAL.] (a) A person must file an application 11.28 and a renewal application fee to renew the limited well/boring 11.29 contractor's license by the date stated in the license. 11.30 (b) The renewal application feeshall be set by the11.31commissioner under section 16A.1285for a limited well/boring 11.32 contractor's license is $75. 11.33 (c) The renewal application must include information that 11.34 the applicant has met continuing education requirements 11.35 established by the commissioner by rule. 11.36 (d) At the time of the renewal, the commissioner must have 12.1 on file all properly completed well sealing reports, well 12.2 permits, vertical heat exchanger permits, and well notifications 12.3 for work conducted by the licensee since the last license 12.4 renewal. 12.5 [EFFECTIVE DATE.] This section is effective July 1, 2002. 12.6 Sec. 15. Minnesota Statutes 2000, section 103I.531, 12.7 subdivision 9, is amended to read: 12.8 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 12.9 to submit all information required for renewal in subdivision 8 12.10 or submits the application and information after the required 12.11 renewal date: 12.12 (1) the licensee must includean additionala late feeset12.13by the commissionerof $75; and 12.14 (2) the licensee may not conduct activities authorized by 12.15 the limited well/boring contractor's license until the renewal 12.16 application, renewal application fee, and late fee, and all 12.17 other information required in subdivision 8 are submitted. 12.18 [EFFECTIVE DATE.] This section is effective July 1, 2002. 12.19 Sec. 16. Minnesota Statutes 2000, section 103I.535, 12.20 subdivision 2, is amended to read: 12.21 Subd. 2. [APPLICATION FEE.] The application fee for an 12.22 elevator shaft contractor's license is$50$75. The 12.23 commissioner may not act on an application until the application 12.24 fee is paid. 12.25 [EFFECTIVE DATE.] This section is effective July 1, 2002. 12.26 Sec. 17. Minnesota Statutes 2000, section 103I.535, 12.27 subdivision 6, is amended to read: 12.28 Subd. 6. [LICENSE FEE.] The fee for an elevator shaft 12.29 contractor's license is$50$75. 12.30 [EFFECTIVE DATE.] This section is effective July 1, 2002. 12.31 Sec. 18. Minnesota Statutes 2000, section 103I.535, 12.32 subdivision 8, is amended to read: 12.33 Subd. 8. [RENEWAL.] (a) A person must file an application 12.34 and a renewal application fee to renew the license by the date 12.35 stated in the license. 12.36 (b) The renewal application feeshall be set by the13.1commissioner under section 16A.1285for an elevator shaft 13.2 contractor's license is $75. 13.3 (c) The renewal application must include information that 13.4 the applicant has met continuing education requirements 13.5 established by the commissioner by rule. 13.6 (d) At the time of renewal, the commissioner must have on 13.7 file all reports and permits for elevator shaft work conducted 13.8 by the licensee since the last license renewal. 13.9 [EFFECTIVE DATE.] This section is effective July 1, 2002. 13.10 Sec. 19. Minnesota Statutes 2000, section 103I.535, 13.11 subdivision 9, is amended to read: 13.12 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 13.13 to submit all information required for renewal in subdivision 8 13.14 or submits the application and information after the required 13.15 renewal date: 13.16 (1) the licensee must includean additionala late feeset13.17by the commissionerof $75; and 13.18 (2) the licensee may not conduct activities authorized by 13.19 the elevator shaft contractor's license until the renewal 13.20 application, renewal application fee, and late fee, and all 13.21 other information required in subdivision 8 are submitted. 13.22 [EFFECTIVE DATE.] This section is effective July 1, 2002. 13.23 Sec. 20. Minnesota Statutes 2000, section 103I.541, 13.24 subdivision 2b, is amended to read: 13.25 Subd. 2b. [APPLICATION FEE.] The application fee for a 13.26 monitoring well contractor registration is$50$75. The 13.27 commissioner may not act on an application until the application 13.28 fee is paid. 13.29 [EFFECTIVE DATE.] This section is effective July 1, 2002. 13.30 Sec. 21. Minnesota Statutes 2000, section 103I.541, 13.31 subdivision 4, is amended to read: 13.32 Subd. 4. [RENEWAL.] (a) A person must file an application 13.33 and a renewal application fee to renew the registration by the 13.34 date stated in the registration. 13.35 (b) The renewal application feeshall be set by the13.36commissioner under section 16A.1285for a monitoring well 14.1 contractor's registration is $75. 14.2 (c) The renewal application must include information that 14.3 the applicant has met continuing education requirements 14.4 established by the commissioner by rule. 14.5 (d) At the time of the renewal, the commissioner must have 14.6 on file all well reports, well sealing reports, well permits, 14.7 and notifications for work conducted by the registered person 14.8 since the last registration renewal. 14.9 [EFFECTIVE DATE.] This section is effective July 1, 2002. 14.10 Sec. 22. Minnesota Statutes 2000, section 103I.541, 14.11 subdivision 5, is amended to read: 14.12 Subd. 5. [INCOMPLETE OR LATE RENEWAL.] If a registered 14.13 person submits a renewal application after the required renewal 14.14 date: 14.15 (1) the registered person must includean additionala late 14.16 feeset by the commissionerof $75; and 14.17 (2) the registered person may not conduct activities 14.18 authorized by the monitoring well contractor's registration 14.19 until the renewal application, renewal application fee, late 14.20 fee, and all other information required in subdivision 4 are 14.21 submitted. 14.22 [EFFECTIVE DATE.] This section is effective July 1, 2002. 14.23 Sec. 23. Minnesota Statutes 2000, section 103I.545, is 14.24 amended to read: 14.25 103I.545 [REGISTRATION OF DRILLING MACHINES REQUIRED.] 14.26 Subdivision 1. [DRILLING MACHINE.] (a) A person may not 14.27 use a drilling machine such as a cable tool, rotary tool, hollow 14.28 rod tool, or auger for a drilling activity requiring a license 14.29 or registration under this chapter unless the drilling machine 14.30 is registered with the commissioner. 14.31 (b) A person must apply for the registration on forms 14.32 prescribed by the commissioner and submit a$50$75 registration 14.33 fee. 14.34 (c) A registration is valid for one year. 14.35 Subd. 2. [PUMP HOIST.] (a) A person may not use a machine 14.36 such as a pump hoist for an activity requiring a license or 15.1 registration under this chapter to repair wells or borings, seal 15.2 wells or borings, or install pumps unless the machine is 15.3 registered with the commissioner. 15.4 (b) A person must apply for the registration on forms 15.5 prescribed by the commissioner and submit a$50$75 registration 15.6 fee. 15.7 (c) A registration is valid for one year. 15.8 [EFFECTIVE DATE.] This section is effective July 1, 2002. 15.9 Sec. 24. Minnesota Statutes 2000, section 121A.15, is 15.10 amended by adding a subdivision to read: 15.11 Subd. 3a. [DISCLOSURES REQUIRED.] (a) This paragraph 15.12 applies to any written information about immunization 15.13 requirements for enrollment in a school or child care facility 15.14 that: 15.15 (1) is provided to a person to be immunized or enrolling or 15.16 enrolled in a school or child care facility, or to the person's 15.17 parent or guardian if the person is under 18 years of age and 15.18 not emancipated; and 15.19 (2) is provided by the department of health; the department 15.20 of children, families, and learning; the department of human 15.21 services; an immunization provider; or a school or child care 15.22 facility. 15.23 Such written information must describe the exemptions from 15.24 immunizations permitted under subdivision 3, paragraphs (c) and 15.25 (d). The information on exemptions from immunizations provided 15.26 according to this paragraph must be in a font size at least 15.27 equal to the font size of the immunization requirements, in the 15.28 same font style as the immunization requirements, and on the 15.29 same page of the written document as the immunization 15.30 requirements. 15.31 (b) Before immunizing a person, an immunization provider 15.32 must provide the person, or the person's parent or guardian if 15.33 the person is under 18 years of age and not emancipated, with 15.34 the following information in writing: 15.35 (1) a list of the immunizations required for enrollment in 15.36 a school or child care facility; 16.1 (2) a description of the exemptions from immunizations 16.2 permitted under subdivision 3, paragraphs (c) and (d); 16.3 (3) a list of additional immunizations currently 16.4 recommended by the commissioner; and 16.5 (4) in accordance with federal law, a copy of the vaccine 16.6 information sheet from the federal Department of Health and 16.7 Human Services that lists possible adverse reactions to the 16.8 immunization to be provided. 16.9 Sec. 25. Minnesota Statutes 2000, section 121A.15, is 16.10 amended by adding a subdivision to read: 16.11 Subd. 12. [MODIFICATIONS TO SCHEDULE.] (a) The 16.12 commissioner of health may adopt modifications to the 16.13 immunization requirements of this section. A proposed 16.14 modification made under this subdivision must be part of the 16.15 current immunization recommendations of each of the following 16.16 organizations: the United States Public Health Service's 16.17 Advisory Committee on Immunization Practices, the American 16.18 Academy of Family Physicians, and the American Academy of 16.19 Pediatrics. In proposing a modification to the immunization 16.20 schedule, the commissioner must: 16.21 (1) consult with the commissioner of children, families, 16.22 and learning; the commissioner of human services; the chancellor 16.23 of the Minnesota state colleges and universities; and the 16.24 president of the University of Minnesota; and 16.25 (2) consider the following criteria: the epidemiology of 16.26 the disease, the morbidity and mortality rates for the disease, 16.27 the safety and efficacy of the vaccine, the cost of a 16.28 vaccination program, the cost of enforcing vaccination 16.29 requirements, and a cost-benefit analysis of the vaccination. 16.30 (b) Before a proposed modification may be adopted, the 16.31 commissioner must notify the chairs of the house and senate 16.32 committees with jurisdiction over health policy issues. If the 16.33 chairs of the relevant standing committees determine a public 16.34 hearing regarding the proposed modifications is in order, the 16.35 hearing must be scheduled within 60 days of receiving notice 16.36 from the commissioner. If a hearing is scheduled, the 17.1 commissioner may not adopt any proposed modifications until 17.2 after the hearing is held. 17.3 (c) The commissioner shall comply with the requirements of 17.4 chapter 14 regarding the adoption of any proposed modifications 17.5 to the immunization schedule. 17.6 (d) In addition to the publication requirements of chapter 17.7 14, the commissioner of health must inform all immunization 17.8 providers of any adopted modifications to the immunization 17.9 schedule in a timely manner. 17.10 Sec. 26. Minnesota Statutes 2000, section 135A.14, is 17.11 amended by adding a subdivision to read: 17.12 Subd. 7. [MODIFICATIONS TO SCHEDULE.] (a) The commissioner 17.13 of health may adopt modifications to the immunization 17.14 requirements of this section. A proposed modification made 17.15 under this subdivision must be part of the current immunization 17.16 recommendations of each of the following organizations: the 17.17 United States Public Health Service's Advisory Committee on 17.18 Immunization Practices, the American Academy of Family 17.19 Physicians, and the American Academy of Pediatrics. In 17.20 proposing a modification to the immunization schedule, the 17.21 commissioner must: 17.22 (1) consult with the commissioner of children, families, 17.23 and learning; the commissioner of human services; the chancellor 17.24 of the Minnesota state colleges and universities; and the 17.25 president of the University of Minnesota; and 17.26 (2) consider the following criteria: the epidemiology of 17.27 the disease, the morbidity and mortality rates for the disease, 17.28 the safety and efficacy of the vaccine, the cost of a 17.29 vaccination program, the cost of enforcing vaccination 17.30 requirements, and a cost-benefit analysis of the vaccination. 17.31 (b) Before a proposed modification may be adopted, the 17.32 commissioner must notify the chairs of the house and senate 17.33 committees with jurisdiction over health policy issues. If the 17.34 chairs of the relevant standing committees determine a public 17.35 hearing regarding the proposed modifications is in order, the 17.36 hearing must be scheduled within 60 days of receiving notice 18.1 from the commissioner. If a hearing is scheduled, the 18.2 commissioner may not adopt any proposed modifications until 18.3 after the hearing is held. 18.4 (c) The commissioner shall comply with the requirements of 18.5 chapter 14 regarding the adoption of any proposed modifications 18.6 to the immunization schedule. 18.7 (d) In addition to the publication requirements of chapter 18.8 14, the commissioner of health must inform all immunization 18.9 providers of any adopted modifications to the immunization 18.10 schedule in a timely manner. 18.11 Sec. 27. [144.0751] [HEALTH STANDARDS.] 18.12 (a) Safe drinking water or air quality standards 18.13 established or revised by the commissioner of health must: 18.14 (1) be based on scientifically acceptable, peer-reviewed 18.15 information; and 18.16 (2) include a reasonable margin of safety to adequately 18.17 protect the health of infants, children, and adults by taking 18.18 into consideration risks to each of the following health 18.19 outcomes: reproductive development and function, respiratory 18.20 function, immunologic suppression or hypersensitization, 18.21 development of the brain and nervous system, endocrine 18.22 (hormonal) function, cancer, general infant and child 18.23 development, and any other important health outcomes identified 18.24 by the commissioner. 18.25 (b) For purposes of this section, "peer-reviewed" means a 18.26 scientifically based review conducted by individuals with 18.27 substantial knowledge and experience in toxicology, health risk 18.28 assessment, or other related fields as determined by the 18.29 commissioner. 18.30 Sec. 28. Minnesota Statutes 2000, section 144.1202, 18.31 subdivision 4, is amended to read: 18.32 Subd. 4. [AGREEMENT; CONDITIONS OF IMPLEMENTATION.] (a) An 18.33 agreement entered into before August 2,20022003, must remain 18.34 in effect until terminated under the Atomic Energy Act of 1954, 18.35 United States Code, title 42, section 2021, paragraph (j). The 18.36 governor may not enter into an initial agreement with the 19.1 Nuclear Regulatory Commission after August 1,20022003. If an 19.2 agreement is not entered into by August 1,20022003, any rules 19.3 adopted under this section are repealed effective August 1,200219.4 2003. 19.5 (b) An agreement authorized under subdivision 1 must be 19.6 approved by law before it may be implemented. 19.7 Sec. 29. [144.1205] [RADIOACTIVE MATERIAL; SOURCE AND 19.8 SPECIAL NUCLEAR MATERIAL; FEES; INSPECTION.] 19.9 Subdivision 1. [APPLICATION AND LICENSE RENEWAL FEE.] When 19.10 a license is required for radioactive material or source or 19.11 special nuclear material by a rule adopted under section 19.12 144.1202, subdivision 2, an application fee according to 19.13 subdivision 4 must be paid upon initial application for a 19.14 license. The licensee must renew the license 60 days before the 19.15 expiration date of the license by paying a license renewal fee 19.16 equal to the application fee under subdivision 4. The 19.17 expiration date of a license is the date set by the United 19.18 States Nuclear Regulatory Commission before transfer of the 19.19 licensing program under section 144.1202 and thereafter as 19.20 specified by rule of the commissioner of health. 19.21 Subd. 2. [ANNUAL FEE.] A licensee must pay an annual fee 19.22 at least 60 days before the anniversary date of the issuance of 19.23 the license. The annual fee is an amount equal to 80 percent of 19.24 the application fee under subdivision 4, rounded to the nearest 19.25 whole dollar. 19.26 Subd. 3. [FEE CATEGORIES; INCORPORATION OF FEDERAL 19.27 LICENSING CATEGORIES.] (a) Fee categories under this section are 19.28 equivalent to the licensing categories used by the United States 19.29 Nuclear Regulatory Commission under Code of Federal Regulations, 19.30 title 10, parts 30 to 36, 39, 40, 70, 71, and 150, except as 19.31 provided in paragraph (b). 19.32 (b) The category of "Academic, small" is the type of 19.33 license required for the use of radioactive materials in a 19.34 teaching institution. Radioactive materials are limited to ten 19.35 radionuclides not to exceed a total activity amount of one curie. 19.36 Subd. 4. [APPLICATION FEE.] A licensee must pay an 20.1 application fee as follows: 20.2 Radioactive material, Application U.S. Nuclear Regulatory 20.3 source and fee Commission licensing 20.4 special material category as reference 20.6 Type A broadscope $20,000 Medical institution type A 20.7 Type B broadscope $15,000 Research and development 20.8 type B 20.9 Type C broadscope $10,000 Academic type C 20.10 Medical use $4,000 Medical 20.11 Medical institution 20.12 Medical private practice 20.13 Mobile nuclear 20.14 medical laboratory $4,000 Mobile medical laboratory 20.15 Medical special use 20.16 sealed sources $6,000 Teletherapy 20.17 High dose rate remote 20.18 afterloaders 20.19 Stereotactic 20.20 radiosurgery devices 20.21 In vitro testing $2,300 In vitro testing 20.22 laboratories 20.23 Measuring gauge, 20.24 sealed sources $2,000 Fixed gauges 20.25 Portable gauges 20.26 Analytical instruments 20.27 Measuring systems - other 20.28 Gas chromatographs $1,200 Gas chromatographs 20.29 Manufacturing and 20.30 distribution $14,700 Manufacturing and 20.31 distribution - other 20.32 Distribution only $8,800 Distribution of 20.33 radioactive material 20.34 for commercial use only 20.35 Other services $1,500 Other services 20.36 Nuclear medicine 21.1 pharmacy $4,100 Nuclear pharmacy 21.2 Waste disposal $9,400 Waste disposal service 21.3 prepackage 21.4 Waste disposal service 21.5 processing/repackage 21.6 Waste storage only $7,000 To receive and store 21.7 radioactive material waste 21.8 Industrial 21.9 radiography $8,400 Industrial radiography 21.10 fixed location 21.11 Industrial radiography 21.12 portable/temporary sites 21.13 Irradiator - 21.14 self-shielded $4,100 Irradiators self-shielded 21.15 less than 10,000 curies 21.16 Irradiator - 21.17 less than 10,000 Ci $7,500 Irradiators less than 21.18 10,000 curies 21.19 Irradiator - 21.20 more than 10,000 Ci $11,500 Irradiators greater than 21.21 10,000 curies 21.22 Research and 21.23 development, 21.24 no distribution $4,100 Research and development 21.25 Radioactive material 21.26 possession only $1,000 Byproduct possession only 21.27 Source material $1,000 Source material shielding 21.28 Special nuclear 21.29 material, less than 21.30 200 grams $1,000 Special nuclear material 21.31 plutonium-neutron sources 21.32 less than 200 grams 21.33 Pacemaker 21.34 manufacturing $1,000 Pacemaker byproduct 21.35 and/or special nuclear 21.36 material - medical 22.1 institution 22.2 General license 22.3 distribution $2,100 General license 22.4 distribution 22.5 General license 22.6 distribution, exempt $1,500 General license 22.7 distribution - 22.8 certain exempt items 22.9 Academic, small $1,000 Possession limit of ten 22.10 radionuclides, not to 22.11 exceed a total of one curie 22.12 of activity 22.13 Veterinary $2,000 Veterinary use 22.14 Well logging $5,000 Well logging 22.15 Subd. 5. [PENALTY FOR LATE PAYMENT.] An annual fee or a 22.16 license renewal fee submitted to the commissioner after the due 22.17 date specified by rule must be accompanied by an additional 22.18 amount equal to 25 percent of the fee due. 22.19 Subd. 6. [INSPECTIONS.] The commissioner of health shall 22.20 make periodic safety inspections of the radioactive material and 22.21 source and special nuclear material of a licensee. The 22.22 commissioner shall prescribe the frequency of safety inspections 22.23 by rule. 22.24 Subd. 7. [RECOVERY OF REINSPECTION COST.] If the 22.25 commissioner finds serious violations of public health standards 22.26 during an inspection under subdivision 6, the licensee must pay 22.27 all costs associated with subsequent reinspection of the 22.28 source. The costs shall be the actual costs incurred by the 22.29 commissioner and include, but are not limited to, labor, 22.30 transportation, per diem, materials, legal fees, testing, and 22.31 monitoring costs. 22.32 Subd. 8. [RECIPROCITY FEE.] A licensee submitting an 22.33 application for reciprocal recognition of a materials license 22.34 issued by another agreement state or the United States Nuclear 22.35 Regulatory Commission for a period of 180 days or less during a 22.36 calendar year must pay one-half of the application fee specified 23.1 under subdivision 4. For a period of 181 days or more, the 23.2 licensee must pay the entire application fee under subdivision 4. 23.3 Subd. 9. [FEES FOR LICENSE AMENDMENTS.] A licensee must 23.4 pay a fee to amend a license as follows: 23.5 (1) to amend a license requiring no license review 23.6 including, but not limited to, facility name change or removal 23.7 of a previously authorized user, no fee; 23.8 (2) to amend a license requiring review including, but not 23.9 limited to, addition of isotopes, procedure changes, new 23.10 authorized users, or a new radiation safety officer, $200; and 23.11 (3) to amend a license requiring review and a site visit 23.12 including, but not limited to, facility move or addition of 23.13 processes, $400. 23.14 [EFFECTIVE DATE.] This section is effective July 1, 2002. 23.15 Sec. 30. Minnesota Statutes 2000, section 144.122, is 23.16 amended to read: 23.17 144.122 [LICENSE, PERMIT, AND SURVEY FEES.] 23.18 (a) The state commissioner of health, by rule, may 23.19 prescribe reasonable procedures and fees for filing with the 23.20 commissioner as prescribed by statute and for the issuance of 23.21 original and renewal permits, licenses, registrations, and 23.22 certifications issued under authority of the commissioner. The 23.23 expiration dates of the various licenses, permits, 23.24 registrations, and certifications as prescribed by the rules 23.25 shall be plainly marked thereon. Fees may include application 23.26 and examination fees and a penalty fee for renewal applications 23.27 submitted after the expiration date of the previously issued 23.28 permit, license, registration, and certification. The 23.29 commissioner may also prescribe, by rule, reduced fees for 23.30 permits, licenses, registrations, and certifications when the 23.31 application therefor is submitted during the last three months 23.32 of the permit, license, registration, or certification period. 23.33 Fees proposed to be prescribed in the rules shall be first 23.34 approved by the department of finance. All fees proposed to be 23.35 prescribed in rules shall be reasonable. The fees shall be in 23.36 an amount so that the total fees collected by the commissioner 24.1 will, where practical, approximate the cost to the commissioner 24.2 in administering the program. All fees collected shall be 24.3 deposited in the state treasury and credited to the state 24.4 government special revenue fund unless otherwise specifically 24.5 appropriated by law for specific purposes. 24.6 (b) The commissioner may charge a fee for voluntary 24.7 certification of medical laboratories and environmental 24.8 laboratories, and for environmental and medical laboratory 24.9 services provided by the department, without complying with 24.10 paragraph (a) or chapter 14. Fees charged for environment and 24.11 medical laboratory services provided by the department must be 24.12 approximately equal to the costs of providing the services. 24.13 (c) The commissioner may develop a schedule of fees for 24.14 diagnostic evaluations conducted at clinics held by the services 24.15 for children with handicaps program. All receipts generated by 24.16 the program are annually appropriated to the commissioner for 24.17 use in the maternal and child health program. 24.18 (d) The commissioner, for fiscal years 1996 and beyond,24.19 shall set license fees for hospitals and nursing homes that are 24.20 not boarding care homes at the following levels: 24.21 Joint Commission on Accreditation of Healthcare 24.22 Organizations (JCAHO hospitals)$1,01724.23 $7,055 24.24 Non-JCAHO hospitals$762 plus $34 per bed24.25 $4,680 plus $234 per bed 24.26 Nursing home$78 plus $19 per bed24.27 $183 plus $91 per bed 24.28For fiscal years 1996 and beyond,The commissioner shall 24.29 set license fees for outpatient surgical centers, boarding care 24.30 homes, and supervised living facilities at the following levels: 24.31 Outpatient surgical centers$51724.32 $1,512 24.33 Boarding care homes$78 plus $19 per bed24.34 $183 plus $91 per bed 24.35 Supervised living facilities$78 plus $19 per bed24.36 $183 plus $91 per bed. 25.1 (e) Unless prohibited by federal law, the commissioner of 25.2 health shall charge applicants the following fees to cover the 25.3 cost of any initial certification surveys required to determine 25.4 a provider's eligibility to participate in the Medicare or 25.5 Medicaid program: 25.6 Prospective payment surveys for $ 900 25.7 hospitals 25.9 Swing bed surveys for nursing homes $1,200 25.11 Psychiatric hospitals $1,400 25.13 Rural health facilities $1,100 25.15 Portable X-ray providers $ 500 25.17 Home health agencies $1,800 25.19 Outpatient therapy agencies $ 800 25.21 End stage renal dialysis providers $2,100 25.23 Independent therapists $ 800 25.25 Comprehensive rehabilitation $1,200 25.26 outpatient facilities 25.28 Hospice providers $1,700 25.30 Ambulatory surgical providers $1,800 25.32 Hospitals $4,200 25.34 Other provider categories or Actual surveyor costs: 25.35 additional resurveys required average surveyor cost x 25.36 to complete initial certification number of hours for the 25.37 survey process. 25.38 These fees shall be submitted at the time of the 25.39 application for federal certification and shall not be 25.40 refunded. All fees collected after the date that the imposition 25.41 of fees is not prohibited by federal law shall be deposited in 25.42 the state treasury and credited to the state government special 25.43 revenue fund. 25.44 Sec. 31. Minnesota Statutes 2000, section 144.1464, is 25.45 amended to read: 25.46 144.1464 [SUMMER HEALTH CARE INTERNS.] 25.47 Subdivision 1. [SUMMER INTERNSHIPS.] The commissioner of 25.48 health, through a contract with a nonprofit organization as 25.49 required by subdivision 4, shall award grants to hospitalsand, 25.50 clinics, nursing facilities, and home care providers to 25.51 establish a secondary and post-secondary summer health care 26.1 intern program. The purpose of the program is to expose 26.2 interested secondary and post-secondary pupils to various 26.3 careers within the health care profession. 26.4 Subd. 2. [CRITERIA.] (a) The commissioner, through the 26.5 organization under contract, shall award grants to 26.6 hospitalsand, clinics, nursing facilities, and home care 26.7 providers that agree to: 26.8 (1) provide secondary and post-secondary summer health care 26.9 interns with formal exposure to the health care profession; 26.10 (2) provide an orientation for the secondary and 26.11 post-secondary summer health care interns; 26.12 (3) pay one-half the costs of employing the secondary and 26.13 post-secondary summer health care intern, based on an overall26.14hourly wage that is at least the minimum wage but does not26.15exceed $6 an hour; 26.16 (4) interview and hire secondary and post-secondary pupils 26.17 for a minimum of six weeks and a maximum of 12 weeks; and 26.18 (5) employ at least one secondary student for each 26.19 post-secondary student employed, to the extent that there are 26.20 sufficient qualifying secondary student applicants. 26.21 (b) In order to be eligible to be hired as a secondary 26.22 summer health intern by a hospitalor, clinic, nursing facility, 26.23 or home care provider, a pupil must: 26.24 (1) intend to complete high school graduation requirements 26.25 and be between the junior and senior year of high school; and 26.26 (2) be from a school district in proximity to the facility;26.27and26.28(3) provide the facility with a letter of recommendation26.29from a health occupations or science educator. 26.30 (c) In order to be eligible to be hired as a post-secondary 26.31 summer health care intern by a hospital or clinic, a pupil must: 26.32 (1) intend to complete a health care training program or a 26.33 two-year or four-year degree program and be planning on 26.34 enrolling in or be enrolled in that training program or degree 26.35 program; and 26.36 (2) be enrolled in a Minnesota educational institution or 27.1 be a resident of the state of Minnesota; priority must be given 27.2 to applicants from a school district or an educational 27.3 institution in proximity to the facility; and27.4(3) provide the facility with a letter of recommendation27.5from a health occupations or science educator. 27.6 (d) Hospitalsand, clinics, nursing facilities, and home 27.7 care providers awarded grants may employ pupils as secondary and 27.8 post-secondary summer health care interns beginning on or after 27.9 June 15, 1993, if they agree to pay the intern, during the 27.10 period before disbursement of state grant money, with money 27.11 designated as the facility's 50 percent contribution towards 27.12 internship costs. 27.13 Subd. 3. [GRANTS.] The commissioner, through the 27.14 organization under contract, shall award separate grants to 27.15 hospitalsand, clinics, nursing facilities, and home care 27.16 providers meeting the requirements of subdivision 2. The grants 27.17 must be used to pay one-half of the costs of employing secondary 27.18 and post-secondary pupils in a hospitalor, clinic, nursing 27.19 facility, or home care setting during the course of the 27.20 program. No more than 50 percent of the participants may be 27.21 post-secondary students, unless the program does not receive 27.22 enough qualified secondary applicants per fiscal year. No more 27.23 than five pupils may be selected from any secondary or 27.24 post-secondary institution to participate in the program and no 27.25 more than one-half of the number of pupils selected may be from 27.26 the seven-county metropolitan area. 27.27 Subd. 4. [CONTRACT.] The commissioner shall contract with 27.28 a statewide, nonprofit organization representing facilities at 27.29 which secondary and post-secondary summer health care interns 27.30 will serve, to administer the grant program established by this 27.31 section. Grant funds that are not used in one fiscal year may 27.32 be carried over to the next fiscal year. The organization 27.33 awarded the grant shall provide the commissioner with any 27.34 information needed by the commissioner to evaluate the program, 27.35 in the form and at the times specified by the commissioner. 27.36 Sec. 32. Minnesota Statutes 2000, section 144.148, 28.1 subdivision 2, is amended to read: 28.2 Subd. 2. [PROGRAM.] (a) The commissioner of health shall 28.3 award rural hospital capital improvement grants to eligible 28.4 rural hospitals. Except as provided in paragraph (b), a grant 28.5 shall not exceed$300,000$500,000 per hospital. Prior to the 28.6 receipt of any grant, the hospital must certify to the 28.7 commissioner that at least one-quarter of the grant amount, 28.8 which may include in-kind services, is available for the same 28.9 purposes from nonstate resources. 28.10 (b) A grant shall not exceed $1,500,000 per eligible rural 28.11 hospital that also satisfies the following criteria: 28.12 (1) is the only hospital in a county; 28.13 (2) has 25 or fewer licensed hospital beds with a net 28.14 hospital operating margin not greater than an average of two 28.15 percent over the three fiscal years prior to application; 28.16 (3) is located in a medically underserved community (MUC) 28.17 or a health professional shortage area (HPSA); 28.18 (4) is located near a migrant worker employment site and 28.19 regularly treats significant numbers of migrant workers and 28.20 their families; and 28.21 (5) has not previously received a grant under this section 28.22 prior to July 1, 1999. 28.23 Sec. 33. [144.1499] [PROMOTION OF HEALTH CARE AND 28.24 LONG-TERM CARE CAREERS.] 28.25 The commissioner of health, in consultation with an 28.26 organization representing health care employers, long-term care 28.27 employers, and educational institutions, may make grants to 28.28 qualifying consortia as defined in section 116L.11, subdivision 28.29 4, for intergenerational programs to encourage middle and high 28.30 school students to work and volunteer in health care and 28.31 long-term care settings. To qualify for a grant under this 28.32 section, a consortium shall: 28.33 (1) develop a health and long-term care careers curriculum 28.34 that provides career exploration and training in national skill 28.35 standards for health care and long-term care and that is 28.36 consistent with Minnesota graduation standards and other related 29.1 requirements; 29.2 (2) offer programs for high school students that provide 29.3 training in health and long-term care careers with credits that 29.4 articulate into post-secondary programs; and 29.5 (3) provide technical support to the participating health 29.6 care and long-term care employer to enable the use of the 29.7 employer's facilities and programs for kindergarten to grade 12 29.8 health and long-term care careers education. 29.9 Sec. 34. [144.1502] [DENTISTS LOAN FORGIVENESS.] 29.10 Subdivision 1. [DEFINITION.] For purposes of this section, 29.11 "qualifying educational loans" means government, commercial, and 29.12 foundation loans for actual costs paid for tuition, reasonable 29.13 education expenses, and reasonable living expenses related to 29.14 the graduate or undergraduate education of a dentist. 29.15 Subd. 2. [CREATION OF ACCOUNT; LOAN FORGIVENESS 29.16 PROGRAM.] A dentist education account is established in the 29.17 general fund. The commissioner of health shall use money from 29.18 the account to establish a loan forgiveness program for dentists 29.19 who agree to care for substantial numbers of state public 29.20 program participants and other low- to moderate-income uninsured 29.21 patients. 29.22 Subd. 3. [ELIGIBILITY.] To be eligible to participate in 29.23 the loan forgiveness program, a dental student must submit an 29.24 application to the commissioner of health while attending a 29.25 program of study designed to prepare the individual to become a 29.26 licensed dentist. For fiscal year 2002, applicants may have 29.27 graduated from a dentistry program in calendar year 2001. A 29.28 dental student who is accepted into the loan forgiveness program 29.29 must sign a contract to agree to serve a minimum three-year 29.30 service obligation during which at least 25 percent of the 29.31 dentist's yearly patient encounters are delivered to state 29.32 public program enrollees or patients receiving sliding fee 29.33 schedule discounts through a formal sliding fee schedule meeting 29.34 the standards established by the United States Department of 29.35 Health and Human Services under Code of Federal Regulations, 29.36 title 42, section 51, chapter 303. The service obligation shall 30.1 begin no later than March 31 of the first year following 30.2 completion of training. If fewer applications are submitted by 30.3 dental students than there are participant slots available, the 30.4 commissioner may consider applications submitted by dental 30.5 program graduates who are licensed dentists. Dentists selected 30.6 for loan forgiveness must comply with all terms and conditions 30.7 of this section. 30.8 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 30.9 may accept up to 14 applicants per year for participation in the 30.10 loan forgiveness program. Applicants are responsible for 30.11 securing their own loans. The commissioner shall select 30.12 participants based on their suitability for practice serving 30.13 public program patients, as indicated by experience or 30.14 training. The commissioner shall give preference to applicants 30.15 who have attended a Minnesota dentistry educational institution 30.16 and to applicants closest to completing their training. For 30.17 each year that a participant meets the service obligation 30.18 required under subdivision 3, up to a maximum of four years, the 30.19 commissioner shall make annual disbursements directly to the 30.20 participant equivalent to $10,000 per year of service, not to 30.21 exceed $40,000 or the balance of the qualifying educational 30.22 loans, whichever is less. Before receiving loan repayment 30.23 disbursements and as requested, the participant must complete 30.24 and return to the commissioner an affidavit of practice form 30.25 provided by the commissioner verifying that the participant is 30.26 practicing as required under subdivision 3. The participant 30.27 must provide the commissioner with verification that the full 30.28 amount of loan repayment disbursement received by the 30.29 participant has been applied toward the designated loans. After 30.30 each disbursement, verification must be received by the 30.31 commissioner and approved before the next loan repayment 30.32 disbursement is made. Participants who move their practice 30.33 remain eligible for loan repayment as long as they practice as 30.34 required under subdivision 3. 30.35 Subd. 5. [PENALTY FOR NONFULFILLMENT.] If a participant 30.36 does not fulfill the service commitment under subdivision 3, the 31.1 commissioner of health shall collect from the participant 100 31.2 percent of any payments made for qualified educational loans and 31.3 interest at a rate established according to section 270.75. The 31.4 commissioner shall deposit the money collected in the dentist 31.5 education account established under subdivision 2. 31.6 Subd. 6. [SUSPENSION OR WAIVER OF OBLIGATION.] Payment or 31.7 service obligations cancel in the event of a participant's 31.8 death. The commissioner of health may waive or suspend payment 31.9 or service obligations in cases of total and permanent 31.10 disability or long-term temporary disability lasting for more 31.11 than two years. The commissioner shall evaluate all other 31.12 requests for suspension or waivers on a case-by-case basis and 31.13 may grant a waiver of all or part of the money owed as a result 31.14 of a nonfulfillment penalty if emergency circumstances prevented 31.15 fulfillment of the required service commitment. 31.16 Sec. 35. Minnesota Statutes 2000, section 144.226, 31.17 subdivision 4, is amended to read: 31.18 Subd. 4. [VITAL RECORDS SURCHARGE.] In addition to any fee 31.19 prescribed under subdivision 1, there is a nonrefundable 31.20 surcharge of$3$2 for each certified and noncertified birth or 31.21 death record, and for a certification that the record cannot be 31.22 found. The local or state registrar shall forward this amount 31.23 to the state treasurer to be deposited into the state government 31.24 special revenue fund. This surcharge shall not be charged under 31.25 those circumstances in which no fee for a birth or death record 31.26 is permitted under subdivision 1, paragraph (a).This surcharge31.27requirement expires June 30, 2002.31.28 Sec. 36. Minnesota Statutes 2000, section 144.395, 31.29 subdivision 2, is amended to read: 31.30 Subd. 2. [EXPENDITURES.] (a) Up to five percent of the 31.31 fair market value of the fund on the preceding July 1, must be 31.32 spent to reduce the human and economic consequences of tobacco 31.33 use among the youth of this state through state and local 31.34 tobacco prevention measures and efforts, and for other public 31.35 health initiatives. 31.36 (b) Notwithstanding paragraph (a), on January 1, 2000, up 32.1 to five percent of the fair market value of the fund is 32.2 appropriated to the commissioner of health to distribute as 32.3 grants under section 144.396, subdivisions 5 and 6, in 32.4 accordance with allocations in paragraph (c), clauses (1) and 32.5 (2). Up to $200,000 of this appropriation is available to the 32.6 commissioner to conduct the statewide assessments described in 32.7 section 144.396, subdivision 3. 32.8 (c) Beginning July 1, 2000, and on July 1 of each year 32.9 thereafter, the money in paragraph (a) is appropriated as 32.10 follows, except as provided in paragraphs (d) and (e): 32.11 (1) 67 percent to the commissioner of health to distribute 32.12 as grants under section 144.396, subdivision 5, to fund 32.13 statewide tobacco use prevention initiatives aimed at youth; 32.14 (2) 16.5 percent to the commissioner of health to 32.15 distribute as grants under section 144.396, subdivision 6, to 32.16 fund local public health initiatives aimed at tobacco use 32.17 prevention in coordination with other local health-related 32.18 efforts to achieve measurable improvements in health among 32.19 youth; and 32.20 (3) 16.5 percent to the commissioner of health to 32.21 distribute in accordance with section 144.396, subdivision 7. 32.22 (d) A maximum of $150,000 of each annual appropriation to 32.23 the commissioner of health in paragraphs (b) and (c) may be used 32.24 by the commissioner for administrative expenses associated with 32.25 implementing this section. 32.26 (e) Beginning July 1, 2001,$1,100,000$1,250,000 of each 32.27 annual appropriation to the commissioner under paragraph (c), 32.28 clause (1), may be used to provide base level funding for the 32.29 commissioner's tobacco prevention and control programs and 32.30 activities. This appropriation must occur before any other 32.31 appropriation under this subdivision. 32.32 Sec. 37. Minnesota Statutes 2000, section 144.551, 32.33 subdivision 1, is amended to read: 32.34 Subdivision 1. [RESTRICTED CONSTRUCTION OR MODIFICATION.] 32.35 (a) The following construction or modification may not be 32.36 commenced: 33.1 (1) any erection, building, alteration, reconstruction, 33.2 modernization, improvement, extension, lease, or other 33.3 acquisition by or on behalf of a hospital that increases the bed 33.4 capacity of a hospital, relocates hospital beds from one 33.5 physical facility, complex, or site to another, or otherwise 33.6 results in an increase or redistribution of hospital beds within 33.7 the state; and 33.8 (2) the establishment of a new hospital. 33.9 (b) This section does not apply to: 33.10 (1) construction or relocation within a county by a 33.11 hospital, clinic, or other health care facility that is a 33.12 national referral center engaged in substantial programs of 33.13 patient care, medical research, and medical education meeting 33.14 state and national needs that receives more than 40 percent of 33.15 its patients from outside the state of Minnesota; 33.16 (2) a project for construction or modification for which a 33.17 health care facility held an approved certificate of need on May 33.18 1, 1984, regardless of the date of expiration of the 33.19 certificate; 33.20 (3) a project for which a certificate of need was denied 33.21 before July 1, 1990, if a timely appeal results in an order 33.22 reversing the denial; 33.23 (4) a project exempted from certificate of need 33.24 requirements by Laws 1981, chapter 200, section 2; 33.25 (5) a project involving consolidation of pediatric 33.26 specialty hospital services within the Minneapolis-St. Paul 33.27 metropolitan area that would not result in a net increase in the 33.28 number of pediatric specialty hospital beds among the hospitals 33.29 being consolidated; 33.30 (6) a project involving the temporary relocation of 33.31 pediatric-orthopedic hospital beds to an existing licensed 33.32 hospital that will allow for the reconstruction of a new 33.33 philanthropic, pediatric-orthopedic hospital on an existing site 33.34 and that will not result in a net increase in the number of 33.35 hospital beds. Upon completion of the reconstruction, the 33.36 licenses of both hospitals must be reinstated at the capacity 34.1 that existed on each site before the relocation; 34.2 (7) the relocation or redistribution of hospital beds 34.3 within a hospital building or identifiable complex of buildings 34.4 provided the relocation or redistribution does not result in: 34.5 (i) an increase in the overall bed capacity at that site; (ii) 34.6 relocation of hospital beds from one physical site or complex to 34.7 another; or (iii) redistribution of hospital beds within the 34.8 state or a region of the state; 34.9 (8) relocation or redistribution of hospital beds within a 34.10 hospital corporate system that involves the transfer of beds 34.11 from a closed facility site or complex to an existing site or 34.12 complex provided that: (i) no more than 50 percent of the 34.13 capacity of the closed facility is transferred; (ii) the 34.14 capacity of the site or complex to which the beds are 34.15 transferred does not increase by more than 50 percent; (iii) the 34.16 beds are not transferred outside of a federal health systems 34.17 agency boundary in place on July 1, 1983; and (iv) the 34.18 relocation or redistribution does not involve the construction 34.19 of a new hospital building; 34.20 (9) a construction project involving up to 35 new beds in a 34.21 psychiatric hospital in Rice county that primarily serves 34.22 adolescents and that receives more than 70 percent of its 34.23 patients from outside the state of Minnesota; 34.24 (10) a project to replace a hospital or hospitals with a 34.25 combined licensed capacity of 130 beds or less if: (i) the new 34.26 hospital site is located within five miles of the current site; 34.27 and (ii) the total licensed capacity of the replacement 34.28 hospital, either at the time of construction of the initial 34.29 building or as the result of future expansion, will not exceed 34.30 70 licensed hospital beds, or the combined licensed capacity of 34.31 the hospitals, whichever is less; 34.32 (11) the relocation of licensed hospital beds from an 34.33 existing state facility operated by the commissioner of human 34.34 services to a new or existing facility, building, or complex 34.35 operated by the commissioner of human services; from one 34.36 regional treatment center site to another; or from one building 35.1 or site to a new or existing building or site on the same 35.2 campus; 35.3 (12) the construction or relocation of hospital beds 35.4 operated by a hospital having a statutory obligation to provide 35.5 hospital and medical services for the indigent that does not 35.6 result in a net increase in the number of hospital beds;or35.7 (13) a construction project involving the addition of up to 35.8 31 new beds in an existing nonfederal hospital in Beltrami 35.9 county; or 35.10 (14) a construction project involving the addition of up to 35.11 eight new beds in an existing nonfederal hospital in Otter Tail 35.12 county with 100 licensed acute care beds. 35.13 Sec. 38. Minnesota Statutes 2000, section 144.98, 35.14 subdivision 3, is amended to read: 35.15 Subd. 3. [FEES.] (a) An application for certification 35.16 under subdivision 1 must be accompanied by the biennial fee 35.17 specified in this subdivision. The fees are for: 35.18 (1) nonrefundable base certification fee,$500$1,200; and 35.19 (2) test category certification fees: 35.20 Test Category Certification Fee 35.21 Clean water program bacteriology$200$600 35.22 Safe drinking water program bacteriology $600 35.23 Clean water program inorganic chemistry,35.24fewer than four constituents$100$600 35.25 Safe drinking water program inorganic chemistry,35.26four or more constituents$300$600 35.27 Clean water program chemistry metals,35.28fewer than four constituents$200$800 35.29 Safe drinking water program chemistry metals,35.30four or more constituents$500$800 35.31 Resource conservation and recovery program 35.32 chemistry metals $800 35.33 Clean water program volatile organic compounds$600$1,200 35.34 Safe drinking water program 35.35 volatile organic compounds $1,200 35.36 Resource conservation and recovery program 36.1 volatile organic compounds $1,200 36.2 Underground storage tank program 36.3 volatile organic compounds $1,200 36.4 Clean water program other organic compounds$600$1,200 36.5 Safe drinking water program other organic compounds $1,200 36.6 Resource conservation and recovery program 36.7 other organic compounds $1,200 36.8 (b) The total biennial certification fee is the base fee 36.9 plus the applicable test category fees.The biennial36.10certification fee for a contract laboratory is 1.5 times the36.11total certification fee.36.12 (c) Laboratories located outside of this state that require 36.13 an on-site survey will be assessed an additional$1,200$2,500 36.14 fee. 36.15 (d) Fees must be set so that the total fees support the 36.16 laboratory certification program. Direct costs of the 36.17 certification service include program administration, 36.18 inspections, the agency's general support costs, and attorney 36.19 general costs attributable to the fee function. 36.20 (e) A change fee shall be assessed if a laboratory requests 36.21 additional analytes or methods at any time other than when 36.22 applying for or renewing its certification. The change fee is 36.23 equal to the test category certification fee for the analyte. 36.24 (f) A variance fee shall be assessed if a laboratory 36.25 requests and is granted a variance from a rule adopted under 36.26 this section. The variance fee is $500 per variance. 36.27 (g) Refunds or credits shall not be made for analytes or 36.28 methods requested but not approved. 36.29 (h) Certification of a laboratory shall not be awarded 36.30 until all fees are paid. 36.31 Sec. 39. Minnesota Statutes 2000, section 144A.44, 36.32 subdivision 1, is amended to read: 36.33 Subdivision 1. [STATEMENT OF RIGHTS.] A person who 36.34 receives home care services has these rights: 36.35 (1) the right to receive written information about rights 36.36 in advance of receiving care or during the initial evaluation 37.1 visit before the initiation of treatment, including what to do 37.2 if rights are violated; 37.3 (2) the right to receive care and services according to a 37.4 suitable and up-to-date plan, and subject to accepted medical or 37.5 nursing standards, to take an active part in creating and 37.6 changing the plan and evaluating care and services; 37.7 (3) the right to be told in advance of receiving care about 37.8 the services that will be provided, the disciplines that will 37.9 furnish care, the frequency of visits proposed to be furnished, 37.10 other choices that are available, and the consequences of these 37.11 choices including the consequences of refusing these services; 37.12 (4) the right to be told in advance of any change in the 37.13 plan of care and to take an active part in any change; 37.14 (5) the right to refuse services or treatment; 37.15 (6) the right to know, in advance, any limits to the 37.16 services available from a provider, and the provider's grounds 37.17 for a termination of services; 37.18 (7) the right to know in advance of receiving care whether 37.19 the services are covered by health insurance, medical 37.20 assistance, or other health programs, the charges for services 37.21 that will not be covered by Medicare, and the charges that the 37.22 individual may have to pay; 37.23 (8) the right to know what the charges are for services, no 37.24 matter who will be paying the bill; 37.25 (9) the right to know that there may be other services 37.26 available in the community, including other home care services 37.27 and providers, and to know where to go for information about 37.28 these services; 37.29 (10) the right to choose freely among available providers 37.30 and to change providers after services have begun, within the 37.31 limits of health insurance, medical assistance, or other health 37.32 programs; 37.33 (11) the right to have personal, financial, and medical 37.34 information kept private, and to be advised of the provider's 37.35 policies and procedures regarding disclosure of such 37.36 information; 38.1 (12) the right to be allowed access to records and written 38.2 information from records in accordance with section 144.335; 38.3 (13) the right to be served by people who are properly 38.4 trained and competent to perform their duties; 38.5 (14) the right to be treated with courtesy and respect, and 38.6 to have the patient's property treated with respect; 38.7 (15) the right to be free from physical and verbal abuse; 38.8 (16) the right to reasonable, advance notice of changes in 38.9 services or charges, including at least ten days' advance notice 38.10 of the termination of a service by a provider, except in cases 38.11 where: 38.12 (i) the recipient of services engages in conduct that 38.13 alters the conditions of employment as specified in the 38.14 employment contract between the home care provider and the 38.15 individual providing home care services, or creates an abusive 38.16 or unsafe work environment for the individual providing home 38.17 care services; or 38.18 (ii) an emergency for the informal caregiver or a 38.19 significant change in the recipient's condition has resulted in 38.20 service needs that exceed the current service provider agreement 38.21 and that cannot be safely met by the home care provider; 38.22 (17) the right to a coordinated transfer when there will be 38.23 a change in the provider of services; 38.24 (18) the right to voice grievances regarding treatment or 38.25 care that is, or fails to be, furnished, or regarding the lack 38.26 of courtesy or respect to the patient or the patient's property; 38.27 (19) the right to know how to contact an individual 38.28 associated with the provider who is responsible for handling 38.29 problems and to have the provider investigate and attempt to 38.30 resolve the grievance or complaint; 38.31 (20) the right to know the name and address of the state or 38.32 county agency to contact for additional information or 38.33 assistance; and 38.34 (21) the right to assert these rights personally, or have 38.35 them asserted by the patient's family or guardian when the 38.36 patient has been judged incompetent, without retaliation. 39.1 Sec. 40. Minnesota Statutes 2000, section 144A.4605, 39.2 subdivision 4, is amended to read: 39.3 Subd. 4. [LICENSE REQUIRED.] (a) A housing with services 39.4 establishment registered under chapter 144D that is required to 39.5 obtain a home care license must obtain an assisted living home 39.6 care license according to this section or a class A or class E 39.7 license according to rule. A housing with services 39.8 establishment that obtains a class E license under this 39.9 subdivision remains subject to the payment limitations in 39.10 sections 256B.0913, subdivision 5, paragraph (h), and 256B.0915, 39.11 subdivision 3, paragraph (g). 39.12 (b) A board and lodging establishment registered for 39.13 special services as of December 31, 1996, and also registered as 39.14 a housing with services establishment under chapter 144D, must 39.15 deliver home care services according to sections 144A.43 to 39.16 144A.48, and may apply for a waiver from requirements under 39.17 Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a 39.18 licensed agency under the standards of section 157.17. Such 39.19 waivers as may be granted by the department will expire upon 39.20 promulgation of home care rules implementing section 144A.4605. 39.21 (c) An adult foster care provider licensed by the 39.22 department of human services and registered under chapter 144D 39.23 may continue to provide health-related services under its foster 39.24 care license until the promulgation of home care rules 39.25 implementing this section. 39.26 (d) An assisted living home care provider licensed under 39.27 this section must comply with the disclosure provisions of 39.28 section 325F.691 to the extent they are applicable. 39.29 [EFFECTIVE DATE.] This section is effective October 1, 2001. 39.30 Sec. 41. Minnesota Statutes 2000, section 144D.03, 39.31 subdivision 2, is amended to read: 39.32 Subd. 2. [REGISTRATION INFORMATION.] The establishment 39.33 shall provide the following information to the commissioner in 39.34 order to be registered: 39.35 (1) the business name, street address, and mailing address 39.36 of the establishment; 40.1 (2) the name and mailing address of the owner or owners of 40.2 the establishment and, if the owner or owners are not natural 40.3 persons, identification of the type of business entity of the 40.4 owner or owners, and the names and addresses of the officers and 40.5 members of the governing body, or comparable persons for 40.6 partnerships, limited liability corporations, or other types of 40.7 business organizations of the owner or owners; 40.8 (3) the name and mailing address of the managing agent, 40.9 whether through management agreement or lease agreement, of the 40.10 establishment, if different from the owner or owners, and the 40.11 name of the on-site manager, if any; 40.12 (4) verification that the establishment has entered into an 40.13 elderly housing with services contract, as required in section 40.14 144D.04, with each resident or resident's representative; 40.15 (5) verification that the establishment is complying with 40.16 the requirements of section 325F.691, if applicable; 40.17(5)(6) the name and address of at least one natural person 40.18 who shall be responsible for dealing with the commissioner on 40.19 all matters provided for in sections 144D.01 to 144D.06, and on 40.20 whom personal service of all notices and orders shall be made, 40.21 and who shall be authorized to accept service on behalf of the 40.22 owner or owners and the managing agent, if any; and 40.23(6)(7) the signature of the authorized representative of 40.24 the owner or owners or, if the owner or owners are not natural 40.25 persons, signatures of at least two authorized representatives 40.26 of each owner, one of which shall be an officer of the owner. 40.27 Personal service on the person identified under clause(5)40.28 (6) by the owner or owners in the registration shall be 40.29 considered service on the owner or owners, and it shall not be a 40.30 defense to any action that personal service was not made on each 40.31 individual or entity. The designation of one or more 40.32 individuals under this subdivision shall not affect the legal 40.33 responsibility of the owner or owners under sections 144D.01 to 40.34 144D.06. 40.35 [EFFECTIVE DATE.] This section is effective October 1, 2001. 40.36 Sec. 42. Minnesota Statutes 2000, section 144D.04, 41.1 subdivision 2, is amended to read: 41.2 Subd. 2. [CONTENTS OF CONTRACT.] An elderly housing with 41.3 services contract, which need not be entitled as such to comply 41.4 with this section, shall include at least the following elements 41.5 in itself or through supporting documents or attachments: 41.6 (1) name, street address, and mailing address of the 41.7 establishment; 41.8 (2) the name and mailing address of the owner or owners of 41.9 the establishment and, if the owner or owners is not a natural 41.10 person, identification of the type of business entity of the 41.11 owner or owners; 41.12 (3) the name and mailing address of the managing agent, 41.13 through management agreement or lease agreement, of the 41.14 establishment, if different from the owner or owners; 41.15 (4) the name and address of at least one natural person who 41.16 is authorized to accept service on behalf of the owner or owners 41.17 and managing agent; 41.18 (5) statement describing the registration and licensure 41.19 status of the establishment and any provider providing 41.20 health-related or supportive services under an arrangement with 41.21 the establishment; 41.22 (6) term of the contract; 41.23 (7) description of the services to be provided to the 41.24 resident in the base rate to be paid by resident; 41.25 (8) description of any additional services available for an 41.26 additional fee from the establishment directly or through 41.27 arrangements with the establishment; 41.28 (9) fee schedules outlining the cost of any additional 41.29 services; 41.30 (10) description of the process through which the contract 41.31 may be modified, amended, or terminated; 41.32 (11) description of the establishment's complaint 41.33 resolution process available to residents including the 41.34 toll-free complaint line for the office of ombudsman for older 41.35 Minnesotans; 41.36 (12) the resident's designated representative, if any; 42.1 (13) the establishment's referral procedures if the 42.2 contract is terminated; 42.3 (14) criteria used by the establishment to determine who 42.4 may continue to reside in the elderly housing with services 42.5 establishment; 42.6 (15) billing and payment procedures and requirements; 42.7 (16) statement regarding the ability of residents to 42.8 receive services from service providers with whom the 42.9 establishment does not have an arrangement; and 42.10 (17) statement regarding the availability of public funds 42.11 for payment for residence or services in the establishment. 42.12 [EFFECTIVE DATE.] This section is effective October 1, 2001. 42.13 Sec. 43. Minnesota Statutes 2000, section 144D.04, 42.14 subdivision 3, is amended to read: 42.15 Subd. 3. [CONTRACTS IN PERMANENT FILES.] Elderly housing 42.16 with services contracts and related documents executed by each 42.17 resident or resident's representative shall be maintained by the 42.18 establishment in files from the date of execution until three 42.19 years after the contract is terminated. The contracts and the 42.20 written disclosures required under section 325F.691, if 42.21 applicable, shall be made available for on-site inspection by 42.22 the commissioner upon request at any time. 42.23 [EFFECTIVE DATE.] This section is effective October 1, 2001. 42.24 Sec. 44. Minnesota Statutes 2000, section 144D.06, is 42.25 amended to read: 42.26 144D.06 [OTHER LAWS.] 42.27 A housing with services establishment shall obtain and 42.28 maintain all other licenses, permits, registrations, or other 42.29 governmental approvals required of it in addition to 42.30 registration under this chapter. A housing with services 42.31 establishment is subject to the provisions of section 325F.691 42.32 and chapter 504B. 42.33 [EFFECTIVE DATE.] This section is effective October 1, 2001. 42.34 Sec. 45. [145.56] [SUICIDE PREVENTION.] 42.35 Subdivision 1. [SUICIDE PREVENTION PLAN.] The commissioner 42.36 of health shall refine, coordinate, and implement the state's 43.1 suicide prevention plan using an evidence-based, public health 43.2 approach focused on prevention, in collaboration with the 43.3 commissioner of human services; the commissioner of public 43.4 safety; the commissioner of children, families, and learning; 43.5 and appropriate agencies, organizations, and institutions in the 43.6 community. 43.7 Subd. 2. [COMMUNITY-BASED PROGRAMS.] (a) The commissioner 43.8 shall establish a grant program to fund: 43.9 (1) community-based programs to provide education, 43.10 outreach, and advocacy services to populations who may be at 43.11 risk for suicide; 43.12 (2) community-based programs that educate community helpers 43.13 and gatekeepers, such as family members, spiritual leaders, 43.14 coaches, and business owners, employers, and coworkers on how to 43.15 prevent suicide by encouraging help-seeking behaviors; 43.16 (3) community-based programs that educate populations at 43.17 risk for suicide and community helpers and gatekeepers that must 43.18 include information on the symptoms of depression and other 43.19 psychiatric illnesses, the warning signs of suicide, skills for 43.20 preventing suicides, and making or seeking effective referrals 43.21 to intervention and community resources; and 43.22 (4) community-based programs to provide evidence-based 43.23 suicide prevention and intervention education to school staff, 43.24 parents, and students in grades kindergarten through 12. 43.25 Subd. 3. [WORKPLACE AND PROFESSIONAL EDUCATION.] (a) The 43.26 commissioner shall promote the use of employee assistance and 43.27 workplace programs to support employees with depression and 43.28 other psychiatric illnesses and substance abuse disorders, and 43.29 refer them to services. In promoting these programs, the 43.30 commissioner shall collaborate with employer and professional 43.31 associations, unions, and safety councils. 43.32 (b) The commissioner shall provide training and technical 43.33 assistance to local public health and other community-based 43.34 professionals to provide for integrated implementation of best 43.35 practices for preventing suicides. 43.36 Subd. 4. [COLLECTION AND REPORTING SUICIDE DATA.] The 44.1 commissioner shall coordinate with federal, regional, local, and 44.2 other state agencies to collect, analyze, and annually issue a 44.3 public report on Minnesota-specific data on suicide and suicidal 44.4 behaviors. 44.5 Subd. 5. [PERIODIC EVALUATIONS; BIENNIAL REPORTS.] The 44.6 commissioner shall conduct periodic evaluations of the impact of 44.7 and outcomes from implementation of the state's suicide 44.8 prevention plan and each of the activities specified in this 44.9 section. By July 1, 2002, and July 1 of each even-numbered year 44.10 thereafter, the commissioner shall report the results of these 44.11 evaluations to the chairs of the policy and finance committees 44.12 in the house and senate with jurisdiction over health and human 44.13 services issues. 44.14 Sec. 46. Minnesota Statutes 2000, section 145.881, 44.15 subdivision 2, is amended to read: 44.16 Subd. 2. [DUTIES.] The advisory task force shall meet on a 44.17 regular basis to perform the following duties: 44.18 (a) review and report on the health care needs of mothers 44.19 and children throughout the state of Minnesota; 44.20 (b) review and report on the type, frequency and impact of 44.21 maternal and child health care services provided to mothers and 44.22 children under existing maternal and child health care programs, 44.23 including programs administered by the commissioner of health; 44.24 (c) establish, review, and report to the commissioner a 44.25 list of program guidelines and criteria which the advisory task 44.26 force considers essential to providing an effective maternal and 44.27 child health care program to low income populations and high 44.28 risk persons and fulfilling the purposes defined in section 44.29 145.88; 44.30 (d) review staff recommendations of the department of 44.31 health regarding maternal and child health grant awards before 44.32 the awards are made; 44.33 (e) make recommendations to the commissioner for the use of 44.34 other federal and state funds available to meet maternal and 44.35 child health needs; 44.36 (f) make recommendations to the commissioner of health on 45.1 priorities for funding the following maternal and child health 45.2 services: (1) prenatal, delivery and postpartum care, (2) 45.3 comprehensive health care for children, especially from birth 45.4 through five years of age, (3) adolescent health services, (4) 45.5 family planning services, (5) preventive dental care, (6) 45.6 special services for chronically ill and handicapped children 45.7 and (7) any other services which promote the health of mothers 45.8 and children;and45.9 (g) make recommendations to the commissioner of health on 45.10 the process to distribute, award and administer the maternal and 45.11 child health block grant funds; and 45.12 (h) review the measures that are used to define the 45.13 variables of the funding distribution formula in section 45.14 145.882, subdivision 4, every two years and make recommendations 45.15 to the commissioner of health for changes based upon principles 45.16 established by the advisory task force for this purpose. 45.17 Sec. 47. [145.9268] [COMMUNITY CLINIC GRANTS.] 45.18 Subdivision 1. [DEFINITION.] For purposes of this section, 45.19 "eligible community clinic" means: 45.20 (1) a clinic that provides services under conditions as 45.21 defined in Minnesota Rules, part 9505.0255, and utilizes a 45.22 sliding fee scale to determine eligibility for charity care; 45.23 (2) an Indian tribal government or Indian health service 45.24 unit; or 45.25 (3) a consortium of clinics comprised of entities under 45.26 clause (1) or (2). 45.27 Subd. 2. [GRANTS AUTHORIZED.] The commissioner of health 45.28 shall award grants to eligible community clinics to improve the 45.29 ongoing viability of Minnesota's clinic-based safety net 45.30 providers. Grants shall be awarded to support the capacity of 45.31 eligible community clinics to serve low-income populations, 45.32 reduce current or future uncompensated care burdens, or provide 45.33 for improved care delivery infrastructure. The commissioner 45.34 shall award grants to community clinics in metropolitan and 45.35 rural areas of the state, and shall ensure geographic 45.36 representation in grant awards among all regions of the state. 46.1 Subd. 3. [ALLOCATION OF GRANTS.] (a) To receive a grant 46.2 under this section, an eligible community clinic must submit an 46.3 application to the commissioner of health by the deadline 46.4 established by the commissioner. A grant may be awarded upon 46.5 the signing of a grant contract. Community clinics may apply 46.6 for and the commissioner may award grants for one-year or 46.7 two-year periods. 46.8 (b) An application must be on a form and contain 46.9 information as specified by the commissioner but at a minimum 46.10 must contain: 46.11 (1) a description of the purpose or project for which grant 46.12 funds will be used; 46.13 (2) a description of the problem or problems the grant 46.14 funds will be used to address; and 46.15 (3) a description of achievable objectives, a workplan, and 46.16 a timeline for implementation and completion of processes or 46.17 projects enabled by the grant. 46.18 (c) The commissioner shall review each application to 46.19 determine whether the application is complete and whether the 46.20 applicant and the project are eligible for a grant. In 46.21 evaluating applications according to paragraph (d), the 46.22 commissioner shall establish criteria including, but not limited 46.23 to: the priority level of the project; the applicant's 46.24 thoroughness and clarity in describing the problem grant funds 46.25 are intended to address; a description of the applicant's 46.26 proposed project; the manner in which the applicant will 46.27 demonstrate the effectiveness of any projects undertaken; and 46.28 evidence of efficiencies and effectiveness gained through 46.29 collaborative efforts. The commissioner may also take into 46.30 account other relevant factors, including, but not limited to, 46.31 the percentage for which uninsured patients represent the 46.32 applicant's patient base and the degree to which grant funds 46.33 will be used to support services increasing access to health 46.34 care services. During application review, the commissioner may 46.35 request additional information about a proposed project, 46.36 including information on project cost. Failure to provide the 47.1 information requested disqualifies an applicant. The 47.2 commissioner has discretion over the number of grants awarded. 47.3 (d) In determining which eligible community clinics will 47.4 receive grants under this section, the commissioner shall give 47.5 preference to those grant applications that show evidence of 47.6 collaboration with other eligible community clinics, hospitals, 47.7 health care providers, or community organizations. In addition, 47.8 the commissioner shall give priority, in declining order, to 47.9 grant applications for projects that: 47.10 (1) provide a direct offset to expenses incurred for 47.11 services provided to the clinic's target population; 47.12 (2) establish, update, or improve information, data 47.13 collection, or billing systems; 47.14 (3) procure, modernize, remodel, or replace equipment used 47.15 an the delivery of direct patient care at a clinic; 47.16 (4) provide improvements for care delivery, such as 47.17 increased translation and interpretation services; or 47.18 (5) other projects determined by the commissioner to 47.19 improve the ability of applicants to provide care to the 47.20 vulnerable populations they serve. 47.21 (e) A grant awarded to an eligible community clinic may not 47.22 exceed $300,000 per eligible community clinic. For an applicant 47.23 applying as a consortium of clinics, a grant may not exceed 47.24 $300,000 per clinic included in the consortium. The 47.25 commissioner has discretion over the number of grants awarded. 47.26 Subd. 4. [EVALUATION AND REPORT.] The commissioner of 47.27 health shall evaluate the overall effectiveness of the grant 47.28 program. The commissioner shall collect progress reports to 47.29 evaluate the grant program from the eligible community clinics 47.30 receiving grants. Every two years, as part of this evaluation, 47.31 the commissioner shall report to the legislature on priority 47.32 areas for grants set under subdivision 3 and provide any 47.33 recommendations for adding or changing priority areas. 47.34 Sec. 48. [145.928] [ELIMINATING HEALTH DISPARITIES.] 47.35 Subdivision 1. [GOAL; ESTABLISHMENT.] It is the goal of 47.36 the state, by 2010, to decrease by 50 percent the disparities in 48.1 infant mortality rates and adult and child immunization rates 48.2 for American Indians and populations of color, as compared with 48.3 rates for whites. To do so and to achieve other measurable 48.4 outcomes, the commissioner of health shall establish a program 48.5 to close the gap in the health status of American Indians and 48.6 populations of color as compared with whites in the following 48.7 priority areas: infant mortality, breast and cervical cancer 48.8 screening, HIV/AIDS and sexually transmitted infections, adult 48.9 and child immunizations, cardiovascular disease, diabetes, and 48.10 accidental injuries and violence. 48.11 Subd. 2. [STATE-COMMUNITY PARTNERSHIPS; PLAN.] The 48.12 commissioner, in partnership with culturally-based community 48.13 organizations; the Indian affairs council under section 3.922; 48.14 the council on affairs of Chicano/Latino people under section 48.15 3.9223; the council on Black Minnesotans under section 3.9225; 48.16 the council on Asian-Pacific Minnesotans under section 3.9226; 48.17 community health boards as defined in section 145A.02; and 48.18 tribal governments, shall develop and implement a comprehensive, 48.19 coordinated plan to reduce health disparities in the health 48.20 disparity priority areas identified in subdivision 1. 48.21 Subd. 3. [MEASURABLE OUTCOMES.] The commissioner, in 48.22 consultation with the community partners listed in subdivision 48.23 2, shall establish measurable outcomes to achieve the goal 48.24 specified in subdivision 1 and to determine the effectiveness of 48.25 the grants and other activities funded under this section in 48.26 reducing health disparities in the priority areas identified in 48.27 subdivision 1. The development of measurable outcomes must be 48.28 completed before any funds are distributed under this section. 48.29 Subd. 4. [STATEWIDE ASSESSMENT.] The commissioner shall 48.30 enhance current data tools to ensure a statewide assessment of 48.31 the risk behaviors associated with the health disparity priority 48.32 areas identified in subdivision 1. The statewide assessment 48.33 must be used to establish a baseline to measure the effect of 48.34 activities funded under this section. To the extent feasible, 48.35 the commissioner shall conduct the assessment so that the 48.36 results may be compared to national data. 49.1 Subd. 5. [TECHNICAL ASSISTANCE.] The commissioner shall 49.2 provide the necessary expertise to grant applicants to ensure 49.3 that submitted proposals are likely to be successful in reducing 49.4 the health disparities identified in subdivision 1. The 49.5 commissioner shall provide grant recipients with guidance and 49.6 training on best or most promising strategies to use to reduce 49.7 the health disparities identified in subdivision 1. The 49.8 commissioner shall also assist grant recipients in the 49.9 development of materials and procedures to evaluate local 49.10 community activities. 49.11 Subd. 6. [PROCESS.] (a) The commissioner, in consultation 49.12 with the community partners listed in subdivision 2, shall 49.13 develop the criteria and procedures used to allocate grants 49.14 under this section. In developing the criteria, the 49.15 commissioner shall establish an administrative cost limit for 49.16 grant recipients. At the time a grant is awarded, the 49.17 commissioner must provide a grant recipient with information on 49.18 the outcomes established according to subdivision 3. 49.19 (b) A grant recipient must coordinate its activities to 49.20 reduce health disparities with other entities receiving funds 49.21 under this section that are in the grant recipient's service 49.22 area. 49.23 Subd. 7. [COMMUNITY GRANT PROGRAM; IMMUNIZATION RATES AND 49.24 INFANT MORTALITY RATES.] (a) The commissioner shall award grants 49.25 to eligible applicants for local or regional projects and 49.26 initiatives directed at reducing health disparities in one or 49.27 both of the following priority areas: 49.28 (1) decreasing racial and ethnic disparities in infant 49.29 mortality rates; or 49.30 (2) increasing adult and child immunization rates in 49.31 nonwhite racial and ethnic populations. 49.32 (b) The commissioner may award up to 20 percent of the 49.33 funds available as planning grants. Planning grants must be 49.34 used to address such areas as community assessment, coordination 49.35 activities, and development of community supported strategies. 49.36 (c) Eligible applicants may include, but are not limited 50.1 to, faith-based organizations, social service organizations, 50.2 community nonprofit organizations, community health boards, 50.3 tribal governments, and community clinics. Applicants must 50.4 submit proposals to the commissioner. A proposal must specify 50.5 the strategies to be implemented to address one or both of the 50.6 priority areas listed in paragraph (a) and must be targeted to 50.7 achieve the outcomes established according to subdivision 3. 50.8 (d) The commissioner shall give priority to applicants who 50.9 demonstrate that their proposed project or initiative: 50.10 (1) is supported by the community the applicant will serve; 50.11 (2) is research-based or based on promising strategies; 50.12 (3) is designed to complement other related community 50.13 activities; 50.14 (4) utilizes strategies that positively impact both 50.15 priority areas; 50.16 (5) reflects racially and ethnically appropriate 50.17 approaches; and 50.18 (6) will be implemented through or with community-based 50.19 organizations that reflect the race or ethnicity of the 50.20 population to be reached. 50.21 Subd. 8. [COMMUNITY GRANT PROGRAM; OTHER HEALTH 50.22 DISPARITIES.] (a) The commissioner shall award grants to 50.23 eligible applicants for local or regional projects and 50.24 initiatives directed at reducing health disparities in one or 50.25 more of the following priority areas: 50.26 (1) decreasing racial and ethnic disparities in morbidity 50.27 and mortality rates from breast and cervical cancer; 50.28 (2) decreasing racial and ethnic disparities in morbidity 50.29 and mortality rates from HIV/AIDS and sexually transmitted 50.30 infections; 50.31 (3) decreasing racial and ethnic disparities in morbidity 50.32 and mortality rates from cardiovascular disease; 50.33 (4) decreasing racial and ethnic disparities in morbidity 50.34 and mortality rates from diabetes; or 50.35 (5) decreasing racial and ethnic disparities in morbidity 50.36 and mortality rates from accidental injuries or violence. 51.1 (b) The commissioner may award up to 20 percent of the 51.2 funds available as planning grants. Planning grants must be 51.3 used to address such areas as community assessment, determining 51.4 community priority areas, coordination activities, and 51.5 development of community supported strategies. 51.6 (c) Eligible applicants may include, but are not limited 51.7 to, faith-based organizations, social service organizations, 51.8 community nonprofit organizations, community health boards, and 51.9 community clinics. Applicants shall submit proposals to the 51.10 commissioner. A proposal must specify the strategies to be 51.11 implemented to address one or more of the priority areas listed 51.12 in paragraph (a) and must be targeted to achieve the outcomes 51.13 established according to subdivision 3. 51.14 (d) The commissioner shall give priority to applicants who 51.15 demonstrate that their proposed project or initiative: 51.16 (1) is supported by the community the applicant will serve; 51.17 (2) is research-based or based on promising strategies; 51.18 (3) is designed to complement other related community 51.19 activities; 51.20 (4) utilizes strategies that positively impact more than 51.21 one priority area; 51.22 (5) reflects racially and ethnically appropriate 51.23 approaches; and 51.24 (6) will be implemented through or with community-based 51.25 organizations that reflect the race or ethnicity of the 51.26 population to be reached. 51.27 Subd. 9. [HEALTH OF FOREIGN-BORN PERSONS.] (a) The 51.28 commissioner shall distribute funds to community health boards 51.29 for health screening and follow-up services for tuberculosis for 51.30 foreign-born persons. Funds shall be distributed based on the 51.31 following formula: 51.32 (1) $1,500 per foreign-born person with pulmonary 51.33 tuberculosis in the community health board's service area; 51.34 (2) $500 per foreign-born person with extrapulmonary 51.35 tuberculosis in the community health board's service area; 51.36 (3) $500 per month of directly observed therapy provided by 52.1 the community health board for each uninsured foreign-born 52.2 person with pulmonary or extrapulmonary tuberculosis; and 52.3 (4) $50 per foreign-born person in the community health 52.4 board's service area. 52.5 (b) Payments must be made at the end of each state fiscal 52.6 year. The amount paid per tuberculosis case, per month of 52.7 directly observed therapy, and per foreign-born person must be 52.8 proportionately increased or decreased to fit the actual amount 52.9 appropriated for that fiscal year. 52.10 Subd. 10. [TRIBAL GOVERNMENTS.] The commissioner shall 52.11 award grants to American Indian tribal governments for 52.12 implementation of community interventions to reduce health 52.13 disparities for the priority areas listed in subdivisions 7 and 52.14 8. A community intervention must be targeted to achieve the 52.15 outcomes established according to subdivision 3. Tribal 52.16 governments must submit proposals to the commissioner and must 52.17 demonstrate partnerships with local public health entities. The 52.18 distribution formula shall be determined by the commissioner, in 52.19 consultation with the tribal governments. 52.20 Subd. 11. [COORDINATION.] The commissioner shall 52.21 coordinate the projects and initiatives funded under this 52.22 section with other efforts at the local, state, or national 52.23 level to avoid duplication and promote complementary efforts. 52.24 Subd. 12. [EVALUATION.] Using the outcomes established 52.25 according to subdivision 3, the commissioner shall conduct a 52.26 biennial evaluation of the community grant programs, community 52.27 health board activities, and tribal government activities funded 52.28 under this section. Grant recipients, tribal governments, and 52.29 community health boards shall cooperate with the commissioner in 52.30 the evaluation and shall provide the commissioner with the 52.31 information needed to conduct the evaluation. 52.32 Subd. 13. [REPORT.] The commissioner shall submit a 52.33 biennial report to the legislature on the local community 52.34 projects, tribal government, and community health board 52.35 prevention activities funded under this section. These reports 52.36 must include information on grant recipients, activities that 53.1 were conducted using grant funds, evaluation data, and outcome 53.2 measures, if available. These reports are due by January 15 of 53.3 every other year, beginning in the year 2003. 53.4 Subd. 14. [SUPPLANTATION OF EXISTING FUNDS.] Funds 53.5 received under this section must be used to develop new programs 53.6 or expand current programs that reduce health disparities. 53.7 Funds must not be used to supplant current county or tribal 53.8 expenditures. 53.9 Sec. 49. Minnesota Statutes 2000, section 145A.15, 53.10 subdivision 1, is amended to read: 53.11 Subdivision 1. [ESTABLISHMENT.] (a) The commissioner of 53.12 health shall expand the current grant program to fund additional 53.13 projects designed to prevent child abuse and neglect and reduce 53.14 juvenile delinquency by promoting positive parenting, resiliency 53.15 in children, and a healthy beginning for children by providing 53.16 early intervention services for families in need. Grant dollars 53.17 shall be available to train paraprofessionals to provide in-home 53.18 intervention services and to allow public health nurses to do 53.19 case management of services. The grant program shall provide 53.20 early intervention services for families in need and will 53.21 include: 53.22 (1) expansion of current public health nurse and family 53.23 aide home visiting programs and public health home visiting 53.24 projects which prevent child abuse and neglect, prevent juvenile 53.25 delinquency, and build resiliency in children; 53.26 (2) early intervention to promote a healthy and nurturing 53.27 beginning; 53.28 (3) distribution of educational and public information 53.29 programs and materials in hospital maternity divisions, 53.30 well-baby clinics, obstetrical clinics, and community clinics; 53.31 and 53.32 (4) training of home visitors in skills necessary for 53.33 comprehensive home visiting which promotes a healthy and 53.34 nurturing beginning for the child. 53.35 (b) No new grants shall be awarded under this section after 53.36 June 30, 2001. Grant contracts awarded and in effect under this 54.1 section as of July 1, 2001, shall continue until their 54.2 expiration date. 54.3 Sec. 50. Minnesota Statutes 2000, section 145A.15, is 54.4 amended by adding a subdivision to read: 54.5 Subd. 5. [EXPIRATION.] This section expires June 30, 2003. 54.6 Sec. 51. Minnesota Statutes 2000, section 145A.16, 54.7 subdivision 1, is amended to read: 54.8 Subdivision 1. [ESTABLISHMENT.] The commissioner shall 54.9 establish a grant program to fund universally offered home 54.10 visiting programs designed to serve all live births in 54.11 designated geographic areas. The commissioner shall designate 54.12 the geographic area to be served by each program. At least one 54.13 program must provide home visiting services to families within 54.14 the seven-county metropolitan area, and at least one program 54.15 must provide home visiting services to families outside the 54.16 metropolitan area. The purpose of the program is to strengthen 54.17 families and to promote positive parenting and healthy child 54.18 development. No new grants shall be awarded under this section 54.19 after June 30, 2001. Competitive grant contracts awarded and in 54.20 effect under this section as of July 1, 2001, shall expire 54.21 December 31, 2003. 54.22 Sec. 52. Minnesota Statutes 2000, section 145A.16, is 54.23 amended by adding a subdivision to read: 54.24 Subd. 10. [EXPIRATION.] This section expires December 31, 54.25 2003. 54.26 Sec. 53. [145A.17] [FAMILY HOME VISITING PROGRAMS.] 54.27 Subdivision 1. [ESTABLISHMENT; GOALS.] The commissioner 54.28 shall establish a program to fund family home visiting programs 54.29 designed to foster a healthy beginning for children in families 54.30 at or below 200 percent of the federal poverty guidelines, 54.31 prevent child abuse and neglect, reduce juvenile delinquency, 54.32 promote positive parenting and resiliency in children, and 54.33 promote family health and economic self-sufficiency. A program 54.34 funded under this section must serve families at or below 200 54.35 percent of the federal poverty guidelines, and other families 54.36 determined to be at risk, including but not limited to being at 55.1 risk for child abuse, child neglect, or juvenile delinquency. 55.2 Programs must give priority for services to families considered 55.3 to be in need of services, including but not limited to families 55.4 with: 55.5 (1) adolescent parents; 55.6 (2) a history of alcohol or other drug abuse; 55.7 (3) a history of child abuse, domestic abuse, or other 55.8 types of violence; 55.9 (4) a history of domestic abuse, rape, or other forms of 55.10 victimization; 55.11 (5) reduced cognitive functioning; 55.12 (6) a lack of knowledge of child growth and development 55.13 stages; 55.14 (7) low resiliency to adversities and environmental 55.15 stresses; or 55.16 (8) insufficient financial resources to meet family needs. 55.17 Subd. 2. [ALLOCATION OF FUNDS.] The commissioner shall 55.18 distribute funds available under this section to community 55.19 health boards, as defined in section 145A.02, and to tribal 55.20 governments. Funds shall be distributed to community health 55.21 boards as follows: (1) each community health board shall 55.22 receive an allocation of $25,000 per year; and (2) remaining 55.23 funds available to community health boards shall be distributed 55.24 according to the formula in section 256J.625, subdivision 3. 55.25 The commissioner, in consultation with tribal governments, shall 55.26 establish a formula for distributing funds to tribal governments. 55.27 Subd. 3. [REQUIREMENTS FOR PROGRAMS; PROCESS.] (a) Before 55.28 a community health board or tribal government may receive an 55.29 allocation under subdivision 2, a community health board or 55.30 tribal government must submit a proposal to the commissioner 55.31 that includes identification, based on a community assessment, 55.32 of the populations at or below 200 percent of the federal 55.33 poverty guidelines that will be served and the other populations 55.34 that will be served. Each program that receives funds must: 55.35 (1) use either a broad community-based or selective 55.36 community-based strategy to provide preventive and early 56.1 intervention home visiting services; 56.2 (2) offer a home visit by a trained home visitor. If a 56.3 home visit is accepted, the first home visit must occur 56.4 prenatally or as soon after birth as possible and must include a 56.5 public health nursing assessment by a public health nurse; 56.6 (3) offer, at a minimum, information on infant care, child 56.7 growth and development, positive parenting, preventing diseases, 56.8 preventing exposure to environmental hazards, and support 56.9 services available in the community; 56.10 (4) provide information on and referrals to health care 56.11 services, if needed, including information on health care 56.12 coverage for which the child or family may be eligible; and 56.13 provide information on preventive services, developmental 56.14 assessments, and the availability of public assistance programs 56.15 as appropriate; 56.16 (5) provide youth development programs; 56.17 (6) recruit home visitors who will represent, to the extent 56.18 possible, the races, cultures, and languages spoken by families 56.19 that may be served; 56.20 (7) train and supervise home visitors in accordance with 56.21 the requirements established under subdivision 4; 56.22 (8) maximize resources and minimize duplication by 56.23 coordinating activities with local social and human services 56.24 organizations, education organizations, and other appropriate 56.25 governmental entities and community-based organizations and 56.26 agencies; and 56.27 (9) utilize appropriate racial and ethnic approaches to 56.28 providing home visiting services. 56.29 (b) Funds available under this section shall not be used 56.30 for medical services. The commissioner shall establish an 56.31 administrative cost limit for recipients of funds. The outcome 56.32 measures established under subdivision 6 must be specified to 56.33 recipients of funds at the time the funds are distributed. 56.34 (c) Data collected on individuals served by the home 56.35 visiting programs must remain confidential and must not be 56.36 disclosed by providers of home visiting services without a 57.1 specific informed written consent that identifies disclosures to 57.2 be made. Upon request, agencies providing home visiting 57.3 services must provide recipients with information on 57.4 disclosures, including the names of entities and individuals 57.5 receiving the information and the general purpose of the 57.6 disclosure. Prospective and current recipients of home visiting 57.7 services must be told and informed in writing that written 57.8 consent for disclosure of data is not required for access to 57.9 home visiting services. 57.10 Subd. 4. [TRAINING.] The commissioner shall establish 57.11 training requirements for home visitors and minimum requirements 57.12 for supervision by a public health nurse. The requirements for 57.13 nurses must be consistent with chapter 148. Training must 57.14 include child development, positive parenting techniques, 57.15 screening and referrals for child abuse and neglect, and diverse 57.16 cultural practices in child rearing and family systems. 57.17 Subd. 5. [TECHNICAL ASSISTANCE.] The commissioner shall 57.18 provide administrative and technical assistance to each program, 57.19 including assistance in data collection and other activities 57.20 related to conducting short- and long-term evaluations of the 57.21 programs as required under subdivision 7. The commissioner may 57.22 request research and evaluation support from the University of 57.23 Minnesota. 57.24 Subd. 6. [OUTCOME MEASURES.] The commissioner shall 57.25 establish outcomes to determine the impact of family home 57.26 visiting programs funded under this section on the following 57.27 areas: 57.28 (1) appropriate utilization of preventive health care; 57.29 (2) rates of substantiated child abuse and neglect; 57.30 (3) rates of unintentional child injuries; 57.31 (4) rates of children who are screened and who pass early 57.32 childhood screening; and 57.33 (5) any additional qualitative goals and quantitative 57.34 measures established by the commissioner. 57.35 Subd. 7. [EVALUATION.] Using the qualitative goals and 57.36 quantitative outcome measures established under subdivisions 1 58.1 and 6, the commissioner shall conduct ongoing evaluations of the 58.2 programs funded under this section. Community health boards and 58.3 tribal governments shall cooperate with the commissioner in the 58.4 evaluations and shall provide the commissioner with the 58.5 information necessary to conduct the evaluations. As part of 58.6 the ongoing evaluations, the commissioner shall rate the impact 58.7 of the programs on the outcome measures listed in subdivision 6, 58.8 and shall periodically determine whether home visiting programs 58.9 are the best way to achieve the qualitative goals established 58.10 under subdivisions 1 and 6. If the commissioner determines that 58.11 home visiting programs are not the best way to achieve these 58.12 goals, the commissioner shall provide the legislature with 58.13 alternative methods for achieving them. 58.14 Subd. 8. [REPORT.] By January 15, 2002, and January 15 of 58.15 each even-numbered year thereafter, the commissioner shall 58.16 submit a report to the legislature on the family home visiting 58.17 programs funded under this section and on the results of the 58.18 evaluations conducted under subdivision 7. 58.19 Subd. 9. [NO SUPPLANTING OF EXISTING FUNDS.] Funding 58.20 available under this section may be used only to supplement, not 58.21 to replace, nonstate funds being used for home visiting services 58.22 as of July 1, 2001. 58.23 Sec. 54. Minnesota Statutes 2000, section 157.16, 58.24 subdivision 3, is amended to read: 58.25 Subd. 3. [ESTABLISHMENT FEES; DEFINITIONS.] (a) The 58.26 following fees are required for food and beverage service 58.27 establishments, hotels, motels, lodging establishments, and 58.28 resorts licensed under this chapter. Food and beverage service 58.29 establishments must pay the highest applicable fee under 58.30 paragraph (e), clause (1), (2), (3), or (4), and establishments 58.31 serving alcohol must pay the highest applicable fee under 58.32 paragraph (e), clause (6) or (7). The license fee for new 58.33 operators previously licensed under this chapter for the same 58.34 calendar year is one-half of the appropriate annual license fee, 58.35 plus any penalty that may be required. The license fee for 58.36 operators opening on or after October 1 is one-half of the 59.1 appropriate annual license fee, plus any penalty that may be 59.2 required. 59.3 (b) All food and beverage service establishments, except 59.4 special event food stands, and all hotels, motels, lodging 59.5 establishments, and resorts shall pay an annual base fee of 59.6$100$145. 59.7 (c) A special event food stand shall pay a flat fee 59.8 of$30$35 annually. "Special event food stand" means a fee 59.9 category where food is prepared or served in conjunction with 59.10 celebrations, county fairs, or special events from a special 59.11 event food stand as defined in section 157.15. 59.12 (d) In addition to the base fee in paragraph (b), each food 59.13 and beverage service establishment, other than a special event 59.14 food stand, and each hotel, motel, lodging establishment, and 59.15 resort shall pay an additional annual fee for each fee category 59.16 as specified in this paragraph: 59.17 (1) Limited food menu selection,$30$40. "Limited food 59.18 menu selection" means a fee category that provides one or more 59.19 of the following: 59.20 (i) prepackaged food that receives heat treatment and is 59.21 served in the package; 59.22 (ii) frozen pizza that is heated and served; 59.23 (iii) a continental breakfast such as rolls, coffee, juice, 59.24 milk, and cold cereal; 59.25 (iv) soft drinks, coffee, or nonalcoholic beverages; or 59.26 (v) cleaning for eating, drinking, or cooking utensils, 59.27 when the only food served is prepared off site. 59.28 (2) Small establishment, including boarding establishments, 59.29$55$75. "Small establishment" means a fee category that has no 59.30 salad bar and meets one or more of the following: 59.31 (i) possesses food service equipment that consists of no 59.32 more than a deep fat fryer, a grill, two hot holding containers, 59.33 and one or more microwave ovens; 59.34 (ii) serves dipped ice cream or soft serve frozen desserts; 59.35 (iii) serves breakfast in an owner-occupied bed and 59.36 breakfast establishment; 60.1 (iv) is a boarding establishment; or 60.2 (v) meets the equipment criteria in clause (3), item (i) or 60.3 (ii), and has a maximum patron seating capacity of not more than 60.4 50. 60.5 (3) Medium establishment,$150$210. "Medium establishment" 60.6 means a fee category that meets one or more of the following: 60.7 (i) possesses food service equipment that includes a range, 60.8 oven, steam table, salad bar, or salad preparation area; 60.9 (ii) possesses food service equipment that includes more 60.10 than one deep fat fryer, one grill, or two hot holding 60.11 containers; or 60.12 (iii) is an establishment where food is prepared at one 60.13 location and served at one or more separate locations. 60.14 Establishments meeting criteria in clause (2), item (v), 60.15 are not included in this fee category. 60.16 (4) Large establishment,$250$350. "Large establishment" 60.17 means either: 60.18 (i) a fee category that (A) meets the criteria in clause 60.19 (3), items (i) or (ii), for a medium establishment, (B) seats 60.20 more than 175 people, and (C) offers the full menu selection an 60.21 average of five or more days a week during the weeks of 60.22 operation; or 60.23 (ii) a fee category that (A) meets the criteria in clause 60.24 (3), item (iii), for a medium establishment, and (B) prepares 60.25 and serves 500 or more meals per day. 60.26 (5) Other food and beverage service, including food carts, 60.27 mobile food units, seasonal temporary food stands, and seasonal 60.28 permanent food stands,$30$40. 60.29 (6) Beer or wine table service,$30$40. "Beer or wine 60.30 table service" means a fee category where the only alcoholic 60.31 beverage service is beer or wine, served to customers seated at 60.32 tables. 60.33 (7) Alcoholic beverage service, other than beer or wine 60.34 table service,$75$105. 60.35 "Alcohol beverage service, other than beer or wine table 60.36 service" means a fee category where alcoholic mixed drinks are 61.1 served or where beer or wine are served from a bar. 61.2 (8) Lodging per sleeping accommodation unit,$4$6, 61.3 including hotels, motels, lodging establishments, and resorts, 61.4 up to a maximum of$400$600. "Lodging per sleeping 61.5 accommodation unit" means a fee category including the number of 61.6 guest rooms, cottages, or other rental units of a hotel, motel, 61.7 lodging establishment, or resort; or the number of beds in a 61.8 dormitory. 61.9 (9) First public swimming pool,$100$140; each additional 61.10 public swimming pool,$50$80. "Public swimming pool" means a 61.11 fee category that has the meaning given in Minnesota Rules, part 61.12 4717.0250, subpart 8. 61.13 (10) First spa,$50$80; each additional spa,$25$40. 61.14 "Spa pool" means a fee category that has the meaning given in 61.15 Minnesota Rules, part 4717.0250, subpart 9. 61.16 (11) Private sewer or water,$30$40. "Individual private 61.17 water" means a fee category with a water supply other than a 61.18 community public water supply as defined in Minnesota Rules, 61.19 chapter 4720. "Individual private sewer" means a fee category 61.20 with an individual sewage treatment system which uses subsurface 61.21 treatment and disposal. 61.22 (e)A fee is not required for a food and beverage service61.23establishment operated by a school as defined in sections61.24120A.05, subdivisions 9, 11, 13, and 17 and 120A.22.61.25(f)A fee of $150 for review of the construction plans must 61.26 accompany the initial license application for food and beverage 61.27 service establishments, hotels, motels, lodging establishments, 61.28 or resorts. 61.29(g)(f) When existing food and beverage service 61.30 establishments, hotels, motels, lodging establishments, or 61.31 resorts are extensively remodeled, a fee of $150 must be 61.32 submitted with the remodeling plans. 61.33(h)(g) Seasonal temporary food stands and special event 61.34 food stands are not required to submit construction or 61.35 remodeling plans for review. 61.36 [EFFECTIVE DATE.] This section is effective January 1, 2002. 62.1 Sec. 55. Minnesota Statutes 2000, section 157.22, as 62.2 amended by Laws 2001, chapter 65, section 1, is amended to read: 62.3 157.22 [EXEMPTIONS.] 62.4 This chapter shall not be construed to apply to: 62.5 (1) interstate carriers under the supervision of the United 62.6 States Department of Health and Human Services; 62.7 (2) any building constructed and primarily used for 62.8 religious worship; 62.9 (3) any building owned, operated, and used by a college or 62.10 university in accordance with health regulations promulgated by 62.11 the college or university under chapter 14; 62.12 (4) any person, firm, or corporation whose principal mode 62.13 of business is licensed under sections 28A.04 and 28A.05, is 62.14 exempt at that premises from licensure as a food or beverage 62.15 establishment; provided that the holding of any license pursuant 62.16 to sections 28A.04 and 28A.05 shall not exempt any person, firm, 62.17 or corporation from the applicable provisions of this chapter or 62.18 the rules of the state commissioner of health relating to food 62.19 and beverage service establishments; 62.20 (5) family day care homes and group family day care homes 62.21 governed by sections 245A.01 to 245A.16; 62.22 (6) nonprofit senior citizen centers for the sale of 62.23 home-baked goods; 62.24 (7) fraternal or patriotic organizations that are tax 62.25 exempt under section 501(c)(3), 501(c)(4), 501(c)(6), 501(c)(7), 62.26 501(c)(10), or 501(c)(19) of the Internal Revenue Code of 1986, 62.27 or organizations related to or affiliated with such fraternal or 62.28 patriotic organizations. Such organizations may organize events 62.29 at which home-prepared food is donated by organization members 62.30 for sale at the events, provided: 62.31 (i) the event is not a circus, carnival, or fair; 62.32 (ii) the organization controls the admission of persons to 62.33 the event, the event agenda, or both; and 62.34 (iii) the organization's licensed kitchen is not used in 62.35 any manner for the event;and62.36 (8) food not prepared at an establishment and brought in by 63.1 individuals attending a potluck event for consumption at the 63.2 potluck event. An organization sponsoring a potluck event under 63.3 this clause may advertise the potluck event to the public 63.4 through any means. Individuals who are not members of an 63.5 organization sponsoring a potluck event under this clause may 63.6 attend the potluck event and consume the food at the event. 63.7 Licensed food establishments other than schools cannot be 63.8 sponsors of potluck events. A school may sponsor and hold 63.9 potluck events in areas of the school other than the school's 63.10 kitchen, provided that the school's kitchen is not used in any 63.11 manner for the potluck event. For purposes of this clause, 63.12 "school" means a public school as defined in section 120A.05, 63.13 subdivisions 9, 11, 13, and 17, or a nonpublic school, church, 63.14 or religious organization at which a child is provided with 63.15 instruction in compliance with sections 120A.22 and 120A.24. 63.16 Potluck event food shall not be brought into a licensed food 63.17 establishment kitchen; and 63.18 (9) a home school in which a child is provided instruction 63.19 at home. 63.20 Sec. 56. Minnesota Statutes 2000, section 326.38, is 63.21 amended to read: 63.22 326.38 [LOCAL REGULATIONS.] 63.23 Any city having a system of waterworks or sewerage, or any 63.24 town in which reside over 5,000 people exclusive of any 63.25 statutory cities located therein, or the metropolitan airports 63.26 commission, may, by ordinance, adopt local regulations providing 63.27 for plumbing permits, bonds, approval of plans, and inspections 63.28 of plumbing, which regulations are not in conflict with the 63.29 plumbing standards on the same subject prescribed by the state 63.30 commissioner of health. No city or such town shall prohibit 63.31 plumbers licensed by the state commissioner of health from 63.32 engaging in or working at the business, except cities and 63.33 statutory cities which, prior to April 21, 1933, by ordinance 63.34 required the licensing of plumbers. Any city by ordinance may 63.35 prescribe regulations, reasonable standards, and inspections and 63.36 grant permits to any person, firm, or corporation engaged in the 64.1 business of installing water softeners, who is not licensed as a 64.2 master plumber or journeyman plumber by the state commissioner 64.3 of health, to connect water softening and water filtering 64.4 equipment to private residence water distribution systems, where 64.5 provision has been previously made therefor and openings left 64.6 for that purpose or by use of cold water connections to a 64.7 domestic water heater; where it is not necessary to rearrange, 64.8 make any extension or alteration of, or addition to any pipe, 64.9 fixture or plumbing connected with the water system except to 64.10 connect the water softener, and provided the connections so made 64.11 comply with minimum standards prescribed by the state 64.12 commissioner of health. 64.13 Sec. 57. [325F.691] [DISCLOSURE OF SPECIAL CARE STATUS 64.14 REQUIRED.] 64.15 Subdivision 1. [PERSONS TO WHOM DISCLOSURE IS 64.16 REQUIRED.] Housing with services establishments, as defined in 64.17 sections 144D.01 to 144D.07, that secure, segregate, or provide 64.18 a special program or special unit for residents with a diagnosis 64.19 of probable Alzheimer's disease or a related disorder or that 64.20 advertise, market, or otherwise promote the establishment as 64.21 providing specialized care for Alzheimer's disease or a related 64.22 disorder are considered a "special care unit." All special care 64.23 units shall provide a written disclosure to the following: 64.24 (1) the commissioner of health, if requested; 64.25 (2) the office of ombudsman for older Minnesotans; and 64.26 (3) each person seeking placement within a residence, or 64.27 the person's authorized representative, before an agreement to 64.28 provide the care is entered into. 64.29 Subd. 2. [CONTENT.] Written disclosure shall include, but 64.30 is not limited to, the following: 64.31 (1) a statement of the overall philosophy and how it 64.32 reflects the special needs of residents with Alzheimer's disease 64.33 or other dementias; 64.34 (2) the criteria for determining who may reside in the 64.35 special care unit; 64.36 (3) the process used for assessment and establishment of 65.1 the service plan or agreement, including how the plan is 65.2 responsive to changes in the resident's condition; 65.3 (4) staffing credentials, job descriptions, and staff 65.4 duties and availability, including any training specific to 65.5 dementia; 65.6 (5) physical environment as well as design and security 65.7 features that specifically address the needs of residents with 65.8 Alzheimer's disease or other dementias; 65.9 (6) frequency and type of programs and activities for 65.10 residents of the special care unit; 65.11 (7) involvement of families in resident care and 65.12 availability of family support programs; 65.13 (8) fee schedules for additional services to the residents 65.14 of the special care unit; and 65.15 (9) a statement that residents will be given a written 65.16 notice 30 days prior to changes in the fee schedule. 65.17 Subd. 3. [DUTY TO UPDATE.] Substantial changes to 65.18 disclosures must be reported to the parties listed in 65.19 subdivision 1 at the time the change is made. 65.20 Subd. 4. [REMEDY.] The attorney general may seek the 65.21 remedies set forth in section 8.31 for repeated and intentional 65.22 violations of this section. However, no private right of action 65.23 may be maintained as provided under section 8.31, subdivision 3a. 65.24 [EFFECTIVE DATE.] This section is effective October 1, 2001. 65.25 Sec. 58. [RECOMMENDATIONS; INCENTIVES FOR MAGNET 65.26 HOSPITALS.] 65.27 The commissioner of health shall develop recommendations 65.28 for incentives that may be implemented to increase the number of 65.29 magnet hospitals in Minnesota. These recommendations must be 65.30 reported by December 1, 2001 to the chairs of the house and 65.31 senate committees with jurisdiction over health and human 65.32 services policy and finance issues. 65.33 Sec. 59. [STUDY; FACTORS INFLUENCING PATIENT CARE AND 65.34 PATIENT SAFETY.] 65.35 The commissioner of health, in consultation with relevant 65.36 stakeholders, shall review available research and literature and 66.1 identify the major factors influencing patient care and patient 66.2 safety, including but not limited to staffing levels for nurses 66.3 and other health care professionals in health care facilities. 66.4 This report must be coordinated, to the extent possible, with 66.5 other studies relating to health quality and patient safety 66.6 authorized by the 2001 legislature. The commissioner shall 66.7 report findings from the study, including recommendations on 66.8 ongoing analysis and measurement of these factors for the 66.9 Minnesota health care system, to the chairs of the policy and 66.10 finance committees in the house and senate with jurisdiction 66.11 over health and human services issues by February 15, 2002. 66.12 Sec. 60. [STUDY; IMPACT OF WORKFORCE SHORTAGE ON HEALTH 66.13 CARE COSTS.] 66.14 The commissioner of health shall review available data, 66.15 research, and literature and assess the effects of health care 66.16 labor availability and its impact on health care costs. The 66.17 commissioner shall report findings and recommendations to the 66.18 chairs of the policy and finance committees in the house and 66.19 senate with jurisdiction over health and human services issues 66.20 by February 15, 2002. 66.21 Sec. 61. [MEDICATIONS DISPENSED IN SCHOOLS STUDY.] 66.22 (a) The commissioner of health, in consultation with the 66.23 board of nursing, shall study the relationship between the Nurse 66.24 Practice Act, Minnesota Statutes, sections 148.171 to 148.285; 66.25 and 121A.22, which specifies the administration of medications 66.26 in schools and the activities authorized under these sections, 66.27 including the administration of prescription and nonprescription 66.28 medications and medications needed by students to manage a 66.29 chronic illness. The commissioner shall also make 66.30 recommendations on necessary statutory changes needed to promote 66.31 student health and safety in relation to administering 66.32 medications in schools and addressing the changing health needs 66.33 of students. 66.34 (b) The commissioner shall convene a work group to assist 66.35 in the study and recommendations. The work group shall consist 66.36 of representatives of the commissioner of human services; the 67.1 commissioner of children, families, and learning; the board of 67.2 nursing; the board of teaching; school nurses; parents; school 67.3 administrators; school board associations; the American Academy 67.4 of Pediatrics; and the Minnesota Nurse's Association. 67.5 (c) The commissioner shall submit these recommendations and 67.6 any recommended statutory changes to the legislature by January 67.7 15, 2002. 67.8 Sec. 62. [REPEALER.] 67.9 (a) Minnesota Statutes 2000, section 144.148, subdivision 67.10 8, is repealed. 67.11 (b) Minnesota Statutes 2000, sections 121A.15, subdivision 67.12 6; and 145.927, are repealed. 67.13 [EFFECTIVE DATE.] Paragraph (a) of this section is 67.14 effective the day following final enactment. 67.15 ARTICLE 2 67.16 HEALTH CARE 67.17 Section 1. Minnesota Statutes 2000, section 62A.095, 67.18 subdivision 1, is amended to read: 67.19 Subdivision 1. [APPLICABILITY.] (a) No health plan shall 67.20 be offered, sold, or issued to a resident of this state, or to 67.21 cover a resident of this state, unless the health plan complies 67.22 with subdivision 2. 67.23 (b) Health plans providing benefits under health care 67.24 programs administered by the commissioner of human services are 67.25 not subject to the limits described in subdivision 2 but are 67.26 subject to the right of subrogation provisions under section 67.27 256B.37 and the lien provisions under section 256.015; 256B.042; 67.28 256D.03, subdivision 8; or 256L.03, subdivision 6. 67.29 Sec. 2. Minnesota Statutes 2000, section 62J.692, 67.30 subdivision 7, is amended to read: 67.31 Subd. 7. [TRANSFERS FROM THE COMMISSIONER OF HUMAN 67.32 SERVICES.] (a) The amount transferred according to section 67.33 256B.69, subdivision 5c, paragraph (a), clause (1), shall be 67.34 distributed by the commissioner to clinical medical education 67.35 programs that meet the qualifications of subdivision 3 based on 67.36 a distribution formula that reflects a summation of two factors: 68.1 (1) an education factor, which is determined by the total 68.2 number of eligible trainee FTEs and the total statewide average 68.3 costs per trainee, by type of trainee, in each clinical medical 68.4 education program; and 68.5 (2) a public program volume factor, which is determined by 68.6 the total volume of public program revenue received by each 68.7 training site as a percentage of all public program revenue 68.8 received by all training sites in the fund pool created under 68.9 this subdivision. 68.10 In this formula, the education factor shall be weighted at 68.11 50 percent and the public program volume factor shall be 68.12 weighted at 50 percent. 68.13(b)Public program revenue for the distribution formulain68.14paragraph (a)shall include revenue from medical assistance, 68.15 prepaid medical assistance, general assistance medical care, and 68.16 prepaid general assistance medical care. 68.17(c)Training sites that receive no public program revenue 68.18 shall be ineligible for funds available under this 68.19subdivisionparagraph. 68.20 (b) Fifty percent of the amount transferred according to 68.21 section 256B.69, subdivision 5c, paragraph (a), clause (2), 68.22 shall be distributed by the commissioner to the University of 68.23 Minnesota board of regents for the purposes described in 68.24 sections 137.38 to 137.40. Of the remaining amount transferred 68.25 according to section 256B.69, subdivision 5c, paragraph (a), 68.26 clause (2), 24 percent of the amount shall be distributed by the 68.27 commissioner to the Hennepin County Medical Center for clinical 68.28 medical education. The remaining 26 percent of the amount 68.29 transferred shall be distributed by the commissioner in 68.30 accordance with subdivision 7a. If the federal approval is not 68.31 obtained for the matching funds under section 256B.69, 68.32 subdivision 5c, paragraph (a), clause (2), 100 percent of the 68.33 amount transferred under this paragraph shall be distributed by 68.34 the commissioner to the University of Minnesota board of regents 68.35 for the purposes described in sections 137.38 to 137.40. 68.36 Sec. 3. Minnesota Statutes 2000, section 62J.692, is 69.1 amended by adding a subdivision to read: 69.2 Subd. 7a. [CLINICAL MEDICAL EDUCATION INNOVATIONS 69.3 GRANTS.] (a) The commissioner shall award grants to teaching 69.4 institutions and clinical training sites for projects that 69.5 increase dental access for underserved populations and promote 69.6 innovative clinical training of dental professionals. In 69.7 awarding the grants, the commissioner, in consultation with the 69.8 commissioner of human services, shall consider the following: 69.9 (1) potential to successfully increase access to an 69.10 underserved population; 69.11 (2) the long-term viability of the project to improve 69.12 access beyond the period of initial funding; 69.13 (3) evidence of collaboration between the applicant and 69.14 local communities; 69.15 (4) the efficiency in the use of the funding; and 69.16 (5) the priority level of the project in relation to state 69.17 clinical education, access, and workforce goals. 69.18 (b) The commissioner shall periodically evaluate the 69.19 priorities in awarding the innovations grants in order to ensure 69.20 that the priorities meet the changing workforce needs of the 69.21 state. 69.22 Sec. 4. Minnesota Statutes 2000, section 137.38, 69.23 subdivision 1, is amended to read: 69.24 Subdivision 1. [CONDITION.] If the board of regents 69.25 accepts thefunding appropriated foramount transferred under 69.26 section 62J.692, subdivision 7, paragraph (b), to be used for 69.27 the purposes described in sections 137.38 to 137.40, it shall 69.28 comply with the duties for which theappropriations aretransfer 69.29 is made. 69.30 Sec. 5. Minnesota Statutes 2000, section 150A.10, is 69.31 amended by adding a subdivision to read: 69.32 Subd. 1a. [LIMITED AUTHORIZATION FOR DENTAL 69.33 HYGIENISTS.] (a) Notwithstanding subdivision 1, a dental 69.34 hygienist licensed under this chapter may be employed or 69.35 retained by a health care facility to perform dental hygiene 69.36 services described under paragraph (b) without the patient first 70.1 being examined by a licensed dentist if the dental hygienist: 70.2 (1) has two years practical clinical experience with a 70.3 licensed dentist within the preceding five years; and 70.4 (2) has entered into a collaborative agreement with a 70.5 licensed dentist that designates authorization for the services 70.6 provided by the dental hygienist. 70.7 (b) The dental hygiene services authorized to be performed 70.8 by a dental hygienist under this subdivision are limited to 70.9 removal of deposits and stains from the surfaces of the teeth, 70.10 application of topical preventive or prophylactic agents, 70.11 polishing and smoothing restorations, removal of marginal 70.12 overhangs, performance of preliminary charting, taking of 70.13 radiographs, and performance of root planing and soft-tissue 70.14 curettage. The dental hygienist shall not place pit and fissure 70.15 sealants, unless the patient has been recently examined and the 70.16 treatment planned by a licensed dentist. The dental hygienist 70.17 shall not perform injections of anesthetic agents or the 70.18 administration of nitrous oxide unless under the indirect 70.19 supervision of a licensed dentist. The performance of dental 70.20 hygiene services in a health care facility is limited to 70.21 patients, students, and residents of the facility. 70.22 (c) A collaborating dentist must be licensed under this 70.23 chapter and may enter into a collaborative agreement with no 70.24 more than four dental hygienists. The collaborative agreement 70.25 must include: 70.26 (1) consideration for medically compromised patients and 70.27 medical conditions for which a dental evaluation and treatment 70.28 plan must occur prior to the provision of dental hygiene 70.29 services; and 70.30 (2) a period of time in which an examination by a dentist 70.31 should occur. 70.32 The collaborative agreement must be maintained by the dentist 70.33 and the dental hygienist and must be made available to the board 70.34 upon request. 70.35 (d) For the purposes of this subdivision, a "health care 70.36 facility" is limited to a hospital; nursing home; home health 71.1 agency; group home serving the elderly, disabled, or juveniles; 71.2 state-operated facility licensed by the commissioner of human 71.3 services or the commissioner of corrections; and federal, state, 71.4 or local public health facility, community clinic, or tribal 71.5 clinic. 71.6 (e) For purposes of this subdivision, a "collaborative 71.7 agreement" means a written agreement with a licensed dentist who 71.8 authorizes and accepts responsibility for the services performed 71.9 by the dental hygienist. The services authorized under this 71.10 subdivision and the collaborative agreement may be performed 71.11 without the presence of a licensed dentist and may be performed 71.12 at a location other than the usual place of practice of the 71.13 dentist or dental hygienist and without a dentist's diagnosis 71.14 and treatment plan, unless specified in the collaborative 71.15 agreement. 71.16 Sec. 6. Minnesota Statutes 2000, section 256.01, 71.17 subdivision 2, as amended by Laws 2001, chapter 178, article 1, 71.18 section 2, is amended to read: 71.19 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 71.20 section 241.021, subdivision 2, the commissioner of human 71.21 services shall: 71.22 (1) Administer and supervise all forms of public assistance 71.23 provided for by state law and other welfare activities or 71.24 services as are vested in the commissioner. Administration and 71.25 supervision of human services activities or services includes, 71.26 but is not limited to, assuring timely and accurate distribution 71.27 of benefits, completeness of service, and quality program 71.28 management. In addition to administering and supervising human 71.29 services activities vested by law in the department, the 71.30 commissioner shall have the authority to: 71.31 (a) require county agency participation in training and 71.32 technical assistance programs to promote compliance with 71.33 statutes, rules, federal laws, regulations, and policies 71.34 governing human services; 71.35 (b) monitor, on an ongoing basis, the performance of county 71.36 agencies in the operation and administration of human services, 72.1 enforce compliance with statutes, rules, federal laws, 72.2 regulations, and policies governing welfare services and promote 72.3 excellence of administration and program operation; 72.4 (c) develop a quality control program or other monitoring 72.5 program to review county performance and accuracy of benefit 72.6 determinations; 72.7 (d) require county agencies to make an adjustment to the 72.8 public assistance benefits issued to any individual consistent 72.9 with federal law and regulation and state law and rule and to 72.10 issue or recover benefits as appropriate; 72.11 (e) delay or deny payment of all or part of the state and 72.12 federal share of benefits and administrative reimbursement 72.13 according to the procedures set forth in section 256.017; 72.14 (f) make contracts with and grants to public and private 72.15 agencies and organizations, both profit and nonprofit, and 72.16 individuals, using appropriated funds; and 72.17 (g) enter into contractual agreements with federally 72.18 recognized Indian tribes with a reservation in Minnesota to the 72.19 extent necessary for the tribe to operate a federally approved 72.20 family assistance program or any other program under the 72.21 supervision of the commissioner. The commissioner shall consult 72.22 with the affected county or counties in the contractual 72.23 agreement negotiations, if the county or counties wish to be 72.24 included, in order to avoid the duplication of county and tribal 72.25 assistance program services. The commissioner may establish 72.26 necessary accounts for the purposes of receiving and disbursing 72.27 funds as necessary for the operation of the programs. 72.28 (2) Inform county agencies, on a timely basis, of changes 72.29 in statute, rule, federal law, regulation, and policy necessary 72.30 to county agency administration of the programs. 72.31 (3) Administer and supervise all child welfare activities; 72.32 promote the enforcement of laws protecting handicapped, 72.33 dependent, neglected and delinquent children, and children born 72.34 to mothers who were not married to the children's fathers at the 72.35 times of the conception nor at the births of the children; 72.36 license and supervise child-caring and child-placing agencies 73.1 and institutions; supervise the care of children in boarding and 73.2 foster homes or in private institutions; and generally perform 73.3 all functions relating to the field of child welfare now vested 73.4 in the state board of control. 73.5 (4) Administer and supervise all noninstitutional service 73.6 to handicapped persons, including those who are visually 73.7 impaired, hearing impaired, or physically impaired or otherwise 73.8 handicapped. The commissioner may provide and contract for the 73.9 care and treatment of qualified indigent children in facilities 73.10 other than those located and available at state hospitals when 73.11 it is not feasible to provide the service in state hospitals. 73.12 (5) Assist and actively cooperate with other departments, 73.13 agencies and institutions, local, state, and federal, by 73.14 performing services in conformity with the purposes of Laws 73.15 1939, chapter 431. 73.16 (6) Act as the agent of and cooperate with the federal 73.17 government in matters of mutual concern relative to and in 73.18 conformity with the provisions of Laws 1939, chapter 431, 73.19 including the administration of any federal funds granted to the 73.20 state to aid in the performance of any functions of the 73.21 commissioner as specified in Laws 1939, chapter 431, and 73.22 including the promulgation of rules making uniformly available 73.23 medical care benefits to all recipients of public assistance, at 73.24 such times as the federal government increases its participation 73.25 in assistance expenditures for medical care to recipients of 73.26 public assistance, the cost thereof to be borne in the same 73.27 proportion as are grants of aid to said recipients. 73.28 (7) Establish and maintain any administrative units 73.29 reasonably necessary for the performance of administrative 73.30 functions common to all divisions of the department. 73.31 (8) Act as designated guardian of both the estate and the 73.32 person of all the wards of the state of Minnesota, whether by 73.33 operation of law or by an order of court, without any further 73.34 act or proceeding whatever, except as to persons committed as 73.35 mentally retarded. For children under the guardianship of the 73.36 commissioner whose interests would be best served by adoptive 74.1 placement, the commissioner may contract with a licensed 74.2 child-placing agency or a tribal social services agency to 74.3 provide adoption services. A contract with a licensed 74.4 child-placing agency must be designed to supplement existing 74.5 county efforts and may not replace existing county programs, 74.6 unless the replacement is agreed to by the county board and the 74.7 appropriate exclusive bargaining representative or the 74.8 commissioner has evidence that child placements of the county 74.9 continue to be substantially below that of other counties. 74.10 Funds encumbered and obligated under an agreement for a specific 74.11 child shall remain available until the terms of the agreement 74.12 are fulfilled or the agreement is terminated. 74.13 (9) Act as coordinating referral and informational center 74.14 on requests for service for newly arrived immigrants coming to 74.15 Minnesota. 74.16 (10) The specific enumeration of powers and duties as 74.17 hereinabove set forth shall in no way be construed to be a 74.18 limitation upon the general transfer of powers herein contained. 74.19 (11) Establish county, regional, or statewide schedules of 74.20 maximum fees and charges which may be paid by county agencies 74.21 for medical, dental, surgical, hospital, nursing and nursing 74.22 home care and medicine and medical supplies under all programs 74.23 of medical care provided by the state and for congregate living 74.24 care under the income maintenance programs. 74.25 (12) Have the authority to conduct and administer 74.26 experimental projects to test methods and procedures of 74.27 administering assistance and services to recipients or potential 74.28 recipients of public welfare. To carry out such experimental 74.29 projects, it is further provided that the commissioner of human 74.30 services is authorized to waive the enforcement of existing 74.31 specific statutory program requirements, rules, and standards in 74.32 one or more counties. The order establishing the waiver shall 74.33 provide alternative methods and procedures of administration, 74.34 shall not be in conflict with the basic purposes, coverage, or 74.35 benefits provided by law, and in no event shall the duration of 74.36 a project exceed four years. It is further provided that no 75.1 order establishing an experimental project as authorized by the 75.2 provisions of this section shall become effective until the 75.3 following conditions have been met: 75.4 (a) The secretary of health and human services of the 75.5 United States has agreed, for the same project, to waive state 75.6 plan requirements relative to statewide uniformity. 75.7 (b) A comprehensive plan, including estimated project 75.8 costs, shall be approved by the legislative advisory commission 75.9 and filed with the commissioner of administration. 75.10 (13) According to federal requirements, establish 75.11 procedures to be followed by local welfare boards in creating 75.12 citizen advisory committees, including procedures for selection 75.13 of committee members. 75.14 (14) Allocate federal fiscal disallowances or sanctions 75.15 which are based on quality control error rates for the aid to 75.16 families with dependent children program formerly codified in 75.17 sections 256.72 to 256.87, medical assistance, or food stamp 75.18 program in the following manner: 75.19 (a) One-half of the total amount of the disallowance shall 75.20 be borne by the county boards responsible for administering the 75.21 programs. For the medical assistance and the AFDC program 75.22 formerly codified in sections 256.72 to 256.87, disallowances 75.23 shall be shared by each county board in the same proportion as 75.24 that county's expenditures for the sanctioned program are to the 75.25 total of all counties' expenditures for the AFDC program 75.26 formerly codified in sections 256.72 to 256.87, and medical 75.27 assistance programs. For the food stamp program, sanctions 75.28 shall be shared by each county board, with 50 percent of the 75.29 sanction being distributed to each county in the same proportion 75.30 as that county's administrative costs for food stamps are to the 75.31 total of all food stamp administrative costs for all counties, 75.32 and 50 percent of the sanctions being distributed to each county 75.33 in the same proportion as that county's value of food stamp 75.34 benefits issued are to the total of all benefits issued for all 75.35 counties. Each county shall pay its share of the disallowance 75.36 to the state of Minnesota. When a county fails to pay the 76.1 amount due hereunder, the commissioner may deduct the amount 76.2 from reimbursement otherwise due the county, or the attorney 76.3 general, upon the request of the commissioner, may institute 76.4 civil action to recover the amount due. 76.5 (b) Notwithstanding the provisions of paragraph (a), if the 76.6 disallowance results from knowing noncompliance by one or more 76.7 counties with a specific program instruction, and that knowing 76.8 noncompliance is a matter of official county board record, the 76.9 commissioner may require payment or recover from the county or 76.10 counties, in the manner prescribed in paragraph (a), an amount 76.11 equal to the portion of the total disallowance which resulted 76.12 from the noncompliance, and may distribute the balance of the 76.13 disallowance according to paragraph (a). 76.14 (15) Develop and implement special projects that maximize 76.15 reimbursements and result in the recovery of money to the 76.16 state. For the purpose of recovering state money, the 76.17 commissioner may enter into contracts with third parties. Any 76.18 recoveries that result from projects or contracts entered into 76.19 under this paragraph shall be deposited in the state treasury 76.20 and credited to a special account until the balance in the 76.21 account reaches $1,000,000. When the balance in the account 76.22 exceeds $1,000,000, the excess shall be transferred and credited 76.23 to the general fund. All money in the account is appropriated 76.24 to the commissioner for the purposes of this paragraph. 76.25 (16) Have the authority to make direct payments to 76.26 facilities providing shelter to women and their children 76.27 according to section 256D.05, subdivision 3. Upon the written 76.28 request of a shelter facility that has been denied payments 76.29 under section 256D.05, subdivision 3, the commissioner shall 76.30 review all relevant evidence and make a determination within 30 76.31 days of the request for review regarding issuance of direct 76.32 payments to the shelter facility. Failure to act within 30 days 76.33 shall be considered a determination not to issue direct payments. 76.34 (17) Have the authority to establish and enforce the 76.35 following county reporting requirements: 76.36 (a) The commissioner shall establish fiscal and statistical 77.1 reporting requirements necessary to account for the expenditure 77.2 of funds allocated to counties for human services programs. 77.3 When establishing financial and statistical reporting 77.4 requirements, the commissioner shall evaluate all reports, in 77.5 consultation with the counties, to determine if the reports can 77.6 be simplified or the number of reports can be reduced. 77.7 (b) The county board shall submit monthly or quarterly 77.8 reports to the department as required by the commissioner. 77.9 Monthly reports are due no later than 15 working days after the 77.10 end of the month. Quarterly reports are due no later than 30 77.11 calendar days after the end of the quarter, unless the 77.12 commissioner determines that the deadline must be shortened to 77.13 20 calendar days to avoid jeopardizing compliance with federal 77.14 deadlines or risking a loss of federal funding. Only reports 77.15 that are complete, legible, and in the required format shall be 77.16 accepted by the commissioner. 77.17 (c) If the required reports are not received by the 77.18 deadlines established in clause (b), the commissioner may delay 77.19 payments and withhold funds from the county board until the next 77.20 reporting period. When the report is needed to account for the 77.21 use of federal funds and the late report results in a reduction 77.22 in federal funding, the commissioner shall withhold from the 77.23 county boards with late reports an amount equal to the reduction 77.24 in federal funding until full federal funding is received. 77.25 (d) A county board that submits reports that are late, 77.26 illegible, incomplete, or not in the required format for two out 77.27 of three consecutive reporting periods is considered 77.28 noncompliant. When a county board is found to be noncompliant, 77.29 the commissioner shall notify the county board of the reason the 77.30 county board is considered noncompliant and request that the 77.31 county board develop a corrective action plan stating how the 77.32 county board plans to correct the problem. The corrective 77.33 action plan must be submitted to the commissioner within 45 days 77.34 after the date the county board received notice of noncompliance. 77.35 (e) The final deadline for fiscal reports or amendments to 77.36 fiscal reports is one year after the date the report was 78.1 originally due. If the commissioner does not receive a report 78.2 by the final deadline, the county board forfeits the funding 78.3 associated with the report for that reporting period and the 78.4 county board must repay any funds associated with the report 78.5 received for that reporting period. 78.6 (f) The commissioner may not delay payments, withhold 78.7 funds, or require repayment under paragraph (c) or (e) if the 78.8 county demonstrates that the commissioner failed to provide 78.9 appropriate forms, guidelines, and technical assistance to 78.10 enable the county to comply with the requirements. If the 78.11 county board disagrees with an action taken by the commissioner 78.12 under paragraph (c) or (e), the county board may appeal the 78.13 action according to sections 14.57 to 14.69. 78.14 (g) Counties subject to withholding of funds under 78.15 paragraph (c) or forfeiture or repayment of funds under 78.16 paragraph (e) shall not reduce or withhold benefits or services 78.17 to clients to cover costs incurred due to actions taken by the 78.18 commissioner under paragraph (c) or (e). 78.19 (18) Allocate federal fiscal disallowances or sanctions for 78.20 audit exceptions when federal fiscal disallowances or sanctions 78.21 are based on a statewide random sample for the foster care 78.22 program under title IV-E of the Social Security Act, United 78.23 States Code, title 42, in direct proportion to each county's 78.24 title IV-E foster care maintenance claim for that period. 78.25 (19) Be responsible for ensuring the detection, prevention, 78.26 investigation, and resolution of fraudulent activities or 78.27 behavior by applicants, recipients, and other participants in 78.28 the human services programs administered by the department. 78.29 (20) Require county agencies to identify overpayments, 78.30 establish claims, and utilize all available and cost-beneficial 78.31 methodologies to collect and recover these overpayments in the 78.32 human services programs administered by the department. 78.33 (21) Have the authority to administer a drug rebate program 78.34 for drugs purchased pursuant to the prescription drug program 78.35 established under section 256.955 after the beneficiary's 78.36 satisfaction of any deductible established in the program. The 79.1 commissioner shall require a rebate agreement from all 79.2 manufacturers of covered drugs as defined in section 256B.0625, 79.3 subdivision 13. Rebate agreements for prescription drugs 79.4 delivered on or after July 1, 2002, must include rebates for 79.5 individuals covered under the prescription drug program who are 79.6 under 65 years of age. For each drug, the amount of the rebate 79.7 shall be equal to the basic rebate as defined for purposes of 79.8 the federal rebate program in United States Code, title 42, 79.9 section 1396r-8(c)(1). This basic rebate shall be applied to 79.10 single-source and multiple-source drugs. The manufacturers must 79.11 provide full payment within 30 days of receipt of the state 79.12 invoice for the rebate within the terms and conditions used for 79.13 the federal rebate program established pursuant to section 1927 79.14 of title XIX of the Social Security Act. The manufacturers must 79.15 provide the commissioner with any information necessary to 79.16 verify the rebate determined per drug. The rebate program shall 79.17 utilize the terms and conditions used for the federal rebate 79.18 program established pursuant to section 1927 of title XIX of the 79.19 Social Security Act. 79.20 (22) Have the authority to administer the federal drug 79.21 rebate program for drugs purchased under the medical assistance 79.22 program as allowed by section 1927 of title XIX of the Social 79.23 Security Act and according to the terms and conditions of 79.24 section 1927. Rebates shall be collected for all drugs that 79.25 have been dispensed or administered in an outpatient setting and 79.26 that are from manufacturers who have signed a rebate agreement 79.27 with the United States Department of Health and Human Services. 79.28(22)(23) Operate the department's communication systems 79.29 account established in Laws 1993, First Special Session chapter 79.30 1, article 1, section 2, subdivision 2, to manage shared 79.31 communication costs necessary for the operation of the programs 79.32 the commissioner supervises. A communications account may also 79.33 be established for each regional treatment center which operates 79.34 communications systems. Each account must be used to manage 79.35 shared communication costs necessary for the operations of the 79.36 programs the commissioner supervises. The commissioner may 80.1 distribute the costs of operating and maintaining communication 80.2 systems to participants in a manner that reflects actual usage. 80.3 Costs may include acquisition, licensing, insurance, 80.4 maintenance, repair, staff time and other costs as determined by 80.5 the commissioner. Nonprofit organizations and state, county, 80.6 and local government agencies involved in the operation of 80.7 programs the commissioner supervises may participate in the use 80.8 of the department's communications technology and share in the 80.9 cost of operation. The commissioner may accept on behalf of the 80.10 state any gift, bequest, devise or personal property of any 80.11 kind, or money tendered to the state for any lawful purpose 80.12 pertaining to the communication activities of the department. 80.13 Any money received for this purpose must be deposited in the 80.14 department's communication systems accounts. Money collected by 80.15 the commissioner for the use of communication systems must be 80.16 deposited in the state communication systems account and is 80.17 appropriated to the commissioner for purposes of this section. 80.18(23)(24) Receive any federal matching money that is made 80.19 available through the medical assistance program for the 80.20 consumer satisfaction survey. Any federal money received for 80.21 the survey is appropriated to the commissioner for this 80.22 purpose. The commissioner may expend the federal money received 80.23 for the consumer satisfaction survey in either year of the 80.24 biennium. 80.25(24)(25) Incorporate cost reimbursement claims from First 80.26 Call Minnesota and Greater Twin Cities United Way into the 80.27 federal cost reimbursement claiming processes of the department 80.28 according to federal law, rule, and regulations. Any 80.29 reimbursement received is appropriated to the commissioner and 80.30 shall be disbursed to First Call Minnesota and Greater Twin 80.31 Cities United Way according to normal department payment 80.32 schedules. 80.33(25)(26) Develop recommended standards for foster care 80.34 homes that address the components of specialized therapeutic 80.35 services to be provided by foster care homes with those services. 80.36 [EFFECTIVE DATE.] This section is effective 30 days 81.1 following final enactment. 81.2 Sec. 7. Minnesota Statutes 2000, section 256.955, 81.3 subdivision 2a, is amended to read: 81.4 Subd. 2a. [ELIGIBILITY.] An individual satisfying the 81.5 following requirements and the requirements described in 81.6 subdivision 2, paragraph (d), is eligible for the prescription 81.7 drug program: 81.8 (1) is at least 65 years of age or older; and 81.9 (2) is eligible as a qualified Medicare beneficiary 81.10 according to section 256B.057, subdivision 3or, 3a, or, 3b, 81.11 clause (1), or is eligible under section 256B.057, subdivision 3 81.12or, 3a, or 3b, clause (1), and is also eligible for medical 81.13 assistance or general assistance medical care with a spenddown 81.14 as defined in section 256B.056, subdivision 5. 81.15 [EFFECTIVE DATE.] This section is effective January 1, 2002. 81.16 Sec. 8. Minnesota Statutes 2000, section 256.955, 81.17 subdivision 2b, is amended to read: 81.18 Subd. 2b. [ELIGIBILITY.] Effective July 1, 2002, an 81.19 individual satisfying the following requirements and the 81.20 requirements described in subdivision 2, paragraph (d), is 81.21 eligible for the prescription drug program: 81.22 (1) is under 65 years of age; and 81.23 (2) is eligible as a qualified Medicare beneficiary 81.24 according to section 256B.057, subdivision 3,or 3a or is 81.25 eligible under section 256B.057, subdivision 3,or 3a and is 81.26 also eligible for medical assistance or general assistance 81.27 medical care with a spenddown as defined in section 256B.056, 81.28 subdivision 5. 81.29 [EFFECTIVE DATE.] This section is effective July 1, 2002. 81.30 Sec. 9. [256.956] [PURCHASING ALLIANCE STOP-LOSS FUND.] 81.31 Subdivision 1. [DEFINITIONS.] For purposes of this 81.32 section, the following definitions apply: 81.33 (a) "Commissioner" means the commissioner of human services. 81.34 (b) "Health plan" means a policy, contract, or certificate 81.35 issued by a health plan company to a qualifying purchasing 81.36 alliance. Any health plan issued to the members of a qualifying 82.1 purchasing alliance must meet the requirements of chapter 62L. 82.2 (c) "Health plan company" means: 82.3 (1) a health carrier as defined under section 62A.011, 82.4 subdivision 2; 82.5 (2) a community integrated service network operating under 82.6 chapter 62N; or 82.7 (3) an accountable provider network operating under chapter 82.8 62T. 82.9 (d) "Qualifying employer" means an employer who: 82.10 (1) is a member of a qualifying purchasing alliance; 82.11 (2) has at least one employee but no more than ten 82.12 employees or is a sole proprietor or farmer; 82.13 (3) did not offer employer-subsidized health care coverage 82.14 to its employees for at least 12 months prior to joining the 82.15 purchasing alliance; and 82.16 (4) is offering health coverage through the purchasing 82.17 alliance to all employees who work at least 20 hours per week 82.18 unless the employee is eligible for Medicare. 82.19 For purposes of this subdivision, "employer-subsidized health 82.20 coverage" means health coverage for which the employer pays at 82.21 least 50 percent of the cost of coverage for the employee. 82.22 (e) "Qualifying enrollee" means an employee of a qualifying 82.23 employer or the employee's dependent covered by a health plan. 82.24 (f) "Qualifying purchasing alliance" means a purchasing 82.25 alliance as defined in section 62T.01, subdivision 2, that: 82.26 (1) meets the requirements of chapter 62T; 82.27 (2) services a geographic area located in outstate 82.28 Minnesota, excluding the city of Duluth; and 82.29 (3) is organized and operating before May 1, 2001. 82.30 The criteria used by the qualifying purchasing alliance for 82.31 membership must be approved by the commissioner of health. A 82.32 qualifying purchasing alliance may begin enrolling qualifying 82.33 employers after July 1, 2001, with enrollment ending by December 82.34 31, 2003. 82.35 Subd. 2. [CREATION OF ACCOUNT.] A purchasing alliance 82.36 stop-loss fund account is established in the general fund. The 83.1 commissioner shall use the money to establish a stop-loss fund 83.2 from which a health plan company may receive reimbursement for 83.3 claims paid for qualifying enrollees. The account consists of 83.4 money appropriated by the legislature. Money from the account 83.5 must be used for the stop-loss fund. 83.6 Subd. 3. [REIMBURSEMENT.] (a) A health plan company may 83.7 receive reimbursement from the fund for 90 percent of the 83.8 portion of the claim that exceeds $30,000 but not of the portion 83.9 that exceeds $100,000 in a calendar year for a qualifying 83.10 enrollee. 83.11 (b) Claims shall be reported and funds shall be distributed 83.12 on a calendar-year basis. Claims shall be eligible for 83.13 reimbursement only for the calendar year in which the claims 83.14 were paid. 83.15 (c) Once claims paid on behalf of a qualifying enrollee 83.16 reach $100,000 in a given calendar year, no further claims may 83.17 be submitted for reimbursement on behalf of that enrollee in 83.18 that calendar year. 83.19 Subd. 4. [REQUEST PROCESS.] (a) Each health plan company 83.20 must submit a request for reimbursement from the fund on a form 83.21 prescribed by the commissioner. Requests for payment must be 83.22 submitted no later than April 1 following the end of the 83.23 calendar year for which the reimbursement request is being made, 83.24 beginning April 1, 2002. 83.25 (b) The commissioner may require a health plan company to 83.26 submit claims data as needed in connection with the 83.27 reimbursement request. 83.28 Subd. 5. [DISTRIBUTION.] (a) The commissioner shall 83.29 calculate the total claims reimbursement amount for all 83.30 qualifying health plan companies for the calendar year for which 83.31 claims are being reported and shall distribute the stop-loss 83.32 funds on an annual basis. 83.33 (b) In the event that the total amount requested for 83.34 reimbursement by the health plan companies for a calendar year 83.35 exceeds the funds available for distribution for claims paid by 83.36 all health plan companies during the same calendar year, the 84.1 commissioner shall provide for the pro rata distribution of the 84.2 available funds. Each health plan company shall be eligible to 84.3 receive only a proportionate amount of the available funds as 84.4 the health plan company's total eligible claims paid compares to 84.5 the total eligible claims paid by all health plan companies. 84.6 (c) In the event that funds available for distribution for 84.7 claims paid by all health plan companies during a calendar year 84.8 exceed the total amount requested for reimbursement by all 84.9 health plan companies during the same calendar year, any excess 84.10 funds shall be reallocated for distribution in the next calendar 84.11 year. 84.12 Subd. 6. [DATA.] Upon the request of the commissioner, 84.13 each health plan company shall furnish such data as the 84.14 commissioner deems necessary to administer the fund. The 84.15 commissioner may require that such data be submitted on a per 84.16 enrollee, aggregate, or categorical basis. Any data submitted 84.17 under this section shall be classified as private data or 84.18 nonpublic data as defined in section 13.02. 84.19 Subd. 7. [DELEGATION.] The commissioner may delegate any 84.20 or all of the commissioner's administrative duties to another 84.21 state agency or to a private contractor. 84.22 Subd. 8. [REPORT.] The commissioner of commerce, in 84.23 consultation with the office of rural health and the qualifying 84.24 purchasing alliances, shall evaluate the extent to which the 84.25 purchasing alliance stop-loss fund increases the availability of 84.26 employer-subsidized health care coverage for residents residing 84.27 in the geographic areas served by the qualifying purchasing 84.28 alliances. A preliminary report must be submitted to the 84.29 legislature by February 15, 2003, and a final report must be 84.30 submitted by February 15, 2004. 84.31 Subd. 9. [SUNSET.] This section shall expire January 1, 84.32 2005. 84.33 Sec. 10. [256.958] [RETIRED DENTIST PROGRAM.] 84.34 Subdivision 1. [PROGRAM.] The commissioner of human 84.35 services shall establish a program to reimburse a retired 84.36 dentist for the dentist's license fee and for the reasonable 85.1 cost of malpractice insurance compared to other dentists in the 85.2 community in exchange for the dentist providing 100 hours of 85.3 dental services on a volunteer basis within a 12-month period at 85.4 a community dental clinic or a dental training clinic located at 85.5 a Minnesota state college or university. 85.6 Subd. 2. [DOCUMENTATION.] Upon completion of the required 85.7 hours, the retired dentist shall submit to the commissioner the 85.8 following: 85.9 (1) documentation of the service provided; 85.10 (2) the cost of malpractice insurance for the 12-month 85.11 period; and 85.12 (3) the cost of the license. 85.13 Subd. 3. [REIMBURSEMENT.] Upon receipt of the information 85.14 described in subdivision 2, the commissioner shall provide 85.15 reimbursement to the retired dentist for the cost of malpractice 85.16 insurance for the previous 12-month period and the cost of the 85.17 license. 85.18 Sec. 11. [256.959] [DENTAL PRACTICE DONATION PROGRAM.] 85.19 Subdivision 1. [ESTABLISHMENT.] The commissioner of human 85.20 services shall establish a dental practice donation program that 85.21 coordinates the donation of a qualifying dental practice to a 85.22 qualified charitable organization and assists in locating a 85.23 dentist licensed under chapter 150A who wishes to maintain the 85.24 dental practice. 85.25 Subd. 2. [QUALIFYING DENTAL PRACTICE.] To qualify for the 85.26 dental practice donation program, a dental practice must meet 85.27 the following requirements: 85.28 (1) the dental practice must be owned by the donating 85.29 dentist; 85.30 (2) the dental practice must be located in a designated 85.31 underserved area of the state as defined by the commissioner; 85.32 and 85.33 (3) the practice must be equipped with the basic dental 85.34 equipment necessary to maintain a dental practice as determined 85.35 by the commissioner. 85.36 Subd. 3. [COORDINATION.] The commissioner shall establish 86.1 a procedure for dentists to donate their dental practices to a 86.2 qualified charitable organization. The commissioner shall 86.3 authorize a practice for donation only if it meets the 86.4 requirements of subdivision 2 and there is a licensed dentist 86.5 who is interested in entering into an agreement as described in 86.6 subdivision 4. Upon donation of the practice, the commissioner 86.7 shall provide the donating dentist with a statement verifying 86.8 that a donation of the practice was made to a qualifying 86.9 charitable organization for purposes of state and federal income 86.10 tax returns. 86.11 Subd. 4. [DONATED DENTAL PRACTICE AGREEMENT.] (a) A 86.12 dentist accepting the donated practice must enter into an 86.13 agreement with the qualified charitable organization to maintain 86.14 the dental practice for a minimum of five years at the donated 86.15 practice site and to provide services to underserved populations 86.16 up to a preagreed percentage of patients served. 86.17 (b) The agreement must include the terms for the recovery 86.18 of the donated dental practice if the dentist accepting the 86.19 practice does not fulfill the service commitment required under 86.20 this subdivision. 86.21 (c) Any costs associated with operating the dental practice 86.22 during the service commitment time period are the financial 86.23 responsibility of the dentist accepting the practice. 86.24 Sec. 12. Minnesota Statutes 2000, section 256.9657, 86.25 subdivision 2, is amended to read: 86.26 Subd. 2. [HOSPITAL SURCHARGE.] (a) Effective October 1, 86.27 1992, each Minnesota hospital except facilities of the federal 86.28 Indian Health Service and regional treatment centers shall pay 86.29 to the medical assistance account a surcharge equal to 1.4 86.30 percent of net patient revenues excluding net Medicare revenues 86.31 reported by that provider to the health care cost information 86.32 system according to the schedule in subdivision 4. 86.33 (b) Effective July 1, 1994, the surcharge under paragraph 86.34 (a) is increased to 1.56 percent. 86.35 (c) Notwithstanding the Medicare cost finding and allowable 86.36 cost principles, the hospital surcharge is not an allowable cost 87.1 for purposes of rate setting under sections 256.9685 to 256.9695. 87.2 Sec. 13. Minnesota Statutes 2000, section 256.969, is 87.3 amended by adding a subdivision to read: 87.4 Subd. 26. [GREATER MINNESOTA PAYMENT ADJUSTMENT AFTER JUNE 87.5 30, 2001.] (a) For admissions occurring after June 30, 2001, the 87.6 commissioner shall pay fee-for-service inpatient admissions for 87.7 the diagnosis-related groups specified in paragraph (b) at 87.8 hospitals located outside of the seven-county metropolitan area 87.9 at the higher of: 87.10 (1) the hospital's current payment rate for the diagnostic 87.11 category to which the diagnosis-related group belongs, exclusive 87.12 of disproportionate population adjustments received under 87.13 subdivision 9 and hospital payment adjustments received under 87.14 subdivision 23; or 87.15 (2) 90 percent of the average payment rate for that 87.16 diagnostic category for hospitals located within the 87.17 seven-county metropolitan area, exclusive of disproportionate 87.18 population adjustments received under subdivision 9 and hospital 87.19 payment adjustments received under subdivisions 20 and 23. The 87.20 commissioner may adjust this percentage each year so that the 87.21 estimated payment increases under this paragraph are equal to 87.22 the funding provided under section 256B.195 for this purpose. 87.23 (b) The payment increases provided in paragraph (a) apply 87.24 to the following diagnosis-related groups, as they fall within 87.25 the diagnostic categories: 87.26 (1) 370 cesarean section with complicating diagnosis; 87.27 (2) 371 cesarean section without complicating diagnosis; 87.28 (3) 372 vaginal delivery with complicating diagnosis; 87.29 (4) 373 vaginal delivery without complicating diagnosis; 87.30 (5) 386 extreme immaturity and respiratory distress 87.31 syndrome, neonate; 87.32 (6) 388 full-term neonates with other problems; 87.33 (7) 390 prematurity without major problems; 87.34 (8) 391 normal newborn; 87.35 (9) 385 neonate, died or transferred to another acute care 87.36 facility; 88.1 (10) 425 acute adjustment reaction and psychosocial 88.2 dysfunction; 88.3 (11) 430 psychoses; 88.4 (12) 431 childhood mental disorders; and 88.5 (13) 164-167 appendectomy. 88.6 Sec. 14. Minnesota Statutes 2000, section 256B.04, is 88.7 amended by adding a subdivision to read: 88.8 Subd. 1b. [CONTRACT FOR ADMINISTRATIVE SERVICES FOR 88.9 AMERICAN INDIAN CHILDREN.] Notwithstanding subdivision 1, the 88.10 commissioner may contract with federally recognized Indian 88.11 tribes with a reservation in Minnesota for the provision of 88.12 early and periodic screening, diagnosis, and treatment 88.13 administrative services for American Indian children, according 88.14 to Code of Federal Regulations, title 42, section 441, subpart 88.15 B, and Minnesota Rules, part 9505.1693 et seq., when the tribe 88.16 chooses to provide such services. For purposes of this 88.17 subdivision, "American Indian" has the meaning given to persons 88.18 to whom services will be provided for in Code of Federal 88.19 Regulations, title 42, section 36.12. Notwithstanding Minnesota 88.20 Rules, part 9505.1748, subpart 1, the commissioner, the local 88.21 agency, and the tribe may contract with any entity for the 88.22 provision of early and periodic screening, diagnosis, and 88.23 treatment administrative services. 88.24 [EFFECTIVE DATE.] This section is effective the day 88.25 following final enactment. 88.26 Sec. 15. Minnesota Statutes 2000, section 256B.055, 88.27 subdivision 3a, is amended to read: 88.28 Subd. 3a. [MFIP-S FAMILIES;FAMILIESELIGIBLE UNDER PRIOR88.29AFDC RULESWITH CHILDREN.](a) Beginning January 1, 1998, or on88.30the date that MFIP-S is implemented in counties, medical88.31assistance may be paid for a person receiving public assistance88.32under the MFIP-S program.Beginning July 1, 2002, medical 88.33 assistance may be paid for a person who is a child under the age 88.34 of 18, or age 18 if a full-time student in a secondary school, 88.35 or in the equivalent level of vocational or technical training, 88.36 and reasonably expected to complete the program before reaching 89.1 age 19; the parent of a dependent child, including a pregnant 89.2 woman; or a caretaker relative of a dependent child. 89.3(b) Beginning January 1, 1998, medical assistance may be89.4paid for a person who would have been eligible for public89.5assistance under the income and resource standards, or who would89.6have been eligible but for excess income or assets, under the89.7state's AFDC plan in effect as of July 16, 1996, as required by89.8the Personal Responsibility and Work Opportunity Reconciliation89.9Act of 1996 (PRWORA), Public Law Number 104-193.89.10 [EFFECTIVE DATE.] This section is effective July 1, 2002. 89.11 Sec. 16. Minnesota Statutes 2000, section 256B.056, 89.12 subdivision 1a, is amended to read: 89.13 Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless 89.14 specifically required by state law or rule or federal law or 89.15 regulation, the methodologies used in counting income and assets 89.16 to determine eligibility for medical assistance for persons 89.17 whose eligibility category is based on blindness, disability, or 89.18 age of 65 or more years, the methodologies for the supplemental 89.19 security income program shall be used. Increases in benefits 89.20 under title II of the Social Security Act shall not be counted 89.21 as income for purposes of this subdivision until July 1 of each 89.22 year. Effective upon federal approval, for children eligible 89.23 under section 256B.055, subdivision 12, or for home and 89.24 community-based waiver services whose eligibility for medical 89.25 assistance is determined without regard to parental income, 89.26 child support payments, including any payments made by an 89.27 obligor in satisfaction of or in addition to a temporary or 89.28 permanent order for child support, and social security payments 89.29 are not counted as income. For families and children, which 89.30 includes all other eligibility categories, the methodologies 89.31 under the state's AFDC plan in effect as of July 16, 1996, as 89.32 required by the Personal Responsibility and Work Opportunity 89.33 Reconciliation Act of 1996 (PRWORA), Public Law Number 104-193, 89.34 shall be used, except that effective July 1, 2002, the $90 and 89.35 $30 and one-third earned income disregards shall not apply and 89.36 the disregard specified in subdivision 1c shall apply. 90.1 Effective upon federal approval, in-kind contributions to, and 90.2 payments made on behalf of, a recipient, by an obligor, in 90.3 satisfaction of or in addition to a temporary or permanent order 90.4 for child support or maintenance, shall be considered income to 90.5 the recipient. For these purposes, a "methodology" does not 90.6 include an asset or income standard, or accounting method, or 90.7 method of determining effective dates. 90.8 [EFFECTIVE DATE.] This section is effective July 1, 2001. 90.9 Sec. 17. Minnesota Statutes 2000, section 256B.056, is 90.10 amended by adding a subdivision to read: 90.11 Subd. 1b. [AGED, BLIND, AND DISABLED INCOME 90.12 METHODOLOGY.] The $20 general income disregard allowed under the 90.13 supplemental security income program is included in the standard 90.14 and shall not be allowed as a deduction from income for a person 90.15 eligible under section 256B.055, subdivisions 7, 7a, and 12. 90.16 [EFFECTIVE DATE.] This section is effective July 1, 2001. 90.17 Sec. 18. Minnesota Statutes 2000, section 256B.056, is 90.18 amended by adding a subdivision to read: 90.19 Subd. 1c. [FAMILIES WITH CHILDREN INCOME METHODOLOGY.] (a) 90.20 For children ages one to five whose eligibility is determined 90.21 under section 256B.057, subdivision 2, 21 percent of countable 90.22 earned income shall be disregarded for up to four months. 90.23 (b) For families with children whose eligibility is 90.24 determined using the standard specified in section 256B.056, 90.25 subdivision 4, paragraph (c), 17 percent of countable earned 90.26 income shall be disregarded for up to four months. 90.27 (c) If the disregard has been applied to the wage earner's 90.28 income for four months, the disregard shall not be applied again 90.29 until the wage earner's income has not been considered in 90.30 determining medical assistance eligibility for 12 consecutive 90.31 months. 90.32 [EFFECTIVE DATE.] This section is effective July 1, 2002. 90.33 Sec. 19. Minnesota Statutes 2000, section 256B.056, 90.34 subdivision 3, is amended to read: 90.35 Subd. 3. [ASSET LIMITATIONS FOR ELDERLY AND DISABLED 90.36 INDIVIDUALS.] To be eligible for medical assistance, a person 91.1 must not individually own more than $3,000 in assets, or if a 91.2 member of a household with two family members, husband and wife, 91.3 or parent and child, the household must not own more than $6,000 91.4 in assets, plus $200 for each additional legal dependent. In 91.5 addition to these maximum amounts, an eligible individual or 91.6 family may accrue interest on these amounts, but they must be 91.7 reduced to the maximum at the time of an eligibility 91.8 redetermination. The accumulation of the clothing and personal 91.9 needs allowance according to section 256B.35 must also be 91.10 reduced to the maximum at the time of the eligibility 91.11 redetermination. The value of assets that are not considered in 91.12 determining eligibility for medical assistance is the value of 91.13 those assets excluded underthe AFDC state plan as of July 16,91.141996, as required by the Personal Responsibility and Work91.15Opportunity Reconciliation Act of 1996 (PRWORA), Public Law91.16Number 104-193, for families and children, andthe supplemental 91.17 security income program for aged, blind, and disabled persons, 91.18 with the following exceptions: 91.19 (a) Household goods and personal effects are not considered. 91.20 (b) Capital and operating assets of a trade or business 91.21 that the local agency determines are necessary to the person's 91.22 ability to earn an income are not considered. 91.23 (c) Motor vehicles are excluded to the same extent excluded 91.24 by the supplemental security income program. 91.25 (d) Assets designated as burial expenses are excluded to 91.26 the same extent excluded by the supplemental security income 91.27 program. 91.28 (e) Effective upon federal approval, for a person who no 91.29 longer qualifies as an employed person with a disability due to 91.30 loss of earnings, assets allowed while eligible for medical 91.31 assistance under section 256B.057, subdivision 9, are not 91.32 considered for 12 months, beginning with the first month of 91.33 ineligibility as an employed person with a disability, to the 91.34 extent that the person's total assets remain within the allowed 91.35 limits of section 256B.057, subdivision 9, paragraph (b). 91.36 Sec. 20. Minnesota Statutes 2000, section 256B.056, is 92.1 amended by adding a subdivision to read: 92.2 Subd. 3a. [ASSET LIMITATIONS FOR FAMILIES AND CHILDREN.] A 92.3 household of two or more persons must not own more than $30,000 92.4 in total net assets, and a household of one person must not own 92.5 more than $15,000 in total net assets. In addition to these 92.6 maximum amounts, an eligible individual or family may accrue 92.7 interest on these amounts, but they must be reduced to the 92.8 maximum at the time of an eligibility redetermination. The 92.9 value of assets that are not considered in determining 92.10 eligibility for medical assistance for families and children is 92.11 the value of those assets excluded under the AFDC state plan as 92.12 of July 16, 1996, as required by the Personal Responsibility and 92.13 Work Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 92.14 Number 104-193, with the following exceptions: 92.15 (1) household goods and personal effects are not 92.16 considered; 92.17 (2) capital and operating assets of a trade or business up 92.18 to $200,000 are not considered; 92.19 (3) one motor vehicle is excluded for each person of legal 92.20 driving age who is employed or seeking employment; 92.21 (4) one burial plot and all other burial expenses equal to 92.22 the supplemental security income program asset limit are not 92.23 considered for each individual; 92.24 (5) court-ordered settlements up to $10,000 are not 92.25 considered; 92.26 (6) individual retirement accounts and funds are not 92.27 considered; and 92.28 (7) assets owned by children are not considered. 92.29 [EFFECTIVE DATE.] This section is effective July 1, 2002. 92.30 Sec. 21. Minnesota Statutes 2000, section 256B.056, 92.31 subdivision 4, is amended to read: 92.32 Subd. 4. [INCOME.] (a) To be eligible for medical 92.33 assistance, a person eligible under section 256B.055, 92.34subdivisionsubdivisions 7,not receiving supplemental security92.35income program payments, and7a, and 12, may have income up to 92.36 100 percent of the federal poverty guidelines. Effective 93.1 January 1, 2000, and each successive January, recipients of 93.2 supplemental security income may have an income up to the 93.3 supplemental security income standard in effect on that date. 93.4 (b) To be eligible for medical assistance, families and 93.5 children may have an income up to 133-1/3 percent of the AFDC 93.6 income standard in effect under the July 16, 1996, AFDC state 93.7 plan. Effective July 1, 2000, the base AFDC standard in effect 93.8 on July 16, 1996, shall be increased by three 93.9 percent.Effective January 1, 2000, and each successive93.10January, recipients of supplemental security income may have an93.11income up to the supplemental security income standard in effect93.12on that date.93.13 (c) Effective July 1, 2002, to be eligible for medical 93.14 assistance, families and children may have an income up to 100 93.15 percent of the federal poverty guidelines for the family size. 93.16 (d) In computing income to determine eligibility of persons 93.17 under paragraphs (a) to (c) who are not residents of long-term 93.18 care facilities, the commissioner shall disregard increases in 93.19 income as required by Public Law Numbers 94-566, section 503; 93.20 99-272; and 99-509. Veterans aid and attendance benefits and 93.21 Veterans Administration unusual medical expense payments are 93.22 considered income to the recipient. 93.23 [EFFECTIVE DATE.] This section is effective July 1, 2001. 93.24 Sec. 22. Minnesota Statutes 2000, section 256B.056, 93.25 subdivision 4b, is amended to read: 93.26 Subd. 4b. [INCOME VERIFICATION.] The local agency shall 93.27 not require a monthly income verification form for a recipient 93.28 who is a resident of a long-term care facility and who has 93.29 monthly earned income of $80 or less. The commissioner or 93.30 county agency shall use electronic verification as the primary 93.31 method of income verification. If there is a discrepancy 93.32 between reported income and electronically verified income, an 93.33 individual may be required to submit additional verification. 93.34 Sec. 23. Minnesota Statutes 2000, section 256B.056, 93.35 subdivision 5, is amended to read: 93.36 Subd. 5. [EXCESS INCOME.] A person who has excess income 94.1 is eligible for medical assistance if the person has expenses 94.2 for medical care that are more than the amount of the person's 94.3 excess income, computed by deducting incurred medical expenses 94.4 from the excess income to reduce the excess to the income 94.5 standard specified in subdivision45c. The person shall elect 94.6 to have the medical expenses deducted at the beginning of a 94.7 one-month budget period or at the beginning of a six-month 94.8 budget period. The commissioner shall allow persons eligible 94.9 for assistance on a one-month spenddown basis under this 94.10 subdivision to elect to pay the monthly spenddown amount in 94.11 advance of the month of eligibility to the state agency in order 94.12 to maintain eligibility on a continuous basis. If the recipient 94.13 does not pay the spenddown amount on or before the 20th of the 94.14 month, the recipient is ineligible for this option for the 94.15 following month. The local agency shall code the Medicaid 94.16 Management Information System (MMIS) to indicate that the 94.17 recipient has elected this option. The state agency shall 94.18 convey recipient eligibility information relative to the 94.19 collection of the spenddown to providers through the Electronic 94.20 Verification System (EVS). A recipient electing advance payment 94.21 must pay the state agency the monthly spenddown amount on or 94.22 before the 20th of the month in order to be eligible for this 94.23 option in the following month. 94.24 [EFFECTIVE DATE.] This section is effective July 1, 2001. 94.25 Sec. 24. Minnesota Statutes 2000, section 256B.056, is 94.26 amended by adding a subdivision to read: 94.27 Subd. 5c. [EXCESS INCOME STANDARD.] (a) The excess income 94.28 standard for families with children is the standard specified in 94.29 subdivision 4. 94.30 (b) The excess income standard for a person whose 94.31 eligibility is based on blindness, disability, or age of 65 or 94.32 more years is 70 percent of the federal poverty guidelines for 94.33 the family size. Effective July 1, 2002, the excess income 94.34 standard for this paragraph shall equal 75 percent of the 94.35 federal poverty guidelines. 94.36 [EFFECTIVE DATE.] This section is effective July 1, 2001. 95.1 Sec. 25. Minnesota Statutes 2000, section 256B.057, 95.2 subdivision 2, is amended to read: 95.3 Subd. 2. [CHILDREN.] Except as specified in subdivision 95.4 1b, effective July 1, 2002, a child one throughfive18 years of 95.5 age in a family whose countable income islessno greater than 95.6133170 percent of the federal poverty guidelines for the same 95.7 family size, is eligible for medical assistance.A child six95.8through 18 years of age, who was born after September 30, 1983,95.9in a family whose countable income is less than 100 percent of95.10the federal poverty guidelines for the same family size is95.11eligible for medical assistance.95.12 [EFFECTIVE DATE.] This section is effective July 1, 2002. 95.13 Sec. 26. Minnesota Statutes 2000, section 256B.057, 95.14 subdivision 3, is amended to read: 95.15 Subd. 3. [QUALIFIED MEDICARE BENEFICIARIES.] A person who 95.16 is entitled to Part A Medicare benefits, whose income is equal 95.17 to or less than 100 percent of the federal poverty guidelines, 95.18 and whose assets are no more than $10,000 for a single 95.19 individual and $18,000 for a married couple or family of two or 95.20 more, is eligible for medical assistance reimbursement of Part A 95.21 and Part B premiums, Part A and Part B coinsurance and 95.22 deductibles, and cost-effective premiums for enrollment with a 95.23 health maintenance organization or a competitive medical plan 95.24 under section 1876 of the Social Security Act. Reimbursement of 95.25 the Medicare coinsurance and deductibles, when added to the 95.26 amount paid by Medicare, must not exceed the total rate the 95.27 provider would have received for the same service or services if 95.28 the person were a medical assistance recipient with Medicare 95.29 coverage. Increases in benefits under Title II of the Social 95.30 Security Act shall not be counted as income for purposes of this 95.31 subdivision untilthe first day of the second full month95.32following publication of the change in the federal poverty95.33guidelinesJuly 1 of each year. 95.34 [EFFECTIVE DATE.] This section is effective July 1, 2001. 95.35 Sec. 27. Minnesota Statutes 2000, section 256B.057, 95.36 subdivision 7, is amended to read: 96.1 Subd. 7. [WAIVER OF MAINTENANCE OF EFFORT REQUIREMENT.] 96.2 Unless a federal waiver of the maintenance of effort requirement 96.3 of section 2105(d) of title XXI of the Balanced Budget Act of 96.4 1997, Public Law Number 105-33, Statutes at Large, volume 111, 96.5 page 251, is granted by the federal Department of Health and 96.6 Human Services by September 30, 1998, eligibility for children 96.7 under age 21 must be determined without regard to asset 96.8 standards established in section 256B.056, subdivision33a. 96.9 The commissioner of human services shall publish a notice in the 96.10 State Register upon receipt of a federal waiver. 96.11 Sec. 28. Minnesota Statutes 2000, section 256B.057, 96.12 subdivision 9, is amended to read: 96.13 Subd. 9. [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 96.14 assistance may be paid for a person who is employed and who: 96.15 (1) meets the definition of disabled under the supplemental 96.16 security income program; 96.17 (2) is at least 16 but less than 65 years of age; 96.18 (3) meets the asset limits in paragraph (b); and 96.19 (4) pays a premium, if required, under paragraph (c). 96.20 Any spousal income or assets shall be disregarded for purposes 96.21 of eligibility and premium determinations. 96.22 After the month of enrollment, a person enrolled in medical 96.23 assistance under this subdivision who is temporarily unable to 96.24 work and without receipt of earned income due to a medical 96.25 condition, as verified by a physician, may retain eligibility 96.26 for up to four calendar months. 96.27 (b) For purposes of determining eligibility under this 96.28 subdivision, a person's assets must not exceed $20,000, 96.29 excluding: 96.30 (1) all assets excluded under section 256B.056; 96.31 (2) retirement accounts, including individual accounts, 96.32 401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 96.33 (3) medical expense accounts set up through the person's 96.34 employer. 96.35 (c) A person whose earned and unearned income is equal to 96.36 or greaterthan 200than 100 percent of federal poverty 97.1 guidelines for the applicable family size must pay a premium to 97.2 be eligible for medical assistance under this subdivision. The 97.3 premium shall beequal to ten percent of the person's gross97.4earned and unearned income above 200 percent of federal poverty97.5guidelines for the applicable family size up to the cost of97.6coveragebased on the person's gross earned and unearned income 97.7 and the applicable family size using a sliding fee scale 97.8 established by the commissioner, which begins at one percent of 97.9 income at 100 percent of the federal poverty guidelines and 97.10 increases to 7.5 percent of income for those with incomes at or 97.11 above 300 percent of the federal poverty guidelines. Annual 97.12 adjustments in the premium schedule based upon changes in the 97.13 federal poverty guidelines shall be effective for premiums due 97.14 in July of each year. 97.15 (d) A person's eligibility and premium shall be determined 97.16 by the local county agency. Premiums must be paid to the 97.17 commissioner. All premiums are dedicated to the commissioner. 97.18 (e) Any required premium shall be determined at application 97.19 and redetermined annually at recertification or when a change in 97.20 income or family size occurs. 97.21 (f) Premium payment is due upon notification from the 97.22 commissioner of the premium amount required. Premiums may be 97.23 paid in installments at the discretion of the commissioner. 97.24 (g) Nonpayment of the premium shall result in denial or 97.25 termination of medical assistance unless the person demonstrates 97.26 good cause for nonpayment. Good cause exists if the 97.27 requirements specified in Minnesota Rules, part 9506.0040, 97.28 subpart 7, items B to D, are met. Nonpayment shall include 97.29 payment with a returned, refused, or dishonored instrument. The 97.30 commissioner may require a guaranteed form of payment as the 97.31 only means to replace a returned, refused, or dishonored 97.32 instrument. 97.33 [EFFECTIVE DATE.] This section is effective November 1, 97.34 2001. 97.35 Sec. 29. Minnesota Statutes 2000, section 256B.057, is 97.36 amended by adding a subdivision to read: 98.1 Subd. 10. [CERTAIN PERSONS NEEDING TREATMENT FOR BREAST OR 98.2 CERVICAL CANCER.] (a) Medical assistance may be paid for a 98.3 person who: 98.4 (1) has been screened for breast or cervical cancer by the 98.5 Minnesota breast and cervical cancer control program, and 98.6 program funds have been used to pay for the person's screening; 98.7 (2) according to the person's treating health professional, 98.8 needs treatment, including diagnostic services necessary to 98.9 determine the extent and proper course of treatment, for breast 98.10 or cervical cancer, including precancerous conditions and early 98.11 stage cancer; 98.12 (3) meets the income eligibility guidelines for the 98.13 Minnesota breast and cervical cancer control program; 98.14 (4) is under age 65; 98.15 (5) is not otherwise eligible for medical assistance under 98.16 United States Code, title 42, section 1396(a)(10)(A)(i); and 98.17 (6) is not otherwise covered under creditable coverage, as 98.18 defined under United States Code, title 42, section 300gg(c). 98.19 (b) Medical assistance provided for an eligible person 98.20 under this subdivision shall be limited to services provided 98.21 during the period that the person receives treatment for breast 98.22 or cervical cancer. 98.23 (c) A person meeting the criteria in paragraph (a) is 98.24 eligible for medical assistance without meeting the eligibility 98.25 criteria relating to income and assets in section 256B.056, 98.26 subdivisions 1a to 5b. 98.27 [EFFECTIVE DATE.] This section is effective July 1, 2002. 98.28 Sec. 30. Minnesota Statutes 2000, section 256B.0625, 98.29 subdivision 3b, is amended to read: 98.30 Subd. 3b. [TELEMEDICINE CONSULTATIONS.](a)Medical 98.31 assistance covers telemedicine consultations. Telemedicine 98.32 consultations must be made via two-way, interactive video or 98.33 store-and-forward technology. Store-and-forward technology 98.34 includes telemedicine consultations that do not occur in real 98.35 time via synchronous transmissions, and that do not require a 98.36 face-to-face encounter with the patient for all or any part of 99.1 any such telemedicine consultation. The patient record must 99.2 include a written opinion from the consulting physician 99.3 providing the telemedicine consultation. A communication 99.4 between two physicians that consists solely of a telephone 99.5 conversation is not a telemedicine consultation. Coverage is 99.6 limited to three telemedicine consultations per recipient per 99.7 calendar week. Telemedicine consultations shall be paid at the 99.8 full allowable rate. 99.9(b) This subdivision expires July 1, 2001.99.10 Sec. 31. Minnesota Statutes 2000, section 256B.0625, is 99.11 amended by adding a subdivision to read: 99.12 Subd. 5a. [INTENSIVE EARLY INTERVENTION BEHAVIOR THERAPY 99.13 SERVICES FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS.] (a) 99.14 [COVERAGE.] Medical assistance covers home-based intensive early 99.15 intervention behavior therapy for children with autism spectrum 99.16 disorders. Children with autism spectrum disorder, and their 99.17 custodial parents or foster parents, may access other covered 99.18 services to treat autism spectrum disorder, and are not required 99.19 to receive intensive early intervention behavior therapy 99.20 services under this subdivision. Intensive early intervention 99.21 behavior therapy does not include coverage for services to treat 99.22 developmental disorders of language, early onset psychosis, 99.23 Rett's disorder, selective mutism, social anxiety disorder, 99.24 stereotypic movement disorder, dementia, obsessive compulsive 99.25 disorder, schizoid personality disorder, avoidant personality 99.26 disorder, or reactive attachment disorder. If a child with 99.27 autism spectrum disorder is diagnosed to have one or more of 99.28 these conditions, intensive early intervention behavior therapy 99.29 includes coverage only for services necessary to treat the 99.30 autism spectrum disorder. 99.31 (b) [PURPOSE OF INTENSIVE EARLY INTERVENTION BEHAVIOR 99.32 THERAPY SERVICES (IEIBTS).] The purpose of IEIBTS is to improve 99.33 the child's behavioral functioning, to prevent development of 99.34 challenging behaviors, to eliminate autistic behaviors, to 99.35 reduce the risk of out-of-home placement, and to establish 99.36 independent typical functioning in language and social 100.1 behavior. The procedures used to accomplish these goals are 100.2 based upon research in applied behavior analysis. 100.3 (c) [ELIGIBLE CHILDREN.] A child is eligible to initiate 100.4 IEIBTS if, the child meets the additional eligibility criteria 100.5 in paragraph (d) and in a diagnostic assessment by a mental 100.6 health professional who is not under the employ of the service 100.7 provider, the child: 100.8 (1) is found to have an autism spectrum disorder; 100.9 (2) has a current IQ of either untestable, or at least 30; 100.10 (3) if nonverbal, initiated behavior therapy by 42 months 100.11 of age; 100.12 (4) if verbal, initiated behavior therapy by 48 months of 100.13 age; or 100.14 (5) if having an IQ of at least 50, initiated behavior 100.15 therapy by 84 months of age. 100.16 To continue after six-month individualized treatment plan (ITP) 100.17 reviews, at least one of the child's custodial parents or foster 100.18 parents must participate in an average of at least five hours of 100.19 documented behavior therapy per week for six months, and 100.20 consistently implement behavior therapy recommendations 24 hours 100.21 a day. To continue after six-month individualized treatment 100.22 plan (ITP) reviews, the child must show documented progress 100.23 toward mastery of six-month benchmark behavior objectives. The 100.24 maximum number of months during which services may be billed is 100.25 54, or up to the month of August in the first year in which the 100.26 child completes first grade, whichever comes last. If 100.27 significant progress towards treatment goals has not been 100.28 achieved after 24 months of treatment, treatment must be 100.29 discontinued. 100.30 (d) [ADDITIONAL ELIGIBILITY CRITERIA.] A child is eligible 100.31 to initiate IEIBTS if: 100.32 (1) in medical and diagnostic assessments by medical and 100.33 mental health professionals, it is determined that the child 100.34 does not have severe or profound mental retardation; 100.35 (2) an accurate assessment of the child's hearing has been 100.36 performed, including audiometry if the brain stem auditory 101.1 evokes response; 101.2 (3) a blood lead test has been performed prior to 101.3 initiation of treatment; and 101.4 (4) an EEG or neurologic evaluation is done, prior to 101.5 initiation of treatment, if the child has a history of staring 101.6 spells or developmental regression. 101.7 (e) [COVERED SERVICES.] The focus of IEIBTS must be to 101.8 treat the principal diagnostic features of the autism spectrum 101.9 disorder. All IEIBTS must be delivered by a team of 101.10 practitioners under the consistent supervision of a single 101.11 clinical supervisor. A mental health professional must develop 101.12 the ITP for IEIBTS. The ITP must include six-month benchmark 101.13 behavior objectives. All behavior therapy must be based upon 101.14 research in applied behavior analysis, with an emphasis upon 101.15 positive reinforcement of carefully task-analyzed skills for 101.16 optimum rates of progress. All behavior therapy must be 101.17 consistently applied and generalized throughout the 24-hour day 101.18 and seven-day week by all of the child's regular care 101.19 providers. When placing the child in school activities, a 101.20 majority of the peers must have no mental health diagnosis, and 101.21 the child must have sufficient social skills to succeed with 80 101.22 percent of the school activities. Reactive consequences, such 101.23 as redirection, correction, positive practice, or time-out, must 101.24 be used only when necessary to improve the child's success when 101.25 proactive procedures alone have not been effective. IEIBTS must 101.26 be delivered by a team of behavior therapy practitioners who are 101.27 employed under the direction of the same agency. The team may 101.28 deliver up to 200 billable hours per year of direct clinical 101.29 supervisor services, up to 700 billable hours per year of senior 101.30 behavior therapist services, and up to 1,800 billable hours per 101.31 year of direct behavior therapist services. A one-hour clinical 101.32 review meeting for the child, parents, and staff must be 101.33 scheduled 50 weeks a year, at which behavior therapy is reviewed 101.34 and planned. At least one-quarter of the annual clinical 101.35 supervisor billable hours shall consist of on-site clinical 101.36 meeting time. At least one-half of the annual senior behavior 102.1 therapist billable hours shall consist of direct services to the 102.2 child or parents. All of the behavioral therapist billable 102.3 hours shall consist of direct on-site services to the child or 102.4 parents. None of the senior behavior therapist billable hours 102.5 or behavior therapist billable hours shall consist of clinical 102.6 meeting time. If there is any regression of the autistic 102.7 spectrum disorder after 12 months of therapy, a neurologic 102.8 consultation must be performed. 102.9 (f) [PROVIDER QUALIFICATIONS.] The provider agency must be 102.10 capable of delivering consistent applied behavior analysis 102.11 (ABA)-based behavior therapy in the home. The site director of 102.12 the agency must be a mental health professional and a board 102.13 certified behavior analyst certified by the behavior analyst 102.14 certification board. Each clinical supervisor must be a 102.15 certified associate behavior analyst certified by the behavior 102.16 analyst certification board or have equivalent experience in 102.17 applied behavior analysis. 102.18 (g) [SUPERVISION REQUIREMENTS.] (1) Each behavior therapist 102.19 practitioner must be continuously supervised while in the home 102.20 until the practitioner has mastered competencies for independent 102.21 practice. Each behavior therapist must have mastered three 102.22 credits of academic content and practice in an applied behavior 102.23 analysis sequence at an accredited university before providing 102.24 more than 12 months of therapy. A college degree or minimum 102.25 hours of experience are not required. Each behavior therapist 102.26 must continue training through weekly direct observation by the 102.27 senior behavior therapist, through demonstrated performance in 102.28 clinical meetings with the clinical supervisor, and annual 102.29 training in applied behavior analysis. 102.30 (2) Each senior behavior therapist practitioner must have 102.31 mastered the senior behavior therapy competencies, completed one 102.32 year of practice as a behavior therapist, and six months of 102.33 co-therapy training with another senior behavior therapist or 102.34 have an equivalent amount of experience in applied behavior 102.35 analysis. Each senior behavior therapist must have mastered 12 102.36 credits of academic content and practice in an applied behavior 103.1 analysis sequence at an accredited university before providing 103.2 more than 12 months of senior behavior therapy. Each senior 103.3 behavior therapist must continue training through demonstrated 103.4 performance in clinical meetings with the clinical supervisor, 103.5 and annual training in applied behavior analysis. 103.6 (3) Each clinical supervisor practitioner must have 103.7 mastered the clinical supervisor and family consultation 103.8 competencies, completed two years of practice as a senior 103.9 behavior therapist and one year of co-therapy training with 103.10 another clinical supervisor, or equivalent experience in applied 103.11 behavior analysis. Each clinical supervisor must continue 103.12 training through annual training in applied behavior analysis. 103.13 (h) [PLACE OF SERVICE.] IEIBTS are provided primarily in 103.14 the child's home and community. Services may be provided in the 103.15 child's natural school or preschool classroom, home of a 103.16 relative, natural recreational setting, or day care. 103.17 (i) [PRIOR AUTHORIZATION REQUIREMENTS.] Prior authorization 103.18 shall be required for services provided after 200 hours of 103.19 clinical supervisor, 700 hours of senior behavior therapist, or 103.20 1,800 hours of behavior therapist services per year. 103.21 (j) [PAYMENT RATES.] The following payment rates apply: 103.22 (1) for an IEIBTS clinical supervisor practitioner under 103.23 supervision of a mental health professional, the lower of the 103.24 submitted charge or $67 per hour unit; 103.25 (2) for an IEIBTS senior behavior therapist practitioner 103.26 under supervision of a mental health professional, the lower of 103.27 the submitted charge or $37 per hour unit; or 103.28 (3) for an IEIBTS behavior therapist practitioner under 103.29 supervision of a mental health professional, the lower of the 103.30 submitted charge or $27 per hour unit. 103.31 An IEIBTS practitioner may receive payment for travel time which 103.32 exceeds 50 minutes one-way. The maximum payment allowed will be 103.33 $0.51 per minute for up to a maximum of 300 hours per year. 103.34 For any week during which the above charges are made to 103.35 medical assistance, payments for the following services are 103.36 excluded: supervising mental health professional hours and 104.1 personal care attendant, home-based mental health, 104.2 family-community support, or mental health behavioral aide hours. 104.3 (k) [REPORT.] The commissioner shall collect evidence of 104.4 the effectiveness of intensive early intervention behavior 104.5 therapy services and present a report to the legislature by July 104.6 1, 2006. 104.7 [EFFECTIVE DATE.] This section is effective January 1, 2003. 104.8 Sec. 32. Minnesota Statutes 2000, section 256B.0625, 104.9 subdivision 13, is amended to read: 104.10 Subd. 13. [DRUGS.] (a) Medical assistance covers drugs, 104.11 except for fertility drugs when specifically used to enhance 104.12 fertility, if prescribed by a licensed practitioner and 104.13 dispensed by a licensed pharmacist, by a physician enrolled in 104.14 the medical assistance program as a dispensing physician, or by 104.15 a physician or a nurse practitioner employed by or under 104.16 contract with a community health board as defined in section 104.17 145A.02, subdivision 5, for the purposes of communicable disease 104.18 control. The commissioner, after receiving recommendations from 104.19 professional medical associations and professional pharmacist 104.20 associations, shall designate a formulary committee to advise 104.21 the commissioner on the names of drugs for which payment is 104.22 made, recommend a system for reimbursing providers on a set fee 104.23 or charge basis rather than the present system, and develop 104.24 methods encouraging use of generic drugs when they are less 104.25 expensive and equally effective as trademark drugs. The 104.26 formulary committee shall consist of nine members, four of whom 104.27 shall be physicians who are not employed by the department of 104.28 human services, and a majority of whose practice is for persons 104.29 paying privately or through health insurance, three of whom 104.30 shall be pharmacists who are not employed by the department of 104.31 human services, and a majority of whose practice is for persons 104.32 paying privately or through health insurance, a consumer 104.33 representative, and a nursing home representative. Committee 104.34 members shall serve three-year terms and shall serve without 104.35 compensation. Members may be reappointed once. 104.36 (b) The commissioner shall establish a drug formulary. Its 105.1 establishment and publication shall not be subject to the 105.2 requirements of the Administrative Procedure Act, but the 105.3 formulary committee shall review and comment on the formulary 105.4 contents. The formulary committee shall review and recommend 105.5 drugs which require prior authorization. The formulary 105.6 committee may recommend drugs for prior authorization directly 105.7 to the commissioner, as long as opportunity for public input is 105.8 provided. Prior authorization may be requested by the 105.9 commissioner based on medical and clinical criteria before 105.10 certain drugs are eligible for payment. Before a drug may be 105.11 considered for prior authorization at the request of the 105.12 commissioner: 105.13 (1) the drug formulary committee must develop criteria to 105.14 be used for identifying drugs; the development of these criteria 105.15 is not subject to the requirements of chapter 14, but the 105.16 formulary committee shall provide opportunity for public input 105.17 in developing criteria; 105.18 (2) the drug formulary committee must hold a public forum 105.19 and receive public comment for an additional 15 days; and 105.20 (3) the commissioner must provide information to the 105.21 formulary committee on the impact that placing the drug on prior 105.22 authorization will have on the quality of patient care and 105.23 information regarding whether the drug is subject to clinical 105.24 abuse or misuse. Prior authorization may be required by the 105.25 commissioner before certain formulary drugs are eligible for 105.26 payment. The formulary shall not include: 105.27 (i) drugs or products for which there is no federal 105.28 funding; 105.29 (ii) over-the-counter drugs, except for antacids, 105.30 acetaminophen, family planning products, aspirin, insulin, 105.31 products for the treatment of lice, vitamins for adults with 105.32 documented vitamin deficiencies, vitamins for children under the 105.33 age of seven and pregnant or nursing women, and any other 105.34 over-the-counter drug identified by the commissioner, in 105.35 consultation with the drug formulary committee, as necessary, 105.36 appropriate, and cost-effective for the treatment of certain 106.1 specified chronic diseases, conditions or disorders, and this 106.2 determination shall not be subject to the requirements of 106.3 chapter 14; 106.4 (iii) anorectics, except that medically necessary 106.5 anorectics shall be covered for a recipient previously diagnosed 106.6 as having pickwickian syndrome and currently diagnosed as having 106.7 diabetes and being morbidly obese; 106.8 (iv) drugs for which medical value has not been 106.9 established; and 106.10 (v) drugs from manufacturers who have not signed a rebate 106.11 agreement with the Department of Health and Human Services 106.12 pursuant to section 1927 of title XIX of the Social Security Act. 106.13 The commissioner shall publish conditions for prohibiting 106.14 payment for specific drugs after considering the formulary 106.15 committee's recommendations. An honorarium of $100 per meeting 106.16 and reimbursement for mileage shall be paid to each committee 106.17 member in attendance. 106.18 (c) The basis for determining the amount of payment shall 106.19 be the lower of the actual acquisition costs of the drugs plus a 106.20 fixed dispensing fee; the maximum allowable cost set by the 106.21 federal government or by the commissioner plus the fixed 106.22 dispensing fee; or the usual and customary price charged to the 106.23 public. The pharmacy dispensing fee shall be $3.65, except that 106.24 the dispensing fee for intravenous solutions which must be 106.25 compounded by the pharmacist shall be $8 per bag, $14 per bag 106.26 for cancer chemotherapy products, and $30 per bag for total 106.27 parenteral nutritional products dispensed in one liter 106.28 quantities, or $44 per bag for total parenteral nutritional 106.29 products dispensed in quantities greater than one liter. Actual 106.30 acquisition cost includes quantity and other special discounts 106.31 except time and cash discounts. The actual acquisition cost of 106.32 a drug shall be estimated by the commissioner, at average 106.33 wholesale price minus nine percent, except that where a drug has 106.34 had its wholesale price reduced as a result of the actions of 106.35 the National Association of Medicaid Fraud Control Units, the 106.36 estimated actual acquisition cost shall be the reduced average 107.1 wholesale price, without the nine percent deduction. The 107.2 maximum allowable cost of a multisource drug may be set by the 107.3 commissioner and it shall be comparable to, but no higher than, 107.4 the maximum amount paid by other third-party payors in this 107.5 state who have maximum allowable cost programs. The 107.6 commissioner shall set maximum allowable costs for multisource 107.7 drugs that are not on the federal upper limit list as described 107.8 in United States Code, title 42, chapter 7, section 1396r-8(e), 107.9 the Social Security Act, and Code of Federal Regulations, title 107.10 42, part 447, section 447.332. Establishment of the amount of 107.11 payment for drugs shall not be subject to the requirements of 107.12 the Administrative Procedure Act. An additional dispensing fee 107.13 of $.30 may be added to the dispensing fee paid to pharmacists 107.14 for legend drug prescriptions dispensed to residents of 107.15 long-term care facilities when a unit dose blister card system, 107.16 approved by the department, is used. Under this type of 107.17 dispensing system, the pharmacist must dispense a 30-day supply 107.18 of drug. The National Drug Code (NDC) from the drug container 107.19 used to fill the blister card must be identified on the claim to 107.20 the department. The unit dose blister card containing the drug 107.21 must meet the packaging standards set forth in Minnesota Rules, 107.22 part 6800.2700, that govern the return of unused drugs to the 107.23 pharmacy for reuse. The pharmacy provider will be required to 107.24 credit the department for the actual acquisition cost of all 107.25 unused drugs that are eligible for reuse. Over-the-counter 107.26 medications must be dispensed in the manufacturer's unopened 107.27 package. The commissioner may permit the drug clozapine to be 107.28 dispensed in a quantity that is less than a 30-day supply. 107.29 Whenever a generically equivalent product is available, payment 107.30 shall be on the basis of the actual acquisition cost of the 107.31 generic drug, unless the prescriber specifically indicates 107.32 "dispense as written - brand necessary" on the prescription as 107.33 required by section 151.21, subdivision 2. 107.34 (d) For purposes of this subdivision, "multisource drugs" 107.35 means covered outpatient drugs, excluding innovator multisource 107.36 drugs for which there are two or more drug products, which: 108.1 (1) are related as therapeutically equivalent under the 108.2 Food and Drug Administration's most recent publication of 108.3 "Approved Drug Products with Therapeutic Equivalence 108.4 Evaluations"; 108.5 (2) are pharmaceutically equivalent and bioequivalent as 108.6 determined by the Food and Drug Administration; and 108.7 (3) are sold or marketed in Minnesota. 108.8 "Innovator multisource drug" means a multisource drug that was 108.9 originally marketed under an original new drug application 108.10 approved by the Food and Drug Administration. 108.11 (e) The basis for determining the amount of payment for 108.12 drugs administered in an outpatient setting shall be the lower 108.13 of the usual and customary cost submitted by the provider; the 108.14 average wholesale price minus five percent; or the maximum 108.15 allowable cost set by the federal government under United States 108.16 Code, title 42, chapter 7, section 1396r-8(e) and Code of 108.17 Federal Regulations, title 42, section 447.332, or by the 108.18 commissioner under paragraph (c). 108.19 [EFFECTIVE DATE.] This section is effective 30 days 108.20 following final enactment. 108.21 Sec. 33. Minnesota Statutes 2000, section 256B.0625, 108.22 subdivision 13a, is amended to read: 108.23 Subd. 13a. [DRUG UTILIZATION REVIEW BOARD.] A nine-member 108.24 drug utilization review board is established. The board is 108.25 comprised of at least three but no more than four licensed 108.26 physicians actively engaged in the practice of medicine in 108.27 Minnesota; at least three licensed pharmacists actively engaged 108.28 in the practice of pharmacy in Minnesota; and one consumer 108.29 representative; the remainder to be made up of health care 108.30 professionals who are licensed in their field and have 108.31 recognized knowledge in the clinically appropriate prescribing, 108.32 dispensing, and monitoring of covered outpatient drugs. The 108.33 board shall be staffed by an employee of the department who 108.34 shall serve as an ex officio nonvoting member of the board. The 108.35 members of the board shall be appointed by the commissioner and 108.36 shall serve three-year terms. The members shall be selected 109.1 from lists submitted by professional associations. The 109.2 commissioner shall appoint the initial members of the board for 109.3 terms expiring as follows: three members for terms expiring 109.4 June 30, 1996; three members for terms expiring June 30, 1997; 109.5 and three members for terms expiring June 30, 1998. Members may 109.6 be reappointed once. The board shall annually elect a chair 109.7 from among the members. 109.8 The commissioner shall, with the advice of the board: 109.9 (1) implement a medical assistance retrospective and 109.10 prospective drug utilization review program as required by 109.11 United States Code, title 42, section 1396r-8(g)(3); 109.12 (2) develop and implement the predetermined criteria and 109.13 practice parameters for appropriate prescribing to be used in 109.14 retrospective and prospective drug utilization review; 109.15 (3) develop, select, implement, and assess interventions 109.16 for physicians, pharmacists, and patients that are educational 109.17 and not punitive in nature; 109.18 (4) establish a grievance and appeals process for 109.19 physicians and pharmacists under this section; 109.20 (5) publish and disseminate educational information to 109.21 physicians and pharmacists regarding the board and the review 109.22 program; 109.23 (6) adopt and implement procedures designed to ensure the 109.24 confidentiality of any information collected, stored, retrieved, 109.25 assessed, or analyzed by the board, staff to the board, or 109.26 contractors to the review program that identifies individual 109.27 physicians, pharmacists, or recipients; 109.28 (7) establish and implement an ongoing process to (i) 109.29 receive public comment regarding drug utilization review 109.30 criteria and standards, and (ii) consider the comments along 109.31 with other scientific and clinical information in order to 109.32 revise criteria and standards on a timely basis; and 109.33 (8) adopt any rules necessary to carry out this section. 109.34 The board may establish advisory committees. The 109.35 commissioner may contract with appropriate organizations to 109.36 assist the board in carrying out the board's duties. The 110.1 commissioner may enter into contracts for services to develop 110.2 and implement a retrospective and prospective review program. 110.3 The board shall report to the commissioner annually on the 110.4 date the Drug Utilization Review Annual Report is due to the 110.5 Health Care Financing Administration. This report is to cover 110.6 the preceding federal fiscal year. The commissioner shall make 110.7 the report available to the public upon request. The report 110.8 must include information on the activities of the board and the 110.9 program; the effectiveness of implemented interventions; 110.10 administrative costs; and any fiscal impact resulting from the 110.11 program. An honorarium of$50$100 per meeting and 110.12 reimbursement for mileage shall be paid to each board member in 110.13 attendance. 110.14 Sec. 34. Minnesota Statutes 2000, section 256B.0625, 110.15 subdivision 17, is amended to read: 110.16 Subd. 17. [TRANSPORTATION COSTS.] (a) Medical assistance 110.17 covers transportation costs incurred solely for obtaining 110.18 emergency medical care or transportation costs incurred by 110.19 nonambulatory persons in obtaining emergency or nonemergency 110.20 medical care when paid directly to an ambulance company, common 110.21 carrier, or other recognized providers of transportation 110.22 services. For the purpose of this subdivision, a person who is 110.23 incapable of transport by taxicab or bus shall be considered to 110.24 be nonambulatory. 110.25 (b) Medical assistance covers special transportation, as 110.26 defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 110.27 if the provider receives and maintains a current physician's 110.28 order by the recipient's attending physician certifying that the 110.29 recipient has a physical or mental impairment that would 110.30 prohibit the recipient from safely accessing and using a bus, 110.31 taxi, other commercial transportation, or private automobile. 110.32 Special transportation includes driver-assisted service to 110.33 eligible individuals. Driver-assisted service includes 110.34 passenger pickup at and return to the individual's residence or 110.35 place of business, assistance with admittance of the individual 110.36 to the medical facility, and assistance in passenger securement 111.1 or in securing of wheelchairs or stretchers in the vehicle. The 111.2 commissioner shall establish maximum medical assistance 111.3 reimbursement rates for special transportation services for 111.4 persons who need a wheelchairliftaccessible van or 111.5stretcher-equippedstretcher-accessible vehicle and for those 111.6 who do not need a wheelchairliftaccessible van or 111.7stretcher-equippedstretcher-accessible vehicle. The average of 111.8 these two rates per trip must not exceed $15 for the base rate 111.9 and$1.20$1.40 per mile. Special transportation provided to 111.10 nonambulatory persons who do not need a wheelchairlift111.11 accessible van orstretcher-equippedstretcher-accessible 111.12 vehicle, may be reimbursed at a lower rate than special 111.13 transportation provided to persons who need a wheelchairlift111.14 accessible van orstretcher-equippedstretcher-accessible 111.15 vehicle. 111.16 [EFFECTIVE DATE.] This section is effective July 1, 2001. 111.17 Sec. 35. Minnesota Statutes 2000, section 256B.0625, 111.18 subdivision 17a, is amended to read: 111.19 Subd. 17a. [PAYMENT FOR AMBULANCE SERVICES.] Effective for 111.20 services rendered on or after July 1,19992001, medical 111.21 assistance payments for ambulance services shall beincreased by111.22five percentpaid at the Medicare reimbursement rate or at the 111.23 medical assistance payment rate in effect on July 1, 2000, 111.24 whichever is greater. 111.25 Sec. 36. Minnesota Statutes 2000, section 256B.0625, 111.26 subdivision 18a, is amended to read: 111.27 Subd. 18a. [PAYMENT FOR MEALS AND LODGINGACCESS TO 111.28 MEDICAL SERVICES.] (a) Medical assistance reimbursement for 111.29 meals for persons traveling to receive medical care may not 111.30 exceed $5.50 for breakfast, $6.50 for lunch, or $8 for dinner. 111.31 (b) Medical assistance reimbursement for lodging for 111.32 persons traveling to receive medical care may not exceed $50 per 111.33 day unless prior authorized by the local agency. 111.34 (c) Medical assistance direct mileage reimbursement to the 111.35 eligible person or the eligible person's driver may not exceed 111.36 20 cents per mile. 112.1 (d) Medical assistance covers oral language interpreter 112.2 services when provided by an enrolled health care provider 112.3 during the course of providing a direct, person-to-person 112.4 covered health care service to an enrolled recipient with 112.5 limited English proficiency. 112.6 Sec. 37. Minnesota Statutes 2000, section 256B.0625, 112.7 subdivision 30, is amended to read: 112.8 Subd. 30. [OTHER CLINIC SERVICES.] (a) Medical assistance 112.9 covers rural health clinic services, federally qualified health 112.10 center services, nonprofit community health clinic services, 112.11 public health clinic services, and the services of a clinic 112.12 meeting the criteria established in rule by the commissioner. 112.13 Rural health clinic services and federally qualified health 112.14 center services mean services defined in United States Code, 112.15 title 42, section 1396d(a)(2)(B) and (C). Payment for rural 112.16 health clinic and federally qualified health center services 112.17 shall be made according to applicable federal law and regulation. 112.18 (b) A federally qualified health center that is beginning 112.19 initial operation shall submit an estimate of budgeted costs and 112.20 visits for the initial reporting period in the form and detail 112.21 required by the commissioner. A federally qualified health 112.22 center that is already in operation shall submit an initial 112.23 report using actual costs and visits for the initial reporting 112.24 period. Within 90 days of the end of its reporting period, a 112.25 federally qualified health center shall submit, in the form and 112.26 detail required by the commissioner, a report of its operations, 112.27 including allowable costs actually incurred for the period and 112.28 the actual number of visits for services furnished during the 112.29 period, and other information required by the commissioner. 112.30 Federally qualified health centers that file Medicare cost 112.31 reports shall provide the commissioner with a copy of the most 112.32 recent Medicare cost report filed with the Medicare program 112.33 intermediary for the reporting year which support the costs 112.34 claimed on their cost report to the state. 112.35 (c) In order to continue cost-based payment under the 112.36 medical assistance program according to paragraphs (a) and (b), 113.1 a federally qualified health center or rural health clinic must 113.2 apply for designation as an essential community provider within 113.3 six months of final adoption of rules by the department of 113.4 health according to section 62Q.19, subdivision 7. For those 113.5 federally qualified health centers and rural health clinics that 113.6 have applied for essential community provider status within the 113.7 six-month time prescribed, medical assistance payments will 113.8 continue to be made according to paragraphs (a) and (b) for the 113.9 first three years after application. For federally qualified 113.10 health centers and rural health clinics that either do not apply 113.11 within the time specified above or who have had essential 113.12 community provider status for three years, medical assistance 113.13 payments for health services provided by these entities shall be 113.14 according to the same rates and conditions applicable to the 113.15 same service provided by health care providers that are not 113.16 federally qualified health centers or rural health clinics. 113.17 (d) Effective July 1, 1999, the provisions of paragraph (c) 113.18 requiring a federally qualified health center or a rural health 113.19 clinic to make application for an essential community provider 113.20 designation in order to have cost-based payments made according 113.21 to paragraphs (a) and (b) no longer apply. 113.22 (e) Effective January 1, 2000, payments made according to 113.23 paragraphs (a) and (b) shall be limited to the cost phase-out 113.24 schedule of the Balanced Budget Act of 1997. 113.25 (f) Effective January 1, 2001, each federally qualified 113.26 health center and rural health clinic may elect to be paid 113.27 either under the prospective payment system established in 113.28 United States Code, title 42, section 1396a(aa) or under an 113.29 alternative payment methodology consistent with the requirements 113.30 of United States Code, title 42, section 1396a(aa) and approved 113.31 by the Health Care Financing Administration. The alternative 113.32 payment methodology shall be 100 percent of cost as determined 113.33 according to Medicare cost principles. 113.34 Sec. 38. Minnesota Statutes 2000, section 256B.0625, 113.35 subdivision 34, is amended to read: 113.36 Subd. 34. [INDIAN HEALTH SERVICES FACILITIES.] Medical 114.1 assistance payments and MinnesotaCare payments to facilities of 114.2 the Indian health service and facilities operated by a tribe or 114.3 tribal organization under funding authorized by United States 114.4 Code, title 25, sections 450f to 450n, or title III of the 114.5 Indian Self-Determination and Education Assistance Act, Public 114.6 Law Number 93-638, for enrollees who are eligible for federal 114.7 financial participation, shall be at the option of the facility 114.8 in accordance with the rate published by the United States 114.9 Assistant Secretary for Health under the authority of United 114.10 States Code, title 42, sections 248(a) and 249(b). General 114.11 assistance medical care payments to facilities of the Indian 114.12 health services and facilities operated by a tribe or tribal 114.13 organization for the provision of outpatient medical care 114.14 services billed after June 30, 1990, must be in accordance with 114.15 the general assistance medical care rates paid for the same 114.16 services when provided in a facility other than a facility of 114.17 the Indian health service or a facility operated by a tribe or 114.18 tribal organization. MinnesotaCare payments for enrollees who 114.19 are not eligible for federal financial participation at 114.20 facilities of the Indian Health Service and facilities operated 114.21 by a tribe or tribal organization for the provision of 114.22 outpatient medical services must be in accordance with the 114.23 medical assistance rates paid for the same services when 114.24 provided in a facility other than a facility of the Indian 114.25 Health Service or a facility operated by a tribe or tribal 114.26 organization. 114.27 [EFFECTIVE DATE.] This section is effective the day 114.28 following final enactment. 114.29 Sec. 39. Minnesota Statutes 2000, section 256B.0625, is 114.30 amended by adding a subdivision to read: 114.31 Subd. 43. [TARGETED CASE MANAGEMENT SERVICES.] Medical 114.32 assistance covers case management services for vulnerable adults 114.33 and persons with developmental disabilities not receiving home 114.34 and community-based waiver services. 114.35 Sec. 40. Minnesota Statutes 2000, section 256B.0635, 114.36 subdivision 1, is amended to read: 115.1 Subdivision 1. [INCREASED EMPLOYMENT.]Beginning January115.21, 1998(a) Until June 30, 2002, medical assistance may be paid 115.3 for persons who received MFIP-S or medical assistance for 115.4 families and children in at least three of six months preceding 115.5 the month in which the person became ineligible for MFIP-S or 115.6 medical assistance, if the ineligibility was due to an increase 115.7 in hours of employment or employment income or due to the loss 115.8 of an earned income disregard. In addition, to receive 115.9 continued assistance under this section, persons who received 115.10 medical assistance for families and children but did not receive 115.11 MFIP-S must have had income less than or equal to the assistance 115.12 standard for their family size under the state's AFDC plan in 115.13 effect as of July 16, 1996,as required by the Personal115.14Responsibility and Work Opportunity Reconciliation Act of 1996115.15(PRWORA), Public Law Number 104-193,increased by three percent 115.16 effective July 1, 2000, at the time medical assistance 115.17 eligibility began. A person who is eligible for extended 115.18 medical assistance is entitled to six months of assistance 115.19 without reapplication, unless the assistance unit ceases to 115.20 include a dependent child. For a person under 21 years of age, 115.21 medical assistance may not be discontinued within the six-month 115.22 period of extended eligibility until it has been determined that 115.23 the person is not otherwise eligible for medical assistance. 115.24 Medical assistance may be continued for an additional six months 115.25 if the person meets all requirements for the additional six 115.26 months, according to title XIX of the Social Security Act, as 115.27 amended by section 303 of the Family Support Act of 1988, Public 115.28 Law Number 100-485. 115.29 (b) Beginning July 1, 2002, medical assistance for families 115.30 and children may be paid for persons who were eligible under 115.31 section 256B.055, subdivision 3a, in at least three of six 115.32 months preceding the month in which the person became ineligible 115.33 under that section if the ineligibility was due to an increase 115.34 in hours of employment or employment income or due to the loss 115.35 of an earned income disregard. A person who is eligible for 115.36 extended medical assistance is entitled to six months of 116.1 assistance without reapplication, unless the assistance unit 116.2 ceases to include a dependent child, except medical assistance 116.3 may not be discontinued for that dependent child under 21 years 116.4 of age within the six-month period of extended eligibility until 116.5 it has been determined that the person is not otherwise eligible 116.6 for medical assistance. Medical assistance may be continued for 116.7 an additional six months if the person meets all requirements 116.8 for the additional six months, according to title XIX of the 116.9 Social Security Act, as amended by section 303 of the Family 116.10 Support Act of 1988, Public Law Number 100-485. 116.11 [EFFECTIVE DATE.] This section is effective July 1, 2001. 116.12 Sec. 41. Minnesota Statutes 2000, section 256B.0635, 116.13 subdivision 2, is amended to read: 116.14 Subd. 2. [INCREASED CHILD OR SPOUSAL SUPPORT.]Beginning116.15January 1, 1998(a) Until June 30, 2002, medical assistance may 116.16 be paid for persons who received MFIP-S or medical assistance 116.17 for families and children in at least three of the six months 116.18 preceding the month in which the person became ineligible for 116.19 MFIP-S or medical assistance, if the ineligibility was the 116.20 result of the collection of child or spousal support under part 116.21 D of title IV of the Social Security Act. In addition, to 116.22 receive continued assistance under this section, persons who 116.23 received medical assistance for families and children but did 116.24 not receive MFIP-S must have had income less than or equal to 116.25 the assistance standard for their family size under the state's 116.26 AFDC plan in effect as of July 16, 1996,as required by the116.27Personal Responsibility and Work Opportunity Reconciliation Act116.28of 1996 (PRWORA), Public Law Number 104-193increased by three 116.29 percent effective July 1, 2000, at the time medical assistance 116.30 eligibility began. A person who is eligible for extended 116.31 medical assistance under this subdivision is entitled to four 116.32 months of assistance without reapplication, unless the 116.33 assistance unit ceases to include a dependent child. For a116.34person under 21 years of age, except medical assistance may not 116.35 be discontinued for that dependent child under 21 years of age 116.36 within the four-month period of extended eligibility until it 117.1 has been determined that the person is not otherwise eligible 117.2 for medical assistance. 117.3 (b) Beginning July 1, 2002, medical assistance for families 117.4 and children may be paid for persons who were eligible under 117.5 section 256B.055, subdivision 3a, in at least three of the six 117.6 months preceding the month in which the person became ineligible 117.7 under that section if the ineligibility was the result of the 117.8 collection of child or spousal support under part D of title IV 117.9 of the Social Security Act. A person who is eligible for 117.10 extended medical assistance under this subdivision is entitled 117.11 to four months of assistance without reapplication, unless the 117.12 assistance unit ceases to include a dependent child, except 117.13 medical assistance may not be discontinued for that dependent 117.14 child under 21 years of age within the four-month period of 117.15 extended eligibility until it has been determined that the 117.16 person is not otherwise eligible for medical assistance. 117.17 [EFFECTIVE DATE.] This section is effective July 1, 2001. 117.18 Sec. 42. [256B.0637] [PRESUMPTIVE ELIGIBILITY FOR CERTAIN 117.19 PERSONS NEEDING TREATMENT FOR BREAST OR CERVICAL CANCER.] 117.20 Medical assistance is available during a presumptive 117.21 eligibility period for persons who meet the criteria in section 117.22 256B.057, subdivision 10. For purposes of this section, the 117.23 presumptive eligibility period begins on the date on which an 117.24 entity designated by the commissioner determines, based on 117.25 preliminary information, that the person meets the criteria in 117.26 section 256B.057, subdivision 10. The presumptive eligibility 117.27 period ends on the day on which a determination is made as to 117.28 the person's eligibility, except that if an application is not 117.29 submitted by the last day of the month following the month 117.30 during which the determination based on preliminary information 117.31 is made, the presumptive eligibility period ends on that last 117.32 day of the month. 117.33 [EFFECTIVE DATE.] This section is effective July 1, 2002. 117.34 Sec. 43. Minnesota Statutes 2000, section 256B.0644, is 117.35 amended to read: 117.36 256B.0644 [PARTICIPATION REQUIRED FOR REIMBURSEMENT UNDER 118.1 OTHER STATE HEALTH CARE PROGRAMS.] 118.2 A vendor of medical care, as defined in section 256B.02, 118.3 subdivision 7, and a health maintenance organization, as defined 118.4 in chapter 62D, must participate as a provider or contractor in 118.5 the medical assistance program, general assistance medical care 118.6 program, and MinnesotaCare as a condition of participating as a 118.7 provider in health insurance plans and programs or contractor 118.8 for state employees established under section 43A.18, the public 118.9 employees insurance program under section 43A.316, for health 118.10 insurance plans offered to local statutory or home rule charter 118.11 city, county, and school district employees, the workers' 118.12 compensation system under section 176.135, and insurance plans 118.13 provided through the Minnesota comprehensive health association 118.14 under sections 62E.01 to 62E.19. The limitations on insurance 118.15 plans offered to local government employees shall not be 118.16 applicable in geographic areas where provider participation is 118.17 limited by managed care contracts with the department of human 118.18 services. For providers other than health maintenance 118.19 organizations, participation in the medical assistance program 118.20 means that (1) the provider accepts new medical assistance, 118.21 general assistance medical care, and MinnesotaCare patients or 118.22 (2) at least 20 percent of the provider's patients are covered 118.23 by medical assistance, general assistance medical care, and 118.24 MinnesotaCare as their primary source of coverage. Patients 118.25 seen on a volunteer basis by the provider at a location other 118.26 than the provider's usual place of practice may be considered in 118.27 meeting this participation requirement. The commissioner shall 118.28 establish participation requirements for health maintenance 118.29 organizations. The commissioner shall provide lists of 118.30 participating medical assistance providers on a quarterly basis 118.31 to the commissioner of employee relations, the commissioner of 118.32 labor and industry, and the commissioner of commerce. Each of 118.33 the commissioners shall develop and implement procedures to 118.34 exclude as participating providers in the program or programs 118.35 under their jurisdiction those providers who do not participate 118.36 in the medical assistance program. The commissioner of employee 119.1 relations shall implement this section through contracts with 119.2 participating health and dental carriers. 119.3 Sec. 44. [256B.0924] [TARGETED CASE MANAGEMENT SERVICES 119.4 FOR VULNERABLE ADULTS AND PERSONS WITH DEVELOPMENTAL 119.5 DISABILITIES.] 119.6 Subdivision 1. [PURPOSE.] The state recognizes that 119.7 targeted case management services can decrease the need for more 119.8 costly services such as multiple emergency room visits or 119.9 hospitalizations by linking eligible individuals with less 119.10 costly services available in the community. 119.11 Subd. 2. [DEFINITIONS.] For purposes of this section, the 119.12 following terms have the meanings given: 119.13 (a) "Targeted case management" means services which will 119.14 assist medical assistance eligible persons to gain access to 119.15 needed medical, social, educational, and other services. 119.16 Targeted case management does not include therapy, treatment, 119.17 legal, or outreach services. 119.18 (b) "Targeted case management for adults" means activities 119.19 that coordinate and link social and other services designed to 119.20 help eligible persons gain access to needed protective services, 119.21 social, health care, mental health, habilitative, educational, 119.22 vocational, recreational, advocacy, legal, chemical, health, and 119.23 other related services. 119.24 Subd. 3. [ELIGIBILITY.] Persons are eligible to receive 119.25 targeted case management services under this section if the 119.26 requirements in paragraphs (a) and (b) are met. 119.27 (a) The person must be assessed and determined by the local 119.28 county agency to: 119.29 (1) be age 18 or older; 119.30 (2) be receiving medical assistance; 119.31 (3) have significant functional limitations; and 119.32 (4) be in need of service coordination to attain or 119.33 maintain living in an integrated community setting. 119.34 (b) The person must be a vulnerable adult in need of adult 119.35 protection as defined in section 626.5572, or is an adult with 119.36 mental retardation as defined in section 252A.02, subdivision 2, 120.1 or a related condition as defined in section 252.27, subdivision 120.2 1a, and is not receiving home and community-based waiver 120.3 services. 120.4 Subd. 4. [TARGETED CASE MANAGEMENT SERVICE 120.5 ACTIVITIES.] (a) For persons with mental retardation or a 120.6 related condition, targeted case management services must meet 120.7 the provisions of section 256B.092. 120.8 (b) For persons not eligible as a person with mental 120.9 retardation or a related condition, targeted case management 120.10 service activities include: 120.11 (1) an assessment of the person's need for targeted case 120.12 management services; 120.13 (2) the development of a written personal service plan; 120.14 (3) a regular review and revision of the written personal 120.15 service plan with the recipient and the recipient's legal 120.16 representative, and others as identified by the recipient, to 120.17 ensure access to necessary services and supports identified in 120.18 the plan; 120.19 (4) effective communication with the recipient and the 120.20 recipient's legal representative and others identified by the 120.21 recipient; 120.22 (5) coordination of referrals for needed services with 120.23 qualified providers; 120.24 (6) coordination and monitoring of the overall service 120.25 delivery to ensure the quality and effectiveness of services; 120.26 (7) assistance to the recipient and the recipient's legal 120.27 representative to help make an informed choice of services; 120.28 (8) advocating on behalf of the recipient when service 120.29 barriers are encountered or referring the recipient and the 120.30 recipient's legal representative to an independent advocate; 120.31 (9) monitoring and evaluating services identified in the 120.32 personal service plan to ensure personal outcomes are met and to 120.33 ensure satisfaction with services and service delivery; 120.34 (10) conducting face-to-face monitoring with the recipient 120.35 at least twice a year; 120.36 (11) completing and maintain necessary documentation that 121.1 supports verifies the activities in this section; 121.2 (12) coordinating with the medical assistance facility 121.3 discharge planner in the 180-day period prior to the recipient's 121.4 discharge into the community; and 121.5 (13) a personal service plan developed and reviewed at 121.6 least annually with the recipient and the recipient's legal 121.7 representative. The personal service plan must be revised when 121.8 there is a change in the recipient's status. The personal 121.9 service plan must identify: 121.10 (i) the desired personal short and long-term outcomes; 121.11 (ii) the recipient's preferences for services and supports, 121.12 including development of a person-centered plan if requested; 121.13 and 121.14 (iii) formal and informal services and supports based on 121.15 areas of assessment, such as: social, health, mental health, 121.16 residence, family, educational and vocational, safety, legal, 121.17 self-determination, financial, and chemical health as determined 121.18 by the recipient and the recipient's legal representative and 121.19 the recipient's support network. 121.20 Subd. 5. [PROVIDER STANDARDS.] County boards or providers 121.21 who contract with the county are eligible to receive medical 121.22 assistance reimbursement for adult targeted case management 121.23 services. To qualify as a provider of targeted case management 121.24 services the vendor must: 121.25 (1) have demonstrated the capacity and experience to 121.26 provide the activities of case management services defined in 121.27 subdivision 4; 121.28 (2) be able to coordinate and link community resources 121.29 needed by the recipient; 121.30 (3) have the administrative capacity and experience to 121.31 serve the eligible population in providing services and to 121.32 ensure quality of services under state and federal requirements; 121.33 (4) have a financial management system that provides 121.34 accurate documentation of services and costs under state and 121.35 federal requirements; 121.36 (5) have the capacity to document and maintain individual 122.1 case records complying with state and federal requirements; 122.2 (6) coordinate with county social service agencies 122.3 responsible for planning for community social services under 122.4 chapters 256E and 256F; conducting adult protective 122.5 investigations under section 626.557, and conducting prepetition 122.6 screenings for commitments under section 253B.07; 122.7 (7) coordinate with health care providers to ensure access 122.8 to necessary health care services; 122.9 (8) have a procedure in place that notifies the recipient 122.10 and the recipient's legal representative of any conflict of 122.11 interest if the contracted targeted case management service 122.12 provider also provides the recipient's services and supports and 122.13 provides information on all potential conflicts of interest and 122.14 obtains the recipient's informed consent and provides the 122.15 recipient with alternatives; and 122.16 (9) have demonstrated the capacity to achieve the following 122.17 performance outcomes: access, quality, and consumer 122.18 satisfaction. 122.19 Subd. 6. [PAYMENT FOR TARGETED CASE MANAGEMENT.] (a) 122.20 Medical assistance and MinnesotaCare payment for targeted case 122.21 management shall be made on a monthly basis. In order to 122.22 receive payment for an eligible adult, the provider must 122.23 document at least one contact per month and not more than two 122.24 consecutive months without a face-to-face contact with the adult 122.25 or the adult's legal representative. 122.26 (b) Payment for targeted case management provided by county 122.27 staff under this subdivision shall be based on the monthly rate 122.28 methodology under section 256B.094, subdivision 6, paragraph 122.29 (b), calculated as one combined average rate together with adult 122.30 mental health case management under section 256B.0625, 122.31 subdivision 20, except for calendar year 2002. In calendar year 122.32 2002, the rate for case management under this section shall be 122.33 the same as the rate for adult mental health case management in 122.34 effect as of December 31, 2001. Billing and payment must 122.35 identify the recipient's primary population group to allow 122.36 tracking of revenues. 123.1 (c) Payment for targeted case management provided by 123.2 county-contracted vendors shall be based on a monthly rate 123.3 negotiated by the host county. The negotiated rate must not 123.4 exceed the rate charged by the vendor for the same service to 123.5 other payers. If the service is provided by a team of 123.6 contracted vendors, the county may negotiate a team rate with a 123.7 vendor who is a member of the team. The team shall determine 123.8 how to distribute the rate among its members. No reimbursement 123.9 received by contracted vendors shall be returned to the county, 123.10 except to reimburse the county for advance funding provided by 123.11 the county to the vendor. 123.12 (d) If the service is provided by a team that includes 123.13 contracted vendors and county staff, the costs for county staff 123.14 participation on the team shall be included in the rate for 123.15 county-provided services. In this case, the contracted vendor 123.16 and the county may each receive separate payment for services 123.17 provided by each entity in the same month. In order to prevent 123.18 duplication of services, the county must document, in the 123.19 recipient's file, the need for team targeted case management and 123.20 a description of the different roles of the team members. 123.21 (e) Notwithstanding section 256B.19, subdivision 1, the 123.22 nonfederal share of costs for targeted case management shall be 123.23 provided by the recipient's county of responsibility, as defined 123.24 in sections 256G.01 to 256G.12, from sources other than federal 123.25 funds or funds used to match other federal funds. 123.26 (f) The commissioner may suspend, reduce, or terminate 123.27 reimbursement to a provider that does not meet the reporting or 123.28 other requirements of this section. The county of 123.29 responsibility, as defined in sections 256G.01 to 256G.12, is 123.30 responsible for any federal disallowances. The county may share 123.31 this responsibility with its contracted vendors. 123.32 (g) The commissioner shall set aside five percent of the 123.33 federal funds received under this section for use in reimbursing 123.34 the state for costs of developing and implementing this section. 123.35 (h) Notwithstanding section 256.025, subdivision 2, 123.36 payments to counties for targeted case management expenditures 124.1 under this section shall only be made from federal earnings from 124.2 services provided under this section. Payments to contracted 124.3 vendors shall include both the federal earnings and the county 124.4 share. 124.5 (i) Notwithstanding section 256B.041, county payments for 124.6 the cost of case management services provided by county staff 124.7 shall not be made to the state treasurer. For the purposes of 124.8 targeted case management services provided by county staff under 124.9 this section, the centralized disbursement of payments to 124.10 counties under section 256B.041 consists only of federal 124.11 earnings from services provided under this section. 124.12 (j) If the recipient is a resident of a nursing facility, 124.13 intermediate care facility, or hospital, and the recipient's 124.14 institutional care is paid by medical assistance, payment for 124.15 targeted case management services under this subdivision is 124.16 limited to the last 180 days of the recipient's residency in 124.17 that facility and may not exceed more than six months in a 124.18 calendar year. 124.19 (k) Payment for targeted case management services under 124.20 this subdivision shall not duplicate payments made under other 124.21 program authorities for the same purpose. 124.22 (l) Any growth in targeted case management services and 124.23 cost increases under this section shall be the responsibility of 124.24 the counties. 124.25 Subd. 7. [IMPLEMENTATION AND EVALUATION.] The commissioner 124.26 of human services in consultation with county boards shall 124.27 establish a program to accomplish the provisions of subdivisions 124.28 1 to 6. The commissioner in consultation with county boards 124.29 shall establish performance measures to evaluate the 124.30 effectiveness of the targeted case management services. If a 124.31 county fails to meet agreed upon performance measures, the 124.32 commissioner may authorize contracted providers other than the 124.33 county. Providers contracted by the commissioner shall also be 124.34 subject to the standards in subdivision 6. 124.35 [EFFECTIVE DATE.] This section is effective January 1, 2002. 124.36 Sec. 45. Minnesota Statutes 2000, section 256B.19, 125.1 subdivision 1c, is amended to read: 125.2 Subd. 1c. [ADDITIONAL PORTION OF NONFEDERAL SHARE.]In125.3addition to any payment required under subdivision 1b,(a) 125.4 Hennepin county shall be responsible for a monthly transfer 125.5 payment of $1,500,000, due before noon on the 15th of each month 125.6 and the University of Minnesota shall be responsible for a 125.7 monthly transfer payment of $500,000 due before noon on the 15th 125.8 of each month, beginning July 15, 1995. These sums shall be 125.9 part of the designated governmental unit's portion of the 125.10 nonfederal share of medical assistance costs, but shall not be 125.11 subject to payback provisions of section 256.025. 125.12 (b) Beginning July 1, 2001, Hennepin county's payment under 125.13 paragraph (a) shall be $2,066,000 each month. 125.14 (c) Beginning July 1, 2001, the commissioner shall increase 125.15 annual capitation payments to metropolitan health plan under 125.16 section 256B.69 for the prepaid medical assistance program by 125.17 approximately $3,400,000, plus any available federal matching 125.18 funds, to recognize higher than average medical education costs. 125.19 Sec. 46. [256B.195] [ADDITIONAL INTERGOVERNMENTAL 125.20 TRANSFERS; HOSPITAL PAYMENTS.] 125.21 Subdivision 1. [FEDERAL APPROVAL REQUIRED.] Sections 125.22 145.9268, 256.969, subdivision 26, and this section are 125.23 contingent on federal approval of the intergovernmental 125.24 transfers and payments to safety net hospitals and community 125.25 clinics authorized under this section. These sections are also 125.26 contingent on current payment, by the government entities, of 125.27 intergovernmental transfers under section 256B.19 and this 125.28 section. 125.29 Subd. 2. [PAYMENTS FROM GOVERNMENTAL ENTITIES.] (a) In 125.30 addition to any payment required under section 256B.19, 125.31 effective July 15, 2001, the following government entities shall 125.32 make the payments indicated before noon on the 15th of each 125.33 month: 125.34 (1) Hennepin county, $2,000,000; and 125.35 (2) Ramsey county, $1,000,000. 125.36 (b) These sums shall be part of the designated governmental 126.1 unit's portion of the nonfederal share of medical assistance 126.2 costs. Of these payments, Hennepin county shall pay 71 percent 126.3 directly to Hennepin County Medical Center, and Ramsey county 126.4 shall pay 71 percent directly to Regions hospital. The counties 126.5 must provide certification to the commissioner of payments to 126.6 hospitals under this subdivision. 126.7 Subd. 3. [PAYMENTS TO CERTAIN SAFETY NET PROVIDERS.] (a) 126.8 Effective July 15, 2001, the commissioner shall make the 126.9 following payments to the hospitals indicated after noon on the 126.10 15th of each month: 126.11 (1) to Hennepin County Medical Center, any federal matching 126.12 funds available to match the payments received by the medical 126.13 center under subdivision 2, to increase payments for medical 126.14 assistance admissions and to recognize higher medical assistance 126.15 costs in institutions that provide high levels of charity care; 126.16 and 126.17 (2) to Regions hospital, any federal matching funds 126.18 available to match the payments received by the hospital under 126.19 subdivision 2, to increase payments for medical assistance 126.20 admissions and to recognize higher medical assistance costs in 126.21 institutions that provide high levels of charity care. 126.22 (b) Effective July 15, 2001, the following percentages of 126.23 the transfers under subdivision 2 shall be retained by the 126.24 commissioner for deposit each month into the general fund: 126.25 (1) 18 percent, plus any federal matching funds, shall be 126.26 allocated for the following purposes: 126.27 (i) during the fiscal year beginning July 1, 2001, of the 126.28 amount available under this clause, 39.7 percent shall be 126.29 allocated to make increased hospital payments under section 126.30 256.969, subdivision 26; 34.2 percent shall be allocated to fund 126.31 the amounts due from small rural hospitals, as defined in 126.32 section 144.148, for overpayments under section 256.969, 126.33 subdivision 5a, resulting from a determination that medical 126.34 assistance and general assistance payments exceeded the charge 126.35 limit during the period from 1994 to 1997; and 26.1 percent 126.36 shall be allocated to the commissioner of health for rural 127.1 hospital capital improvement grants under section 144.148; and 127.2 (ii) during fiscal years beginning on or after July 1, 127.3 2002, of the amount available under this clause, 55 percent 127.4 shall be allocated to make increased hospital payments under 127.5 section 256.969, subdivision 26, and 45 percent shall be 127.6 allocated to the commissioner of health for rural hospital 127.7 capital improvement grants under section 144.148; and 127.8 (2) 11 percent shall be allocated to the commissioner of 127.9 health to fund community clinic grants under section 145.9268. 127.10 (c) This subdivision shall apply to fee-for-service 127.11 payments only and shall not increase capitation payments or 127.12 payments made based on average rates. 127.13 (d) Medical assistance rate or payment changes, including 127.14 those required to obtain federal financial participation under 127.15 section 62J.692, subdivision 8, shall precede the determination 127.16 of intergovernmental transfer amounts determined in this 127.17 subdivision. Participation in the intergovernmental transfer 127.18 program shall not result in the offset of any health care 127.19 provider's receipt of medical assistance payment increases other 127.20 than limits resulting from hospital-specific charge limits and 127.21 limits on disproportionate share hospital payments. 127.22 Subd. 4. [ADJUSTMENTS PERMITTED.] (a) The commissioner may 127.23 adjust the intergovernmental transfers under subdivision 2 and 127.24 the payments under subdivision 3, and payments and transfers 127.25 under subdivision 5, based on the commissioner's determination 127.26 of Medicare upper payment limits, hospital-specific charge 127.27 limits, and hospital-specific limitations on disproportionate 127.28 share payments. Any adjustments must be made on a proportional 127.29 basis. If participation by a particular hospital under this 127.30 section is limited, the commissioner shall adjust the payments 127.31 that relate to that hospital under subdivisions 2, 3, and 5 on a 127.32 proportional basis in order to allow the hospital to participate 127.33 under this section to the fullest extent possible and shall 127.34 increase other payments under subdivisions 2, 3, and 5 to the 127.35 extent allowable to maintain the overall level of payments under 127.36 this section. The commissioner may make adjustments under this 128.1 subdivision only after consultation with the counties and 128.2 hospitals identified in subdivisions 2 and 3, and, if 128.3 subdivision 5 receives federal approval, with the hospital and 128.4 educational institution identified in subdivision 5. 128.5 (b) The ratio of medical assistance payments specified in 128.6 subdivision 3 to the intergovernmental transfers specified in 128.7 subdivision 2 shall not be reduced except as provided under 128.8 paragraph (a). 128.9 Subd. 5. [INCLUSION OF FAIRVIEW UNIVERSITY MEDICAL 128.10 CENTER.] (a) Upon federal approval of the inclusion of Fairview 128.11 university medical center in the nonstate government category, 128.12 the commissioner shall establish an intergovernmental transfer 128.13 with the University of Minnesota in an amount determined by the 128.14 commissioner based on the increase in the Medicare upper payment 128.15 limit due solely to the inclusion of Fairview university medical 128.16 center as a nonstate government hospital and limited by 128.17 hospital-specific charge limits and the amount available under 128.18 the hospital-specific disproportionate share limit. 128.19 (b) The commissioner shall increase payments for medical 128.20 assistance admissions at Fairview University Medical Center by 128.21 71 percent of the transfer plus any federal matching payments on 128.22 that amount, to increase payments for medical assistance 128.23 admissions and to recognize higher medical assistance costs in 128.24 institutions that provide high levels of charity care. From 128.25 this payment, Fairview University Medical Center shall pay to 128.26 the University of Minnesota the cost of the transfer, on the 128.27 same day the payment is received. Eighteen percent of the 128.28 transfer plus any federal matching payments shall be used as 128.29 specified in subdivision 3, paragraph (b), clause (1). Payments 128.30 under section 256.969, subdivision 26, may be increased above 128.31 the 90 percent level specified in that subdivision within the 128.32 limits of additional funding available under this subdivision. 128.33 Eleven percent of the transfer shall be used to increase the 128.34 grants under section 145.9268. 128.35 Sec. 47. [256B.53] [DENTAL ACCESS GRANTS.] 128.36 (a) The commissioner shall award grants to community 129.1 clinics or other nonprofit community organizations, political 129.2 subdivisions, professional associations, or other organizations 129.3 that demonstrate the ability to provide dental services 129.4 effectively to public program recipients. Grants may be used to 129.5 fund the costs related to coordinating access for recipients, 129.6 developing and implementing patient care criteria, upgrading or 129.7 establishing new facilities, acquiring furnishings or equipment, 129.8 recruiting new providers, or other development costs that will 129.9 improve access to dental care in a region. 129.10 (b) In awarding grants, the commissioner shall give 129.11 priority to applicants that plan to serve areas of the state in 129.12 which the number of dental providers is not currently sufficient 129.13 to meet the needs of recipients of public programs or uninsured 129.14 individuals. The commissioner shall consider the following in 129.15 awarding the grants: 129.16 (1) potential to successfully increase access to an 129.17 underserved population; 129.18 (2) the long-term viability of the project to improve 129.19 access beyond the period of initial funding; 129.20 (3) the efficiency in the use of the funding; and 129.21 (4) the experience of the applicants in providing services 129.22 to the target population. 129.23 (c) The commissioner shall consider grants for the 129.24 following: 129.25 (1) implementation of new programs or continued expansion 129.26 of current access programs that have demonstrated success in 129.27 providing dental services in underserved areas; 129.28 (2) a program for mobile or other types of outreach dental 129.29 clinics in underserved geographic areas; 129.30 (3) a program for school-based dental clinics in schools 129.31 with high numbers of children receiving medical assistance; 129.32 (4) a program testing new models of care that are sensitive 129.33 to the cultural needs of the recipients; 129.34 (5) a program creating new educational campaigns that 129.35 inform individuals of the importance of good oral health and the 129.36 link between dental disease and overall health status; 130.1 (6) a program that organizes a network of volunteer 130.2 dentists to provide dental services to public program recipients 130.3 or uninsured individuals; and 130.4 (7) a program that tests new delivery models by creating 130.5 partnerships between local providers and county public health 130.6 agencies. 130.7 (d) The commissioner shall evaluate the effects of the 130.8 dental access initiatives funded through the dental access 130.9 grants and submit a report to the legislature by January 15, 130.10 2003. 130.11 Sec. 48. [256B.55] [DENTAL ACCESS ADVISORY COMMITTEE.] 130.12 Subdivision 1. [ESTABLISHMENT.] The commissioner shall 130.13 establish a dental access advisory committee to monitor the 130.14 purchasing, administration, and coverage of dental care services 130.15 for the public health care programs to ensure dental care access 130.16 and quality for public program recipients. 130.17 Subd. 2. [MEMBERSHIP.] (a) The membership of the advisory 130.18 committee shall include, but is not limited to, representatives 130.19 of dentists, including a dentist practicing in the seven-county 130.20 metropolitan area and a dentist practicing outside the 130.21 seven-county metropolitan area; oral surgeons; pediatric 130.22 dentists; dental hygienists; community clinics; client advocacy 130.23 groups; public health; health service plans; the University of 130.24 Minnesota school of dentistry and the department of pediatrics; 130.25 and the commissioner of health. 130.26 (b) The advisory committee is governed by section 15.059 130.27 for membership terms and removal of members. Members shall not 130.28 receive per diem compensation or reimbursement for expenses. 130.29 Subd. 3. [DUTIES.] The advisory committee shall provide 130.30 recommendations on the following: 130.31 (1) how to reduce the administrative burden governing 130.32 dental care coverage policies in order to promote administrative 130.33 simplification, including prior authorization, coverage limits, 130.34 and co-payment collections; 130.35 (2) developing and implementing an action plan to improve 130.36 the oral health of children and persons with special needs in 131.1 the state; 131.2 (3) exploring alternative ways of purchasing and improving 131.3 access to dental services; 131.4 (4) developing ways to foster greater responsibility among 131.5 health care program recipients in seeking and obtaining dental 131.6 care, including initiatives to keep dental appointments and 131.7 comply with dental care plans; 131.8 (5) exploring innovative ways for dental providers to 131.9 schedule public program patients in order to reduce or minimize 131.10 the effect of appointment no shows; 131.11 (6) exploring ways to meet the barriers that may be present 131.12 in providing dental services to health care program recipients 131.13 such as language, culture, disability, and lack of 131.14 transportation; and 131.15 (7) exploring the possibility of pediatricians, family 131.16 physicians, and nurse practitioners providing basic oral health 131.17 screenings and basic preventive dental services. 131.18 Subd. 4. [REPORT.] The commissioner shall submit a report 131.19 by February 1, 2002, and by February 1, 2003, summarizing the 131.20 activities and recommendations of the advisory committee. 131.21 Subd. 5. [SUNSET.] Notwithstanding section 15.059, 131.22 subdivision 5, this section expires June 30, 2003. 131.23 Sec. 49. Minnesota Statutes 2000, section 256B.69, 131.24 subdivision 4, is amended to read: 131.25 Subd. 4. [LIMITATION OF CHOICE.] (a) The commissioner 131.26 shall develop criteria to determine when limitation of choice 131.27 may be implemented in the experimental counties. The criteria 131.28 shall ensure that all eligible individuals in the county have 131.29 continuing access to the full range of medical assistance 131.30 services as specified in subdivision 6. 131.31 (b) The commissioner shall exempt the following persons 131.32 from participation in the project, in addition to those who do 131.33 not meet the criteria for limitation of choice: 131.34 (1) persons eligible for medical assistance according to 131.35 section 256B.055, subdivision 1; 131.36 (2) persons eligible for medical assistance due to 132.1 blindness or disability as determined by the social security 132.2 administration or the state medical review team, unless: 132.3 (i) they are 65 years of age or older,; or 132.4 (ii) they reside in Itasca county or they reside in a 132.5 county in which the commissioner conducts a pilot project under 132.6 a waiver granted pursuant to section 1115 of the Social Security 132.7 Act; 132.8 (3) recipients who currently have private coverage through 132.9 a health maintenance organization; 132.10 (4) recipients who are eligible for medical assistance by 132.11 spending down excess income for medical expenses other than the 132.12 nursing facility per diem expense; 132.13 (5) recipients who receive benefits under the Refugee 132.14 Assistance Program, established under United States Code, title 132.15 8, section 1522(e); 132.16 (6) children who are both determined to be severely 132.17 emotionally disturbed and receiving case management services 132.18 according to section 256B.0625, subdivision 20;and132.19 (7) adults who are both determined to be seriously and 132.20 persistently mentally ill and received case management services 132.21 according to section 256B.0625, subdivision 20; and 132.22 (8) persons eligible for medical assistance according to 132.23 section 256B.057, subdivision 10. 132.24 Children under age 21 who are in foster placement may enroll in 132.25 the project on an elective basis. Individuals excluded under 132.26 clauses (6) and (7) may choose to enroll on an elective basis. 132.27 (c) The commissioner may allow persons with a one-month 132.28 spenddown who are otherwise eligible to enroll to voluntarily 132.29 enroll or remain enrolled, if they elect to prepay their monthly 132.30 spenddown to the state. 132.31 (d)Beginning on or after July 1, 1997,The commissioner 132.32 may require those individuals to enroll in the prepaid medical 132.33 assistance program who otherwise would have been excluded 132.34 under paragraph (b), clauses (1)and, (3), and (8), and under 132.35 Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L. 132.36 (e) Before limitation of choice is implemented, eligible 133.1 individuals shall be notified and after notification, shall be 133.2 allowed to choose only among demonstration providers. The 133.3 commissioner may assign an individual with private coverage 133.4 through a health maintenance organization, to the same health 133.5 maintenance organization for medical assistance coverage, if the 133.6 health maintenance organization is under contract for medical 133.7 assistance in the individual's county of residence. After 133.8 initially choosing a provider, the recipient is allowed to 133.9 change that choice only at specified times as allowed by the 133.10 commissioner. If a demonstration provider ends participation in 133.11 the project for any reason, a recipient enrolled with that 133.12 provider must select a new provider but may change providers 133.13 without cause once more within the first 60 days after 133.14 enrollment with the second provider. 133.15 [EFFECTIVE DATE.] This section is effective July 1, 2002. 133.16 Sec. 50. Minnesota Statutes 2000, section 256B.69, 133.17 subdivision 5c, is amended to read: 133.18 Subd. 5c. [MEDICAL EDUCATION AND RESEARCH FUND.] (a) 133.19Beginning in January 1999 and each year thereafter:133.20(1)The commissioner of human services shall transferan133.21amount equal to the reduction in the prepaid medical assistance133.22and prepaid general assistance medical care payments resulting133.23from clause (2), excluding nursing facility and elderly waiver133.24payments and demonstration projects operating under subdivision133.2523, to the medical education and research fund established under133.26section 62J.692;each year to the medical education and research 133.27 fund established under section 62J.692, the following: 133.28(2)(1) an amount equal to the reduction in the prepaid 133.29 medical assistance and prepaid general assistance medical care 133.30 payments as specified in this clause. Until January 1, 2002, 133.31 the county medical assistance and general assistance medical 133.32 care capitation base rate prior to plan specific adjustments and 133.33 after the regional rate adjustments under section 256B.69, 133.34 subdivision 5b,shall beis reduced 6.3 percent for Hennepin 133.35 county, two percent for the remaining metropolitan counties, and 133.36 no reduction for nonmetropolitan Minnesota counties; and after 134.1 January 1, 2002, the county medical assistance and general 134.2 assistance medical care capitation base rate prior to plan 134.3 specific adjustmentsshall beis reduced 6.3 percent for 134.4 Hennepin county, two percent for the remaining metropolitan 134.5 counties, and 1.6 percent for nonmetropolitan Minnesota 134.6 counties. Nursing facility and elderly waiver payments and 134.7 demonstration project payments operating under subdivision 23 134.8 are excluded from this reduction. The amount calculated under 134.9 this clause shall not be adjusted for periods already paid due 134.10 to subsequent changes to the capitation payments; and 134.11 (2) beginning July 1, 2001, $2,537,000 from the capitation 134.12 rates paid under this section plus any federal matching funds on 134.13 this amount. 134.14(3) the amount calculated under clause (1) shall not be134.15adjusted for subsequent changes to the capitation payments for134.16periods already paid.134.17 (b) This subdivision shall be effective upon approval of a 134.18 federal waiver which allows federal financial participation in 134.19 the medical education and research fund. 134.20 Sec. 51. Minnesota Statutes 2000, section 256B.69, is 134.21 amended by adding a subdivision to read: 134.22 Subd. 6c. [DENTAL SERVICES DEMONSTRATION PROJECT.] The 134.23 commissioner shall establish a dental services demonstration 134.24 project in Crow Wing, Todd, Morrison, Wadena, and Cass counties 134.25 for provision of dental services to medical assistance, general 134.26 assistance medical care, and MinnesotaCare recipients. The 134.27 commissioner may contract on a prospective per capita payment 134.28 basis for these dental services with an organization licensed 134.29 under chapter 62C, 62D, or 62N in accordance with section 134.30 256B.037 or may establish and administer a fee-for-service 134.31 system for the reimbursement of dental services. 134.32 Sec. 52. Minnesota Statutes 2000, section 256B.69, 134.33 subdivision 23, is amended to read: 134.34 Subd. 23. [ALTERNATIVE INTEGRATED LONG-TERM CARE SERVICES; 134.35 ELDERLY AND DISABLED PERSONS.] (a) The commissioner may 134.36 implement demonstration projects to create alternative 135.1 integrated delivery systems for acute and long-term care 135.2 services to elderly persons and persons with disabilities as 135.3 defined in section 256B.77, subdivision 7a, that provide 135.4 increased coordination, improve access to quality services, and 135.5 mitigate future cost increases. The commissioner may seek 135.6 federal authority to combine Medicare and Medicaid capitation 135.7 payments for the purpose of such demonstrations. Medicare funds 135.8 and services shall be administered according to the terms and 135.9 conditions of the federal waiver and demonstration provisions. 135.10 For the purpose of administering medical assistance funds, 135.11 demonstrations under this subdivision are subject to 135.12 subdivisions 1 to 22. The provisions of Minnesota Rules, parts 135.13 9500.1450 to 9500.1464, apply to these demonstrations, with the 135.14 exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, 135.15 subpart 1, items B and C, which do not apply to persons 135.16 enrolling in demonstrations under this section. An initial open 135.17 enrollment period may be provided. Persons who disenroll from 135.18 demonstrations under this subdivision remain subject to 135.19 Minnesota Rules, parts 9500.1450 to 9500.1464. When a person is 135.20 enrolled in a health plan under these demonstrations and the 135.21 health plan's participation is subsequently terminated for any 135.22 reason, the person shall be provided an opportunity to select a 135.23 new health plan and shall have the right to change health plans 135.24 within the first 60 days of enrollment in the second health 135.25 plan. Persons required to participate in health plans under 135.26 this section who fail to make a choice of health plan shall not 135.27 be randomly assigned to health plans under these demonstrations. 135.28 Notwithstanding section 256L.12, subdivision 5, and Minnesota 135.29 Rules, part 9505.5220, subpart 1, item A, if adopted, for the 135.30 purpose of demonstrations under this subdivision, the 135.31 commissioner may contract with managed care organizations, 135.32 including counties, to serve only elderly persons eligible for 135.33 medical assistance, elderly and disabled persons, or disabled 135.34 persons only. For persons with primary diagnoses of mental 135.35 retardation or a related condition, serious and persistent 135.36 mental illness, or serious emotional disturbance, the 136.1 commissioner must ensure that the county authority has approved 136.2 the demonstration and contracting design. Enrollment in these 136.3 projects for persons with disabilities shall be voluntaryuntil136.4July 1, 2001. The commissioner shall not implement any 136.5 demonstration project under this subdivision for persons with 136.6 primary diagnoses of mental retardation or a related condition, 136.7 serious and persistent mental illness, or serious emotional 136.8 disturbance, without approval of the county board of the county 136.9 in which the demonstration is being implemented. 136.10 Before implementation of a demonstration project for 136.11 disabled persons, the commissioner must provide information to 136.12 appropriate committees of the house of representatives and 136.13 senate and must involve representatives of affected disability 136.14 groups in the design of the demonstration projects. 136.15 (b) A nursing facility reimbursed under the alternative 136.16 reimbursement methodology in section 256B.434 may, in 136.17 collaboration with a hospital, clinic, or other health care 136.18 entity provide services under paragraph (a). The commissioner 136.19 shall amend the state plan and seek any federal waivers 136.20 necessary to implement this paragraph. 136.21 Sec. 53. Minnesota Statutes 2000, section 256B.75, is 136.22 amended to read: 136.23 256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 136.24 (a) For outpatient hospital facility fee payments for 136.25 services rendered on or after October 1, 1992, the commissioner 136.26 of human services shall pay the lower of (1) submitted charge, 136.27 or (2) 32 percent above the rate in effect on June 30, 1992, 136.28 except for those services for which there is a federal maximum 136.29 allowable payment. Effective for services rendered on or after 136.30 January 1, 2000, payment rates for nonsurgical outpatient 136.31 hospital facility fees and emergency room facility fees shall be 136.32 increased by eight percent over the rates in effect on December 136.33 31, 1999, except for those services for which there is a federal 136.34 maximum allowable payment. Services for which there is a 136.35 federal maximum allowable payment shall be paid at the lower of 136.36 (1) submitted charge, or (2) the federal maximum allowable 137.1 payment. Total aggregate payment for outpatient hospital 137.2 facility fee services shall not exceed the Medicare upper 137.3 limit. If it is determined that a provision of this section 137.4 conflicts with existing or future requirements of the United 137.5 States government with respect to federal financial 137.6 participation in medical assistance, the federal requirements 137.7 prevail. The commissioner may, in the aggregate, prospectively 137.8 reduce payment rates to avoid reduced federal financial 137.9 participation resulting from rates that are in excess of the 137.10 Medicare upper limitations. 137.11 (b) Notwithstanding paragraph (a), payment for outpatient, 137.12 emergency, and ambulatory surgery hospital facility fee services 137.13 for critical access hospitals designated under section 144.1483, 137.14 clause (11), shall be paid on a cost-based payment system that 137.15 is based on the cost-finding methods and allowable costs of the 137.16 Medicare program. 137.17 (c) Effective for services provided on or after July 1, 137.18 2002, rates that are based on the Medicare outpatient 137.19 prospective payment system shall be replaced by a budget neutral 137.20 prospective payment system that is derived using medical 137.21 assistance data. The commissioner shall provide a proposal to 137.22 the 2002 legislature to define and implement this provision. 137.23 Sec. 54. Minnesota Statutes 2000, section 256B.76, is 137.24 amended to read: 137.25 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 137.26 (a) Effective for services rendered on or after October 1, 137.27 1992, the commissioner shall make payments for physician 137.28 services as follows: 137.29 (1) payment for level one Health Care Finance 137.30 Administration's common procedural coding system (HCPCS) codes 137.31 titled "office and other outpatient services," "preventive 137.32 medicine new and established patient," "delivery, antepartum, 137.33 and postpartum care," "critical care,"Caesareancesarean 137.34 delivery and pharmacologic management provided to psychiatric 137.35 patients, and HCPCS level three codes for enhanced services for 137.36 prenatal high risk, shall be paid at the lower of (i) submitted 138.1 charges, or (ii) 25 percent above the rate in effect on June 30, 138.2 1992. If the rate on any procedure code within these categories 138.3 is different than the rate that would have been paid under the 138.4 methodology in section 256B.74, subdivision 2, then the larger 138.5 rate shall be paid; 138.6 (2) payments for all other services shall be paid at the 138.7 lower of (i) submitted charges, or (ii) 15.4 percent above the 138.8 rate in effect on June 30, 1992; 138.9 (3) all physician rates shall be converted from the 50th 138.10 percentile of 1982 to the 50th percentile of 1989, less the 138.11 percent in aggregate necessary to equal the above increases 138.12 except that payment rates for home health agency services shall 138.13 be the rates in effect on September 30, 1992; 138.14 (4) effective for services rendered on or after January 1, 138.15 2000, payment rates for physician and professional services 138.16 shall be increased by three percent over the rates in effect on 138.17 December 31, 1999, except for home health agency and family 138.18 planning agency services; and 138.19 (5) the increases in clause (4) shall be implemented 138.20 January 1, 2000, for managed care. 138.21 (b) Effective for services rendered on or after October 1, 138.22 1992, the commissioner shall make payments for dental services 138.23 as follows: 138.24 (1) dental services shall be paid at the lower of (i) 138.25 submitted charges, or (ii) 25 percent above the rate in effect 138.26 on June 30, 1992; 138.27 (2) dental rates shall be converted from the 50th 138.28 percentile of 1982 to the 50th percentile of 1989, less the 138.29 percent in aggregate necessary to equal the above increases; 138.30 (3) effective for services rendered on or after January 1, 138.31 2000, payment rates for dental services shall be increased by 138.32 three percent over the rates in effect on December 31, 1999; 138.33 (4) the commissioner shall award grants to community 138.34 clinics or other nonprofit community organizations, political 138.35 subdivisions, professional associations, or other organizations 138.36 that demonstrate the ability to provide dental services 139.1 effectively to public program recipients. Grants may be used to 139.2 fund the costs related to coordinating access for recipients, 139.3 developing and implementing patient care criteria, upgrading or 139.4 establishing new facilities, acquiring furnishings or equipment, 139.5 recruiting new providers, or other development costs that will 139.6 improve access to dental care in a region. In awarding grants, 139.7 the commissioner shall give priority to applicants that plan to 139.8 serve areas of the state in which the number of dental providers 139.9 is not currently sufficient to meet the needs of recipients of 139.10 public programs or uninsured individuals. The commissioner 139.11 shall consider the following in awarding the grants: (i) 139.12 potential to successfully increase access to an underserved 139.13 population; (ii) the ability to raise matching funds; (iii) the 139.14 long-term viability of the project to improve access beyond the 139.15 period of initial funding; (iv) the efficiency in the use of the 139.16 funding; and (v) the experience of the proposers in providing 139.17 services to the target population. 139.18 The commissioner shall monitor the grants and may terminate 139.19 a grant if the grantee does not increase dental access for 139.20 public program recipients. The commissioner shall consider 139.21 grants for the following: 139.22 (i) implementation of new programs or continued expansion 139.23 of current access programs that have demonstrated success in 139.24 providing dental services in underserved areas; 139.25 (ii) a pilot program for utilizing hygienists outside of a 139.26 traditional dental office to provide dental hygiene services; 139.27 and 139.28 (iii) a program that organizes a network of volunteer 139.29 dentists, establishes a system to refer eligible individuals to 139.30 volunteer dentists, and through that network provides donated 139.31 dental care services to public program recipients or uninsured 139.32 individuals. 139.33 (5) beginning October 1, 1999, the payment for tooth 139.34 sealants and fluoride treatments shall be the lower of (i) 139.35 submitted charge, or (ii) 80 percent of median 1997 charges;and139.36 (6) the increases listed in clauses (3) and (5) shall be 140.1 implemented January 1, 2000, for managed care; and 140.2 (7) effective for services provided on or after January 1, 140.3 2002, payment for diagnostic examinations and dental x-rays 140.4 provided to children under age 21 shall be the lower of (i) the 140.5 submitted charge, or (ii) 85 percent of median 1999 charges. 140.6 (c) Effective for dental services rendered on or after 140.7 January 1, 2002, the commissioner may, within the limits of 140.8 available appropriation, increase reimbursements to dentists and 140.9 dental clinics deemed by the commissioner to be critical access 140.10 dental providers. Reimbursement to a critical access dental 140.11 provider may be increased by not more than 50 percent above the 140.12 reimbursement rate that would otherwise be paid to the 140.13 provider. Payments to health plan companies shall be adjusted 140.14 to reflect increased reimbursements to critical access dental 140.15 providers as approved by the commissioner. In determining which 140.16 dentists and dental clinics shall be deemed critical access 140.17 dental providers, the commissioner shall review: 140.18 (1) the utilization rate in the service area in which the 140.19 dentist or dental clinic operates for dental services to 140.20 patients covered by medical assistance, general assistance 140.21 medical care, or MinnesotaCare as their primary source of 140.22 coverage; 140.23 (2) the level of services provided by the dentist or dental 140.24 clinic to patients covered by medical assistance, general 140.25 assistance medical care, or MinnesotaCare as their primary 140.26 source of coverage; and 140.27 (3) whether the level of services provided by the dentist 140.28 or dental clinic is critical to maintaining adequate levels of 140.29 patient access within the service area. 140.30 In the absence of a critical access dental provider in a service 140.31 area, the commissioner may designate a dentist or dental clinic 140.32 as a critical access dental provider if the dentist or dental 140.33 clinic is willing to provide care to patients covered by medical 140.34 assistance, general assistance medical care, or MinnesotaCare at 140.35 a level which significantly increases access to dental care in 140.36 the service area. 141.1 (d) An entity that operates both a Medicare certified 141.2 comprehensive outpatient rehabilitation facility and a facility 141.3 which was certified prior to January 1, 1993, that is licensed 141.4 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 141.5 whom at least 33 percent of the clients receiving rehabilitation 141.6 services in the most recent calendar year are medical assistance 141.7 recipients, shall be reimbursed by the commissioner for 141.8 rehabilitation services at rates that are 38 percent greater 141.9 than the maximum reimbursement rate allowed under paragraph (a), 141.10 clause (2), when those services are (1) provided within the 141.11 comprehensive outpatient rehabilitation facility and (2) 141.12 provided to residents of nursing facilities owned by the entity. 141.13 Sec. 55. [256B.78] [MEDICAL ASSISTANCE DEMONSTRATION 141.14 PROJECT FOR FAMILY PLANNING SERVICES.] 141.15 (a) The commissioner of human services shall establish a 141.16 medical assistance demonstration project to determine whether 141.17 improved access to coverage of prepregnancy family planning 141.18 services reduces medical assistance and MFIP costs. 141.19 (b) This section is effective upon federal approval of the 141.20 demonstration project. 141.21 Sec. 56. Minnesota Statutes 2000, section 256D.03, 141.22 subdivision 3, is amended to read: 141.23 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 141.24 (a) General assistance medical care may be paid for any person 141.25 who is not eligible for medical assistance under chapter 256B, 141.26 including eligibility for medical assistance based on a 141.27 spenddown of excess income according to section 256B.056, 141.28 subdivision 5, or MinnesotaCare as defined in paragraph (b), 141.29 except as provided in paragraph (c); and: 141.30 (1) who is receiving assistance under section 256D.05, 141.31 except for families with children who are eligible under 141.32 Minnesota family investment program-statewide (MFIP-S), who is 141.33 having a payment made on the person's behalf under sections 141.34 256I.01 to 256I.06, or who resides in group residential housing 141.35 as defined in chapter 256I and can meet a spenddown using the 141.36 cost of remedial services received through group residential 142.1 housing; or 142.2 (2)(i) who is a resident of Minnesota; and whose equity in 142.3 assets is not in excess of $1,000 per assistance unit. Exempt 142.4 assets, the reduction of excess assets, and the waiver of excess 142.5 assets must conform to the medical assistance program in chapter 142.6 256B, with the following exception: the maximum amount of 142.7 undistributed funds in a trust that could be distributed to or 142.8 on behalf of the beneficiary by the trustee, assuming the full 142.9 exercise of the trustee's discretion under the terms of the 142.10 trust, must be applied toward the asset maximum; and 142.11 (ii) who has countable income not in excess of the 142.12 assistance standards established in section 256B.056, 142.13 subdivision45c, paragraph (b), or whose excess income is spent 142.14 downaccording to section 256B.056, subdivision 5,to that 142.15 standard using a six-month budget period. The method for 142.16 calculating earned income disregards and deductions for a person 142.17 who resides with a dependent child under age 21 shall 142.18 followsection 256B.056, subdivision 1a. However, if a142.19disregard of $30 and one-third of the remainder has been applied142.20to the wage earner's income, the disregard shall not be applied142.21again until the wage earner's income has not been considered in142.22an eligibility determination for general assistance, general142.23assistance medical care, medical assistance, or MFIP-S for 12142.24consecutive monthsthe AFDC income disregard and deductions in 142.25 effect under the July 16, 1996, AFDC state plan. The earned 142.26 income and work expense deductions for a person who does not 142.27 reside with a dependent child under age 21 shall be the same as 142.28 the method used to determine eligibility for a person under 142.29 section 256D.06, subdivision 1, except the disregard of the 142.30 first $50 of earned income is not allowed; 142.31 (3) who would be eligible for medical assistance except 142.32 that the person resides in a facility that is determined by the 142.33 commissioner or the federal Health Care Financing Administration 142.34 to be an institution for mental diseases; or 142.35 (4) who is ineligible for medical assistance under chapter 142.36 256B or general assistance medical care under any other 143.1 provision of this section, and is receiving care and 143.2 rehabilitation services from a nonprofit center established to 143.3 serve victims of torture. These individuals are eligible for 143.4 general assistance medical care only for the period during which 143.5 they are receiving services from the center. During this period 143.6 of eligibility, individuals eligible under this clause shall not 143.7 be required to participate in prepaid general assistance medical 143.8 care. 143.9 (b) Beginning January 1, 2000, applicants or recipients who 143.10 meet all eligibility requirements of MinnesotaCare as defined in 143.11 sections 256L.01 to 256L.16, and are: 143.12 (i) adults with dependent children under 21 whose gross 143.13 family income is equal to or less than 275 percent of the 143.14 federal poverty guidelines; or 143.15 (ii) adults without children with earned income and whose 143.16 family gross income is between 75 percent of the federal poverty 143.17 guidelines and the amount set by section 256L.04, subdivision 7, 143.18 shall be terminated from general assistance medical care upon 143.19 enrollment in MinnesotaCare. 143.20 (c) For services rendered on or after July 1, 1997, 143.21 eligibility is limited to one month prior to application if the 143.22 person is determined eligible in the prior month. A 143.23 redetermination of eligibility must occur every 12 months. 143.24 Beginning January 1, 2000, Minnesota health care program 143.25 applications completed by recipients and applicants who are 143.26 persons described in paragraph (b), may be returned to the 143.27 county agency to be forwarded to the department of human 143.28 services or sent directly to the department of human services 143.29 for enrollment in MinnesotaCare. If all other eligibility 143.30 requirements of this subdivision are met, eligibility for 143.31 general assistance medical care shall be available in any month 143.32 during which a MinnesotaCare eligibility determination and 143.33 enrollment are pending. Upon notification of eligibility for 143.34 MinnesotaCare, notice of termination for eligibility for general 143.35 assistance medical care shall be sent to an applicant or 143.36 recipient. If all other eligibility requirements of this 144.1 subdivision are met, eligibility for general assistance medical 144.2 care shall be available until enrollment in MinnesotaCare 144.3 subject to the provisions of paragraph (e). 144.4 (d) The date of an initial Minnesota health care program 144.5 application necessary to begin a determination of eligibility 144.6 shall be the date the applicant has provided a name, address, 144.7 and social security number, signed and dated, to the county 144.8 agency or the department of human services. If the applicant is 144.9 unable to provide an initial application when health care is 144.10 delivered due to a medical condition or disability, a health 144.11 care provider may act on the person's behalf to complete the 144.12 initial application. The applicant must complete the remainder 144.13 of the application and provide necessary verification before 144.14 eligibility can be determined. The county agency must assist 144.15 the applicant in obtaining verification if necessary. On the 144.16 basis of information provided on the completed application, an 144.17 applicant who meets the following criteria shall be determined 144.18 eligible beginning in the month of application: 144.19 (1) has gross income less than 90 percent of the applicable 144.20 income standard; 144.21 (2) has liquid assets that total within $300 of the asset 144.22 standard; 144.23 (3) does not reside in a long-term care facility; and 144.24 (4) meets all other eligibility requirements. 144.25 The applicant must provide all required verifications within 30 144.26 days' notice of the eligibility determination or eligibility 144.27 shall be terminated. 144.28 (e) County agencies are authorized to use all automated 144.29 databases containing information regarding recipients' or 144.30 applicants' income in order to determine eligibility for general 144.31 assistance medical care or MinnesotaCare. Such use shall be 144.32 considered sufficient in order to determine eligibility and 144.33 premium payments by the county agency. 144.34 (f) General assistance medical care is not available for a 144.35 person in a correctional facility unless the person is detained 144.36 by law for less than one year in a county correctional or 145.1 detention facility as a person accused or convicted of a crime, 145.2 or admitted as an inpatient to a hospital on a criminal hold 145.3 order, and the person is a recipient of general assistance 145.4 medical care at the time the person is detained by law or 145.5 admitted on a criminal hold order and as long as the person 145.6 continues to meet other eligibility requirements of this 145.7 subdivision. 145.8 (g) General assistance medical care is not available for 145.9 applicants or recipients who do not cooperate with the county 145.10 agency to meet the requirements of medical assistance. General 145.11 assistance medical care is limited to payment of emergency 145.12 services only for applicants or recipients as described in 145.13 paragraph (b), whose MinnesotaCare coverage is denied or 145.14 terminated for nonpayment of premiums as required by sections 145.15 256L.06 and 256L.07. 145.16 (h) In determining the amount of assets of an individual, 145.17 there shall be included any asset or interest in an asset, 145.18 including an asset excluded under paragraph (a), that was given 145.19 away, sold, or disposed of for less than fair market value 145.20 within the 60 months preceding application for general 145.21 assistance medical care or during the period of eligibility. 145.22 Any transfer described in this paragraph shall be presumed to 145.23 have been for the purpose of establishing eligibility for 145.24 general assistance medical care, unless the individual furnishes 145.25 convincing evidence to establish that the transaction was 145.26 exclusively for another purpose. For purposes of this 145.27 paragraph, the value of the asset or interest shall be the fair 145.28 market value at the time it was given away, sold, or disposed 145.29 of, less the amount of compensation received. For any 145.30 uncompensated transfer, the number of months of ineligibility, 145.31 including partial months, shall be calculated by dividing the 145.32 uncompensated transfer amount by the average monthly per person 145.33 payment made by the medical assistance program to skilled 145.34 nursing facilities for the previous calendar year. The 145.35 individual shall remain ineligible until this fixed period has 145.36 expired. The period of ineligibility may exceed 30 months, and 146.1 a reapplication for benefits after 30 months from the date of 146.2 the transfer shall not result in eligibility unless and until 146.3 the period of ineligibility has expired. The period of 146.4 ineligibility begins in the month the transfer was reported to 146.5 the county agency, or if the transfer was not reported, the 146.6 month in which the county agency discovered the transfer, 146.7 whichever comes first. For applicants, the period of 146.8 ineligibility begins on the date of the first approved 146.9 application. 146.10 (i) When determining eligibility for any state benefits 146.11 under this subdivision, the income and resources of all 146.12 noncitizens shall be deemed to include their sponsor's income 146.13 and resources as defined in the Personal Responsibility and Work 146.14 Opportunity Reconciliation Act of 1996, title IV, Public Law 146.15 Number 104-193, sections 421 and 422, and subsequently set out 146.16 in federal rules. 146.17 (j)(1) An undocumented noncitizen or a nonimmigrant is 146.18 ineligible for general assistance medical care other than 146.19 emergency services. For purposes of this subdivision, a 146.20 nonimmigrant is an individual in one or more of the classes 146.21 listed in United States Code, title 8, section 1101(a)(15), and 146.22 an undocumented noncitizen is an individual who resides in the 146.23 United States without the approval or acquiescence of the 146.24 Immigration and Naturalization Service. 146.25 (2) This paragraph does not apply to a child under age 18, 146.26 to a Cuban or Haitian entrant as defined in Public Law Number 146.27 96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is 146.28 aged, blind, or disabled as defined in Code of Federal 146.29 Regulations, title 42, sections 435.520, 435.530, 435.531, 146.30 435.540, and 435.541, or effective October 1, 1998, to an 146.31 individual eligible for general assistance medical care under 146.32 paragraph (a), clause (4), who cooperates with the Immigration 146.33 and Naturalization Service to pursue any applicable immigration 146.34 status, including citizenship, that would qualify the individual 146.35 for medical assistance with federal financial participation. 146.36 (k) For purposes of paragraphs (g) and (j), "emergency 147.1 services" has the meaning given in Code of Federal Regulations, 147.2 title 42, section 440.255(b)(1), except that it also means 147.3 services rendered because of suspected or actual pesticide 147.4 poisoning. 147.5 (l) Notwithstanding any other provision of law, a 147.6 noncitizen who is ineligible for medical assistance due to the 147.7 deeming of a sponsor's income and resources, is ineligible for 147.8 general assistance medical care. 147.9 [EFFECTIVE DATE.] This section is effective July 1, 2001. 147.10 Sec. 57. Minnesota Statutes 2000, section 256J.31, 147.11 subdivision 12, is amended to read: 147.12 Subd. 12. [RIGHT TO DISCONTINUE CASH ASSISTANCE.] A 147.13 participant who is not in vendor payment status may discontinue 147.14 receipt of the cash assistance portion of the MFIP assistance 147.15 grant and retain eligibility for child care assistance under 147.16 section 119B.05and for medical assistance under sections147.17256B.055, subdivision 3a, and 256B.0635. For the months a 147.18 participant chooses to discontinue the receipt of the cash 147.19 portion of the MFIP grant, the assistance unit accrues months of 147.20 eligibility to be applied toward eligibility for child care 147.21 under section 119B.05and for medical assistance under sections147.22256B.055, subdivision 3a, and 256B.0635. 147.23 [EFFECTIVE DATE.] This section is effective July 1, 2002. 147.24 Sec. 58. Minnesota Statutes 2000, section 256K.03, 147.25 subdivision 1, is amended to read: 147.26 Subdivision 1. [NOTIFICATION OF PROGRAM.] Except for the 147.27 provisions in this section, the provisions for the MFIP 147.28 application process shall be followed. Within two days after 147.29 receipt of a completed combined application form, the county 147.30 agency must refer to the provider the applicant who meets the 147.31 conditions under section 256K.02, and notify the applicant in 147.32 writing of the program including the following provisions: 147.33 (1) notification that, as part of the application process, 147.34 applicants are required to attend orientation, to be followed 147.35 immediately by a job search; 147.36 (2) the program provider, the date, time, and location of 148.1 the scheduled program orientation; 148.2 (3) the procedures for qualifying for and receiving 148.3 benefits under the program; 148.4 (4) the immediate availability of supportive services, 148.5 including, but not limited to, child care, transportation, 148.6medical assistance,and other work-related aid; and 148.7 (5) the rights, responsibilities, and obligations of 148.8 participants in the program, including, but not limited to, the 148.9 grounds for exemptions and deferrals, the consequences for 148.10 refusing or failing to participate fully, and the appeal process. 148.11 [EFFECTIVE DATE.] This section is effective July 1, 2002. 148.12 Sec. 59. Minnesota Statutes 2000, section 256K.07, is 148.13 amended to read: 148.14 256K.07 [ELIGIBILITY FOR FOOD STAMPS, MEDICAL ASSISTANCE,148.15 AND CHILD CARE.] 148.16 The participant shall be treated as an MFIP recipient for 148.17 food stamps, medical assistance,and child care eligibility 148.18 purposes. The participant who leaves the program as a result of 148.19 increased earnings from employment shall be eligible for 148.20transitional medical assistance andchild care without regard to 148.21 MFIP receipt in three of the six months preceding ineligibility. 148.22 [EFFECTIVE DATE.] This section is effective July 1, 2002. 148.23 Sec. 60. Minnesota Statutes 2000, section 256L.03, is 148.24 amended by adding a subdivision to read: 148.25 Subd. 5a. [CO-PAYMENTS FOR CERTAIN CHILDREN.] Effective 148.26 July 1, 2002, through June 30, 2006, the MinnesotaCare benefit 148.27 plan for children enrolled in MinnesotaCare who, in accordance 148.28 with section 256L.15, subdivision 1, paragraph (c), opt not to 148.29 pay a premium shall include a $5 co-payment for nonpreventive 148.30 physician services, chiropractic services, and hospital 148.31 outpatient services as determined by the commissioner. 148.32 [EFFECTIVE DATE.] This section is effective July 1, 2002. 148.33 Sec. 61. Minnesota Statutes 2000, section 256L.05, 148.34 subdivision 2, is amended to read: 148.35 Subd. 2. [COMMISSIONER'S DUTIES.] The commissionershall148.36use individuals' social security numbers as identifiers for149.1purposes of administering the plan and conduct data matches to149.2verify income. Applicants shall submit evidence of individual149.3and family income, earned and unearned, such as the most recent149.4income tax return, wage slips, or other documentation that is149.5determined by the commissioner as necessary to verify income149.6eligibilityor county agency shall use electronic verification 149.7 as the primary method of income verification. If there is a 149.8 discrepancy between reported income and electronically verified 149.9 income, an individual may be required to submit additional 149.10 verification. In addition, the commissioner shall perform 149.11 random audits to verify reported income and eligibility. The 149.12 commissioner may execute data sharing arrangements with the 149.13 department of revenue and any other governmental agency in order 149.14 to perform income verification related to eligibility and 149.15 premium payment under the MinnesotaCare program. 149.16 Sec. 62. Minnesota Statutes 2000, section 256L.06, 149.17 subdivision 3, is amended to read: 149.18 Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 149.19 Premiums are dedicated to the commissioner for MinnesotaCare. 149.20 (b) The commissioner shall develop and implement procedures 149.21 to: (1) require enrollees to report changes in income; (2) 149.22 adjust sliding scale premium payments, based upon changes in 149.23 enrollee income; and (3) disenroll enrollees from MinnesotaCare 149.24 for failure to pay required premiums. Failure to pay includes 149.25 payment with a dishonored check, a returned automatic bank 149.26 withdrawal, or a refused credit card or debit card payment. The 149.27 commissioner may demand a guaranteed form of payment, including 149.28 a cashier's check or a money order, as the only means to replace 149.29 a dishonored, returned, or refused payment. 149.30 (c) Premiums are calculated on a calendar month basis and 149.31 may be paid on a monthly, quarterly, or annual basis, with the 149.32 first payment due upon notice from the commissioner of the 149.33 premium amount required. The commissioner shall inform 149.34 applicants and enrollees of these premium payment options. 149.35 Premium payment is required before enrollment is complete and to 149.36 maintain eligibility in MinnesotaCare. 150.1 (d) Nonpayment of the premium will result in disenrollment 150.2 from the planwithin one calendar month after the due date150.3 effective for the calendar month for which the premium was due. 150.4 Persons disenrolled for nonpayment or who voluntarily terminate 150.5 coverage from the program may not reenroll until four calendar 150.6 months have elapsed. Persons disenrolled for nonpayment who pay 150.7 all past due premiums as well as current premiums due, including 150.8 premiums due for the period of disenrollment, within 20 days of 150.9 disenrollment, shall be reenrolled retroactively to the first 150.10 day of disenrollment. Persons disenrolled for nonpayment or who 150.11 voluntarily terminate coverage from the program may not reenroll 150.12 for four calendar months unless the person demonstrates good 150.13 cause for nonpayment. Good cause does not exist if a person 150.14 chooses to pay other family expenses instead of the premium. 150.15 The commissioner shall define good cause in rule. 150.16 [EFFECTIVE DATE.] This section is effective July 1, 2002. 150.17 Sec. 63. Minnesota Statutes 2000, section 256L.07, 150.18 subdivision 2, is amended to read: 150.19 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 150.20 COVERAGE.] (a) To be eligible, a family or individual must not 150.21 have access to subsidized health coverage through an employer 150.22 and must not have had access to employer-subsidized coverage 150.23 through a current employer for 18 months prior to application or 150.24 reapplication. A family or individual whose employer-subsidized 150.25 coverage is lost due to an employer terminating health care 150.26 coverage as an employee benefit during the previous 18 months is 150.27 not eligible. 150.28 (b) This subdivision does not apply to a family or 150.29 individual who was enrolled in MinnesotaCare within six months 150.30 or less of reapplication and who no longer has 150.31 employer-subsidized coverage due to the employer terminating 150.32 health care coverage as an employee benefit. 150.33 (c) For purposes of this requirement, subsidized health 150.34 coverage means health coverage for which the employer pays at 150.35 least 50 percent of the cost of coverage for the employee or 150.36 dependent, or a higher percentage as specified by the 151.1 commissioner. Children are eligible for employer-subsidized 151.2 coverage through either parent, including the noncustodial 151.3 parent. The commissioner must treat employer contributions to 151.4 Internal Revenue Code Section 125 plans and any other employer 151.5 benefits intended to pay health care costs as qualified employer 151.6 subsidies toward the cost of health coverage for employees for 151.7 purposes of this subdivision. 151.8 [EFFECTIVE DATE.] This section is effective July 1, 2001, 151.9 or upon receipt of federal approval, whichever is later. 151.10 Sec. 64. Minnesota Statutes 2000, section 256L.12, is 151.11 amended by adding a subdivision to read: 151.12 Subd. 11. [COVERAGE AT INDIAN HEALTH SERVICE 151.13 FACILITIES.] For American Indian enrollees of MinnesotaCare, 151.14 MinnesotaCare shall cover health care services provided at 151.15 Indian Health Service facilities and facilities operated by a 151.16 tribe or tribal organization under funding authorized by United 151.17 States Code, title 25, sections 450f to 450n, or title III of 151.18 the Indian Self-Determination and Education Act, Public Law 151.19 Number 93-638, if those services would otherwise be covered 151.20 under section 256L.03. Payments for services provided under 151.21 this subdivision shall be made on a fee-for-service basis, and 151.22 may, at the option of the tribe or organization, be made at the 151.23 rates authorized under sections 256.969, subdivision 16, and 151.24 256B.0625, subdivision 34, for those MinnesotaCare enrollees 151.25 eligible for coverage at medical assistance rates. For purposes 151.26 of this subdivision, "American Indian" has the meaning given to 151.27 persons to whom services will be provided for in the Code of 151.28 Federal Regulations, title 42, section 36.12. 151.29 [EFFECTIVE DATE.] This section is effective the day 151.30 following final enactment. 151.31 Sec. 65. Minnesota Statutes 2000, section 256L.15, 151.32 subdivision 1, is amended to read: 151.33 Subdivision 1. [PREMIUM DETERMINATION.] (a) Families with 151.34 children and individuals shall pay a premium determined 151.35 according to a sliding fee based on a percentage of the family's 151.36 gross family income. 152.1 (b) Pregnant women and children under age two are exempt 152.2 from the provisions of section 256L.06, subdivision 3, paragraph 152.3 (b), clause (3), requiring disenrollment for failure to pay 152.4 premiums. For pregnant women, this exemption continues until 152.5 the first day of the month following the 60th day postpartum. 152.6 Women who remain enrolled during pregnancy or the postpartum 152.7 period, despite nonpayment of premiums, shall be disenrolled on 152.8 the first of the month following the 60th day postpartum for the 152.9 penalty period that otherwise applies under section 256L.06, 152.10 unless they begin paying premiums. 152.11 (c) Effective July 1, 2002, through June 30, 2006, at their 152.12 option, children with gross family income at or below 217 152.13 percent of the federal poverty guidelines who are eligible for 152.14 MinnesotaCare in the first month following termination from 152.15 medical assistance shall not pay a premium for 12 months. 152.16 [EFFECTIVE DATE.] This section is effective July 1, 2002. 152.17 Sec. 66. Minnesota Statutes 2000, section 256L.16, is 152.18 amended to read: 152.19 256L.16 [PAYMENT RATES; SERVICES FOR FAMILIES AND CHILDREN 152.20 UNDER THE MINNESOTACARE HEALTH CARE REFORM WAIVER.] 152.21 Section 256L.11, subdivision 2, shall not apply to services 152.22 provided tochildrenfamilies with children who are eligibleto152.23receive expanded servicesaccording to section256L.03,152.24subdivision 1a256L.04, subdivision 1, paragraph (a). 152.25 Sec. 67. Minnesota Statutes 2000, section 256L.17, 152.26 subdivision 2, is amended to read: 152.27 Subd. 2. [LIMIT ON TOTAL ASSETS.] (a) EffectiveApril 1,152.281997July 1, 2002, or upon federal approval, whichever is later, 152.29 in order to be eligible for the MinnesotaCare program, a 152.30 household of two or more persons must not own more than $30,000 152.31 in total net assets, and a household of one person must not own 152.32 more than $15,000 in total net assets. 152.33 (b) For purposes of this subdivision,total net assets152.34include all assets, with the following exceptions:152.35(1) a homestead is not considered;152.36(2) household goods and personal effects are not153.1considered;153.2(3) any assets owned by children;153.3(4) vehicles used for employment;153.4(5) court-ordered settlements up to $10,000;153.5(6) individual retirement accounts; and153.6(7) capital and operating assets of a trade or business up153.7to $200,000 in net assets are not considered.153.8(c) If an asset excluded under paragraph (b) has a negative153.9value, the negative value shall be subtracted from the total net153.10assets under paragraph (a)assets are determined according to 153.11 section 256B.056, subdivision 3a. 153.12 [EFFECTIVE DATE.] This section is effective July 1, 2001. 153.13 Sec. 68. Laws 1995, chapter 178, article 2, section 36, is 153.14 amended to read: 153.15 Sec. 36. [EMPOWERMENT ZONES; ADMINISTRATIVE SIMPLIFICATION 153.16 OF WELFARE LAWS.] 153.17 (a) The commissioner of human services shall make 153.18 recommendations to effectuate the changes in federal laws and 153.19 regulations, state laws and rules, and the state plan to improve 153.20 the administrative efficiency of the aid to families with 153.21 dependent children, general assistance, work readiness, family 153.22 general assistance, medical assistance, general assistance 153.23 medical care, and food stamp programs. At a minimum, the 153.24 following administrative standards and procedures must be 153.25 changed. 153.26 The commissioner shall: 153.27 (1) require income or eligibility reviews no more 153.28 frequently than annually for cases in which income is normally 153.29 invariant, as in aid to families with dependent children cases 153.30 where the only source of household income is Supplemental Social 153.31 Security Income; 153.32 (2) permit households to report income annually when the 153.33 source of income is excluded, such as a minor's earnings; 153.34 (3)require income or eligibility reviews no more153.35frequently than annually for extended medical assistance cases;153.36(4)require income or eligibility reviews no more 154.1 frequently than annually for a medical assistance postpartum 154.2 client, where the client previously had eligibility under a 154.3 different basis prior to pregnancy or if other household members 154.4 have eligibility with the same income/basis that applies to the 154.5 client; 154.6(5)(4) permit all income or eligibility reviews for foster 154.7 care medical assistance cases to use the short application form; 154.8 and 154.9(6)(5) make dependent care expenses declaratory for 154.10 medical assistance; and154.11(7) permit households to only report gifts worth $100 or154.12more per month. 154.13 (b) The county's administrative savings resulting from 154.14 these changes may be allocated to fund any lawful purpose. 154.15 (c) The recommendations must be provided in a report to the 154.16 chairs of the appropriate legislative committees by August 1, 154.17 1995. The recommendations must include a list of the 154.18 administrative standards and procedures that require approval by 154.19 the federal government before implementation, and also which 154.20 administrative simplification standards and procedures may be 154.21 implemented by a county prior to receiving a federal waiver. 154.22 (d) The commissioner shall seek the necessary waivers from 154.23 the federal government as soon as possible to implement the 154.24 administrative simplification standards and procedures. 154.25 Sec. 69. Laws 1999, chapter 245, article 4, section 110, 154.26 is amended to read: 154.27 Sec. 110. [PROGRAMS FOR SENIOR CITIZENS.] 154.28 The commissioner of human services shall study the 154.29 eligibility criteria of and benefits provided to persons age 65 154.30 and over through the array of cash assistance and health care 154.31 programs administered by the department, and the extent to which 154.32 these programs can be combined, simplified, or coordinated to 154.33 reduce administrative costs and improve access. The 154.34 commissioner shall also study potential barriers to enrollment 154.35 for low-income seniors who would otherwise deplete resources 154.36 necessary to maintain independent community living. At a 155.1 minimum, the study must include an evaluation of asset 155.2 requirements and enrollment sites. The commissioner shall 155.3 report study findings and recommendations to the legislature by 155.4June 30, 2001January 15, 2002. 155.5 Sec. 70. [REGULATORY SIMPLIFICATION FOR STATE HEALTH CARE 155.6 PROGRAM PROVIDERS.] 155.7 The commissioner of human services, in consultation with 155.8 providers participating in state health care programs, shall 155.9 identify nonfinancial barriers to increased provider enrollment 155.10 and provider retention in state health care programs, and shall 155.11 implement procedures to address these barriers. Areas to be 155.12 examined by the commissioner shall include, but are not limited 155.13 to, regulatory complexity and inconsistencies between state 155.14 health care programs, provider requirements, provision of 155.15 technical assistance to providers, responsiveness to provider 155.16 inquiries and complaints, claims processing turnaround times, 155.17 and policies for rejecting provider claims. The commissioner 155.18 shall report to the legislature by February 15, 2002, on any 155.19 changes to the administration of state health care programs that 155.20 will be implemented as a result of the study, and present 155.21 recommendations for any necessary changes in state law. 155.22 Sec. 71. [EXPAND DENTAL AUXILIARY PERSONNEL; 155.23 FOREIGN-TRAINED DENTISTS; DENTAL CLINICS.] 155.24 Subdivision 1. [DEVELOPMENT.] (a) The board of dentistry, 155.25 in consultation with the University of Minnesota school of 155.26 dentistry, the Minnesota state colleges and universities that 155.27 offer a dental auxiliary training program, the commissioner of 155.28 health, and licensed dentists and dental auxiliaries practicing 155.29 in private practice and at community clinics, shall develop new 155.30 expanded duties for registered dental assistants and dental 155.31 hygienists. The new duties must be performed under direct or 155.32 indirect supervision of a licensed dentist. These expanded 155.33 duties must be limited to reversible procedures, including, but 155.34 not limited to, placement, contouring, and adjustment of amalgam 155.35 restorations, temporary restorations, the alignment and 155.36 cementing of stainless steel crowns to primary teeth, and 156.1 application of pit and fissure sealants. These expanded duties 156.2 shall not include or imply a diagnosis or treatment plan, nor 156.3 include prescribing medications, cutting hard or soft tissue, or 156.4 any direct patient care in which formal training has not been 156.5 completed. The board shall establish the necessary educational 156.6 qualifications to perform the new duties. 156.7 (b) The board shall make recommendations to amend Minnesota 156.8 Statutes, chapter 150A, to permit a foreign-trained dentist to 156.9 practice as a dental hygienist or as a registered dental 156.10 assistant. 156.11 (c) The board shall submit the proposed changes to 156.12 Minnesota Statutes, chapter 150A, to the legislature by January 156.13 15, 2002. 156.14 Subd. 2. [DENTAL CLINICS.] The commissioner of health, in 156.15 consultation with the Minnesota state colleges and universities, 156.16 shall determine the capital improvements needed to establish 156.17 community-based dental clinics at state colleges and 156.18 universities to be used as training sites and as public 156.19 community-based dental clinics for public program recipients 156.20 during times when the school is not in session and the clinic is 156.21 not in use. The commissioner shall submit the necessary capital 156.22 improvement costs for start-up equipment and necessary 156.23 infrastructure as part of the 2002 legislative capital budget 156.24 requests. 156.25 Sec. 72. [NOTICE OF PREMIUM CHANGES IN THE EMPLOYED 156.26 PERSONS WITH DISABILITIES PROGRAM.] 156.27 The commissioner of human services shall provide notice to 156.28 all medical assistance recipients receiving coverage through the 156.29 employed persons with disabilities program under Minnesota 156.30 Statutes, section 256B.057, subdivision 9, of the first new 156.31 premium schedule in effect on November 1, 2001, at least two 156.32 months before the month in which the first new premium is due. 156.33 Sec. 73. [ADDITIONAL TRAINING REQUIREMENTS.] 156.34 The board of dentistry may make recommendations to the 2002 156.35 legislature on additional training requirements for dental 156.36 hygienists practicing under the limited authorization provided 157.1 in Minnesota Statutes, section 150A.10, subdivision 1a. 157.2 Sec. 74. [ELIGIBILITY EXCEPTION TO THE PRESCRIPTION DRUG 157.3 PROGRAM.] 157.4 Notwithstanding the requirements of Minnesota Statutes, 157.5 section 256.955, subdivision 2, paragraph (d), from March 1, 157.6 2001, to June 30, 2002, the definition of a "qualified 157.7 individual" in the prescription drug program established under 157.8 Minnesota Statutes, section 256.955, shall include an individual 157.9 who: 157.10 (1) was enrolled in the prescription drug program prior to 157.11 March 1, 2001; 157.12 (2) was enrolled in a Medicare risk plan prior to March 1, 157.13 2001, to which an annual prescription drug benefit of $400 was 157.14 added on March 1, 2001; and 157.15 (3) meets the requirements described in Minnesota Statutes, 157.16 section 256.955, subdivision 2, paragraph (d), clauses (1) and 157.17 (5), and subdivision 2a. 157.18 The prescription benefit offered by the Medicare risk plan shall 157.19 be primary to benefits provided under the prescription drug 157.20 program. 157.21 Sec. 75. [MINNESOTACARE ELIGIBILITY FOR SELF-EMPLOYED 157.22 FARMERS.] 157.23 (a) The commissioner of human services shall seek federal 157.24 approval to redefine in the MinnesotaCare program the definition 157.25 of "gross individual or gross family income" for farm 157.26 self-employed to mean income calculated using as a baseline the 157.27 adjusted gross income reported on the applicant's federal income 157.28 tax form for the previous year and adding back in reported 157.29 depreciation amounts that apply to the business in which the 157.30 family is currently engaged. 157.31 (b) Upon receipt of federal approval, the commissioner 157.32 shall notify the legislature. No change to the definition shall 157.33 be implemented without further action by the legislature. 157.34 Sec. 76. [REPEALER.] 157.35 (a) Minnesota Statutes 2000, section 256B.0635, subdivision 157.36 3, and 256B.19, subdivision 1b, are repealed effective July 1, 158.1 2001. 158.2 (b) Minnesota Statutes 2000, section 256L.02, subdivision 158.3 4, is repealed effective January 1, 2003. 158.4 ARTICLE 3 158.5 CONTINUING CARE 158.6 Section 1. Minnesota Statutes 2000, section 245A.13, 158.7 subdivision 7, is amended to read: 158.8 Subd. 7. [RATE RECOMMENDATION.] The commissioner of human 158.9 services may review rates of a residential program participating 158.10 in the medical assistance program which is in receivership and 158.11 that has needs or deficiencies documented by the department of 158.12 health or the department of human services. If the commissioner 158.13 of human services determines that a review of the rate 158.14 established undersection 256B.501sections 256B.5012 and 158.15 256B.5013 is needed, the commissioner shall: 158.16 (1) review the order or determination that cites the 158.17 deficiencies or needs; and 158.18 (2) determine the need for additional staff, additional 158.19 annual hours by type of employee, and additional consultants, 158.20 services, supplies, equipment, repairs, or capital assets 158.21 necessary to satisfy the needs or deficiencies. 158.22 Sec. 2. Minnesota Statutes 2000, section 245A.13, 158.23 subdivision 8, is amended to read: 158.24 Subd. 8. [ADJUSTMENT TO THE RATE.] Upon review of rates 158.25 under subdivision 7, the commissioner may adjust the residential 158.26 program's payment rate. The commissioner shall review the 158.27 circumstances, together with the residentialprogram cost report158.28 program's most recent income and expense report, to determine 158.29 whether or not the deficiencies or needs can be corrected or met 158.30 by reallocating residential program staff, costs, revenues, 158.31 or any other resources includinganyinvestments, efficiency158.32incentives, or allowances. If the commissioner determines that 158.33 any deficiency cannot be corrected or the need cannot be met 158.34 with the payment rate currently being paid, the commissioner 158.35 shall determine the payment rate adjustment by dividing the 158.36 additional annual costs established during the commissioner's 159.1 review by the residential program's actual resident days from 159.2 the most recentdesk-audited costincome and expense report or 159.3 the estimated resident days in the projected receivership 159.4 period. The payment rate adjustmentmust meet the conditions in159.5Minnesota Rules, parts 9553.0010 to 9553.0080, andremains in 159.6 effect during the period of the receivership or until another 159.7 date set by the commissioner. Upon the subsequent sale, 159.8 closure, or transfer of the residential program, the 159.9 commissioner may recover amounts that were paid as payment rate 159.10 adjustments under this subdivision. This recovery shall be 159.11 determined through a review of actual costs and resident days in 159.12 the receivership period. The costs the commissioner finds to be 159.13 allowable shall be divided by the actual resident days for the 159.14 receivership period. This rate shall be compared to the rate 159.15 paid throughout the receivership period, with the difference 159.16 multiplied by resident days, being the amount to be repaid to 159.17 the commissioner. Allowable costs shall be determined by the 159.18 commissioner as those ordinary, necessary, and related to 159.19 resident care by prudent and cost-conscious management. The 159.20 buyer or transferee shall repay this amount to the commissioner 159.21 within 60 days after the commissioner notifies the buyer or 159.22 transferee of the obligation to repay. This provision does not 159.23 limit the liability of the seller to the commissioner pursuant 159.24 to section 256B.0641. 159.25 Sec. 3. Minnesota Statutes 2000, section 252.275, 159.26 subdivision 4b, is amended to read: 159.27 Subd. 4b. [GUARANTEED FLOOR.] Each countywith an original159.28allocation for the preceding year that is equal to or less than159.29the guaranteed floor minimum index shall have a guaranteed floor159.30equal to its original allocation for the preceding year. Each159.31county with an original allocation for the preceding year that159.32is greater than the guaranteed floor minimum indexshall have a 159.33 guaranteed floor equal to the lesser of clause (1) or (2): 159.34 (1) the county's original allocation for the preceding 159.35 year; or 159.36 (2) 70 percent of the county's reported expenditures 160.1 eligible for reimbursement during the 12 months ending on June 160.2 30 of the preceding calendar year. 160.3For calendar year 1993, the guaranteed floor minimum index160.4shall be $20,000. For each subsequent year, the index shall be160.5adjusted by the projected change in the average value in the160.6United States Department of Labor Bureau of Labor Statistics160.7consumer price index (all urban) for that year.160.8 Notwithstanding this subdivision, no county shall be 160.9 allocated a guaranteed floor of less than $1,000. 160.10 When the amount of funds available for allocation is less 160.11 than the amount available in the previous year, each county's 160.12 previous year allocation shall be reduced in proportion to the 160.13 reduction in the statewide funding, to establish each county's 160.14 guaranteed floor. 160.15 Sec. 4. Minnesota Statutes 2000, section 254B.02, 160.16 subdivision 3, is amended to read: 160.17 Subd. 3. [RESERVE ACCOUNT.] The commissioner shall 160.18 allocate money from the reserve account to counties that, during 160.19 the current fiscal year, have met or exceeded the base level of 160.20 expenditures for eligible chemical dependency services from 160.21 local money. The commissioner shall establish the base level 160.22 for fiscal year 1988 as the amount of local money used for 160.23 eligible services in calendar year 1986. In later years, the 160.24 base level must be increased in the same proportion as state 160.25 appropriations to implement Laws 1986, chapter 394, sections 8 160.26 to 20, are increased. The base level must be decreased if the 160.27 fund balance from which allocations are made under section 160.28 254B.02, subdivision 1, is decreased in later years. The local 160.29 match rate for the reserve account is the same rate as applied 160.30 to the initial allocation. Reserve account payments must not be 160.31 included when calculating the county adjustments made according 160.32 to subdivision 2. For counties providing medical assistance or 160.33 general assistance medical care through managed care plans on 160.34 January 1, 1996, the base year is fiscal year 1995. For 160.35 counties beginning provision of managed care after January 1, 160.36 1996, the base year is the most recent fiscal year before 161.1 enrollment in managed care begins. For counties providing 161.2 managed care, the base level will be increased or decreased in 161.3 proportion to changes in the fund balance from which allocations 161.4 are made under subdivision 2, but will be additionally increased 161.5 or decreased in proportion to the change in county adjusted 161.6 population made in subdivision 1, paragraphs (b) and 161.7 (c). Effective July 1, 2001, at the end of each biennium, any 161.8 funds deposited in the reserve account funds in excess of those 161.9 needed to meet obligations incurred under this section and 161.10 sections 254B.06 and 254B.09 shall cancel to the general fund. 161.11 Sec. 5. Minnesota Statutes 2000, section 254B.03, 161.12 subdivision 1, is amended to read: 161.13 Subdivision 1. [LOCAL AGENCY DUTIES.] (a) Every local 161.14 agency shall provide chemical dependency services to persons 161.15 residing within its jurisdiction who meet criteria established 161.16 by the commissioner for placement in a chemical dependency 161.17 residential or nonresidential treatment service. Chemical 161.18 dependency money must be administered by the local agencies 161.19 according to law and rules adopted by the commissioner under 161.20 sections 14.001 to 14.69. 161.21 (b) In order to contain costs, the county board shall, with 161.22 the approval of the commissioner of human services, select 161.23 eligible vendors of chemical dependency services who can provide 161.24 economical and appropriate treatment. Unless the local agency 161.25 is a social services department directly administered by a 161.26 county or human services board, the local agency shall not be an 161.27 eligible vendor under section 254B.05. The commissioner may 161.28 approve proposals from county boards to provide services in an 161.29 economical manner or to control utilization, with safeguards to 161.30 ensure that necessary services are provided. If a county 161.31 implements a demonstration or experimental medical services 161.32 funding plan, the commissioner shall transfer the money as 161.33 appropriate. If a county selects a vendor located in another 161.34 state, the county shall ensure that the vendor is in compliance 161.35 with the rules governing licensure of programs located in the 161.36 state. 162.1 (c) The calendar year19982002 rate for vendors may not 162.2 increase more than three percent above the rate approved in 162.3 effect on January 1,19972001. The calendar year19992003 162.4 rate for vendors may not increase more than three percent above 162.5 the rate in effect on January 1,19982002. The calendar years 162.6 2004 and 2005 rates may not exceed the rate in effect on January 162.7 1, 2003. 162.8 (d) A culturally specific vendor that provides assessments 162.9 under a variance under Minnesota Rules, part 9530.6610, shall be 162.10 allowed to provide assessment services to persons not covered by 162.11 the variance. 162.12 Sec. 6. Minnesota Statutes 2000, section 254B.04, 162.13 subdivision 1, is amended to read: 162.14 Subdivision 1. [ELIGIBILITY.] (a) Persons eligible for 162.15 benefits under Code of Federal Regulations, title 25, part 20, 162.16 persons eligible for medical assistance benefits under sections 162.17 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, 162.18 or who meet the income standards of section 256B.056, 162.19 subdivision 4, and persons eligible for general assistance 162.20 medical care under section 256D.03, subdivision 3, are entitled 162.21 to chemical dependency fund services. State money appropriated 162.22 for this paragraph must be placed in a separate account 162.23 established for this purpose. 162.24 Persons with dependent children who are determined to be in 162.25 need of chemical dependency treatment pursuant to an assessment 162.26 under section 626.556, subdivision 10, or a case plan under 162.27 section 260C.201, subdivision 6, or 260C.212, shall be assisted 162.28 by the local agency to access needed treatment services. 162.29 Treatment services must be appropriate for the individual or 162.30 family, which may include long-term care treatment or treatment 162.31 in a facility that allows the dependent children to stay in the 162.32 treatment facility. The county shall pay for out-of-home 162.33 placement costs, if applicable. 162.34 (b) A person not entitled to services under paragraph (a), 162.35 but with family income that is less than60 percent of the state162.36median income for a family of like size and composition215 163.1 percent of the federal poverty guidelines for the applicable 163.2 family size, shall be eligible to receive chemical dependency 163.3 fund services within the limit of fundsavailable after persons163.4entitled to services under paragraph (a) have been163.5servedappropriated for this group for the fiscal year. If 163.6 notified by the state agency of limited funds, a county must 163.7 give preferential treatment to persons with dependent children 163.8 who are in need of chemical dependency treatment pursuant to an 163.9 assessment under section 626.556, subdivision 10, or a case plan 163.10 under section 260C.201, subdivision 6, or 260C.212. A county 163.11 may spend money from its own sources to serve persons under this 163.12 paragraph. State money appropriated for this paragraph must be 163.13 placed in a separate account established for this purpose. 163.14 (c) Persons whose income is between60215 percent and115163.15 412 percent of thestate median incomefederal poverty 163.16 guidelines for the applicable family size shall be eligible for 163.17 chemical dependency services on a sliding fee basis, within the 163.18 limit of fundsavailable, after persons entitled to services163.19under paragraph (a) and persons eligible for services under163.20paragraph (b) have been servedappropriated for this group for 163.21 the fiscal year. Persons eligible under this paragraph must 163.22 contribute to the cost of services according to the sliding fee 163.23 scale established under subdivision 3. A county may spend money 163.24 from its own sources to provide services to persons under this 163.25 paragraph. State money appropriated for this paragraph must be 163.26 placed in a separate account established for this purpose. 163.27 Sec. 7. Minnesota Statutes 2000, section 254B.09, is 163.28 amended by adding a subdivision to read: 163.29 Subd. 8. [PAYMENTS TO IMPROVE SERVICES TO AMERICAN 163.30 INDIANS.] The commissioner may set rates for chemical dependency 163.31 services according to the American Indian Health Improvement 163.32 Act, Public Law Number 94-437, for eligible vendors. These 163.33 rates shall supersede rates set in county purchase of service 163.34 agreements when payments are made on behalf of clients eligible 163.35 according to Public Law Number 94-437. 163.36 Sec. 8. Minnesota Statutes 2000, section 256.01, is 164.1 amended by adding a subdivision to read: 164.2 Subd. 19. [GRANTS FOR CASE MANAGEMENT SERVICES TO PERSONS 164.3 WITH HIV OR AIDS.] The commissioner may award grants to eligible 164.4 vendors for the development, implementation, and evaluation of 164.5 case management services for individuals infected with the human 164.6 immunodeficiency virus. HIV/AIDs case management services will 164.7 be provided to increase access to cost effective health care 164.8 services, to reduce the risk of HIV transmission, to ensure that 164.9 basic client needs are met, and to increase client access to 164.10 needed community supports or services. 164.11 Sec. 9. Minnesota Statutes 2000, section 256.476, 164.12 subdivision 1, is amended to read: 164.13 Subdivision 1. [PURPOSE AND GOALS.] The commissioner of 164.14 human services shall establish a consumer support grant 164.15 programto assistfor individuals with functional limitations 164.16 and their familiesin purchasing and securing supports which the164.17individuals need to live as independently and productively in164.18the community as possiblewho wish to purchase and secure their 164.19 own supports. The commissioner and local agencies shall jointly 164.20 develop an implementation plan which must include a way to 164.21 resolve the issues related to county liability. The program 164.22 shall: 164.23 (1) make support grants or exception grants described in 164.24 subdivision 11 available to individuals or families as an 164.25 effective alternative to existing programs and services, such as 164.26 the developmental disability family support program,the164.27alternative care program,personal care attendant services, home 164.28 health aide services, and private duty nursingfacility164.29 services; 164.30 (2) provide consumers more control, flexibility, and 164.31 responsibility overthe needed supportstheir services and 164.32 supports; 164.33 (3) promote local program management and decision making; 164.34 and 164.35 (4) encourage the use of informal and typical community 164.36 supports. 165.1 Sec. 10. Minnesota Statutes 2000, section 256.476, 165.2 subdivision 2, is amended to read: 165.3 Subd. 2. [DEFINITIONS.] For purposes of this section, the 165.4 following terms have the meanings given them: 165.5 (a) "County board" means the county board of commissioners 165.6 for the county of financial responsibility as defined in section 165.7 256G.02, subdivision 4, or its designated representative. When 165.8 a human services board has been established under sections 165.9 402.01 to 402.10, it shall be considered the county board for 165.10 the purposes of this section. 165.11 (b) "Family" means the person's birth parents, adoptive 165.12 parents or stepparents, siblings or stepsiblings, children or 165.13 stepchildren, grandparents, grandchildren, niece, nephew, aunt, 165.14 uncle, or spouse. For the purposes of this section, a family 165.15 member is at least 18 years of age. 165.16 (c) "Functional limitations" means the long-term inability 165.17 to perform an activity or task in one or more areas of major 165.18 life activity, including self-care, understanding and use of 165.19 language, learning, mobility, self-direction, and capacity for 165.20 independent living. For the purpose of this section, the 165.21 inability to perform an activity or task results from a mental, 165.22 emotional, psychological, sensory, or physical disability, 165.23 condition, or illness. 165.24 (d) "Informed choice" means a voluntary decision made by 165.25 the person or the person's legal representative, after becoming 165.26 familiarized with the alternatives to: 165.27 (1) select a preferred alternative from a number of 165.28 feasible alternatives; 165.29 (2) select an alternative which may be developed in the 165.30 future; and 165.31 (3) refuse any or all alternatives. 165.32 (e) "Local agency" means the local agency authorized by the 165.33 county board or, for counties not participating in the consumer 165.34 grant program by July 1, 2002, the commissioner, to carry out 165.35 the provisions of this section. 165.36 (f) "Person" or "persons" means a person or persons meeting 166.1 the eligibility criteria in subdivision 3. 166.2 (g) "Authorized representative" means an individual 166.3 designated by the person or their legal representative to act on 166.4 their behalf. This individual may be a family member, guardian, 166.5 representative payee, or other individual designated by the 166.6 person or their legal representative, if any, to assist in 166.7 purchasing and arranging for supports. For the purposes of this 166.8 section, an authorized representative is at least 18 years of 166.9 age. 166.10 (h) "Screening" means the screening of a person's service 166.11 needs under sections 256B.0911 and 256B.092. 166.12 (i) "Supports" means services, care, aids,home166.13 environmental modifications, or assistance purchased by the 166.14 person or the person's family. Examples of supports include 166.15 respite care, assistance with daily living, andadaptive aids166.16 assistive technology. For the purpose of this section, 166.17 notwithstanding the provisions of section 144A.43, supports 166.18 purchased under the consumer support program are not considered 166.19 home care services. 166.20 (j) "Program of origination" means the program the 166.21 individual transferred from when approved for the consumer 166.22 support grant program. 166.23 Sec. 11. Minnesota Statutes 2000, section 256.476, 166.24 subdivision 3, is amended to read: 166.25 Subd. 3. [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person 166.26 is eligible to apply for a consumer support grant if the person 166.27 meets all of the following criteria: 166.28 (1) the person is eligible for and has been approved to 166.29 receive services under medical assistance as determined under 166.30 sections 256B.055 and 256B.056or the person is eligible for and166.31has been approved to receive services under alternative care166.32services as determined under section 256B.0913or the person has 166.33 been approved to receive a grant under the developmental 166.34 disability family support program under section 252.32; 166.35 (2) the person is able to direct and purchase the person's 166.36 own care and supports, or the person has a family member, legal 167.1 representative, or other authorized representative who can 167.2 purchase and arrange supports on the person's behalf; 167.3 (3) the person has functional limitations, requires ongoing 167.4 supports to live in the community, and is at risk of or would 167.5 continue institutionalization without such supports; and 167.6 (4) the person will live in a home. For the purpose of 167.7 this section, "home" means the person's own home or home of a 167.8 person's family member. These homes are natural home settings 167.9 and are not licensed by the department of health or human 167.10 services. 167.11 (b) Persons may not concurrently receive a consumer support 167.12 grant if they are: 167.13 (1) receiving home and community-based services under 167.14 United States Code, title 42, section 1396h(c); personal care 167.15 attendant and home health aide services under section 256B.0625; 167.16 a developmental disability family support grant; or alternative 167.17 care services under section 256B.0913; or 167.18 (2) residing in an institutional or congregate care setting. 167.19 (c) A person or person's family receiving a consumer 167.20 support grant shall not be charged a fee or premium by a local 167.21 agency for participating in the program. 167.22 (d) The commissioner may limit the participation ofnursing167.23facility residents, residents of intermediate care facilities167.24for persons with mental retardation, and therecipients of 167.25 services from federal waiver programs in the consumer support 167.26 grant program if the participation of these individuals will 167.27 result in an increase in the cost to the state. 167.28 (e) The commissioner shall establish a budgeted 167.29 appropriation each fiscal year for the consumer support grant 167.30 program. The number of individuals participating in the program 167.31 will be adjusted so the total amount allocated to counties does 167.32 not exceed the amount of the budgeted appropriation. The 167.33 budgeted appropriation will be adjusted annually to accommodate 167.34 changes in demand for the consumer support grants. 167.35 Sec. 12. Minnesota Statutes 2000, section 256.476, 167.36 subdivision 4, is amended to read: 168.1 Subd. 4. [SUPPORT GRANTS; CRITERIA AND LIMITATIONS.] (a) A 168.2 county board may choose to participate in the consumer support 168.3 grant program. If a countyboard chooses to participate in the168.4program,has not chosen to participate by July 1, 2002, the 168.5 commissioner shall contract with another county or other entity 168.6 to provide access to residents of the nonparticipating county 168.7 who choose the consumer support grant option. The commissioner 168.8 shall notify the county board in a county that has declined to 168.9 participate of the commissioner's intent to enter into a 168.10 contract with another county or other entity at least 30 days in 168.11 advance of entering into the contract. The local agency shall 168.12 establish written procedures and criteria to determine the 168.13 amount and use of support grants. These procedures must 168.14 include, at least, the availability of respite care, assistance 168.15 with daily living, and adaptive aids. The local agency may 168.16 establish monthly or annual maximum amounts for grants and 168.17 procedures where exceptional resources may be required to meet 168.18 the health and safety needs of the person on a time-limited 168.19 basis, however, the total amount awarded to each individual may 168.20 not exceed the limits established insubdivision 5, paragraph168.21(f)subdivision 11. 168.22 (b) Support grants to a person or a person's family will be 168.23 provided through a monthly subsidy payment and be in the form of 168.24 cash, voucher, or direct county payment to vendor. Support 168.25 grant amounts must be determined by the local agency. Each 168.26 service and item purchased with a support grant must meet all of 168.27 the following criteria: 168.28 (1) it must be over and above the normal cost of caring for 168.29 the person if the person did not have functional limitations; 168.30 (2) it must be directly attributable to the person's 168.31 functional limitations; 168.32 (3) it must enable the person or the person's family to 168.33 delay or prevent out-of-home placement of the person; and 168.34 (4) it must be consistent with the needs identified in the 168.35 service plan, when applicable. 168.36 (c) Items and services purchased with support grants must 169.1 be those for which there are no other public or private funds 169.2 available to the person or the person's family. Fees assessed 169.3 to the person or the person's family for health and human 169.4 services are not reimbursable through the grant. 169.5 (d) In approving or denying applications, the local agency 169.6 shall consider the following factors: 169.7 (1) the extent and areas of the person's functional 169.8 limitations; 169.9 (2) the degree of need in the home environment for 169.10 additional support; and 169.11 (3) the potential effectiveness of the grant to maintain 169.12 and support the person in the family environment or the person's 169.13 own home. 169.14 (e) At the time of application to the program or screening 169.15 for other services, the person or the person's family shall be 169.16 provided sufficient information to ensure an informed choice of 169.17 alternatives by the person, the person's legal representative, 169.18 if any, or the person's family. The application shall be made 169.19 to the local agency and shall specify the needs of the person 169.20 and family, the form and amount of grant requested, the items 169.21 and services to be reimbursed, and evidence of eligibility for 169.22 medical assistanceor alternative care program. 169.23 (f) Upon approval of an application by the local agency and 169.24 agreement on a support plan for the person or person's family, 169.25 the local agency shall make grants to the person or the person's 169.26 family. The grant shall be in an amount for the direct costs of 169.27 the services or supports outlined in the service agreement. 169.28 (g) Reimbursable costs shall not include costs for 169.29 resources already available, such as special education classes, 169.30 day training and habilitation, case management, other services 169.31 to which the person is entitled, medical costs covered by 169.32 insurance or other health programs, or other resources usually 169.33 available at no cost to the person or the person's family. 169.34 (h) The state of Minnesota, the county boards participating 169.35 in the consumer support grant program, or the agencies acting on 169.36 behalf of the county boards in the implementation and 170.1 administration of the consumer support grant program shall not 170.2 be liable for damages, injuries, or liabilities sustained 170.3 through the purchase of support by the individual, the 170.4 individual's family, or the authorized representative under this 170.5 section with funds received through the consumer support grant 170.6 program. Liabilities include but are not limited to: workers' 170.7 compensation liability, the Federal Insurance Contributions Act 170.8 (FICA), or the Federal Unemployment Tax Act (FUTA). For 170.9 purposes of this section, participating county boards and 170.10 agencies acting on behalf of county boards are exempt from the 170.11 provisions of section 268.04. 170.12 Sec. 13. Minnesota Statutes 2000, section 256.476, 170.13 subdivision 5, is amended to read: 170.14 Subd. 5. [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a) 170.15 For the purpose of transferring persons to the consumer support 170.16 grant program from specific programs or services, such as the 170.17 developmental disability family support program andalternative170.18care program,personal careattendantassistant services, home 170.19 health aide services, ornursing facilityprivate duty nursing 170.20 services, the amount of funds transferred by the commissioner 170.21 between the developmental disability family support program 170.22 account,the alternative care account,the medical assistance 170.23 account, or the consumer support grant account shall be based on 170.24 each county's participation in transferring persons to the 170.25 consumer support grant program from those programs and services. 170.26 (b) At the beginning of each fiscal year, county 170.27 allocations for consumer support grants shall be based on: 170.28 (1) the number of persons to whom the county board expects 170.29 to provide consumer supports grants; 170.30 (2) their eligibility for current program and services; 170.31 (3) the amount of nonfederal dollarsexpended on those170.32individuals for those programs and services or, in situations170.33where an individual is unable to obtain the support needed from170.34the program of origination due to the unavailability of service170.35providers at the time or the location where the supports are170.36needed, the allocation will be based on the county's best171.1estimate of the nonfederal dollars that would have been expended171.2if the services had been availableallowed under subdivision 11; 171.3 and 171.4 (4) projected dates when persons will start receiving 171.5 grants. County allocations shall be adjusted periodically by 171.6 the commissioner based on the actual transfer of persons or 171.7 service openings, and the nonfederal dollars associated with 171.8 those persons or service openings, to the consumer support grant 171.9 program. 171.10 (c) The amount of funds transferred by the commissioner 171.11 fromthe alternative care account andthe medical assistance 171.12 account for an individual may be changed if it is determined by 171.13 the county or its agent that the individual's need for support 171.14 has changed. 171.15 (d) The authority to utilize funds transferred to the 171.16 consumer support grant account for the purposes of implementing 171.17 and administering the consumer support grant program will not be 171.18 limited or constrained by the spending authority provided to the 171.19 program of origination. 171.20 (e) The commissionershallmay use up to five percent of 171.21 each county's allocation, as adjusted, for paymentsto that171.22countyfor administrative expenses, to be paid as a 171.23 proportionate addition to reported direct service expenditures. 171.24 (f)Except as provided in this paragraph,The county 171.25 allocation for each individual or individual's family cannot 171.26 exceed80 percent of the total nonfederal dollars expended on171.27the individual by the program of origination except for the171.28developmental disabilities family support grant program which171.29can be approved up to 100 percent of the nonfederal dollars and171.30in situations as described in paragraph (b), clause (3). In171.31situations where exceptional need exists or the individual's171.32need for support increases, up to 100 percent of the nonfederal171.33dollars expended may be allocated to the county. Allocations171.34that exceed 80 percent of the nonfederal dollars expended on the171.35individual by the program of origination must be approved by the171.36commissioner. The remainder of the amount expended on the172.1individual by the program of origination will be used in the172.2following proportions: half will be made available to the172.3consumer support grant program and participating counties for172.4consumer training, resource development, and other costs, and172.5half will be returned to the state general fundthe amount 172.6 allowed under subdivision 11. 172.7 (g) The commissioner may recover, suspend, or withhold 172.8 payments if the county board, local agency, or grantee does not 172.9 comply with the requirements of this section. 172.10 (h) Grant funds unexpended by consumers shall return to the 172.11 state once a year. The annual return of unexpended grant funds 172.12 shall occur in the quarter following the end of the state fiscal 172.13 year. 172.14 Sec. 14. Minnesota Statutes 2000, section 256.476, 172.15 subdivision 8, is amended to read: 172.16 Subd. 8. [COMMISSIONER RESPONSIBILITIES.] The commissioner 172.17 shall: 172.18 (1) transfer and allocate funds pursuant tothis172.19sectionsubdivision 11; 172.20 (2) determine allocations based on projected and actual 172.21 local agency use; 172.22 (3) monitor and oversee overall program spending; 172.23 (4) evaluate the effectiveness of the program; 172.24 (5) provide training and technical assistance for local 172.25 agencies and consumers to help identify potential applicants to 172.26 the program; and 172.27 (6) develop guidelines for local agency program 172.28 administration and consumer information; and172.29(7) apply for a federal waiver or take any other action172.30necessary to maximize federal funding for the program by172.31September 1, 1999. 172.32 Sec. 15. Minnesota Statutes 2000, section 256.476, is 172.33 amended by adding a subdivision to read: 172.34 Subd. 11. [CONSUMER SUPPORT GRANT PROGRAM AFTER JULY 1, 172.35 2001.] (a) Effective July 1, 2001, the commissioner shall 172.36 allocate consumer support grant resources to serve additional 173.1 individuals based on a review of Medicaid authorization and 173.2 payment information of persons eligible for a consumer support 173.3 grant from the most recent fiscal year. The commissioner shall 173.4 use the following methodology to calculate maximum allowable 173.5 monthly consumer support grant levels: 173.6 (1) for individuals whose program of origination is medical 173.7 assistance home care under section 256B.0627, the maximum 173.8 allowable monthly grant levels are calculated by: 173.9 (i) determining the nonfederal share of the average service 173.10 authorization for each home care rating; 173.11 (ii) calculating the overall ratio of actual payments to 173.12 service authorizations by program; 173.13 (iii) applying the overall ratio to the average service 173.14 authorization level of each home care rating; 173.15 (iv) adjusting the result for any authorized rate increases 173.16 provided by the legislature; and 173.17 (v) adjusting the result for the average monthly 173.18 utilization per recipient; and 173.19 (2) for persons with programs of origination other than the 173.20 program described in clause (1), the maximum grant level for an 173.21 individual shall not exceed the total of the nonfederal dollars 173.22 expended on the individual by the program of origination. 173.23 (b) Persons receiving consumer support grants prior to July 173.24 1, 2001, may continue to receive the grant amount established 173.25 prior to July 1, 2001. 173.26 (c) The commissioner may provide up to 200 exception 173.27 grants, including grants in use under paragraph (b). Eligible 173.28 persons shall be provided an exception grant in priority order 173.29 based upon the date of the commissioner's receipt of the county 173.30 request. The maximum allowable grant level for an exception 173.31 grant shall be based upon the nonfederal share of the average 173.32 service authorization from the most recent fiscal year for each 173.33 home care rating category. The amount of each exception grant 173.34 shall be based upon the commissioner's determination of the 173.35 nonfederal dollars that would have been expended if services had 173.36 been available for an individual who is unable to obtain the 174.1 support needed from the program of origination due to the 174.2 unavailability of qualified service providers at the time or the 174.3 location where the supports are needed. 174.4 Sec. 16. Minnesota Statutes 2000, section 256B.0625, 174.5 subdivision 7, is amended to read: 174.6 Subd. 7. [PRIVATE DUTY NURSING.] Medical assistance covers 174.7 private duty nursing services in a recipient's home. Recipients 174.8 who are authorized to receive private duty nursing services in 174.9 their home may use approved hours outside of the home during 174.10 hours when normal life activities take them outside of their 174.11 homeand when, without the provision of private duty nursing,174.12their health and safety would be jeopardized. To use private 174.13 duty nursing services at school, the recipient or responsible 174.14 party must provide written authorization in the care plan 174.15 identifying the chosen provider and the daily amount of services 174.16 to be used at school. Medical assistance does not cover private 174.17 duty nursing services for residents of a hospital, nursing 174.18 facility, intermediate care facility, or a health care facility 174.19 licensed by the commissioner of health, except as authorized in 174.20 section 256B.64 for ventilator-dependent recipients in hospitals 174.21 or unless a resident who is otherwise eligible is on leave from 174.22 the facility and the facility either pays for the private duty 174.23 nursing services or forgoes the facility per diem for the leave 174.24 days that private duty nursing services are used. Total hours 174.25 of service and payment allowed for services outside the home 174.26 cannot exceed that which is otherwise allowed in an in-home 174.27 setting according to section 256B.0627. All private duty 174.28 nursing services must be provided according to the limits 174.29 established under section 256B.0627. Private duty nursing 174.30 services may not be reimbursed if the nurse is thespouse of the174.31recipient or the parent orfoster care provider of a recipient 174.32 who is under age 18, or the recipient's legal guardian. 174.33 Sec. 17. Minnesota Statutes 2000, section 256B.0625, 174.34 subdivision 19a, is amended to read: 174.35 Subd. 19a. [PERSONAL CARE ASSISTANT SERVICES.] Medical 174.36 assistance covers personal care assistant services in a 175.1 recipient's home. To qualify for personal care assistant 175.2 services, recipients or responsible parties must be able to 175.3 identify the recipient's needs, direct and evaluate task 175.4 accomplishment, and provide for health and safety. Approved 175.5 hours may be used outside the home when normal life activities 175.6 take them outside the homeand when, without the provision of175.7personal care, their health and safety would be jeopardized. To 175.8 use personal care assistant services at school, the recipient or 175.9 responsible party must provide written authorization in the care 175.10 plan identifying the chosen provider and the daily amount of 175.11 services to be used at school. Total hours for services, 175.12 whether actually performed inside or outside the recipient's 175.13 home, cannot exceed that which is otherwise allowed for personal 175.14 care assistant services in an in-home setting according to 175.15 section 256B.0627. Medical assistance does not cover personal 175.16 care assistant services for residents of a hospital, nursing 175.17 facility, intermediate care facility, health care facility 175.18 licensed by the commissioner of health, or unless a resident who 175.19 is otherwise eligible is on leave from the facility and the 175.20 facility either pays for the personal care assistant services or 175.21 forgoes the facility per diem for the leave days that personal 175.22 care assistant services are used. All personal care assistant 175.23 services must be provided according to section 256B.0627. 175.24 Personal care assistant services may not be reimbursed if the 175.25 personal care assistant is the spouse or legal guardian of the 175.26 recipient or the parent of a recipient under age 18, or the 175.27 responsible party or the foster care provider of a recipient who 175.28 cannot direct the recipient's own care unless, in the case of a 175.29 foster care provider, a county or state case manager visits the 175.30 recipient as needed, but not less than every six months, to 175.31 monitor the health and safety of the recipient and to ensure the 175.32 goals of the care plan are met. Parents of adult recipients, 175.33 adult children of the recipient or adult siblings of the 175.34 recipient may be reimbursed for personal care assistant services 175.35if they are not the recipient's legal guardian and, if they are 175.36 granted a waiver under section 256B.0627.Until July 1, 2001,176.1andNotwithstanding the provisions of section 256B.0627, 176.2 subdivision 4, paragraph (b), clause (4), the noncorporate legal 176.3 guardian or conservator of an adult, who is not the responsible 176.4 party and not the personal care provider organization, may be 176.5 granted a hardship waiver under section 256B.0627, to be 176.6 reimbursed to provide personal care assistant services to the 176.7 recipient, and shall not be considered to have a service 176.8 provider interest for purposes of participation on the screening 176.9 team under section 256B.092, subdivision 7. 176.10 Sec. 18. Minnesota Statutes 2000, section 256B.0625, 176.11 subdivision 19c, is amended to read: 176.12 Subd. 19c. [PERSONAL CARE.] Medical assistance covers 176.13 personal care assistant services provided by an individual who 176.14 is qualified to provide the services according to subdivision 176.15 19a and section 256B.0627, where the services are prescribed by 176.16 a physician in accordance with a plan of treatment and are 176.17 supervised by the recipientunder the fiscal agent option176.18according to section 256B.0627, subdivision 10,or a qualified 176.19 professional. "Qualified professional" means a mental health 176.20 professional as defined in section 245.462, subdivision 18, or 176.21 245.4871, subdivision 27; or a registered nurse as defined in 176.22 sections 148.171 to 148.285. As part of the assessment, the 176.23 county public health nurse willconsult withassist the 176.24 recipient or responsible partyandto identify the most 176.25 appropriate person to provide supervision of the personal care 176.26 assistant. The qualified professional shall perform the duties 176.27 described in Minnesota Rules, part 9505.0335, subpart 4. 176.28 Sec. 19. Minnesota Statutes 2000, section 256B.0625, 176.29 subdivision 20, is amended to read: 176.30 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 176.31 extent authorized by rule of the state agency, medical 176.32 assistance covers case management services to persons with 176.33 serious and persistent mental illness and children with severe 176.34 emotional disturbance. Services provided under this section 176.35 must meet the relevant standards in sections 245.461 to 176.36 245.4888, the Comprehensive Adult and Children's Mental Health 177.1 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 177.2 9505.0322, excluding subpart 10. 177.3 (b) Entities meeting program standards set out in rules 177.4 governing family community support services as defined in 177.5 section 245.4871, subdivision 17, are eligible for medical 177.6 assistance reimbursement for case management services for 177.7 children with severe emotional disturbance when these services 177.8 meet the program standards in Minnesota Rules, parts 9520.0900 177.9 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 177.10 (c) Medical assistance and MinnesotaCare payment for mental 177.11 health case management shall be made on a monthly basis. In 177.12 order to receive payment for an eligible child, the provider 177.13 must document at least a face-to-face contact with the child, 177.14 the child's parents, or the child's legal representative. To 177.15 receive payment for an eligible adult, the provider must 177.16 document: 177.17 (1) at least a face-to-face contact with the adult or the 177.18 adult's legal representative; or 177.19 (2) at least a telephone contact with the adult or the 177.20 adult's legal representative and document a face-to-face contact 177.21 with the adult or the adult's legal representative within the 177.22 preceding two months. 177.23 (d) Payment for mental health case management provided by 177.24 county or state staff shall be based on the monthly rate 177.25 methodology under section 256B.094, subdivision 6, paragraph 177.26 (b), with separate rates calculated for child welfare and mental 177.27 health, and within mental health, separate rates for children 177.28 and adults. 177.29 (e) Payment for mental health case management provided by 177.30 county-contracted vendors shall be based on a monthly rate 177.31 negotiated by the host county. The negotiated rate must not 177.32 exceed the rate charged by the vendor for the same service to 177.33 other payers. If the service is provided by a team of 177.34 contracted vendors, the county may negotiate a team rate with a 177.35 vendor who is a member of the team. The team shall determine 177.36 how to distribute the rate among its members. No reimbursement 178.1 received by contracted vendors shall be returned to the county, 178.2 except to reimburse the county for advance funding provided by 178.3 the county to the vendor. 178.4 (f) If the service is provided by a team which includes 178.5 contracted vendors and county or state staff, the costs for 178.6 county or state staff participation in the team shall be 178.7 included in the rate for county-provided services. In this 178.8 case, the contracted vendor and the county may each receive 178.9 separate payment for services provided by each entity in the 178.10 same month. In order to prevent duplication of services, the 178.11 county must document, in the recipient's file, the need for team 178.12 case management and a description of the roles of the team 178.13 members. 178.14 (g) The commissioner shall calculate the nonfederal share 178.15 of actual medical assistance and general assistance medical care 178.16 payments for each county, based on the higher of calendar year 178.17 1995 or 1996, by service date, project that amount forward to 178.18 1999, and transfer one-half of the result from medical 178.19 assistance and general assistance medical care to each county's 178.20 mental health grants under sections 245.4886 and 256E.12 for 178.21 calendar year 1999. The annualized minimum amount added to each 178.22 county's mental health grant shall be $3,000 per year for 178.23 children and $5,000 per year for adults. The commissioner may 178.24 reduce the statewide growth factor in order to fund these 178.25 minimums. The annualized total amount transferred shall become 178.26 part of the base for future mental health grants for each county. 178.27 (h) Any net increase in revenue to the county as a result 178.28 of the change in this section must be used to provide expanded 178.29 mental health services as defined in sections 245.461 to 178.30 245.4888, the Comprehensive Adult and Children's Mental Health 178.31 Acts, excluding inpatient and residential treatment. For 178.32 adults, increased revenue may also be used for services and 178.33 consumer supports which are part of adult mental health projects 178.34 approved under Laws 1997, chapter 203, article 7, section 25. 178.35 For children, increased revenue may also be used for respite 178.36 care and nonresidential individualized rehabilitation services 179.1 as defined in section 245.492, subdivisions 17 and 23. 179.2 "Increased revenue" has the meaning given in Minnesota Rules, 179.3 part 9520.0903, subpart 3. 179.4 (i) Notwithstanding section 256B.19, subdivision 1, the 179.5 nonfederal share of costs for mental health case management 179.6 shall be provided by the recipient's county of responsibility, 179.7 as defined in sections 256G.01 to 256G.12, from sources other 179.8 than federal funds or funds used to match other federal funds. 179.9 (j) The commissioner may suspend, reduce, or terminate the 179.10 reimbursement to a provider that does not meet the reporting or 179.11 other requirements of this section. The county of 179.12 responsibility, as defined in sections 256G.01 to 256G.12, is 179.13 responsible for any federal disallowances. The county may share 179.14 this responsibility with its contracted vendors. 179.15 (k) The commissioner shall set aside a portion of the 179.16 federal funds earned under this section to repay the special 179.17 revenue maximization account under section 256.01, subdivision 179.18 2, clause (15). The repayment is limited to: 179.19 (1) the costs of developing and implementing this section; 179.20 and 179.21 (2) programming the information systems. 179.22 (l) Notwithstanding section 256.025, subdivision 2, 179.23 payments to counties for case management expenditures under this 179.24 section shall only be made from federal earnings from services 179.25 provided under this section. Payments to contracted vendors 179.26 shall include both the federal earnings and the county share. 179.27 (m) Notwithstanding section 256B.041, county payments for 179.28 the cost of mental health case management services provided by 179.29 county or state staff shall not be made to the state treasurer. 179.30 For the purposes of mental health case management services 179.31 provided by county or state staff under this section, the 179.32 centralized disbursement of payments to counties under section 179.33 256B.041 consists only of federal earnings from services 179.34 provided under this section. 179.35 (n) Case management services under this subdivision do not 179.36 include therapy, treatment, legal, or outreach services. 180.1 (o) If the recipient is a resident of a nursing facility, 180.2 intermediate care facility, or hospital, and the recipient's 180.3 institutional care is paid by medical assistance, payment for 180.4 case management services under this subdivision is limited to 180.5 the last30180 days of the recipient's residency in that 180.6 facility and may not exceed more thantwosix months in a 180.7 calendar year. 180.8 (p) Payment for case management services under this 180.9 subdivision shall not duplicate payments made under other 180.10 program authorities for the same purpose. 180.11 (q) By July 1, 2000, the commissioner shall evaluate the 180.12 effectiveness of the changes required by this section, including 180.13 changes in number of persons receiving mental health case 180.14 management, changes in hours of service per person, and changes 180.15 in caseload size. 180.16 (r) For each calendar year beginning with the calendar year 180.17 2001, the annualized amount of state funds for each county 180.18 determined under paragraph (g) shall be adjusted by the county's 180.19 percentage change in the average number of clients per month who 180.20 received case management under this section during the fiscal 180.21 year that ended six months prior to the calendar year in 180.22 question, in comparison to the prior fiscal year. 180.23 (s) For counties receiving the minimum allocation of $3,000 180.24 or $5,000 described in paragraph (g), the adjustment in 180.25 paragraph (r) shall be determined so that the county receives 180.26 the higher of the following amounts: 180.27 (1) a continuation of the minimum allocation in paragraph 180.28 (g); or 180.29 (2) an amount based on that county's average number of 180.30 clients per month who received case management under this 180.31 section during the fiscal year that ended six months prior to 180.32 the calendar year in question, in comparison to the prior fiscal 180.33 year, times the average statewide grant per person per month for 180.34 counties not receiving the minimum allocation. 180.35 (t) The adjustments in paragraphs (r) and (s) shall be 180.36 calculated separately for children and adults. 181.1 Sec. 20. Minnesota Statutes 2000, section 256B.0625, is 181.2 amended by adding a subdivision to read: 181.3 Subd. 43. [TARGETED CASE MANAGEMENT.] For purposes of 181.4 subdivisions 43a to 43h, the following terms have the meanings 181.5 given them: 181.6 (1) "home care service recipients" means those individuals 181.7 receiving the following services under section 256B.0627: 181.8 skilled nursing visits, home health aide visits, private duty 181.9 nursing, personal care assistants, or therapies provided through 181.10 a home health agency; 181.11 (2) "home care targeted case management" means the 181.12 provision of targeted case management services for the purpose 181.13 of assisting home care service recipients to gain access to 181.14 needed services and supports so that they may remain in the 181.15 community; 181.16 (3) "institutions" means hospitals, consistent with Code of 181.17 Federal Regulations, title 42, section 440.10; regional 181.18 treatment center inpatient services, consistent with section 181.19 245.474; nursing facilities; and intermediate care facilities 181.20 for persons with mental retardation; 181.21 (4) "relocation targeted case management" means the 181.22 provision of targeted case management services for the purpose 181.23 of assisting recipients to gain access to needed services and 181.24 supports if they choose to move from an institution to the 181.25 community. Relocation targeted case management may be provided 181.26 during the last 180 consecutive days of an eligible recipient's 181.27 institutional stay; and 181.28 (5) "targeted case management" means case management 181.29 services provided to help recipients gain access to needed 181.30 medical, social, educational, and other services and supports. 181.31 Sec. 21. Minnesota Statutes 2000, section 256B.0625, is 181.32 amended by adding a subdivision to read: 181.33 Subd. 43a. [ELIGIBILITY.] The following persons are 181.34 eligible for relocation targeted case management or home 181.35 care-targeted case management: 181.36 (1) medical assistance eligible persons residing in 182.1 institutions who choose to move into the community are eligible 182.2 for relocation targeted case management services; and 182.3 (2) medical assistance eligible persons receiving home care 182.4 services, who are not eligible for any other medical assistance 182.5 reimbursable case management service, are eligible for home 182.6 care-targeted case management services beginning January 1, 2003. 182.7 Sec. 22. Minnesota Statutes 2000, section 256B.0625, is 182.8 amended by adding a subdivision to read: 182.9 Subd. 43b. [RELOCATION TARGETED CASE MANAGEMENT PROVIDER 182.10 QUALIFICATIONS.] The following qualifications and certification 182.11 standards must be met by providers of relocation targeted case 182.12 management: 182.13 (a) The commissioner must certify each provider of 182.14 relocation targeted case management before enrollment. The 182.15 certification process shall examine the provider's ability to 182.16 meet the requirements in this subdivision and other federal and 182.17 state requirements of this service. A certified relocation 182.18 targeted case management provider may subcontract with another 182.19 provider to deliver relocation targeted case management 182.20 services. Subcontracted providers must demonstrate the ability 182.21 to provide the services outlined in subdivision 43d. 182.22 (b) A relocation targeted case management provider is an 182.23 enrolled medical assistance provider who is determined by the 182.24 commissioner to have all of the following characteristics: 182.25 (1) the legal authority to provide public welfare under 182.26 sections 393.01, subdivision 7; and 393.07; or a federally 182.27 recognized Indian tribe; 182.28 (2) the demonstrated capacity and experience to provide the 182.29 components of case management to coordinate and link community 182.30 resources needed by the eligible population; 182.31 (3) the administrative capacity and experience to serve the 182.32 target population for whom it will provide services and ensure 182.33 quality of services under state and federal requirements; 182.34 (4) the legal authority to provide complete investigative 182.35 and protective services under section 626.556, subdivision 10; 182.36 and child welfare and foster care services under section 393.07, 183.1 subdivisions 1 and 2; or a federally recognized Indian tribe; 183.2 (5) a financial management system that provides accurate 183.3 documentation of services and costs under state and federal 183.4 requirements; and 183.5 (6) the capacity to document and maintain individual case 183.6 records under state and federal requirements. 183.7 A provider of targeted case management under subdivision 20 may 183.8 be deemed a certified provider of relocation targeted case 183.9 management. 183.10 Sec. 23. Minnesota Statutes 2000, section 256B.0625, is 183.11 amended by adding a subdivision to read: 183.12 Subd. 43c. [HOME CARE TARGETED CASE MANAGEMENT PROVIDER 183.13 QUALIFICATIONS.] The following qualifications and certification 183.14 standards must be met by providers of home care targeted case 183.15 management. 183.16 (a) The commissioner must certify each provider of home 183.17 care targeted case management before enrollment. The 183.18 certification process shall examine the provider's ability to 183.19 meet the requirements in this subdivision and other state and 183.20 federal requirements of this service. 183.21 (b) A home care targeted case management provider is an 183.22 enrolled medical assistance provider who has a minimum of a 183.23 bachelor's degree or a license in a health or human services 183.24 field, and is determined by the commissioner to have all of the 183.25 following characteristics: 183.26 (1) the demonstrated capacity and experience to provide the 183.27 components of case management to coordinate and link community 183.28 resources needed by the eligible population; 183.29 (2) the administrative capacity and experience to serve the 183.30 target population for whom it will provide services and ensure 183.31 quality of services under state and federal requirements; 183.32 (3) a financial management system that provides accurate 183.33 documentation of services and costs under state and federal 183.34 requirements; 183.35 (4) the capacity to document and maintain individual case 183.36 records under state and federal requirements; and 184.1 (5) the capacity to coordinate with county administrative 184.2 functions. 184.3 Sec. 24. Minnesota Statutes 2000, section 256B.0625, is 184.4 amended by adding a subdivision to read: 184.5 Subd. 43d. [ELIGIBLE SERVICES.] Services eligible for 184.6 medical assistance reimbursement as targeted case management 184.7 include: 184.8 (1) assessment of the recipient's need for targeted case 184.9 management services; 184.10 (2) development, completion, and regular review of a 184.11 written individual service plan, which is based upon the 184.12 assessment of the recipient's needs and choices, and which will 184.13 ensure access to medical, social, educational, and other related 184.14 services and supports; 184.15 (3) routine contact or communication with the recipient, 184.16 recipient's family, primary caregiver, legal representative, 184.17 substitute care provider, service providers, or other relevant 184.18 persons identified as necessary to the development or 184.19 implementation of the goals of the individual service plan; 184.20 (4) coordinating referrals for, and the provision of, case 184.21 management services for the recipient with appropriate service 184.22 providers, consistent with section 1902(a)(23) of the Social 184.23 Security Act; 184.24 (5) coordinating and monitoring the overall service 184.25 delivery to ensure quality of services, appropriateness, and 184.26 continued need; 184.27 (6) completing and maintaining necessary documentation that 184.28 supports and verifies the activities in this subdivision; 184.29 (7) traveling to conduct a visit with the recipient or 184.30 other relevant person necessary to develop or implement the 184.31 goals of the individual service plan; and 184.32 (8) coordinating with the institution discharge planner in 184.33 the 180-day period before the recipient's discharge. 184.34 Sec. 25. Minnesota Statutes 2000, section 256B.0625, is 184.35 amended by adding a subdivision to read: 184.36 Subd. 43e. [TIME LINES.] The following time lines must be 185.1 met for assigning a case manager: 185.2 (1) for relocation targeted case management, an eligible 185.3 recipient must be assigned a case manager who visits the person 185.4 within 20 working days of requesting a case manager from their 185.5 county of financial responsibility as determined under chapter 185.6 256G. If a county agency does not provide case management 185.7 services as required, the recipient may, after written notice to 185.8 the county agency, obtain targeted relocation case management 185.9 services from a home care targeted case management provider, as 185.10 defined in subdivision 43c; and 185.11 (2) for home care targeted case management, an eligible 185.12 recipient must be assigned a case manager within 20 working days 185.13 of requesting a case manager from a home care targeted case 185.14 management provider, as defined in subdivision 43c. 185.15 Sec. 26. Minnesota Statutes 2000, section 256B.0625, is 185.16 amended by adding a subdivision to read: 185.17 Subd. 43f. [EVALUATION.] The commissioner shall evaluate 185.18 the delivery of targeted case management, including, but not 185.19 limited to, access to case management services, consumer 185.20 satisfaction with case management services, and quality of case 185.21 management services. 185.22 Sec. 27. Minnesota Statutes 2000, section 256B.0625, is 185.23 amended by adding a subdivision to read: 185.24 Subd. 43g. [CONTACT DOCUMENTATION.] The case manager must 185.25 document each face-to-face and telephone contact with the 185.26 recipient and others involved in the recipient's individual 185.27 service plan. 185.28 Sec. 28. Minnesota Statutes 2000, section 256B.0625, is 185.29 amended by adding a subdivision to read: 185.30 Subd. 43h. [PAYMENT RATES.] The commissioner shall set 185.31 payment rates for targeted case management under this 185.32 subdivision. Case managers may bill according to the following 185.33 criteria: 185.34 (1) for relocation targeted case management, case managers 185.35 may bill for direct case management activities, including 185.36 face-to-face and telephone contacts, in the 180 days preceding 186.1 an eligible recipient's discharge from an institution; 186.2 (2) for home care targeted case management, case managers 186.3 may bill for direct case management activities, including 186.4 face-to-face and telephone contacts; and 186.5 (3) billings for targeted case management services under 186.6 this subdivision shall not duplicate payments made under other 186.7 program authorities for the same purpose. 186.8 Sec. 29. Minnesota Statutes 2000, section 256B.0627, 186.9 subdivision 1, is amended to read: 186.10 Subdivision 1. [DEFINITION.] (a) "Activities of daily 186.11 living" includes eating, toileting, grooming, dressing, bathing, 186.12 transferring, mobility, and positioning. 186.13 (b) "Assessment" means a review and evaluation of a 186.14 recipient's need for home care services conducted in person. 186.15 Assessments for private duty nursing shall be conducted by a 186.16 registered private duty nurse. Assessments for home health 186.17 agency services shall be conducted by a home health agency 186.18 nurse. Assessments for personal care assistant services shall 186.19 be conducted by the county public health nurse or a certified 186.20 public health nurse under contract with the county. A 186.21 face-to-face assessment must include: documentation of health 186.22 status, determination of need, evaluation of service 186.23 effectiveness, identification of appropriate services, service 186.24 plan development or modification, coordination of services, 186.25 referrals and follow-up to appropriate payers and community 186.26 resources, completion of required reports, recommendation of 186.27 service authorization, and consumer education. Once the need 186.28 for personal care assistant services is determined under this 186.29 section, the county public health nurse or certified public 186.30 health nurse under contract with the county is responsible for 186.31 communicating this recommendation to the commissioner and the 186.32 recipient. A face-to-face assessment for personal 186.33 care assistant services is conducted on those recipients who 186.34 have never had a county public health nurse assessment. A 186.35 face-to-face assessment must occur at least annually or when 186.36 there is a significant change in the recipient's condition or 187.1 when there is a change in the need for personal care assistant 187.2 services. A service update may substitute for the annual 187.3 face-to-face assessment when there is not a significant change 187.4 in recipient condition or a change in the need for personal care 187.5 assistant service. A service update or review for temporary 187.6 increase includes a review of initial baseline data, evaluation 187.7 of service effectiveness, redetermination of service need, 187.8 modification of service plan and appropriate referrals, update 187.9 of initial forms, obtaining service authorization, and on going 187.10 consumer education. Assessments for medical assistance home 187.11 care services for mental retardation or related conditions and 187.12 alternative care services for developmentally disabled home and 187.13 community-based waivered recipients may be conducted by the 187.14 county public health nurse to ensure coordination and avoid 187.15 duplication. Assessments must be completed on forms provided by 187.16 the commissioner within 30 days of a request for home care 187.17 services by a recipient or responsible party. 187.18(b)(c) "Care plan" means a written description of personal 187.19 care assistant services developed by the qualified 187.20 professional or the recipient's physician with the recipient or 187.21 responsible party to be used by the personal care assistant with 187.22 a copy provided to the recipient or responsible party. 187.23 (d) "Complex and regular private duty nursing care" means: 187.24 (1) complex care is private duty nursing provided to 187.25 recipients who are ventilator dependent or for whom a physician 187.26 has certified that were it not for private duty nursing the 187.27 recipient would meet the criteria for inpatient hospital 187.28 intensive care unit (ICU) level of care; and 187.29 (2) regular care is private duty nursing provided to all 187.30 other recipients. 187.31 (e) "Health-related functions" means functions that can be 187.32 delegated or assigned by a licensed health care professional 187.33 under state law to be performed by a personal care attendant. 187.34(c)(f) "Home care services" means a health service, 187.35 determined by the commissioner as medically necessary, that is 187.36 ordered by a physician and documented in a service plan that is 188.1 reviewed by the physician at least once every6260 days for the 188.2 provision of home health services, or private duty nursing, or 188.3 at least once every 365 days for personal care. Home care 188.4 services are provided to the recipient at the recipient's 188.5 residence that is a place other than a hospital or long-term 188.6 care facility or as specified in section 256B.0625. 188.7 (g) "Instrumental activities of daily living" includes meal 188.8 planning and preparation, managing finances, shopping for food, 188.9 clothing, and other essential items, performing essential 188.10 household chores, communication by telephone and other media, 188.11 and getting around and participating in the community. 188.12(d)(h) "Medically necessary" has the meaning given in 188.13 Minnesota Rules, parts 9505.0170 to 9505.0475. 188.14(e)(i) "Personal care assistant" means a person who: 188.15 (1) is at least 18 years old, except for persons 16 to 18 188.16 years of age who participated in a related school-based job 188.17 training program or have completed a certified home health aide 188.18 competency evaluation; 188.19 (2) is able to effectively communicate with the recipient 188.20 and personal care provider organization; 188.21 (3) effective July 1, 1996, has completed one of the 188.22 training requirements as specified in Minnesota Rules, part 188.23 9505.0335, subpart 3, items A to D; 188.24 (4) has the ability to, and provides covered personal 188.25 care assistant services according to the recipient's care plan, 188.26 responds appropriately to recipient needs, and reports changes 188.27 in the recipient's condition to the supervising qualified 188.28 professional or physician; 188.29 (5) is not a consumer of personal care assistant services; 188.30 and 188.31 (6) is subject to criminal background checks and procedures 188.32 specified in section 245A.04. 188.33(f)(j) "Personal care provider organization" means an 188.34 organization enrolled to provide personal care assistant 188.35 services under the medical assistance program that complies with 188.36 the following: (1) owners who have a five percent interest or 189.1 more, and managerial officials are subject to a background study 189.2 as provided in section 245A.04. This applies to currently 189.3 enrolled personal care provider organizations and those agencies 189.4 seeking enrollment as a personal care provider organization. An 189.5 organization will be barred from enrollment if an owner or 189.6 managerial official of the organization has been convicted of a 189.7 crime specified in section 245A.04, or a comparable crime in 189.8 another jurisdiction, unless the owner or managerial official 189.9 meets the reconsideration criteria specified in section 245A.04; 189.10 (2) the organization must maintain a surety bond and liability 189.11 insurance throughout the duration of enrollment and provides 189.12 proof thereof. The insurer must notify the department of human 189.13 services of the cancellation or lapse of policy; and (3) the 189.14 organization must maintain documentation of services as 189.15 specified in Minnesota Rules, part 9505.2175, subpart 7, as well 189.16 as evidence of compliance with personal care assistant training 189.17 requirements. 189.18(g)(k) "Responsible party" means an individual residing 189.19 with a recipient of personal care assistant services who is 189.20 capable of providing the supportive care necessary to assist the 189.21 recipient to live in the community, is at least 18 years old, 189.22 and is not a personal care assistant. Responsible parties who 189.23 are parents of minors or guardians of minors or incapacitated 189.24 persons may delegate the responsibility to another adult during 189.25 a temporary absence of at least 24 hours but not more than six 189.26 months. The person delegated as a responsible party must be 189.27 able to meet the definition of responsible party, except that 189.28 the delegated responsible party is required to reside with the 189.29 recipient only while serving as the responsible party. Foster 189.30 care license holders may be designated the responsible party for 189.31 residents of the foster care home if case management is provided 189.32 as required in section 256B.0625, subdivision 19a. For persons 189.33 who, as of April 1, 1992, are sharing personal care assistant 189.34 services in order to obtain the availability of 24-hour 189.35 coverage, an employee of the personal care provider organization 189.36 may be designated as the responsible party if case management is 190.1 provided as required in section 256B.0625, subdivision 19a. 190.2(h)(l) "Service plan" means a written description of the 190.3 services needed based on the assessment developed by the nurse 190.4 who conducts the assessment together with the recipient or 190.5 responsible party. The service plan shall include a description 190.6 of the covered home care services, frequency and duration of 190.7 services, and expected outcomes and goals. The recipient and 190.8 the provider chosen by the recipient or responsible party must 190.9 be given a copy of the completed service plan within 30 calendar 190.10 days of the request for home care services by the recipient or 190.11 responsible party. 190.12(i)(m) "Skilled nurse visits" are provided in a 190.13 recipient's residence under a plan of care or service plan that 190.14 specifies a level of care which the nurse is qualified to 190.15 provide. These services are: 190.16 (1) nursing services according to the written plan of care 190.17 or service plan and accepted standards of medical and nursing 190.18 practice in accordance with chapter 148; 190.19 (2) services which due to the recipient's medical condition 190.20 may only be safely and effectively provided by a registered 190.21 nurse or a licensed practical nurse; 190.22 (3) assessments performed only by a registered nurse; and 190.23 (4) teaching and training the recipient, the recipient's 190.24 family, or other caregivers requiring the skills of a registered 190.25 nurse or licensed practical nurse. 190.26 (n) "Telehomecare" means the use of telecommunications 190.27 technology by a home health care professional to deliver home 190.28 health care services, within the professional's scope of 190.29 practice, to a patient located at a site other than the site 190.30 where the practitioner is located. 190.31 Sec. 30. Minnesota Statutes 2000, section 256B.0627, 190.32 subdivision 2, is amended to read: 190.33 Subd. 2. [SERVICES COVERED.] Home care services covered 190.34 under this section include: 190.35 (1) nursing services under section 256B.0625, subdivision 190.36 6a; 191.1 (2) private duty nursing services under section 256B.0625, 191.2 subdivision 7; 191.3 (3) home healthaideservices under section 256B.0625, 191.4 subdivision 6a; 191.5 (4) personal care assistant services under section 191.6 256B.0625, subdivision 19a; 191.7 (5) supervision of personal care assistant services 191.8 provided by a qualified professional under section 256B.0625, 191.9 subdivision 19a; 191.10 (6)consultingqualified professional of personal care 191.11 assistant services under the fiscalagentintermediary option as 191.12 specified in subdivision 10; 191.13 (7) face-to-face assessments by county public health nurses 191.14 for services under section 256B.0625, subdivision 19a; and 191.15 (8) service updates and review of temporary increases for 191.16 personal care assistant services by the county public health 191.17 nurse for services under section 256B.0625, subdivision 19a. 191.18 Sec. 31. Minnesota Statutes 2000, section 256B.0627, 191.19 subdivision 4, is amended to read: 191.20 Subd. 4. [PERSONAL CARE ASSISTANT SERVICES.] (a) The 191.21 personal care assistant services that are eligible for payment 191.22 arethe following:services and supports furnished to an 191.23 individual, as needed, to assist in accomplishing activities of 191.24 daily living; instrumental activities of daily living; 191.25 health-related functions through hands-on assistance, 191.26 supervision, and cuing; and redirection and intervention for 191.27 behavior including observation and monitoring. 191.28 (b) Payment for services will be made within the limits 191.29 approved using the prior authorized process established in 191.30 subdivision 5. 191.31 (c) The amount and type of services authorized shall be 191.32 based on an assessment of the recipient's needs in these areas: 191.33 (1) bowel and bladder care; 191.34 (2) skin care to maintain the health of the skin; 191.35 (3) repetitive maintenance range of motion, muscle 191.36 strengthening exercises, and other tasks specific to maintaining 192.1 a recipient's optimal level of function; 192.2 (4) respiratory assistance; 192.3 (5) transfers and ambulation; 192.4 (6) bathing, grooming, and hairwashing necessary for 192.5 personal hygiene; 192.6 (7) turning and positioning; 192.7 (8) assistance with furnishing medication that is 192.8 self-administered; 192.9 (9) application and maintenance of prosthetics and 192.10 orthotics; 192.11 (10) cleaning medical equipment; 192.12 (11) dressing or undressing; 192.13 (12) assistance with eating and meal preparation and 192.14 necessary grocery shopping; 192.15 (13) accompanying a recipient to obtain medical diagnosis 192.16 or treatment; 192.17 (14) assisting, monitoring, or prompting the recipient to 192.18 complete the services in clauses (1) to (13); 192.19 (15) redirection, monitoring, and observation that are 192.20 medically necessary and an integral part of completing the 192.21 personal care assistant services described in clauses (1) to 192.22 (14); 192.23 (16) redirection and intervention for behavior, including 192.24 observation and monitoring; 192.25 (17) interventions for seizure disorders, including 192.26 monitoring and observation if the recipient has had a seizure 192.27 that requires intervention within the past three months; 192.28 (18) tracheostomy suctioning using a clean procedure if the 192.29 procedure is properly delegated by a registered nurse. Before 192.30 this procedure can be delegated to a personal care assistant, a 192.31 registered nurse must determine that the tracheostomy suctioning 192.32 can be accomplished utilizing a clean rather than a sterile 192.33 procedure and must ensure that the personal care assistant has 192.34 been taught the proper procedure; and 192.35 (19) incidental household services that are an integral 192.36 part of a personal care service described in clauses (1) to (18). 193.1 For purposes of this subdivision, monitoring and observation 193.2 means watching for outward visible signs that are likely to 193.3 occur and for which there is a covered personal care service or 193.4 an appropriate personal care intervention. For purposes of this 193.5 subdivision, a clean procedure refers to a procedure that 193.6 reduces the numbers of microorganisms or prevents or reduces the 193.7 transmission of microorganisms from one person or place to 193.8 another. A clean procedure may be used beginning 14 days after 193.9 insertion. 193.10(b)(d) The personal care assistant services that are not 193.11 eligible for payment are the following: 193.12 (1) services not ordered by the physician; 193.13 (2) assessments by personal care assistant provider 193.14 organizations or by independently enrolled registered nurses; 193.15 (3) services that are not in the service plan; 193.16 (4) services provided by the recipient's spouse, legal 193.17 guardian for an adult or child recipient, or parent of a 193.18 recipient under age 18; 193.19 (5) services provided by a foster care provider of a 193.20 recipient who cannot direct the recipient's own care, unless 193.21 monitored by a county or state case manager under section 193.22 256B.0625, subdivision 19a; 193.23 (6) services provided by the residential or program license 193.24 holder in a residence for more than four persons; 193.25 (7) services that are the responsibility of a residential 193.26 or program license holder under the terms of a service agreement 193.27 and administrative rules; 193.28 (8) sterile procedures; 193.29 (9) injections of fluids into veins, muscles, or skin; 193.30 (10) services provided by parents of adult recipients, 193.31 adult children, or siblings of the recipient, unless these 193.32 relatives meet one of the following hardship criteria and the 193.33 commissioner waives this requirement: 193.34 (i) the relative resigns from a part-time or full-time job 193.35 to provide personal care for the recipient; 193.36 (ii) the relative goes from a full-time to a part-time job 194.1 with less compensation to provide personal care for the 194.2 recipient; 194.3 (iii) the relative takes a leave of absence without pay to 194.4 provide personal care for the recipient; 194.5 (iv) the relative incurs substantial expenses by providing 194.6 personal care for the recipient; or 194.7 (v) because of labor conditions, special language needs, or 194.8 intermittent hours of care needed, the relative is needed in 194.9 order to provide an adequate number of qualified personal care 194.10 assistants to meet the medical needs of the recipient; 194.11 (11) homemaker services that are not an integral part of a 194.12 personal care assistant services; 194.13 (12) home maintenance, or chore services; 194.14 (13) services not specified under paragraph (a); and 194.15 (14) services not authorized by the commissioner or the 194.16 commissioner's designee. 194.17 (e) The recipient or responsible party may choose to 194.18 supervise the personal care assistant or to have a qualified 194.19 professional, as defined in section 256B.0625, subdivision 19c, 194.20 provide the supervision. As required under section 256B.0625, 194.21 subdivision 19c, the county public health nurse, as a part of 194.22 the assessment, will assist the recipient or responsible party 194.23 to identify the most appropriate person to provide supervision 194.24 of the personal care assistant. Health-related delegated tasks 194.25 performed by the personal care assistant will be under the 194.26 supervision of a qualified professional or the direction of the 194.27 recipient's physician. If the recipient has a qualified 194.28 professional, Minnesota Rules, part 9505.0335, subpart 4, 194.29 applies. 194.30 Sec. 32. Minnesota Statutes 2000, section 256B.0627, 194.31 subdivision 5, is amended to read: 194.32 Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance 194.33 payments for home care services shall be limited according to 194.34 this subdivision. 194.35 (a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 194.36 recipient may receive the following home care services during a 195.1 calendar year: 195.2 (1) up to two face-to-face assessments to determine a 195.3 recipient's need for personal care assistant services; 195.4 (2) one service update done to determine a recipient's need 195.5 for personal care assistant services; and 195.6 (3) up tofivenine skilled nurse visits. 195.7 (b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 195.8 services above the limits in paragraph (a) must receive the 195.9 commissioner's prior authorization, except when: 195.10 (1) the home care services were required to treat an 195.11 emergency medical condition that if not immediately treated 195.12 could cause a recipient serious physical or mental disability, 195.13 continuation of severe pain, or death. The provider must 195.14 request retroactive authorization no later than five working 195.15 days after giving the initial service. The provider must be 195.16 able to substantiate the emergency by documentation such as 195.17 reports, notes, and admission or discharge histories; 195.18 (2) the home care services were provided on or after the 195.19 date on which the recipient's eligibility began, but before the 195.20 date on which the recipient was notified that the case was 195.21 opened. Authorization will be considered if the request is 195.22 submitted by the provider within 20 working days of the date the 195.23 recipient was notified that the case was opened; 195.24 (3) a third-party payor for home care services has denied 195.25 or adjusted a payment. Authorization requests must be submitted 195.26 by the provider within 20 working days of the notice of denial 195.27 or adjustment. A copy of the notice must be included with the 195.28 request; 195.29 (4) the commissioner has determined that a county or state 195.30 human services agency has made an error; or 195.31 (5) the professional nurse determines an immediate need for 195.32 up to 40 skilled nursing or home health aide visits per calendar 195.33 year and submits a request for authorization within 20 working 195.34 days of the initial service date, and medical assistance is 195.35 determined to be the appropriate payer. 195.36 (c) [RETROACTIVE AUTHORIZATION.] A request for retroactive 196.1 authorization will be evaluated according to the same criteria 196.2 applied to prior authorization requests. 196.3 (d) [ASSESSMENT AND SERVICE PLAN.] Assessments under 196.4 section 256B.0627, subdivision 1, paragraph (a), shall be 196.5 conducted initially, and at least annually thereafter, in person 196.6 with the recipient and result in a completed service plan using 196.7 forms specified by the commissioner. Within 30 days of 196.8 recipient or responsible party request for home care services, 196.9 the assessment, the service plan, and other information 196.10 necessary to determine medical necessity such as diagnostic or 196.11 testing information, social or medical histories, and hospital 196.12 or facility discharge summaries shall be submitted to the 196.13 commissioner. Notwithstanding the provisions of section 196.14 256B.0627, subdivision 12, the commissioner shall maximize 196.15 federal financial participation to pay for public health nurse 196.16 assessments for personal care services. For personal care 196.17 assistant services: 196.18 (1) The amount and type of service authorized based upon 196.19 the assessment and service plan will follow the recipient if the 196.20 recipient chooses to change providers. 196.21 (2) If the recipient's medical need changes, the 196.22 recipient's provider may assess the need for a change in service 196.23 authorization and request the change from the county public 196.24 health nurse. Within 30 days of the request, the public health 196.25 nurse will determine whether to request the change in services 196.26 based upon the provider assessment, or conduct a home visit to 196.27 assess the need and determine whether the change is appropriate. 196.28 (3) To continue to receive personal care assistant services 196.29 after the first year, the recipient or the responsible party, in 196.30 conjunction with the public health nurse, may complete a service 196.31 update on forms developed by the commissioner according to 196.32 criteria and procedures in subdivision 1. 196.33 (e) [PRIOR AUTHORIZATION.] The commissioner, or the 196.34 commissioner's designee, shall review the assessment, service 196.35 update, request for temporary services, service plan, and any 196.36 additional information that is submitted. The commissioner 197.1 shall, within 30 days after receiving a complete request, 197.2 assessment, and service plan, authorize home care services as 197.3 follows: 197.4 (1) [HOME HEALTH SERVICES.] All home health services 197.5 provided by alicensed nurse or ahome health aide must be prior 197.6 authorized by the commissioner or the commissioner's designee. 197.7 Prior authorization must be based on medical necessity and 197.8 cost-effectiveness when compared with other care options. When 197.9 home health services are used in combination with personal care 197.10 and private duty nursing, the cost of all home care services 197.11 shall be considered for cost-effectiveness. The commissioner 197.12 shall limitnurse andhome health aide visits to no more than 197.13 one visit each per day. The commissioner, or the commissioner's 197.14 designee, may authorize up to two skilled nurse visits per day. 197.15 (2) [PERSONAL CARE ASSISTANT SERVICES.] (i) All personal 197.16 care assistant services and supervision by a qualified 197.17 professional, if requested by the recipient, must be prior 197.18 authorized by the commissioner or the commissioner's designee 197.19 except for the assessments established in paragraph (a). The 197.20 amount of personal care assistant services authorized must be 197.21 based on the recipient's home care rating. A child may not be 197.22 found to be dependent in an activity of daily living if because 197.23 of the child's age an adult would either perform the activity 197.24 for the child or assist the child with the activity and the 197.25 amount of assistance needed is similar to the assistance 197.26 appropriate for a typical child of the same age. Based on 197.27 medical necessity, the commissioner may authorize: 197.28 (A) up to two times the average number of direct care hours 197.29 provided in nursing facilities for the recipient's comparable 197.30 case mix level; or 197.31 (B) up to three times the average number of direct care 197.32 hours provided in nursing facilities for recipients who have 197.33 complex medical needs or are dependent in at least seven 197.34 activities of daily living and need physical assistance with 197.35 eating or have a neurological diagnosis; or 197.36 (C) up to 60 percent of the average reimbursement rate, as 198.1 of July 1, 1991, for care provided in a regional treatment 198.2 center for recipients who have Level I behavior, plus any 198.3 inflation adjustment as provided by the legislature for personal 198.4 care service; or 198.5 (D) up to the amount the commissioner would pay, as of July 198.6 1, 1991, plus any inflation adjustment provided for home care 198.7 services, for care provided in a regional treatment center for 198.8 recipients referred to the commissioner by a regional treatment 198.9 center preadmission evaluation team. For purposes of this 198.10 clause, home care services means all services provided in the 198.11 home or community that would be included in the payment to a 198.12 regional treatment center; or 198.13 (E) up to the amount medical assistance would reimburse for 198.14 facility care for recipients referred to the commissioner by a 198.15 preadmission screening team established under section 256B.0911 198.16 or 256B.092; and 198.17 (F) a reasonable amount of time for the provision of 198.18 supervision by a qualified professional of personal 198.19 care assistant services, if a qualified professional is 198.20 requested by the recipient or responsible party. 198.21 (ii) The number of direct care hours shall be determined 198.22 according to the annual cost report submitted to the department 198.23 by nursing facilities. The average number of direct care hours, 198.24 as established by May 1, 1992, shall be calculated and 198.25 incorporated into the home care limits on July 1, 1992. These 198.26 limits shall be calculated to the nearest quarter hour. 198.27 (iii) The home care rating shall be determined by the 198.28 commissioner or the commissioner's designee based on information 198.29 submitted to the commissioner by the county public health nurse 198.30 on forms specified by the commissioner. The home care rating 198.31 shall be a combination of current assessment tools developed 198.32 under sections 256B.0911 and 256B.501 with an addition for 198.33 seizure activity that will assess the frequency and severity of 198.34 seizure activity and with adjustments, additions, and 198.35 clarifications that are necessary to reflect the needs and 198.36 conditions of recipients who need home care including children 199.1 and adults under 65 years of age. The commissioner shall 199.2 establish these forms and protocols under this section and shall 199.3 use an advisory group, including representatives of recipients, 199.4 providers, and counties, for consultation in establishing and 199.5 revising the forms and protocols. 199.6 (iv) A recipient shall qualify as having complex medical 199.7 needs if the care required is difficult to perform and because 199.8 of recipient's medical condition requires more time than 199.9 community-based standards allow or requires more skill than 199.10 would ordinarily be required and the recipient needs or has one 199.11 or more of the following: 199.12 (A) daily tube feedings; 199.13 (B) daily parenteral therapy; 199.14 (C) wound or decubiti care; 199.15 (D) postural drainage, percussion, nebulizer treatments, 199.16 suctioning, tracheotomy care, oxygen, mechanical ventilation; 199.17 (E) catheterization; 199.18 (F) ostomy care; 199.19 (G) quadriplegia; or 199.20 (H) other comparable medical conditions or treatments the 199.21 commissioner determines would otherwise require institutional 199.22 care. 199.23 (v) A recipient shall qualify as having Level I behavior if 199.24 there is reasonable supporting evidence that the recipient 199.25 exhibits, or that without supervision, observation, or 199.26 redirection would exhibit, one or more of the following 199.27 behaviors that cause, or have the potential to cause: 199.28 (A) injury to the recipient's own body; 199.29 (B) physical injury to other people; or 199.30 (C) destruction of property. 199.31 (vi) Time authorized for personal care relating to Level I 199.32 behavior in subclause (v), items (A) to (C), shall be based on 199.33 the predictability, frequency, and amount of intervention 199.34 required. 199.35 (vii) A recipient shall qualify as having Level II behavior 199.36 if the recipient exhibits on a daily basis one or more of the 200.1 following behaviors that interfere with the completion of 200.2 personal care assistant services under subdivision 4, paragraph 200.3 (a): 200.4 (A) unusual or repetitive habits; 200.5 (B) withdrawn behavior; or 200.6 (C) offensive behavior. 200.7 (viii) A recipient with a home care rating of Level II 200.8 behavior in subclause (vii), items (A) to (C), shall be rated as 200.9 comparable to a recipient with complex medical needs under 200.10 subclause (iv). If a recipient has both complex medical needs 200.11 and Level II behavior, the home care rating shall be the next 200.12 complex category up to the maximum rating under subclause (i), 200.13 item (B). 200.14 (3) [PRIVATE DUTY NURSING SERVICES.] All private duty 200.15 nursing services shall be prior authorized by the commissioner 200.16 or the commissioner's designee. Prior authorization for private 200.17 duty nursing services shall be based on medical necessity and 200.18 cost-effectiveness when compared with alternative care options. 200.19 The commissioner may authorize medically necessary private duty 200.20 nursing services in quarter-hour units when: 200.21 (i) the recipient requires more individual and continuous 200.22 care than can be provided during a nurse visit; or 200.23 (ii) the cares are outside of the scope of services that 200.24 can be provided by a home health aide or personal care assistant. 200.25 The commissioner may authorize: 200.26 (A) up to two times the average amount of direct care hours 200.27 provided in nursing facilities statewide for case mix 200.28 classification "K" as established by the annual cost report 200.29 submitted to the department by nursing facilities in May 1992; 200.30 (B) private duty nursing in combination with other home 200.31 care services up to the total cost allowed under clause (2); 200.32 (C) up to 16 hours per day if the recipient requires more 200.33 nursing than the maximum number of direct care hours as 200.34 established in item (A) and the recipient meets the hospital 200.35 admission criteria established under Minnesota Rules, parts 200.369505.05009505.0501 to 9505.0540. 201.1 The commissioner may authorize up to 16 hours per day of 201.2 medically necessary private duty nursing services or up to 24 201.3 hours per day of medically necessary private duty nursing 201.4 services until such time as the commissioner is able to make a 201.5 determination of eligibility for recipients who are 201.6 cooperatively applying for home care services under the 201.7 community alternative care program developed under section 201.8 256B.49, or until it is determined by the appropriate regulatory 201.9 agency that a health benefit plan is or is not required to pay 201.10 for appropriate medically necessary health care services. 201.11 Recipients or their representatives must cooperatively assist 201.12 the commissioner in obtaining this determination. Recipients 201.13 who are eligible for the community alternative care program may 201.14 not receive more hours of nursing under this section than would 201.15 otherwise be authorized under section 256B.49. 201.16 (4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 201.17 ventilator-dependent, the monthly medical assistance 201.18 authorization for home care services shall not exceed what the 201.19 commissioner would pay for care at the highest cost hospital 201.20 designated as a long-term hospital under the Medicare program. 201.21 For purposes of this clause, home care services means all 201.22 services provided in the home that would be included in the 201.23 payment for care at the long-term hospital. 201.24 "Ventilator-dependent" means an individual who receives 201.25 mechanical ventilation for life support at least six hours per 201.26 day and is expected to be or has been dependent for at least 30 201.27 consecutive days. 201.28 (f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 201.29 or the commissioner's designee shall determine the time period 201.30 for which a prior authorization shall be effective. If the 201.31 recipient continues to require home care services beyond the 201.32 duration of the prior authorization, the home care provider must 201.33 request a new prior authorization. Under no circumstances, 201.34 other than the exceptions in paragraph (b), shall a prior 201.35 authorization be valid prior to the date the commissioner 201.36 receives the request or for more than 12 months. A recipient 202.1 who appeals a reduction in previously authorized home care 202.2 services may continue previously authorized services, other than 202.3 temporary services under paragraph (h), pending an appeal under 202.4 section 256.045. The commissioner must provide a detailed 202.5 explanation of why the authorized services are reduced in amount 202.6 from those requested by the home care provider. 202.7 (g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or 202.8 the commissioner's designee shall determine the medical 202.9 necessity of home care services, the level of caregiver 202.10 according to subdivision 2, and the institutional comparison 202.11 according to this subdivision, the cost-effectiveness of 202.12 services, and the amount, scope, and duration of home care 202.13 services reimbursable by medical assistance, based on the 202.14 assessment, primary payer coverage determination information as 202.15 required, the service plan, the recipient's age, the cost of 202.16 services, the recipient's medical condition, and diagnosis or 202.17 disability. The commissioner may publish additional criteria 202.18 for determining medical necessity according to section 256B.04. 202.19 (h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 202.20 The agency nurse, the independently enrolled private duty nurse, 202.21 or county public health nurse may request a temporary 202.22 authorization for home care services by telephone. The 202.23 commissioner may approve a temporary level of home care services 202.24 based on the assessment, and service or care plan information, 202.25 and primary payer coverage determination information as required. 202.26 Authorization for a temporary level of home care services 202.27 including nurse supervision is limited to the time specified by 202.28 the commissioner, but shall not exceed 45 days, unless extended 202.29 because the county public health nurse has not completed the 202.30 required assessment and service plan, or the commissioner's 202.31 determination has not been made. The level of services 202.32 authorized under this provision shall have no bearing on a 202.33 future prior authorization. 202.34 (i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 202.35 Home care services provided in an adult or child foster care 202.36 setting must receive prior authorization by the department 203.1 according to the limits established in paragraph (a). 203.2 The commissioner may not authorize: 203.3 (1) home care services that are the responsibility of the 203.4 foster care provider under the terms of the foster care 203.5 placement agreement and administrative rules; 203.6 (2) personal care assistant services when the foster care 203.7 license holder is also the personal care provider or personal 203.8 care assistant unless the recipient can direct the recipient's 203.9 own care, or case management is provided as required in section 203.10 256B.0625, subdivision 19a; 203.11 (3) personal care assistant services when the responsible 203.12 party is an employee of, or under contract with, or has any 203.13 direct or indirect financial relationship with the personal care 203.14 provider or personal care assistant, unless case management is 203.15 provided as required in section 256B.0625, subdivision 19a; or 203.16 (4) personal care assistant and private duty nursing 203.17 services when the number of foster care residents is greater 203.18 than four unless the county responsible for the recipient's 203.19 foster placement made the placement prior to April 1, 1992, 203.20 requests that personal care assistant and private duty nursing 203.21 services be provided, and case management is provided as 203.22 required in section 256B.0625, subdivision 19a. 203.23 Sec. 33. Minnesota Statutes 2000, section 256B.0627, 203.24 subdivision 7, is amended to read: 203.25 Subd. 7. [NONCOVERED HOME CARE SERVICES.] The following 203.26 home care services are not eligible for payment under medical 203.27 assistance: 203.28 (1) skilled nurse visits for the sole purpose of 203.29 supervision of the home health aide; 203.30 (2) a skilled nursing visit: 203.31 (i) only for the purpose of monitoring medication 203.32 compliance with an established medication program for a 203.33 recipient; or 203.34 (ii) to administer or assist with medication 203.35 administration, including injections, prefilling syringes for 203.36 injections, or oral medication set-up of an adult recipient, 204.1 when as determined and documented by the registered nurse, the 204.2 need can be met by an available pharmacy or the recipient is 204.3 physically and mentally able to self-administer or prefill a 204.4 medication; 204.5 (3) home care services to a recipient who is eligible for 204.6 covered servicesincluding hospice, if elected by the recipient,204.7 under the Medicare program or any other insurance held by the 204.8 recipient; 204.9 (4) services to other members of the recipient's household; 204.10 (5) a visit made by a skilled nurse solely to train other 204.11 home health agency workers; 204.12 (6) any home care service included in the daily rate of the 204.13 community-based residential facility where the recipient is 204.14 residing; 204.15 (7) nursing and rehabilitation therapy services that are 204.16 reasonably accessible to a recipient outside the recipient's 204.17 place of residence, excluding the assessment, counseling and 204.18 education, and personal assistant care; 204.19 (8) any home health agency service, excluding personal care 204.20 assistant services and private duty nursing services, which are 204.21 performed in a place other than the recipient's residence; and 204.22 (9) Medicare evaluation or administrative nursing visits on 204.23 dual-eligible recipients that do not qualify for Medicare visit 204.24 billing. 204.25 Sec. 34. Minnesota Statutes 2000, section 256B.0627, 204.26 subdivision 8, is amended to read: 204.27 Subd. 8. [SHARED PERSONAL CARE ASSISTANT SERVICES.] (a) 204.28 Medical assistance payments for shared personal care assistance 204.29 services shall be limited according to this subdivision. 204.30 (b) Recipients of personal care assistant services may 204.31 share staff and the commissioner shall provide a rate system for 204.32 shared personal care assistant services. For two persons 204.33 sharing services, the rate paid to a provider shall not exceed 204.34 1-1/2 times the rate paid for serving a single individual, and 204.35 for three persons sharing services, the rate paid to a provider 204.36 shall not exceed twice the rate paid for serving a single 205.1 individual. These rates apply only to situations in which all 205.2 recipients were present and received shared services on the date 205.3 for which the service is billed. No more than three persons may 205.4 receive shared services from a personal care assistant in a 205.5 single setting. 205.6 (c) Shared service is the provision of personal 205.7 care assistant services by a personal care assistant to two or 205.8 three recipients at the same time and in the same setting. For 205.9 the purposes of this subdivision, "setting" means: 205.10 (1) the home or foster care home of one of the individual 205.11 recipients; or 205.12 (2) a child care program in which all recipients served by 205.13 one personal care assistant are participating, which is licensed 205.14 under chapter 245A or operated by a local school district or 205.15 private school; or 205.16 (3) outside the home or foster care home of one of the 205.17 recipients when normal life activities take the recipients 205.18 outside the home. 205.19 The provisions of this subdivision do not apply when a 205.20 personal care assistant is caring for multiple recipients in 205.21 more than one setting. 205.22 (d) The recipient or the recipient's responsible party, in 205.23 conjunction with the county public health nurse, shall determine: 205.24 (1) whether shared personal care assistant services is an 205.25 appropriate option based on the individual needs and preferences 205.26 of the recipient; and 205.27 (2) the amount of shared services allocated as part of the 205.28 overall authorization of personal care assistant services. 205.29 The recipient or the responsible party, in conjunction with 205.30 the supervising qualified professional, if a qualified 205.31 professional is requested by any one of the recipients or 205.32 responsible parties, shall arrange the setting and grouping of 205.33 shared services based on the individual needs and preferences of 205.34 the recipients. Decisions on the selection of recipients to 205.35 share services must be based on the ages of the recipients, 205.36 compatibility, and coordination of their care needs. 206.1 (e) The following items must be considered by the recipient 206.2 or the responsible party and the supervising qualified 206.3 professional, if a qualified professional has been requested by 206.4 any one of the recipients or responsible parties, and documented 206.5 in the recipient's health service record: 206.6 (1) the additional qualifications needed by the personal 206.7 care assistant to provide care to several recipients in the same 206.8 setting; 206.9 (2) the additional training and supervision needed by the 206.10 personal care assistant to ensure that the needs of the 206.11 recipient are met appropriately and safely. The provider must 206.12 provide on-site supervision by a qualified professional within 206.13 the first 14 days of shared services, and monthly thereafter, if 206.14 supervision by a qualified provider has been requested by any 206.15 one of the recipients or responsible parties; 206.16 (3) the setting in which the shared services will be 206.17 provided; 206.18 (4) the ongoing monitoring and evaluation of the 206.19 effectiveness and appropriateness of the service and process 206.20 used to make changes in service or setting; and 206.21 (5) a contingency plan which accounts for absence of the 206.22 recipient in a shared services setting due to illness or other 206.23 circumstances and staffing contingencies. 206.24 (f) The provider must offer the recipient or the 206.25 responsible party the option of shared or one-on-one personal 206.26 care assistant services. The recipient or the responsible party 206.27 can withdraw from participating in a shared services arrangement 206.28 at any time. 206.29 (g) In addition to documentation requirements under 206.30 Minnesota Rules, part 9505.2175, a personal care provider must 206.31 meet documentation requirements for shared personal care 206.32 assistant services and must document the following in the health 206.33 service record for each individual recipient sharing services: 206.34 (1) permission by the recipient or the recipient's 206.35 responsible party, if any, for the maximum number of shared 206.36 services hours per week chosen by the recipient; 207.1 (2) permission by the recipient or the recipient's 207.2 responsible party, if any, for personal care assistant services 207.3 provided outside the recipient's residence; 207.4 (3) permission by the recipient or the recipient's 207.5 responsible party, if any, for others to receive shared services 207.6 in the recipient's residence; 207.7 (4) revocation by the recipient or the recipient's 207.8 responsible party, if any, of the shared service authorization, 207.9 or the shared service to be provided to others in the 207.10 recipient's residence, or the shared service to be provided 207.11 outside the recipient's residence; 207.12 (5) supervision of the shared personal care assistant 207.13 services by the qualified professional, if a qualified 207.14 professional is requested by one of the recipients or 207.15 responsible parties, including the date, time of day, number of 207.16 hours spent supervising the provision of shared services, 207.17 whether the supervision was face-to-face or another method of 207.18 supervision, changes in the recipient's condition, shared 207.19 services scheduling issues and recommendations; 207.20 (6) documentation by the qualified professional, if a 207.21 qualified professional is requested by one of the recipients or 207.22 responsible parties, of telephone calls or other discussions 207.23 with the personal care assistant regarding services being 207.24 provided to the recipient who has requested the supervision; and 207.25 (7) daily documentation of the shared services provided by 207.26 each identified personal care assistant including: 207.27 (i) the names of each recipient receiving shared services 207.28 together; 207.29 (ii) the setting for the shared services, including the 207.30 starting and ending times that the recipient received shared 207.31 services; and 207.32 (iii) notes by the personal care assistant regarding 207.33 changes in the recipient's condition, problems that may arise 207.34 from the sharing of services, scheduling issues, care issues, 207.35 and other notes as required by the qualified professional, if a 207.36 qualified professional is requested by one of the recipients or 208.1 responsible parties. 208.2 (h) Unless otherwise provided in this subdivision, all 208.3 other statutory and regulatory provisions relating to personal 208.4 care assistant services apply to shared services. 208.5 (i) In the event that supervision by a qualified 208.6 professional has been requested by one or more recipients, but 208.7 not by all of the recipients, the supervision duties of the 208.8 qualified professional shall be limited to only those recipients 208.9 who have requested the supervision. 208.10 Nothing in this subdivision shall be construed to reduce 208.11 the total number of hours authorized for an individual recipient. 208.12 Sec. 35. Minnesota Statutes 2000, section 256B.0627, 208.13 subdivision 10, is amended to read: 208.14 Subd. 10. [FISCALAGENTINTERMEDIARY OPTION AVAILABLE FOR 208.15 PERSONAL CARE ASSISTANT SERVICES.] (a)"Fiscal agent option" is208.16an option that allows the recipient to:208.17(1) use a fiscal agent instead of a personal care provider208.18organization;208.19(2) supervise the personal care assistant; and208.20(3) use a consulting professional.208.21 The commissioner may allow a recipient of personal care 208.22 assistant services to use a fiscalagentintermediary to assist 208.23 the recipient in paying and accounting for medically necessary 208.24 covered personal care assistant services authorized in 208.25 subdivision 4 and within the payment parameters of subdivision 208.26 5. Unless otherwise provided in this subdivision, all other 208.27 statutory and regulatory provisions relating to personal care 208.28 assistant services apply to a recipient using the fiscalagent208.29 intermediary option. 208.30 (b) The recipient or responsible party shall: 208.31 (1)hire, and terminate the personal care assistant and208.32consulting professional, with the fiscal agentrecruit, hire, 208.33 and terminate a qualified professional, if a qualified 208.34 professional is requested by the recipient or responsible party; 208.35 (2)recruit the personal care assistant and consulting208.36professional and orient and train the personal care assistant in209.1areas that do not require professional delegation as determined209.2by the county public health nurseverify and document the 209.3 credentials of the qualified professional, if a qualified 209.4 professional is requested by the recipient or responsible party; 209.5 (3)supervise and evaluate the personal care assistant in209.6areas that do not require professional delegation as determined209.7in the assessment;209.8(4) cooperate with a consultingdevelop a service plan 209.9 based on physician orders and public health nurse assessment 209.10 with the assistance of a qualified professionaland implement209.11recommendations pertaining to the health and safety of the209.12recipient, if a qualified professional is requested by the 209.13 recipient or responsible party, that addresses the health and 209.14 safety of the recipient; 209.15(5) hire a qualified professional to train and supervise209.16the performance of delegated tasks done by(4) recruit, hire, 209.17 and terminate the personal care assistant; 209.18(6) monitor services and verify in writing the hours worked209.19by the personal care assistant and the consulting(5) orient and 209.20 train the personal care assistant with assistance as needed from 209.21 the qualified professional; 209.22(7) develop and revise a care plan with assistance from a209.23consulting(6) supervise and evaluate the personal care 209.24 assistant with assistance as needed from the recipient's 209.25 physician or the qualified professional; 209.26(8) verify and document the credentials of the consulting209.27 (7) monitor and verify in writing and report to the fiscal 209.28 intermediary the number of hours worked by the personal care 209.29 assistant and the qualified professional; and 209.30(9)(8) enter into a written agreement, as specified in 209.31 paragraph (f). 209.32 (c) The duties of the fiscalagentintermediary shall be to: 209.33 (1) bill the medical assistance program for personal care 209.34 assistant andconsultingqualified professional services; 209.35 (2) request and secure background checks on personal care 209.36 assistants andconsultingqualified professionals according to 210.1 section 245A.04; 210.2 (3) pay the personal care assistant andconsulting210.3 qualified professional based on actual hours of services 210.4 provided; 210.5 (4) withhold and pay all applicable federal and state 210.6 taxes; 210.7 (5) verify anddocumentkeep records of hours worked by the 210.8 personal care assistant andconsultingqualified professional; 210.9 (6) make the arrangements and pay unemployment insurance, 210.10 taxes, workers' compensation, liability insurance, and other 210.11 benefits, if any; 210.12 (7) enroll in the medical assistance program as a fiscal 210.13agentintermediary; and 210.14 (8) enter into a written agreement as specified in 210.15 paragraph (f) before services are provided. 210.16 (d) The fiscalagentintermediary: 210.17 (1) may not be related to the recipient,consulting210.18 qualified professional, or the personal care assistant; 210.19 (2) must ensure arm's length transactions with the 210.20 recipient and personal care assistant; and 210.21 (3) shall be considered a joint employer of the personal 210.22 care assistant andconsultingqualified professional to the 210.23 extent specified in this section. 210.24 The fiscalagentintermediary or owners of the entity that 210.25 provides fiscalagentintermediary services under this 210.26 subdivision must pass a criminal background check as required in 210.27 section 256B.0627, subdivision 1, paragraph (e). 210.28 (e) If the recipient or responsible party requests a 210.29 qualified professional, theconsultingqualified professional 210.30 providing assistance to the recipient shall meet the 210.31 qualifications specified in section 256B.0625, subdivision 19c. 210.32 Theconsultingqualified professional shall assist the recipient 210.33 in developing and revising a plan to meet the 210.34 recipient'sassessedneeds,and supervise the performance of210.35delegated tasks, as determined by the public health nurseas 210.36 assessed by the public health nurse. In performing this 211.1 function, theconsultingqualified professional must visit the 211.2 recipient in the recipient's home at least once annually. 211.3 Theconsultingqualified professional must reportto the local211.4county public health nurse concerns relating to the health and211.5safety of the recipient, andany suspected abuse, neglect, or 211.6 financial exploitation of the recipient to the appropriate 211.7 authorities. 211.8 (f) The fiscalagentintermediary, recipient or responsible 211.9 party, personal care assistant, andconsultingqualified 211.10 professional shall enter into a written agreement before 211.11 services are started. The agreement shall include: 211.12 (1) the duties of the recipient, qualified professional, 211.13 personal care assistant, and fiscal agent based on paragraphs 211.14 (a) to (e); 211.15 (2) the salary and benefits for the personal care assistant 211.16 andthose providing professional consultationthe qualified 211.17 professional; 211.18 (3) the administrative fee of the fiscalagentintermediary 211.19 and services paid for with that fee, including background check 211.20 fees; 211.21 (4) procedures to respond to billing or payment complaints; 211.22 and 211.23 (5) procedures for hiring and terminating the personal care 211.24 assistant andthose providing professional consultationthe 211.25 qualified professional. 211.26 (g) The rates paid for personal care assistant services, 211.27 qualified professionalassistanceservices, and fiscalagency211.28 intermediary services under this subdivision shall be the same 211.29 rates paid for personal care assistant services and qualified 211.30 professional services under subdivision 2 respectively. Except 211.31 for the administrative fee of the fiscalagentintermediary 211.32 specified in paragraph (f), the remainder of the rates paid to 211.33 the fiscalagentintermediary must be used to pay for the salary 211.34 and benefits for the personal care assistant orthose providing211.35professional consultationthe qualified professional. 211.36 (h) As part of the assessment defined in subdivision 1, the 212.1 following conditions must be met to use or continue use of a 212.2 fiscalagentintermediary: 212.3 (1) the recipient must be able to direct the recipient's 212.4 own care, or the responsible party for the recipient must be 212.5 readily available to direct the care of the personal care 212.6 assistant; 212.7 (2) the recipient or responsible party must be 212.8 knowledgeable of the health care needs of the recipient and be 212.9 able to effectively communicate those needs; 212.10 (3) a face-to-face assessment must be conducted by the 212.11 local county public health nurse at least annually, or when 212.12 there is a significant change in the recipient's condition or 212.13 change in the need for personal care assistant services. The212.14county public health nurse shall determine the services that212.15require professional delegation, if any, and the amount and212.16frequency of related supervision; 212.17 (4) the recipient cannot select the shared services option 212.18 as specified in subdivision 8; and 212.19 (5) parties must be in compliance with the written 212.20 agreement specified in paragraph (f). 212.21 (i) The commissioner shall deny, revoke, or suspend the 212.22 authorization to use the fiscalagentintermediary option if: 212.23 (1) it has been determined by theconsultingqualified 212.24 professional or local county public health nurse that the use of 212.25 this option jeopardizes the recipient's health and safety; 212.26 (2) the parties have failed to comply with the written 212.27 agreement specified in paragraph (f); or 212.28 (3) the use of the option has led to abusive or fraudulent 212.29 billing for personal care assistant services. 212.30 The recipient or responsible party may appeal the 212.31 commissioner's action according to section 256.045. The denial, 212.32 revocation, or suspension to use the fiscalagentintermediary 212.33 option shall not affect the recipient's authorized level of 212.34 personal care assistant services as determined in subdivision 5. 212.35 Sec. 36. Minnesota Statutes 2000, section 256B.0627, 212.36 subdivision 11, is amended to read: 213.1 Subd. 11. [SHARED PRIVATE DUTY NURSING CARE OPTION.] (a) 213.2 Medical assistance payments for shared private duty nursing 213.3 services by a private duty nurse shall be limited according to 213.4 this subdivision. For the purposes of this section, "private 213.5 duty nursing agency" means an agency licensed under chapter 144A 213.6 to provide private duty nursing services. 213.7 (b) Recipients of private duty nursing services may share 213.8 nursing staff and the commissioner shall provide a rate 213.9 methodology for shared private duty nursing. For two persons 213.10 sharing nursing care, the rate paid to a provider shall not 213.11 exceed 1.5 times thenonwaiveredregular private duty nursing 213.12 rates paid for serving a single individualwho is not ventilator213.13dependent,by a registered nurse or licensed practical nurse. 213.14 These rates apply only to situations in which both recipients 213.15 are present and receive shared private duty nursing care on the 213.16 date for which the service is billed. No more than two persons 213.17 may receive shared private duty nursing services from a private 213.18 duty nurse in a single setting. 213.19 (c) Shared private duty nursing care is the provision of 213.20 nursing services by a private duty nurse to two recipients at 213.21 the same time and in the same setting. For the purposes of this 213.22 subdivision, "setting" means: 213.23 (1) the home or foster care home of one of the individual 213.24 recipients; or 213.25 (2) a child care program licensed under chapter 245A or 213.26 operated by a local school district or private school; or 213.27 (3) an adult day care service licensed under chapter 245A; 213.28 or 213.29 (4) outside the home or foster care home of one of the 213.30 recipients when normal life activities take the recipients 213.31 outside the home. 213.32 This subdivision does not apply when a private duty nurse 213.33 is caring for multiple recipients in more than one setting. 213.34 (d) The recipient or the recipient's legal representative, 213.35 and the recipient's physician, in conjunction with the home 213.36 health care agency, shall determine: 214.1 (1) whether shared private duty nursing care is an 214.2 appropriate option based on the individual needs and preferences 214.3 of the recipient; and 214.4 (2) the amount of shared private duty nursing services 214.5 authorized as part of the overall authorization of nursing 214.6 services. 214.7 (e) The recipient or the recipient's legal representative, 214.8 in conjunction with the private duty nursing agency, shall 214.9 approve the setting, grouping, and arrangement of shared private 214.10 duty nursing care based on the individual needs and preferences 214.11 of the recipients. Decisions on the selection of recipients to 214.12 share services must be based on the ages of the recipients, 214.13 compatibility, and coordination of their care needs. 214.14 (f) The following items must be considered by the recipient 214.15 or the recipient's legal representative and the private duty 214.16 nursing agency, and documented in the recipient's health service 214.17 record: 214.18 (1) the additional training needed by the private duty 214.19 nurse to provide care to two recipients in the same setting and 214.20 to ensure that the needs of the recipients are met appropriately 214.21 and safely; 214.22 (2) the setting in which the shared private duty nursing 214.23 care will be provided; 214.24 (3) the ongoing monitoring and evaluation of the 214.25 effectiveness and appropriateness of the service and process 214.26 used to make changes in service or setting; 214.27 (4) a contingency plan which accounts for absence of the 214.28 recipient in a shared private duty nursing setting due to 214.29 illness or other circumstances; 214.30 (5) staffing backup contingencies in the event of employee 214.31 illness or absence; and 214.32 (6) arrangements for additional assistance to respond to 214.33 urgent or emergency care needs of the recipients. 214.34 (g) The provider must offer the recipient or responsible 214.35 party the option of shared or one-on-one private duty nursing 214.36 services. The recipient or responsible party can withdraw from 215.1 participating in a shared service arrangement at any time. 215.2 (h) The private duty nursing agency must document the 215.3 following in the health service record for each individual 215.4 recipient sharing private duty nursing care: 215.5 (1) permission by the recipient or the recipient's legal 215.6 representative for the maximum number of shared nursing care 215.7 hours per week chosen by the recipient; 215.8 (2) permission by the recipient or the recipient's legal 215.9 representative for shared private duty nursing services provided 215.10 outside the recipient's residence; 215.11 (3) permission by the recipient or the recipient's legal 215.12 representative for others to receive shared private duty nursing 215.13 services in the recipient's residence; 215.14 (4) revocation by the recipient or the recipient's legal 215.15 representative of the shared private duty nursing care 215.16 authorization, or the shared care to be provided to others in 215.17 the recipient's residence, or the shared private duty nursing 215.18 services to be provided outside the recipient's residence; and 215.19 (5) daily documentation of the shared private duty nursing 215.20 services provided by each identified private duty nurse, 215.21 including: 215.22 (i) the names of each recipient receiving shared private 215.23 duty nursing services together; 215.24 (ii) the setting for the shared services, including the 215.25 starting and ending times that the recipient received shared 215.26 private duty nursing care; and 215.27 (iii) notes by the private duty nurse regarding changes in 215.28 the recipient's condition, problems that may arise from the 215.29 sharing of private duty nursing services, and scheduling and 215.30 care issues. 215.31 (i) Unless otherwise provided in this subdivision, all 215.32 other statutory and regulatory provisions relating to private 215.33 duty nursing services apply to shared private duty nursing 215.34 services. 215.35 Nothing in this subdivision shall be construed to reduce 215.36 the total number of private duty nursing hours authorized for an 216.1 individual recipient under subdivision 5. 216.2 Sec. 37. Minnesota Statutes 2000, section 256B.0627, is 216.3 amended by adding a subdivision to read: 216.4 Subd. 13. [CONSUMER-DIRECTED HOME CARE DEMONSTRATION 216.5 PROJECT.] (a) Upon the receipt of federal waiver authority, the 216.6 commissioner shall implement a consumer-directed home care 216.7 demonstration project. The consumer-directed home care 216.8 demonstration project must demonstrate and evaluate the outcomes 216.9 of a consumer-directed service delivery alternative to improve 216.10 access, increase consumer control and accountability over 216.11 available resources, and enable the use of supports that are 216.12 more individualized and cost-effective for eligible medical 216.13 assistance recipients receiving certain medical assistance home 216.14 care services. The consumer-directed home care demonstration 216.15 project will be administered locally by county agencies, tribal 216.16 governments, or administrative entities under contract with the 216.17 state in regions where counties choose not to provide this 216.18 service. 216.19 (b) Grant awards for persons who have been receiving 216.20 medical assistance covered personal care, home health aide, or 216.21 private duty nursing services for a period of 12 consecutive 216.22 months or more prior to enrollment in the consumer-directed home 216.23 care demonstration project will be established on a case-by-case 216.24 basis using historical service expenditure data. An average 216.25 monthly expenditure for each continuing enrollee will be 216.26 calculated based on historical expenditures made on behalf of 216.27 the enrollee for personal care, home health aide, or private 216.28 duty nursing services during the 12 month period directly prior 216.29 to enrollment in the project. The grant award will equal 90 216.30 percent of the average monthly expenditure. 216.31 (c) Grant awards for project enrollees who have been 216.32 receiving medical assistance covered personal care, home health 216.33 aide, or private duty nursing services for a period of less than 216.34 12 consecutive months prior to project enrollment will be 216.35 calculated on a case-by-case basis using the service 216.36 authorization in place at the time of enrollment. The total 217.1 number of units of personal care, home health aide, or private 217.2 duty nursing services the enrollee has been authorized to 217.3 receive will be converted to the total cost of the authorized 217.4 services in a given month using the statewide average service 217.5 payment rates. To determine an estimated monthly expenditure, 217.6 the total authorized monthly personal care, home health aide or 217.7 private duty nursing service costs will be reduced by a 217.8 percentage rate equivalent to the difference between the 217.9 statewide average service authorization and the statewide 217.10 average utilization rate for each of the services by medical 217.11 assistance eligibles during the most recent fiscal year for 217.12 which 12 months of data is available. The grant award will 217.13 equal 90 percent of the estimated monthly expenditure. 217.14 (d) The state of Minnesota, county agencies, tribal 217.15 governments, or administrative entities under contract with the 217.16 state that participate in the implementation and administration 217.17 of the consumer-directed home care demonstration project, shall 217.18 not be liable for damages, injuries, or liabilities sustained 217.19 through the purchase of support by the individual, the 217.20 individual's family, legal representative, or the authorized 217.21 representative under this section with funds received through 217.22 the consumer-directed home care demonstration project. 217.23 Liabilities include but are not limited to: workers' 217.24 compensation liability, the Federal Insurance Contributions Act 217.25 (FICA), or the Federal Unemployment Tax Act (FUTA). 217.26 (e) With federal approval, the commissioner may adjust 217.27 methodologies in paragraphs (b) and (c) to simplify program 217.28 administration, improve consistency between state and federal 217.29 programs, and maximize federal financial participation. 217.30 Sec. 38. Minnesota Statutes 2000, section 256B.0627, is 217.31 amended by adding a subdivision to read: 217.32 Subd. 14. [TELEHOMECARE; SKILLED NURSE VISITS.] Medical 217.33 assistance covers skilled nurse visits according to section 217.34 256B.0625, subdivision 6a, provided via telehomecare, for 217.35 services which do not require hands-on care between the home 217.36 care nurse and recipient. The provision of telehomecare must be 218.1 made via live, two-way interactive audiovisual technology and 218.2 may be augmented by utilizing store-and-forward technologies. 218.3 Store-and-forward technology includes telehomecare services that 218.4 do not occur in real time via synchronous transmissions, and 218.5 that do not require a face-to-face encounter with the recipient 218.6 for all or any part of any such telehomecare visit. 218.7 Individually identifiable patient data obtained through 218.8 real-time or store-and-forward technology must be maintained as 218.9 health records according to section 144.335. If the video is 218.10 used for research, training, or other purposes unrelated to the 218.11 care of the patient, the identity of the patient must be 218.12 concealed. A communication between the home care nurse and 218.13 recipient that consists solely of a telephone conversation, 218.14 facsimile, electronic mail, or a consultation between two health 218.15 care practitioners, is not to be considered a telehomecare visit. 218.16 Multiple daily skilled nurse visits provided via telehomecare 218.17 are allowed. Coverage of telehomecare is limited to two visits 218.18 per day. All skilled nurse visits provided via telehomecare 218.19 must be prior authorized by the commissioner or the 218.20 commissioner's designee and will be covered at the same 218.21 allowable rate as skilled nurse visits provided in-person. 218.22 Sec. 39. Minnesota Statutes 2000, section 256B.0627, is 218.23 amended by adding a subdivision to read: 218.24 Subd. 15. [THERAPIES THROUGH HOME HEALTH AGENCIES.] (a) 218.25 [PHYSICAL THERAPY.] Medical assistance covers physical therapy 218.26 and related services, including specialized maintenance 218.27 therapy. Services provided by a physical therapy assistant 218.28 shall be reimbursed at the same rate as services performed by a 218.29 physical therapist when the services of the physical therapy 218.30 assistant are provided under the direction of a physical 218.31 therapist who is on the premises. Services provided by a 218.32 physical therapy assistant that are provided under the direction 218.33 of a physical therapist who is not on the premises shall be 218.34 reimbursed at 65 percent of the physical therapist rate. 218.35 Direction of the physical therapy assistant must be provided by 218.36 the physical therapist as described in Minnesota Rules, part 219.1 9505.0390, subpart 1, item B. The physical therapist and 219.2 physical therapist assistant may not both bill for services 219.3 provided to a recipient on the same day. 219.4 (b) [OCCUPATIONAL THERAPY.] Medical assistance covers 219.5 occupational therapy and related services, including specialized 219.6 maintenance therapy. Services provided by an occupational 219.7 therapy assistant shall be reimbursed at the same rate as 219.8 services performed by an occupational therapist when the 219.9 services of the occupational therapy assistant are provided 219.10 under the direction of the occupational therapist who is on the 219.11 premises. Services provided by an occupational therapy 219.12 assistant under the direction of an occupational therapist who 219.13 is not on the premises shall be reimbursed at 65 percent of the 219.14 occupational therapist rate. Direction of the occupational 219.15 therapy assistant must be provided by the occupational therapist 219.16 as described in Minnesota Rules, part 9505.0390, subpart 1, item 219.17 B. The occupational therapist and occupational therapist 219.18 assistant may not both bill for services provided to a recipient 219.19 on the same day. 219.20 Sec. 40. Minnesota Statutes 2000, section 256B.0627, is 219.21 amended by adding a subdivision to read: 219.22 Subd. 16. [HARDSHIP CRITERIA; PRIVATE DUTY NURSING.] (a) 219.23 Payment is allowed for extraordinary services that require 219.24 specialized nursing skills and are provided by parents of minor 219.25 children, spouses, and legal guardians who are providing private 219.26 duty nursing care under the following conditions: 219.27 (1) the provision of these services is not legally required 219.28 of the parents, spouses, or legal guardians; 219.29 (2) the services are necessary to prevent hospitalization 219.30 of the recipient; and 219.31 (3) the recipient is eligible for state plan home care or a 219.32 home and community-based waiver and one of the following 219.33 hardship criteria are met: 219.34 (i) the parent, spouse, or legal guardian resigns from a 219.35 part-time or full-time job to provide nursing care for the 219.36 recipient; or 220.1 (ii) the parent, spouse, or legal guardian goes from a 220.2 full-time to a part-time job with less compensation to provide 220.3 nursing care for the recipient; or 220.4 (iii) the parent, spouse, or legal guardian takes a leave 220.5 of absence without pay to provide nursing care for the 220.6 recipient; or 220.7 (iv) because of labor conditions, special language needs, 220.8 or intermittent hours of care needed, the parent, spouse, or 220.9 legal guardian is needed in order to provide adequate private 220.10 duty nursing services to meet the medical needs of the recipient. 220.11 (b) Private duty nursing may be provided by a parent, 220.12 spouse, or legal guardian who is a nurse licensed in Minnesota. 220.13 Private duty nursing services provided by a parent, spouse, or 220.14 legal guardian cannot be used in lieu of nursing services 220.15 covered and available under liable third-party payors, including 220.16 Medicare. The private duty nursing provided by a parent, 220.17 spouse, or legal guardian must be included in the service plan. 220.18 Authorized skilled nursing services provided by the parent, 220.19 spouse, or legal guardian may not exceed 50 percent of the total 220.20 approved nursing hours, or eight hours per day, whichever is 220.21 less, up to a maximum of 40 hours per week. Nothing in this 220.22 subdivision precludes the parent's, spouse's, or legal 220.23 guardian's obligation of assuming the nonreimbursed family 220.24 responsibilities of emergency backup caregiver and primary 220.25 caregiver. 220.26 (c) A parent or a spouse may not be paid to provide private 220.27 duty nursing care if the parent or spouse fails to pass a 220.28 criminal background check according to section 245A.04, or if it 220.29 has been determined by the home health agency, the case manager, 220.30 or the physician that the private duty nursing care provided by 220.31 the parent, spouse, or legal guardian is unsafe. 220.32 Sec. 41. Minnesota Statutes 2000, section 256B.0627, is 220.33 amended by adding a subdivision to read: 220.34 Subd. 17. [QUALITY ASSURANCE PLAN FOR PERSONAL CARE 220.35 ASSISTANT SERVICES.] The commissioner shall establish a quality 220.36 assurance plan for personal care assistant services that 221.1 includes: 221.2 (1) performance-based provider agreements; 221.3 (2) meaningful consumer input, which may include consumer 221.4 surveys, that measure the extent to which participants receive 221.5 the services and supports described in the individual plan and 221.6 participant satisfaction with such services and supports; 221.7 (3) ongoing monitoring of the health and well-being of 221.8 consumers; and 221.9 (4) an ongoing public process for development, 221.10 implementation, and review of the quality assurance plan. 221.11 Sec. 42. Minnesota Statutes 2000, section 256B.0911, is 221.12 amended by adding a subdivision to read: 221.13 Subd. 4d. [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 221.14 YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 221.15 ensure that individuals with disabilities or chronic illness are 221.16 served in the most integrated setting appropriate to their needs 221.17 and have the necessary information to make informed choices 221.18 about home and community-based service options. 221.19 (b) Individuals under 65 years of age who are admitted to a 221.20 nursing facility from a hospital must be screened prior to 221.21 admission as outlined in subdivisions 4a through 4c. 221.22 (c) Individuals under 65 years of age who are admitted to 221.23 nursing facilities with only a telephone screening must receive 221.24 a face-to-face assessment from the long-term care consultation 221.25 team member of the county in which the facility is located or 221.26 from the recipient's county case manager within 20 working days 221.27 of admission. 221.28 (d) At the face-to-face assessment, the long-term care 221.29 consultation team member or county case manager must perform the 221.30 activities required under subdivision 3b. 221.31 (e) For individuals under 21 years of age, a screening 221.32 interview which recommends nursing facility admission must be 221.33 face-to-face and approved by the commissioner before the 221.34 individual is admitted to the nursing facility. 221.35 (f) In the event that an individual under 65 years of age 221.36 is admitted to a nursing facility on an emergency basis, the 222.1 county must be notified of the admission on the next working 222.2 day, and a face-to-face assessment as described in paragraph (c) 222.3 must be conducted within 20 working days of admission. 222.4 (g) At the face-to-face assessment, the long-term care 222.5 consultation team member or the case manager must present 222.6 information about home and community-based options so the 222.7 individual can make informed choices. If the individual chooses 222.8 home and community-based services, the long-term care 222.9 consultation team member or case manager must complete a written 222.10 relocation plan within 20 working days of the visit. The plan 222.11 shall describe the services needed to move out of the facility 222.12 and a time line for the move which is designed to ensure a 222.13 smooth transition to the individual's home and community. 222.14 (h) An individual under 65 years of age residing in a 222.15 nursing facility shall receive a face-to-face assessment at 222.16 least every 12 months to review the person's service choices and 222.17 available alternatives unless the individual indicates, in 222.18 writing, that annual visits are not desired. In this case, the 222.19 individual must receive a face-to-face assessment at least once 222.20 every 36 months for the same purposes. 222.21 (i) Notwithstanding the provisions of subdivision 6, the 222.22 commissioner may pay county agencies directly for face-to-face 222.23 assessments for individuals under 65 years of age who are being 222.24 considered for placement or residing in a nursing facility. 222.25 Sec. 43. Minnesota Statutes 2000, section 256B.0916, is 222.26 amended by adding a subdivision to read: 222.27 Subd. 6a. [STATEWIDE AVAILABILITY OF CONSUMER-DIRECTED 222.28 COMMUNITY SUPPORT SERVICES.] (a) The commissioner shall submit 222.29 to the federal Health Care Financing Administration by August 1, 222.30 2001, an amendment to the home and community-based waiver for 222.31 persons with mental retardation or related conditions to make 222.32 consumer-directed community support services available in every 222.33 county of the state by January 1, 2002. 222.34 (b) If a county declines to meet the requirements for 222.35 provision of consumer-directed community supports, the 222.36 commissioner shall contract with another county, a group of 223.1 counties, or a private agency to plan for and administer 223.2 consumer-directed community supports in that county. 223.3 (c) The state of Minnesota, county agencies, tribal 223.4 governments, or administrative entities under contract to 223.5 participate in the implementation and administration of the home 223.6 and community-based waiver for persons with mental retardation 223.7 or a related condition, shall not be liable for damages, 223.8 injuries, or liabilities sustained through the purchase of 223.9 support by the individual, the individual's family, legal 223.10 representative, or the authorized representative with funds 223.11 received through the consumer-directed community support service 223.12 under this section. Liabilities include but are not limited 223.13 to: workers' compensation liability, the Federal Insurance 223.14 Contributions Act (FICA), or the Federal Unemployment Tax Act 223.15 (FUTA). 223.16 Sec. 44. Minnesota Statutes 2000, section 256B.0916, 223.17 subdivision 7, is amended to read: 223.18 Subd. 7. [ANNUAL REPORT BY COMMISSIONER.] Beginning 223.19October 1, 1999, and each October 1November 1, 2001, and each 223.20 November 1 thereafter, the commissioner shall issue an annual 223.21 report on county and state use of available resources for the 223.22 home and community-based waiver for persons with mental 223.23 retardation or related conditions. For each county or county 223.24 partnership, the report shall include: 223.25 (1) the amount of funds allocated but not used; 223.26 (2) the county specific allowed reserve amount approved and 223.27 used; 223.28 (3) the number, ages, and living situations of individuals 223.29 screened and waiting for services; 223.30 (4) the urgency of need for services to begin within one, 223.31 two, or more than two years for each individual; 223.32 (5) the services needed; 223.33 (6) the number of additional persons served by approval of 223.34 increased capacity within existing allocations; 223.35 (7) results of action by the commissioner to streamline 223.36 administrative requirements and improve county resource 224.1 management; and 224.2 (8) additional action that would decrease the number of 224.3 those eligible and waiting for waivered services. 224.4 The commissioner shall specify intended outcomes for the program 224.5 and the degree to which these specified outcomes are attained. 224.6 Sec. 45. Minnesota Statutes 2000, section 256B.0916, 224.7 subdivision 9, is amended to read: 224.8 Subd. 9. [LEGAL REPRESENTATIVE PARTICIPATION EXCEPTION.] 224.9 The commissioner, in cooperation with representatives of 224.10 counties, service providers, service recipients, family members, 224.11 legal representatives and advocates, shall develop criteria to 224.12 allow legal representatives to be reimbursed for providing 224.13 specific support services to meet the person's needs when a plan 224.14 which assures health and safety has been agreed upon and carried 224.15 out by the legal representative, the person, and the county. 224.16 Legal representatives providing support underconsumer-directed224.17community support services pursuant to section 256B.092,224.18subdivision 4,the home and community-based waiver for persons 224.19 with mental retardation or related conditions or the consumer 224.20 support grant program pursuant to section256B.092, subdivision224.217256.476, shall not be considered to have a direct or indirect 224.22 service provider interest under section 256B.092, subdivision 7, 224.23 if a health and safety plan which meets the criteria established 224.24 has been agreed upon and implemented. ByOctober 1, 1999August 224.25 1, 2001, the commissioner shall submit, for federal approval, 224.26 amendments to allow legal representatives to provide support and 224.27 receive reimbursement under theconsumer-directed community224.28support services section of thehome and community-based waiver 224.29 plan. 224.30 Sec. 46. Minnesota Statutes 2000, section 256B.092, 224.31 subdivision 5, is amended to read: 224.32 Subd. 5. [FEDERAL WAIVERS.] (a) The commissioner shall 224.33 apply for any federal waivers necessary to secure, to the extent 224.34 allowed by law, federal financial participation under United 224.35 States Code, title 42, sections 1396 et seq., as amended, for 224.36 the provision of services to persons who, in the absence of the 225.1 services, would need the level of care provided in a regional 225.2 treatment center or a community intermediate care facility for 225.3 persons with mental retardation or related conditions. The 225.4 commissioner may seek amendments to the waivers or apply for 225.5 additional waivers under United States Code, title 42, sections 225.6 1396 et seq., as amended, to contain costs. The commissioner 225.7 shall ensure that payment for the cost of providing home and 225.8 community-based alternative services under the federal waiver 225.9 plan shall not exceed the cost of intermediate care services 225.10 including day training and habilitation services that would have 225.11 been provided without the waivered services. 225.12 (b) The commissioner, in administering home and 225.13 community-based waivers for persons with mental retardation and 225.14 related conditions, shall ensure that day services for eligible 225.15 persons are not provided by the person's residential service 225.16 provider, unless the person or the person's legal representative 225.17 is offered a choice of providers and agrees in writing to 225.18 provision of day services by the residential service provider. 225.19 The individual service plan for individuals who choose to have 225.20 their residential service provider provide their day services 225.21 must describe how health, safety, and protection needs will be 225.22 met by frequent and regular contact with persons other than the 225.23 residential service provider. 225.24 Sec. 47. Minnesota Statutes 2000, section 256B.093, 225.25 subdivision 3, is amended to read: 225.26 Subd. 3. [TRAUMATIC BRAIN INJURY PROGRAM DUTIES.] The 225.27 department shall fund administrative case management under this 225.28 subdivision using medical assistance administrative funds. The 225.29 traumatic brain injury program duties include: 225.30 (1) recommending to the commissioner in consultation with 225.31 the medical review agent according to Minnesota Rules, parts 225.32 9505.0500 to 9505.0540, the approval or denial of medical 225.33 assistance funds to pay for out-of-state placements for 225.34 traumatic brain injury services and in-state traumatic brain 225.35 injury services provided by designated Medicare long-term care 225.36 hospitals; 226.1 (2) coordinating the traumatic brain injury home and 226.2 community-based waiver; 226.3 (3)approving traumatic brain injury waiver eligibility or226.4care plans or both;226.5(4)providing ongoing technical assistance and consultation 226.6 to county and facility case managers to facilitate care plan 226.7 development for appropriate, accessible, and cost-effective 226.8 medical assistance services; 226.9(5)(4) providing technical assistance to promote statewide 226.10 development of appropriate, accessible, and cost-effective 226.11 medical assistance services and related policy; 226.12(6)(5) providing training and outreach to facilitate 226.13 access to appropriate home and community-based services to 226.14 prevent institutionalization; 226.15(7)(6) facilitating appropriate admissions, continued stay 226.16 review, discharges, and utilization review for neurobehavioral 226.17 hospitals and other specialized institutions; 226.18(8)(7) providing technical assistance on the use of prior 226.19 authorization of home care services and coordination of these 226.20 services with other medical assistance services; 226.21(9)(8) developing a system for identification of nursing 226.22 facility and hospital residents with traumatic brain injury to 226.23 assist in long-term planning for medical assistance services. 226.24 Factors will include, but are not limited to, number of 226.25 individuals served, length of stay, services received, and 226.26 barriers to community placement; and 226.27(10)(9) providing information, referral, and case 226.28 consultation to access medical assistance services for 226.29 recipients without a county or facility case manager. Direct 226.30 access to this assistance may be limited due to the structure of 226.31 the program. 226.32 Sec. 48. Minnesota Statutes 2000, section 256B.095, is 226.33 amended to read: 226.34 256B.095 [THREE-YEARQUALITY ASSURANCEPILOTPROJECT 226.35 ESTABLISHED.] 226.36 Effective July 1, 1998, an alternative quality assurance 227.1 licensing systempilotproject for programs for persons with 227.2 developmental disabilities is established in Dodge, Fillmore, 227.3 Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele, 227.4 Wabasha, and Winona counties for the purpose of improving the 227.5 quality of services provided to persons with developmental 227.6 disabilities. A county, at its option, may choose to have all 227.7 programs for persons with developmental disabilities located 227.8 within the county licensed under chapter 245A using standards 227.9 determined under the alternative quality assurance licensing 227.10 systempilotproject or may continue regulation of these 227.11 programs under the licensing system operated by the 227.12 commissioner. Thepilotproject expires on June 30,20012005. 227.13 Sec. 49. Minnesota Statutes 2000, section 256B.0951, 227.14 subdivision 1, is amended to read: 227.15 Subdivision 1. [MEMBERSHIP.] The region 10 quality 227.16 assurance commission is established. The commission consists of 227.17 at least 14 but not more than 21 members as follows: at least 227.18 three but not more than five members representing advocacy 227.19 organizations; at least three but not more than five members 227.20 representing consumers, families, and their legal 227.21 representatives; at least three but not more than five members 227.22 representing service providers; at least three but not more than 227.23 five members representing counties; and the commissioner of 227.24 human services or the commissioner's designee. Initial 227.25 membership of the commission shall be recruited and approved by 227.26 the region 10 stakeholders group. Prior to approving the 227.27 commission's membership, the stakeholders group shall provide to 227.28 the commissioner a list of the membership in the stakeholders 227.29 group, as of February 1, 1997, a brief summary of meetings held 227.30 by the group since July 1, 1996, and copies of any materials 227.31 prepared by the group for public distribution. The first 227.32 commission shall establish membership guidelines for the 227.33 transition and recruitment of membership for the commission's 227.34 ongoing existence. Members of the commission who do not receive 227.35 a salary or wages from an employer for time spent on commission 227.36 duties may receive a per diem payment when performing commission 228.1 duties and functions. All members may be reimbursed for 228.2 expenses related to commission activities. Notwithstanding the 228.3 provisions of section 15.059, subdivision 5, the commission 228.4 expires on June 30,20012005. 228.5 Sec. 50. Minnesota Statutes 2000, section 256B.0951, 228.6 subdivision 3, is amended to read: 228.7 Subd. 3. [COMMISSION DUTIES.] (a) By October 1, 1997, the 228.8 commission, in cooperation with the commissioners of human 228.9 services and health, shall do the following: (1) approve an 228.10 alternative quality assurance licensing system based on the 228.11 evaluation of outcomes; (2) approve measurable outcomes in the 228.12 areas of health and safety, consumer evaluation, education and 228.13 training, providers, and systems that shall be evaluated during 228.14 the alternative licensing process; and (3) establish variable 228.15 licensure periods not to exceed three years based on outcomes 228.16 achieved. For purposes of this subdivision, "outcome" means the 228.17 behavior, action, or status of a person that can be observed or 228.18 measured and can be reliably and validly determined. 228.19 (b) By January 15, 1998, the commission shall approve, in 228.20 cooperation with the commissioner of human services, a training 228.21 program for members of the quality assurance teams established 228.22 under section 256B.0952, subdivision 4. 228.23 (c) The commission and the commissioner shall establish an 228.24 ongoing review process for the alternative quality assurance 228.25 licensing system. The review shall take into account the 228.26 comprehensive nature of the alternative system, which is 228.27 designed to evaluate the broad spectrum of licensed and 228.28 unlicensed entities that provide services to clients, as 228.29 compared to the current licensing system. 228.30 (d) The commission shall contract with an independent 228.31 entity to conduct a financial review of the alternative quality 228.32 assurancepilotproject. The review shall take into account the 228.33 comprehensive nature of the alternative system, which is 228.34 designed to evaluate the broad spectrum of licensed and 228.35 unlicensed entities that provide services to clients, as 228.36 compared to the current licensing system. The review shall 229.1 include an evaluation of possible budgetary savings within the 229.2 department of human services as a result of implementation of 229.3 the alternative quality assurancepilotproject. If a federal 229.4 waiver is approved under subdivision 7, the financial review 229.5 shall also evaluate possible savings within the department of 229.6 health. This review must be completed by December 15, 2000. 229.7 (e) The commission shall submit a report to the legislature 229.8 by January 15, 2001, on the results of the review process for 229.9 the alternative quality assurancepilotproject, a summary of 229.10 the results of the independent financial review, and a 229.11 recommendation on whether thepilotproject should be extended 229.12 beyond June 30, 2001. 229.13 (f) The commissioner, in consultation with the commission, 229.14 shall examine the feasibility of expanding the project to other 229.15 populations or geographic areas and identify barriers to 229.16 expansion. The commissioner shall report findings and 229.17 recommendations to the legislature by December 15, 2004. 229.18 Sec. 51. Minnesota Statutes 2000, section 256B.0951, 229.19 subdivision 4, is amended to read: 229.20 Subd. 4. [COMMISSION'S AUTHORITY TO RECOMMEND VARIANCES OF 229.21 LICENSING STANDARDS.] The commission may recommend to the 229.22 commissioners of human services and health variances from the 229.23 standards governing licensure of programs for persons with 229.24 developmental disabilities in order to improve the quality of 229.25 services by implementing an alternative developmental 229.26 disabilities licensing system if the commission determines that 229.27 the alternative licensing system does not adversely affect the 229.28 health or safety of persons being served by the licensed program 229.29 nor compromise the qualifications of staff to provide services. 229.30 Sec. 52. Minnesota Statutes 2000, section 256B.0951, 229.31 subdivision 5, is amended to read: 229.32 Subd. 5. [VARIANCE OF CERTAIN STANDARDS PROHIBITED.] The 229.33 safety standards, rights, or procedural protections under 229.34 sections 245.825; 245.91 to 245.97; 245A.04, subdivisions 3, 3a, 229.35 3b, and 3c; 245A.09, subdivision 2, paragraph (c), clauses (2) 229.36 and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, 230.1 subdivisions 1b, clause (7), and 10; 626.556; 626.557, and 230.2 procedures for the monitoring of psychotropic medications shall 230.3 not be varied under the alternative licensing systempilot230.4 project. The commission may make recommendations to the 230.5 commissioners of human services and health or to the legislature 230.6 regarding alternatives to or modifications of the rules and 230.7 procedures referenced in this subdivision. 230.8 Sec. 53. Minnesota Statutes 2000, section 256B.0951, 230.9 subdivision 7, is amended to read: 230.10 Subd. 7. [WAIVER OF RULES.] The commissioner of health may 230.11 exempt residents of intermediate care facilities for persons 230.12 with mental retardation (ICFs/MR) who participate in the 230.13 three-year quality assurance pilot project established in 230.14 section 256B.095 from the requirements of Minnesota Rules, 230.15 chapter 4665, upon approval by the federal government of a 230.16 waiver of federal certification requirements for ICFs/MR.The230.17commissioners of health and human services shall apply for any230.18necessary waivers as soon as practicable and shall submit the230.19concept paper to the federal government by June 1, 1998.230.20 Sec. 54. Minnesota Statutes 2000, section 256B.0951, is 230.21 amended by adding a subdivision to read: 230.22 Subd. 8. [FEDERAL WAIVER.] The commissioner of human 230.23 services shall seek federal authority to waive provisions of 230.24 intermediate care facilities for persons with mental retardation 230.25 (ICFs/MR) regulations to enable the demonstration and evaluation 230.26 of the alternative quality assurance system for ICFs/MR under 230.27 the project. The commissioner of human services shall apply for 230.28 any necessary waivers as soon as practicable. 230.29 Sec. 55. Minnesota Statutes 2000, section 256B.0951, is 230.30 amended by adding a subdivision to read: 230.31 Subd. 9. [EVALUATION.] The commission, in consultation 230.32 with the commissioner of human services, shall conduct an 230.33 evaluation of the alternative quality assurance system, and 230.34 present a report to the commissioner by June 30, 2004. 230.35 Sec. 56. Minnesota Statutes 2000, section 256B.0952, 230.36 subdivision 1, is amended to read: 231.1 Subdivision 1. [NOTIFICATION.]By January 15, 1998, each231.2affected county shall notify the commission and the231.3commissioners of human services and health as to whether it231.4chooses to implement on July 1, 1998, the alternative licensing231.5system for the pilot project. A county that does not implement231.6the alternative licensing system on July 1, 1998, may give231.7notice to the commission and the commissioners by January 15,231.81999, or January 15, 2000, that it will implement the231.9alternative licensing system on the following July 1. A county231.10that implements the alternative licensing system commits to231.11participate until June 30, 2001.For each year of the project, 231.12 region 10 counties shall give notice to the commission and 231.13 commissioners of human services and health by March 15 of intent 231.14 to join the quality assurance alternative licensing system, 231.15 effective July 1 of that year. A county choosing to participate 231.16 in the alternative licensing system commits to participate until 231.17 June 30, 2005. Counties participating in the quality assurance 231.18 alternative licensing system as of January 1, 2001, shall notify 231.19 the commission and the commissioners of human services and 231.20 health by March 15, 2001, of intent to continue participation. 231.21 Counties that elect to continue participation must participate 231.22 in the alternative licensing system until June 30, 2005. 231.23 Sec. 57. Minnesota Statutes 2000, section 256B.0952, 231.24 subdivision 4, is amended to read: 231.25 Subd. 4. [APPOINTMENT OF QUALITY ASSURANCE MANAGER.] (a) A 231.26 county or group of counties that chooses to participate in the 231.27 alternative licensing system shall designate a quality assurance 231.28 manager and shall establish quality assurance teams in 231.29 accordance with subdivision 5. The manager shall recruit, 231.30 train, and assign duties to the quality assurance team members. 231.31 In assigning team members to conduct the quality assurance 231.32 process at a facility, program, or service, the manager shall 231.33 take into account the size of the service provider, the number 231.34 of services to be reviewed, the skills necessary for team 231.35 members to complete the process, and other relevant factors. 231.36 The manager shall ensure that no team member has a financial, 232.1 personal, or family relationship with the facility, program, or 232.2 service being reviewed or with any clients of the facility, 232.3 program, or service. 232.4 (b) Quality assurance teams shall report the findings of 232.5 their quality assurance reviews to the quality assurance manager. 232.6 The quality assurance manager shall provide the report from the 232.7 quality assurance team to the county and, upon request, to the 232.8 commissioners of human services and health, and shall provide a 232.9 summary of the report to the quality assurance review council. 232.10 Sec. 58. Minnesota Statutes 2000, section 256B.49, is 232.11 amended by adding a subdivision to read: 232.12 Subd. 11. [AUTHORITY.] (a) The commissioner is authorized 232.13 to apply for home and community-based service waivers, as 232.14 authorized under section 1915(c) of the Social Security Act to 232.15 serve persons under the age of 65 who are determined to require 232.16 the level of care provided in a nursing home and persons who 232.17 require the level of care provided in a hospital. The 232.18 commissioner shall apply for the home and community-based 232.19 waivers in order to: (i) promote the support of persons with 232.20 disabilities in the most integrated settings; (ii) expand the 232.21 availability of services for persons who are eligible for 232.22 medical assistance; (iii) promote cost-effective options to 232.23 institutional care; and (iv) obtain federal financial 232.24 participation. 232.25 (b) The provision of waivered services to medical 232.26 assistance recipients with disabilities shall comply with the 232.27 requirements outlined in the federally approved applications for 232.28 home and community-based services and subsequent amendments, 232.29 including provision of services according to a service plan 232.30 designed to meet the needs of the individual. For purposes of 232.31 this section, the approved home and community-based application 232.32 is considered the necessary federal requirement. 232.33 (c) The commissioner shall provide interested persons 232.34 serving on agency advisory committees and task forces, and 232.35 others upon request, with notice of, and an opportunity to 232.36 comment on, any changes or amendments to the federally approved 233.1 applications for home and community-based waivers, prior to 233.2 their submission to the federal health care financing 233.3 administration. 233.4 (d) The commissioner shall seek approval, as authorized 233.5 under section 1915(c) of the Social Security Act, to allow 233.6 medical assistance eligibility under this section for children 233.7 under age 21 without deeming of parental income or assets. 233.8 (e) The commissioner shall seek approval, as authorized 233.9 under section 1915(c) of the Social Act, to allow medical 233.10 assistance eligibility under this section for individuals under 233.11 age 65 without deeming the spouse's income or assets. 233.12 Sec. 59. Minnesota Statutes 2000, section 256B.49, is 233.13 amended by adding a subdivision to read: 233.14 Subd. 12. [INFORMED CHOICE.] Persons who are determined 233.15 likely to require the level of care provided in a nursing 233.16 facility or hospital shall be informed of the home and 233.17 community-based support alternatives to the provision of 233.18 inpatient hospital services or nursing facility services. Each 233.19 person must be given the choice of either institutional or home 233.20 and community-based services using the provisions described in 233.21 section 256B.77, subdivision 2, paragraph (p). 233.22 Sec. 60. Minnesota Statutes 2000, section 256B.49, is 233.23 amended by adding a subdivision to read: 233.24 Subd. 13. [CASE MANAGEMENT.] (a) Each recipient of a home 233.25 and community-based waiver shall be provided case management 233.26 services by qualified vendors as described in the federally 233.27 approved waiver application. The case management service 233.28 activities provided will include: 233.29 (1) assessing the needs of the individual within 20 working 233.30 days of a recipient's request; 233.31 (2) developing the written individual service plan within 233.32 ten working days after the assessment is completed; 233.33 (3) informing the recipient or the recipient's legal 233.34 guardian or conservator of service options; 233.35 (4) assisting the recipient in the identification of 233.36 potential service providers; 234.1 (5) assisting the recipient to access services; 234.2 (6) coordinating, evaluating, and monitoring of the 234.3 services identified in the service plan; 234.4 (7) completing the annual reviews of the service plan; and 234.5 (8) informing the recipient or legal representative of the 234.6 right to have assessments completed and service plans developed 234.7 within specified time periods, and to appeal county action or 234.8 inaction under section 256.045, subdivision 3. 234.9 (b) The case manager may delegate certain aspects of the 234.10 case management service activities to another individual 234.11 provided there is oversight by the case manager. The case 234.12 manager may not delegate those aspects which require 234.13 professional judgment including assessments, reassessments, and 234.14 care plan development. 234.15 Sec. 61. Minnesota Statutes 2000, section 256B.49, is 234.16 amended by adding a subdivision to read: 234.17 Subd. 14. [ASSESSMENT AND REASSESSMENT.] (a) Assessments 234.18 of each recipient's strengths, informal support systems, and 234.19 need for services shall be completed within 20 working days of 234.20 the recipient's request. Reassessment of each recipient's 234.21 strengths, support systems, and need for services shall be 234.22 conducted at least every 12 months and at other times when there 234.23 has been a significant change in the recipient's functioning. 234.24 (b) Persons with mental retardation or a related condition 234.25 who apply for services under the nursing facility level waiver 234.26 programs shall be screened for the appropriate level of care 234.27 according to section 256B.092. 234.28 (c) Recipients who are found eligible for home and 234.29 community-based services under this section before their 65th 234.30 birthday may remain eligible for these services after their 65th 234.31 birthday if they continue to meet all other eligibility factors. 234.32 Sec. 62. Minnesota Statutes 2000, section 256B.49, is 234.33 amended by adding a subdivision to read: 234.34 Subd. 15. [INDIVIDUALIZED SERVICE PLAN.] Each recipient of 234.35 home and community-based waivered services shall be provided a 234.36 copy of the written service plan which: 235.1 (1) is developed and signed by the recipient within ten 235.2 working days of the completion of the assessment; 235.3 (2) meets the assessed needs of the recipient; 235.4 (3) reasonably ensures the health and safety of the 235.5 recipient; 235.6 (4) promotes independence; 235.7 (5) allows for services to be provided in the most 235.8 integrated settings; and 235.9 (6) provides for an informed choice, as defined in section 235.10 256B.77, subdivision 2, paragraph (p), of service and support 235.11 providers. 235.12 Sec. 63. Minnesota Statutes 2000, section 256B.49, is 235.13 amended by adding a subdivision to read: 235.14 Subd. 16. [SERVICES AND SUPPORTS.] (a) Services and 235.15 supports included in the home and community-based waivers for 235.16 persons with disabilities shall meet the requirements set out in 235.17 United States Code, title 42, section 1396n. The services and 235.18 supports, which are offered as alternatives to institutional 235.19 care, shall promote consumer choice, community inclusion, 235.20 self-sufficiency, and self-determination. 235.21 (b) Beginning January 1, 2003, the commissioner shall 235.22 simplify and improve access to home and community-based waivered 235.23 services, to the extent possible, through the establishment of a 235.24 common service menu that is available to eligible recipients 235.25 regardless of age, disability type, or waiver program. 235.26 (c) Consumer directed community support services shall be 235.27 offered as an option to all persons eligible for services under 235.28 subdivision 11, by January 1, 2002. 235.29 (d) Services and supports shall be arranged and provided 235.30 consistent with individualized written plans of care for 235.31 eligible waiver recipients. 235.32 (e) The state of Minnesota and county agencies that 235.33 administer home and community-based waivered services for 235.34 persons with disabilities, shall not be liable for damages, 235.35 injuries, or liabilities sustained through the purchase of 235.36 supports by the individual, the individual's family, legal 236.1 representative, or the authorized representative with funds 236.2 received through the consumer-directed community support service 236.3 under this section. Liabilities include but are not limited 236.4 to: workers' compensation liability, the Federal Insurance 236.5 Contributions Act (FICA), or the Federal Unemployment Tax Act 236.6 (FUTA). 236.7 Sec. 64. Minnesota Statutes 2000, section 256B.49, is 236.8 amended by adding a subdivision to read: 236.9 Subd. 17. [COST OF SERVICES AND SUPPORTS.] (a) The 236.10 commissioner shall ensure that the average per capita 236.11 expenditures estimated in any fiscal year for home and 236.12 community-based waiver recipients does not exceed the average 236.13 per capita expenditures that would have been made to provide 236.14 institutional services for recipients in the absence of the 236.15 waiver. 236.16 (b) The commissioner shall implement on January 1, 2002, 236.17 one or more aggregate, need-based methods for allocating to 236.18 local agencies the home and community-based waivered service 236.19 resources available to support recipients with disabilities in 236.20 need of the level of care provided in a nursing facility or a 236.21 hospital. The commissioner shall allocate resources to single 236.22 counties and county partnerships in a manner that reflects 236.23 consideration of: 236.24 (1) an incentive-based payment process for achieving 236.25 outcomes; 236.26 (2) the need for a state-level risk pool; 236.27 (3) the need for retention of management responsibility at 236.28 the state agency level; and 236.29 (4) a phase-in strategy as appropriate. 236.30 (c) Until the allocation methods described in paragraph (b) 236.31 are implemented, the annual allowable reimbursement level of 236.32 home and community-based waiver services shall be the greater of: 236.33 (1) the statewide average payment amount which the 236.34 recipient is assigned under the waiver reimbursement system in 236.35 place on June 30, 2001, modified by the percentage of any 236.36 provider rate increase appropriated for home and community-based 237.1 services; or 237.2 (2) an amount approved by the commissioner based on the 237.3 recipient's extraordinary needs that cannot be met within the 237.4 current allowable reimbursement level. The increased 237.5 reimbursement level must be necessary to allow the recipient to 237.6 be discharged from an institution or to prevent imminent 237.7 placement in an institution. The additional reimbursement may 237.8 be used to secure environmental modifications; assistive 237.9 technology and equipment; and increased costs for supervision, 237.10 training, and support services necessary to address the 237.11 recipient's extraordinary needs. The commissioner may approve 237.12 an increased reimbursement level for up to one year of the 237.13 recipient's relocation from an institution or up to six months 237.14 of a determination that a current waiver recipient is at 237.15 imminent risk of being placed in an institution. 237.16 (d) Beginning July 1, 2001, medically necessary private 237.17 duty nursing services will be authorized under this section as 237.18 complex and regular care according to section 256B.0627. The 237.19 rate established by the commissioner for registered nurse or 237.20 licensed practical nurse services under any home and 237.21 community-based waiver as of January 1, 2001, shall not be 237.22 reduced. 237.23 Sec. 65. Minnesota Statutes 2000, section 256B.49, is 237.24 amended by adding a subdivision to read: 237.25 Subd. 18. [PAYMENTS.] The commissioner shall reimburse 237.26 approved vendors from the medical assistance account for the 237.27 costs of providing home and community-based services to eligible 237.28 recipients using the invoice processing procedures of the 237.29 Medicaid management information system (MMIS). Recipients will 237.30 be screened and authorized for services according to the 237.31 federally approved waiver application and its subsequent 237.32 amendments. 237.33 Sec. 66. Minnesota Statutes 2000, section 256B.49, is 237.34 amended by adding a subdivision to read: 237.35 Subd. 19. [HEALTH AND WELFARE.] The commissioner of human 237.36 services shall take the necessary safeguards to protect the 238.1 health and welfare of individuals provided services under the 238.2 waiver. 238.3 Sec. 67. Minnesota Statutes 2000, section 256B.49, is 238.4 amended by adding a subdivision to read: 238.5 Subd. 20. [TRAUMATIC BRAIN INJURY AND RELATED CONDITIONS.] 238.6 The commissioner shall seek to amend the traumatic brain injury 238.7 waiver to include, as eligible persons, individuals with an 238.8 acquired or degenerative disease diagnosis where cognitive 238.9 impairment is present, such as multiple sclerosis. 238.10 Sec. 68. Minnesota Statutes 2000, section 256D.35, is 238.11 amended by adding a subdivision to read: 238.12 Subd. 11a. [INSTITUTION.] "Institution" means a hospital, 238.13 consistent with Code of Federal Regulations, title 42, section 238.14 440.10; regional treatment center inpatient services, consistent 238.15 with section 245.474; a nursing facility; and an intermediate 238.16 care facility for persons with mental retardation. 238.17 Sec. 69. Minnesota Statutes 2000, section 256D.35, is 238.18 amended by adding a subdivision to read: 238.19 Subd. 18a. [SHELTER COSTS.] "Shelter costs" means rent, 238.20 manufactured home lot rentals; monthly principal, interest, 238.21 insurance premiums, and property taxes due for mortgages or 238.22 contract for deed costs; costs for utilities, including heating, 238.23 cooling, electricity, water, and sewerage; garbage collection 238.24 fees; and the basic service fee for one telephone. 238.25 Sec. 70. Minnesota Statutes 2000, section 256D.44, 238.26 subdivision 5, is amended to read: 238.27 Subd. 5. [SPECIAL NEEDS.] In addition to the state 238.28 standards of assistance established in subdivisions 1 to 4, 238.29 payments are allowed for the following special needs of 238.30 recipients of Minnesota supplemental aid who are not residents 238.31 of a nursing home, a regional treatment center, or a group 238.32 residential housing facility. 238.33 (a) The county agency shall pay a monthly allowance for 238.34 medically prescribed diets payable under the Minnesota family 238.35 investment program if the cost of those additional dietary needs 238.36 cannot be met through some other maintenance benefit. 239.1 (b) Payment for nonrecurring special needs must be allowed 239.2 for necessary home repairs or necessary repairs or replacement 239.3 of household furniture and appliances using the payment standard 239.4 of the AFDC program in effect on July 16, 1996, for these 239.5 expenses, as long as other funding sources are not available. 239.6 (c) A fee for guardian or conservator service is allowed at 239.7 a reasonable rate negotiated by the county or approved by the 239.8 court. This rate shall not exceed five percent of the 239.9 assistance unit's gross monthly income up to a maximum of $100 239.10 per month. If the guardian or conservator is a member of the 239.11 county agency staff, no fee is allowed. 239.12 (d) The county agency shall continue to pay a monthly 239.13 allowance of $68 for restaurant meals for a person who was 239.14 receiving a restaurant meal allowance on June 1, 1990, and who 239.15 eats two or more meals in a restaurant daily. The allowance 239.16 must continue until the person has not received Minnesota 239.17 supplemental aid for one full calendar month or until the 239.18 person's living arrangement changes and the person no longer 239.19 meets the criteria for the restaurant meal allowance, whichever 239.20 occurs first. 239.21 (e) A fee of ten percent of the recipient's gross income or 239.22 $25, whichever is less, is allowed for representative payee 239.23 services provided by an agency that meets the requirements under 239.24 SSI regulations to charge a fee for representative payee 239.25 services. This special need is available to all recipients of 239.26 Minnesota supplemental aid regardless of their living 239.27 arrangement. 239.28 (f) Notwithstanding the language in this subdivision, an 239.29 amount equal to the maximum allotment authorized by the federal 239.30 Food Stamp Program for a single individual which is in effect on 239.31 the first day of January of the previous year will be added to 239.32 the standards of assistance established in subdivisions 1 to 4 239.33 for individuals under the age of 65 who are relocating from an 239.34 institution and who are shelter needy. An eligible individual 239.35 who receives this benefit prior to age 65 may continue to 239.36 receive the benefit after the age of 65. 240.1 "Shelter needy" means that the assistance unit incurs 240.2 monthly shelter costs that exceed 40 percent of the assistance 240.3 unit's gross income before the application of this special needs 240.4 standard. "Gross income" for the purposes of this section is 240.5 the applicant's or recipient's income as defined in section 240.6 256D.35, subdivision 10, or the standard specified in 240.7 subdivision 3, whichever is greater. A recipient of a federal 240.8 or state housing subsidy, that limits shelter costs to a 240.9 percentage of gross income, shall not be considered shelter 240.10 needy for purposes of this paragraph. 240.11 Sec. 71. [256I.07] [RESPITE CARE PILOT PROJECT FOR FAMILY 240.12 ADULT FOSTER CARE PROVIDERS.] 240.13 Subdivision 1. [PROGRAM ESTABLISHED.] The state recognizes 240.14 the importance of developing and maintaining quality family 240.15 foster care resources. In order to accomplish that goal, the 240.16 commissioner shall establish a two-year respite care pilot 240.17 project for family adult foster care providers in three 240.18 counties. This pilot project is intended to provide support to 240.19 caregivers of family adult foster care residents. The 240.20 commissioner shall establish a state-funded pilot project to 240.21 accomplish the provisions in subdivisions 2 to 4. 240.22 Subd. 2. [ELIGIBILITY.] A family adult foster care home 240.23 provider as defined under section 144D.01, subdivision 7, who 240.24 has been licensed for six months is eligible for up to 30 days 240.25 of respite care per calendar year. In cases of emergency, a 240.26 county social services agency may waive the six-month licensing 240.27 requirement. In order to be eligible to receive respite 240.28 payment, a provider must take time off away from their foster 240.29 care residents. 240.30 Subd. 3. [PAYMENT STRUCTURE.] (a) The rate of payment for 240.31 respite care for an adult foster care resident eligible for only 240.32 group residential housing shall be based on the current monthly 240.33 group residential housing base room and board rate and the 240.34 current maximum monthly group residential housing difficulty of 240.35 care rate. 240.36 (b) The rate of payment for respite care for an adult 241.1 foster care resident eligible for alternative care funds shall 241.2 be based on the resident's alternative care foster care rate. 241.3 (c) The rate of payment for respite care for an adult 241.4 foster care resident eligible for Medicaid home and 241.5 community-based services waiver funds shall be based on the 241.6 group residential housing base room and board rate. 241.7 (d) The total amount available to pay for respite care for 241.8 a family adult foster care provider shall be based on the number 241.9 of residents currently served in the foster care home. Respite 241.10 care must be paid for on a per diem basis and for a full day. 241.11 Subd. 4. [PRIVATE PAY RESIDENTS.] Payment for respite care 241.12 for private pay foster care residents must be arranged between 241.13 the provider and the resident or the resident's family. 241.14 Sec. 72. Laws 1999, chapter 152, section 1, is amended to 241.15 read: 241.16 Section 1. [TASK FORCE.] 241.17 A day training and habilitation task force is established. 241.18 Task force membership shall consist of representatives of the 241.19 commissioner of human services, counties, service consumers, and 241.20 vendors of day training and habilitation as defined in Minnesota 241.21 Statutes, section 252.41, subdivision 9, including at least one 241.22 representative from each association representing day training 241.23 and habilitation vendors. Appointments to the task force shall 241.24 be made by the commissioner of human services and technical 241.25 assistance shall be provided by the department of human services. 241.26 Sec. 73. [SEMI-INDEPENDENT LIVING SERVICES (SILS) STUDY.] 241.27 The commissioner of human services, in consultation with 241.28 county representatives and other interested persons, shall 241.29 develop recommendations revising the funding methodology for 241.30 SILS as defined in Minnesota Statutes, section 252.275, 241.31 subdivisions 3, 4, 4b, and 4c, and report by January 15, 2002, 241.32 to the chair of the house of representatives health and human 241.33 services finance committee and the chair of the senate health, 241.34 human services and corrections budget division. 241.35 Sec. 74. [WAIVER REQUEST REGARDING SPOUSAL INCOME.] 241.36 By September 1, 2001, the commissioner of human services 242.1 shall seek federal approval to allow recipients of home and 242.2 community-based waivers authorized under Minnesota Statutes, 242.3 section 256B.49, to choose either a waiver of deeming of spousal 242.4 income or the spousal impoverishment protections authorized 242.5 under United States Code, title 42, section 1396r-5, with the 242.6 addition of a recipient's maintenance needs in an amount equal 242.7 to the Minnesota supplemental aid equivalent rate as defined in 242.8 Minnesota Statutes, section 256I.03, subdivision 5, plus the 242.9 personal needs allowance as defined in Minnesota Statutes, 242.10 section 256B.35, subdivision 1, paragraph (a). Recipient 242.11 maintenance needs shall be adjusted under this provision each 242.12 July 1. 242.13 Sec. 75. [FEDERAL WAIVER REQUESTS.] 242.14 The commissioner of human services shall submit to the 242.15 federal Health Care Financing Administration by September 1, 242.16 2001, a request for a home and community-based services waiver 242.17 for day services, including: community inclusion, supported 242.18 employment, and day training and habilitation services defined 242.19 in Minnesota Statutes, section 252.41, subdivision 3, clause 242.20 (1), for persons eligible for the waiver under Minnesota 242.21 Statutes, section 256B.092. 242.22 Sec. 76. [REPEALER.] 242.23 (a) Minnesota Statutes 2000, section 256B.0951, subdivision 242.24 6, is repealed. 242.25 (b) Minnesota Statutes 2000, sections 145.9245; 256.476, 242.26 subdivision 7; 256B.0912; 256B.0915, subdivisions 3a, 3b, and 242.27 3c; and 256B.49, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10, 242.28 are repealed. 242.29 (c) Laws 1995, chapter 178, article 2, section 48, 242.30 subdivision 6, is repealed. 242.31 (d) Minnesota Rules, parts 9505.2455; 9505.2458; 9505.2460; 242.32 9505.2465; 9505.2470; 9505.2473; 9505.2475; 9505.2480; 242.33 9505.2485; 9505.2486; 9505.2490; 9505.2495; 9505.2496; 242.34 9505.2500; 9505.3010; 9505.3015; 9505.3020; 9505.3025; 242.35 9505.3030; 9505.3035; 9505.3040; 9505.3065; 9505.3085; 242.36 9505.3135; 9505.3500; 9505.3510; 9505.3520; 9505.3530; 243.1 9505.3535; 9505.3540; 9505.3545; 9505.3550; 9505.3560; 243.2 9505.3570; 9505.3575; 9505.3580; 9505.3585; 9505.3600; 243.3 9505.3610; 9505.3620; 9505.3622; 9505.3624; 9505.3626; 243.4 9505.3630; 9505.3635; 9505.3640; 9505.3645; 9505.3650; 243.5 9505.3660; and 9505.3670, are repealed. 243.6 Sec. 77. [EFFECTIVE DATE.] 243.7 Section 23 is effective January 1, 2003. 243.8 ARTICLE 4 243.9 CONSUMER INFORMATION 243.10 Section 1. [144A.35] [EXPANSION OF BED DISTRIBUTION 243.11 STUDY.] 243.12 The commissioner of human services, shall monitor and 243.13 analyze the distribution of older adult services, including, but 243.14 not limited to, nursing home beds, senior housing, housing with 243.15 services units, and home and community-based services in the 243.16 different geographic areas of the state. The study shall 243.17 include an analysis of the impact of amendments to the nursing 243.18 home moratorium law which would allow for transfers of nursing 243.19 home beds within the state. The commissioner of human services 243.20 shall submit to the legislature, beginning June 1, 2002, and 243.21 each January 15 thereafter, an assessment of the distribution of 243.22 long-term health care services by geographic area, with 243.23 particular attention to service deficits or problems, and 243.24 corrective action plans. 243.25 Sec. 2. Minnesota Statutes 2000, section 256.975, is 243.26 amended by adding a subdivision to read: 243.27 Subd. 7. [CONSUMER INFORMATION AND ASSISTANCE; SENIOR 243.28 LINKAGE.] (a) The Minnesota board on aging shall operate a 243.29 statewide information and assistance service to aid older 243.30 Minnesotans and their families in making informed choices about 243.31 long-term care options and health care benefits. Language 243.32 services to persons with limited English language skills may be 243.33 made available. The service, known as Senior LinkAge Line, must 243.34 be available during business hours through a statewide toll-free 243.35 number and must also be available through the Internet. 243.36 (b) The service must assist older adults, caregivers, and 244.1 providers in accessing information about choices in long-term 244.2 care services that are purchased through private providers or 244.3 available through public options. The service must: 244.4 (1) develop a comprehensive database that includes detailed 244.5 listings in both consumer- and provider-oriented formats; 244.6 (2) make the database accessible on the Internet and 244.7 through other telecommunication and media-related tools; 244.8 (3) link callers to interactive long-term care screening 244.9 tools and make these tools available through the Internet by 244.10 integrating the tools with the database; 244.11 (4) develop community education materials with a focus on 244.12 planning for long-term care and evaluating independent living, 244.13 housing, and service options; 244.14 (5) conduct an outreach campaign to assist older adults and 244.15 their caregivers in finding information on the Internet and 244.16 through other means of communication; 244.17 (6) implement a messaging system for overflow callers and 244.18 respond to these callers by the next business day; 244.19 (7) link callers with county human services and other 244.20 providers to receive more in-depth assistance and consultation 244.21 related to long-term care options; and 244.22 (8) link callers with quality profiles for nursing 244.23 facilities and other providers developed by the commissioner of 244.24 health. 244.25 (c) The Minnesota board on aging shall conduct an 244.26 evaluation of the effectiveness of the statewide information and 244.27 assistance, and submit this evaluation to the legislature by 244.28 December 1, 2002. The evaluation must include an analysis of 244.29 funding adequacy, gaps in service delivery, continuity in 244.30 information between the service and identified linkages, and 244.31 potential use of private funding to enhance the service. 244.32 Sec. 3. [256.9754] [COMMUNITY SERVICES DEVELOPMENT GRANTS 244.33 PROGRAM.] 244.34 Subdivision 1. [DEFINITIONS.] For purposes of this 244.35 section, the following terms have the meanings given. 244.36 (a) "Community" means a town, township, city, or targeted 245.1 neighborhood within a city, or a consortium of towns, townships, 245.2 cities, or targeted neighborhoods within cities. 245.3 (b) "Older adult services" means any services available 245.4 under the elderly waiver program or alternative care grant 245.5 programs; nursing facility services; transportation services; 245.6 respite services; and other community-based services identified 245.7 as necessary either to maintain lifestyle choices for older 245.8 Minnesotans, or to promote independence. 245.9 (c) "Older adult" refers to individuals 65 years of age and 245.10 older. 245.11 Subd. 2. [CREATION.] The community services development 245.12 grants program is created under the administration of the 245.13 commissioner of human services. 245.14 Subd. 3. [PROVISION OF GRANTS.] The commissioner shall 245.15 make grants available to communities, providers of older adult 245.16 services identified in subdivision 1, or to a consortium of 245.17 providers of older adult services, to establish older adult 245.18 services. Grants may be provided for capital and other costs 245.19 including, but not limited to, start-up and training costs, 245.20 equipment, and supplies related to older adult services or other 245.21 residential or service alternatives to nursing facility care. 245.22 Grants may also be made to renovate current buildings, provide 245.23 transportation services, fund programs that would allow older 245.24 adults or disabled individuals to stay in their own homes by 245.25 sharing a home, fund programs that coordinate and manage formal 245.26 and informal services to older adults in their homes to enable 245.27 them to live as independently as possible in their own homes as 245.28 an alternative to nursing home care, or expand state-funded 245.29 programs in the area. 245.30 Subd. 4. [ELIGIBILITY.] Grants may be awarded only to 245.31 communities and providers or to a consortium of providers that 245.32 have a local match of 50 percent of the costs for the project in 245.33 the form of donations, local tax dollars, in-kind donations, 245.34 fundraising, or other local matches. 245.35 Subd. 5. [GRANT PREFERENCE.] The commissioner of human 245.36 services shall give preference when awarding grants under this 246.1 section to areas where nursing facility closures have occurred 246.2 or are occurring. The commissioner may award grants to the 246.3 extent grant funds are available and to the extent applications 246.4 are approved by the commissioner. Denial of approval of an 246.5 application in one year does not preclude submission of an 246.6 application in a subsequent year. The maximum grant amount is 246.7 limited to $750,000. 246.8 Sec. 4. Minnesota Statutes 2000, section 256B.0911, 246.9 subdivision 1, is amended to read: 246.10 Subdivision 1. [PURPOSE AND GOAL.] (a) The purpose ofthe246.11preadmission screening programlong-term care consultation 246.12 services is to assist persons with long-term or chronic care 246.13 needs in making long-term care decisions and selecting options 246.14 that meet their needs and reflect their preferences. The 246.15 availability of, and access to, information and other types of 246.16 assistance is also intended to prevent or delay certified 246.17 nursing facility placementsby assessing applicants and246.18residents and offering cost-effective alternatives appropriate246.19for the person's needsand to provide transition assistance 246.20 after admission. Further, the goal ofthe programthese 246.21 services is to contain costs associated with unnecessary 246.22 certified nursing facility admissions. The commissioners of 246.23 human services and health shall seek to maximize use of 246.24 available federal and state funds and establish the broadest 246.25 program possible within the funding available. 246.26 (b) These services must be coordinated with services 246.27 provided under sections 256.975, subdivision 7, and 256.9772, 246.28 and with services provided by other public and private agencies 246.29 in the community to offer a variety of cost-effective 246.30 alternatives to persons with disabilities and elderly persons. 246.31 The county agency providing long-term care consultation services 246.32 shall encourage the use of volunteers from families, religious 246.33 organizations, social clubs, and similar civic and service 246.34 organizations to provide community-based services. 246.35 Sec. 5. Minnesota Statutes 2000, section 256B.0911, is 246.36 amended by adding a subdivision to read: 247.1 Subd. 1a. [DEFINITIONS.] For purposes of this section, the 247.2 following definitions apply: 247.3 (a) "Long-term care consultation services" means: 247.4 (1) providing information and education to the general 247.5 public regarding availability of the services authorized under 247.6 this section; 247.7 (2) an intake process that provides access to the services 247.8 described in this section; 247.9 (3) assessment of the health, psychological, and social 247.10 needs of referred individuals; 247.11 (4) assistance in identifying services needed to maintain 247.12 an individual in the least restrictive environment; 247.13 (5) providing recommendations on cost-effective community 247.14 services that are available to the individual; 247.15 (6) development of an individual's community support plan; 247.16 (7) providing information regarding eligibility for 247.17 Minnesota health care programs; 247.18 (8) preadmission screening to determine the need for a 247.19 nursing facility level of care; 247.20 (9) preliminary determination of Minnesota health care 247.21 programs eligibility for individuals who need a nursing facility 247.22 level of care, with appropriate referrals for final 247.23 determination; 247.24 (10) providing recommendations for nursing facility 247.25 placement when there are no cost-effective community services 247.26 available; and 247.27 (11) assistance to transition people back to community 247.28 settings after facility admission. 247.29 (b) "Minnesota health care programs" means the medical 247.30 assistance program under chapter 256B, the alternative care 247.31 program under section 256B.0913, and the prescription drug 247.32 program under section 256.955. 247.33 Sec. 6. Minnesota Statutes 2000, section 256B.0911, 247.34 subdivision 3, is amended to read: 247.35 Subd. 3. [PERSONS RESPONSIBLE FOR CONDUCTING THE247.36PREADMISSION SCREENINGLONG-TERM CARE CONSULTATION TEAM.] (a) A 248.1local screeninglong-term care consultation team shall be 248.2 established by the county board of commissioners. Each local 248.3screeningconsultation team shall consist ofscreeners who are a248.4 at least one social worker andaat least one public health 248.5 nurse from their respective county agencies. The board may 248.6 designate public health or social services as the lead agency 248.7 for long-term care consultation services. If a county does not 248.8 have a public health nurse available, it may request approval 248.9 from the commissioner to assign a county registered nurse with 248.10 at least one year experience in home care to participate on the 248.11 team.The screening team members must confer regarding the most248.12appropriate care for each individual screened.Two or more 248.13 counties may collaborate to establish a joint localscreening248.14 consultation team or teams. 248.15 (b)In assessing a person's needs, screeners shall have a248.16physician available for consultation and shall consider the248.17assessment of the individual's attending physician, if any. The248.18individual's physician shall be included if the physician248.19chooses to participate. Other personnel may be included on the248.20team as deemed appropriate by the county agencies.The team is 248.21 responsible for providing long-term care consultation services 248.22 to all persons located in the county who request the services, 248.23 regardless of eligibility for Minnesota health care programs. 248.24 Sec. 7. Minnesota Statutes 2000, section 256B.0911, is 248.25 amended by adding a subdivision to read: 248.26 Subd. 3a. [ASSESSMENT AND SUPPORT PLANNING.] (a) Persons 248.27 requesting assessment, services planning, or other assistance 248.28 intended to support community-based living must be visited by a 248.29 long-term care consultation team within ten working days after 248.30 the date on which an assessment was requested or recommended. 248.31 Assessments must be conducted according to paragraphs (b) to (g). 248.32 (b) The county may utilize a team of either the social 248.33 worker or public health nurse, or both, to conduct the 248.34 assessment in a face-to-face interview. The consultation team 248.35 members must confer regarding the most appropriate care for each 248.36 individual screened or assessed. 249.1 (c) The long-term care consultation team must assess the 249.2 health and social needs of the person, using an assessment form 249.3 provided by the commissioner. 249.4 (d) The team must conduct the assessment in a face-to-face 249.5 interview with the person being assessed and the person's legal 249.6 representative, if applicable. 249.7 (e) The team must provide the person, or the person's legal 249.8 representative, with written recommendations for facility- or 249.9 community-based services. The team must document that the most 249.10 cost-effective alternatives available were offered to the 249.11 individual. For purposes of this requirement, "cost-effective 249.12 alternatives" means community services and living arrangements 249.13 that cost the same as or less than nursing facility care. 249.14 (f) If the person chooses to use community-based services, 249.15 the team must provide the person or the person's legal 249.16 representative with a written community support plan, regardless 249.17 of whether the individual is eligible for Minnesota health care 249.18 programs. The person may request assistance in developing a 249.19 community support plan without participating in a complete 249.20 assessment. 249.21 (g) The team must give the person receiving assessment or 249.22 support planning, or the person's legal representative, 249.23 materials supplied by the commissioner containing the following 249.24 information: 249.25 (1) the purpose of preadmission screening and assessment; 249.26 (2) information about Minnesota health care programs; 249.27 (3) the person's freedom to accept or reject the 249.28 recommendations of the team; 249.29 (4) the person's right to confidentiality under the 249.30 Minnesota Government Data Practices Act, chapter 13; and 249.31 (5) the person's right to appeal the decision regarding the 249.32 need for nursing facility level of care or the county's final 249.33 decisions regarding public programs eligibility according to 249.34 section 256.045, subdivision 3. 249.35 Sec. 8. Minnesota Statutes 2000, section 256B.0911, is 249.36 amended by adding a subdivision to read: 250.1 Subd. 3b. [TRANSITION ASSISTANCE.] (a) A long-term care 250.2 consultation team shall provide assistance to persons residing 250.3 in a nursing facility, hospital, regional treatment center, or 250.4 intermediate care facility for persons with mental retardation 250.5 who request or are referred for assistance. Transition 250.6 assistance must include assessment, community support plan 250.7 development, referrals to Minnesota health care programs, and 250.8 referrals to programs that provide assistance with housing. 250.9 (b) The county shall develop transition processes with 250.10 institutional social workers and discharge planners to ensure 250.11 that: 250.12 (1) persons admitted to facilities receive information 250.13 about transition assistance that is available; 250.14 (2) the assessment is completed for persons within ten 250.15 working days of the date of request or recommendation for 250.16 assessment; and 250.17 (3) there is a plan for transition and follow-up for the 250.18 individual's return to the community. The plan must require 250.19 notification of other local agencies when a person who may 250.20 require assistance is screened by one county for admission to a 250.21 facility located in another county. 250.22 (c) If a person who is eligible for a Minnesota health care 250.23 program is admitted to a nursing facility, the nursing facility 250.24 must include a consultation team member or the case manager in 250.25 the discharge planning process. 250.26 Sec. 9. Minnesota Statutes 2000, section 256B.0911, is 250.27 amended by adding a subdivision to read: 250.28 Subd. 4a. [PREADMISSION SCREENING ACTIVITIES RELATED TO 250.29 NURSING FACILITY ADMISSIONS.] (a) All applicants to Medicaid 250.30 certified nursing facilities, including certified boarding care 250.31 facilities, must be screened prior to admission regardless of 250.32 income, assets, or funding sources for nursing facility care, 250.33 except as described in subdivision 4b. The purpose of the 250.34 screening is to determine the need for nursing facility level of 250.35 care as described in paragraph (d) and to complete activities 250.36 required under federal law related to mental illness and mental 251.1 retardation as outlined in paragraph (b). 251.2 (b) A person who has a diagnosis or possible diagnosis of 251.3 mental illness, mental retardation, or a related condition must 251.4 receive a preadmission screening before admission regardless of 251.5 the exemptions outlined in subdivision 4b, paragraph (b), to 251.6 identify the need for further evaluation and specialized 251.7 services, unless the admission prior to screening is authorized 251.8 by the local mental health authority or the local developmental 251.9 disabilities case manager, or unless authorized by the county 251.10 agency according to Public Law Number 100-508. 251.11 The following criteria apply to the preadmission screening: 251.12 (1) the county must use forms and criteria developed by the 251.13 commissioner to identify persons who require referral for 251.14 further evaluation and determination of the need for specialized 251.15 services; and 251.16 (2) the evaluation and determination of the need for 251.17 specialized services must be done by: 251.18 (i) a qualified independent mental health professional, for 251.19 persons with a primary or secondary diagnosis of a serious 251.20 mental illness; or 251.21 (ii) a qualified mental retardation professional, for 251.22 persons with a primary or secondary diagnosis of mental 251.23 retardation or related conditions. For purposes of this 251.24 requirement, a qualified mental retardation professional must 251.25 meet the standards for a qualified mental retardation 251.26 professional under Code of Federal Regulations, title 42, 251.27 section 483.430. 251.28 (c) The local county mental health authority or the state 251.29 mental retardation authority under Public Law Numbers 100-203 251.30 and 101-508 may prohibit admission to a nursing facility if the 251.31 individual does not meet the nursing facility level of care 251.32 criteria or needs specialized services as defined in Public Law 251.33 Numbers 100-203 and 101-508. For purposes of this section, 251.34 "specialized services" for a person with mental retardation or a 251.35 related condition means active treatment as that term is defined 251.36 under Code of Federal Regulations, title 42, section 483.440 252.1 (a)(1). 252.2 (d) The determination of the need for nursing facility 252.3 level of care must be made according to criteria developed by 252.4 the commissioner. In assessing a person's needs, consultation 252.5 team members shall have a physician available for consultation 252.6 and shall consider the assessment of the individual's attending 252.7 physician, if any. The individual's physician must be included 252.8 if the physician chooses to participate. Other personnel may be 252.9 included on the team as deemed appropriate by the county. 252.10 Sec. 10. Minnesota Statutes 2000, section 256B.0911, is 252.11 amended by adding a subdivision to read: 252.12 Subd. 4b. [EXEMPTIONS AND EMERGENCY ADMISSIONS.] (a) 252.13 Exemptions from the federal screening requirements outlined in 252.14 subdivision 4a, paragraphs (b) and (c), are limited to: 252.15 (1) a person who, having entered an acute care facility 252.16 from a certified nursing facility, is returning to a certified 252.17 nursing facility; and 252.18 (2) a person transferring from one certified nursing 252.19 facility in Minnesota to another certified nursing facility in 252.20 Minnesota. 252.21 (b) Persons who are exempt from preadmission screening for 252.22 purposes of level of care determination include: 252.23 (1) persons described in paragraph (a); 252.24 (2) an individual who has a contractual right to have 252.25 nursing facility care paid for indefinitely by the veterans' 252.26 administration; 252.27 (3) an individual enrolled in a demonstration project under 252.28 section 256B.69, subdivision 8, at the time of application to a 252.29 nursing facility; 252.30 (4) an individual currently being served under the 252.31 alternative care program or under a home and community-based 252.32 services waiver authorized under section 1915(c) of the federal 252.33 Social Security Act; and 252.34 (5) individuals admitted to a certified nursing facility 252.35 for a short-term stay, which is expected to be 14 days or less 252.36 in duration based upon a physician's certification, and who have 253.1 been assessed and approved for nursing facility admission within 253.2 the previous six months. This exemption applies only if the 253.3 consultation team member determines at the time of the initial 253.4 assessment of the six-month period that it is appropriate to use 253.5 the nursing facility for short-term stays and that there is an 253.6 adequate plan of care for return to the home or community-based 253.7 setting. If a stay exceeds 14 days, the individual must be 253.8 referred no later than the first county working day following 253.9 the 14th resident day for a screening, which must be completed 253.10 within five working days of the referral. The payment 253.11 limitations in subdivision 7 apply to an individual found at 253.12 screening to not meet the level of care criteria for admission 253.13 to a certified nursing facility. 253.14 (c) Persons admitted to a Medicaid-certified nursing 253.15 facility from the community on an emergency basis as described 253.16 in paragraph (d) or from an acute care facility on a nonworking 253.17 day must be screened the first working day after admission. 253.18 (d) Emergency admission to a nursing facility prior to 253.19 screening is permitted when all of the following conditions are 253.20 met: 253.21 (1) a person is admitted from the community to a certified 253.22 nursing or certified boarding care facility during county 253.23 nonworking hours; 253.24 (2) a physician has determined that delaying admission 253.25 until preadmission screening is completed would adversely affect 253.26 the person's health and safety; 253.27 (3) there is a recent precipitating event that precludes 253.28 the client from living safely in the community, such as 253.29 sustaining an injury, sudden onset of acute illness, or a 253.30 caregiver's inability to continue to provide care; 253.31 (4) the attending physician has authorized the emergency 253.32 placement and has documented the reason that the emergency 253.33 placement is recommended; and 253.34 (5) the county is contacted on the first working day 253.35 following the emergency admission. 253.36 Transfer of a patient from an acute care hospital to a nursing 254.1 facility is not considered an emergency except for a person who 254.2 has received hospital services in the following situations: 254.3 hospital admission for observation, care in an emergency room 254.4 without hospital admission, or following hospital 24-hour bed 254.5 care. 254.6 Sec. 11. Minnesota Statutes 2000, section 256B.0911, is 254.7 amended by adding a subdivision to read: 254.8 Subd. 4c. [SCREENING REQUIREMENTS.] (a) A person may be 254.9 screened for nursing facility admission by telephone or in a 254.10 face-to-face screening interview. Consultation team members 254.11 shall identify each individual's needs using the following 254.12 categories: 254.13 (1) the person needs no face-to-face screening interview to 254.14 determine the need for nursing facility level of care based on 254.15 information obtained from other health care professionals; 254.16 (2) the person needs an immediate face-to-face screening 254.17 interview to determine the need for nursing facility level of 254.18 care and complete activities required under subdivision 4a; or 254.19 (3) the person may be exempt from screening requirements as 254.20 outlined in subdivision 4b, but will need transitional 254.21 assistance after admission or in-person follow-along after a 254.22 return home. 254.23 (b) Persons admitted on a nonemergency basis to a 254.24 Medicaid-certified nursing facility must be screened prior to 254.25 admission. 254.26 (c) The long-term care consultation team shall recommend a 254.27 case mix classification for persons admitted to a certified 254.28 nursing facility when sufficient information is received to make 254.29 that classification. The nursing facility is authorized to 254.30 conduct all case mix assessments for persons who have been 254.31 screened prior to admission for whom the county did not 254.32 recommend a case mix classification. The nursing facility is 254.33 authorized to conduct all case mix assessments for persons 254.34 admitted to the facility prior to a preadmission screening. The 254.35 county retains the responsibility of distributing appropriate 254.36 case mix forms to the nursing facility. 255.1 (d) The county screening or intake activity must include 255.2 processes to identify persons who may require transition 255.3 assistance as described in subdivision 3b. 255.4 Sec. 12. Minnesota Statutes 2000, section 256B.0911, 255.5 subdivision 5, is amended to read: 255.6 Subd. 5. [SIMPLIFICATION OF FORMSADMINISTRATIVE 255.7 ACTIVITY.] The commissioner shall minimize the number of forms 255.8 required in thepreadmission screening processprovision of 255.9 long-term care consultation services and shall limit the 255.10 screening document to items necessary forcarecommunity support 255.11 plan approval, reimbursement, program planning, evaluation, and 255.12 policy development. 255.13 Sec. 13. Minnesota Statutes 2000, section 256B.0911, 255.14 subdivision 6, is amended to read: 255.15 Subd. 6. [PAYMENT FORPREADMISSION SCREENINGLONG-TERM 255.16 CARE CONSULTATION SERVICES.] (a) The totalscreeningpayment for 255.17 each county must be paid monthly by certified nursing facilities 255.18 in the county. The monthly amount to be paid by each nursing 255.19 facility for each fiscal year must be determined by dividing the 255.20 county's annual allocation forscreeningslong-term care 255.21 consultation services by 12 to determine the monthly payment and 255.22 allocating the monthly payment to each nursing facility based on 255.23 the number of licensed beds in the nursing facility. Payments 255.24 to counties in which there is no certified nursing facility must 255.25 be made by increasing the payment rate of the two facilities 255.26 located nearest to the county seat. 255.27 (b) The commissioner shall include the total annual payment 255.28for screeningdetermined under paragraph (a) for each nursing 255.29 facility reimbursed under section 256B.431 or 256B.434 according 255.30 to section 256B.431, subdivision 2b, paragraph (g), or 256B.435. 255.31 (c) In the event of the layaway, delicensure and 255.32 decertification, or removal from layaway of 25 percent or more 255.33 of the beds in a facility, the commissioner may adjust the per 255.34 diem payment amount in paragraph (b) and may adjust the monthly 255.35 payment amount in paragraph (a). The effective date of an 255.36 adjustment made under this paragraph shall be on or after the 256.1 first day of the month following the effective date of the 256.2 layaway, delicensure and decertification, or removal from 256.3 layaway. 256.4 (d) Payments forscreening activitieslong-term care 256.5 consultation services are available to the county or counties to 256.6 cover staff salaries and expenses to provide thescreening256.7functionservices described in subdivision 1a. Thelead agency256.8 county shall employ, or contract with other agencies to employ, 256.9 within the limits of available funding, sufficient personnel 256.10 toconduct the preadmission screening activityprovide long-term 256.11 care consultation services while meeting the state's long-term 256.12 care outcomes and objectives as defined in section 256B.0917, 256.13 subdivision 1. Thelocal agencycounty shall be accountable for 256.14 meeting local objectives as approved by the commissioner in the 256.15 CSSA biennial plan. 256.16(d)(e) Notwithstanding section 256B.0641, overpayments 256.17 attributable to payment of the screening costs under the medical 256.18 assistance program may not be recovered from a facility. 256.19(e)(f) The commissioner of human services shall amend the 256.20 Minnesota medical assistance plan to include reimbursement for 256.21 the localscreeningconsultation teams. 256.22 (g) The county may bill, as case management services, 256.23 assessments, support planning, and follow-along provided to 256.24 persons determined to be eligible for case management under 256.25 Minnesota health care programs. No individual or family member 256.26 shall be charged for an initial assessment or initial support 256.27 plan development provided under subdivision 3a or 3b. 256.28 Sec. 14. Minnesota Statutes 2000, section 256B.0911, 256.29 subdivision 7, is amended to read: 256.30 Subd. 7. [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.] 256.31 (a) Medical assistance reimbursement for nursing facilities 256.32 shall be authorized for a medical assistance recipient only if a 256.33 preadmission screening has been conducted prior to admission or 256.34 thelocalcountyagencyhas authorized an exemption. Medical 256.35 assistance reimbursement for nursing facilities shall not be 256.36 provided for any recipient who the local screener has determined 257.1 does not meet the level of care criteria for nursing facility 257.2 placement or, if indicated, has not had a level IIPASARROBRA 257.3 evaluation as required under the federal Omnibus Budget 257.4 Reconciliation Act of 1987 completed unless an admission for a 257.5 recipient with mental illness is approved by the local mental 257.6 health authority or an admission for a recipient with mental 257.7 retardation or related condition is approved by the state mental 257.8 retardation authority. 257.9 (b) The nursing facility must not bill a person who is not 257.10 a medical assistance recipient for resident days that preceded 257.11 the date of completion of screening activities as required under 257.12 subdivisions 4a, 4b, and 4c. The nursing facility must include 257.13 unreimbursed resident days in the nursing facility resident day 257.14 totals reported to the commissioner. 257.15 (c) The commissioner shall make a request to the health 257.16 care financing administration for a waiver allowingscreening257.17 team approval of Medicaid payments for certified nursing 257.18 facility care. An individual has a choice and makes the final 257.19 decision between nursing facility placement and community 257.20 placement after the screening team's recommendation, except as 257.21 provided inparagraphs (b) and (c)subdivision 4a, paragraph (c). 257.22(c) The local county mental health authority or the state257.23mental retardation authority under Public Law Numbers 100-203257.24and 101-508 may prohibit admission to a nursing facility, if the257.25individual does not meet the nursing facility level of care257.26criteria or needs specialized services as defined in Public Law257.27Numbers 100-203 and 101-508. For purposes of this section,257.28"specialized services" for a person with mental retardation or a257.29related condition means "active treatment" as that term is257.30defined in Code of Federal Regulations, title 42, section257.31483.440(a)(1).257.32(e) Appeals from the screening team's recommendation or the257.33county agency's final decision shall be made according to257.34section 256.045, subdivision 3.257.35 Sec. 15. Minnesota Statutes 2000, section 256B.0913, 257.36 subdivision 1, is amended to read: 258.1 Subdivision 1. [PURPOSE AND GOALS.] The purpose of the 258.2 alternative care program is to provide funding foror access to258.3 home and community-based services forfrailelderly persons, in 258.4 order to limit nursing facility placements. The program is 258.5 designed to supportfrailelderly persons in their desire to 258.6 remain in the community as independently and as long as possible 258.7 and to support informal caregivers in their efforts to provide 258.8 care forfrailelderly people. Further, the goals of the 258.9 program are: 258.10 (1) to contain medical assistance expenditures byproviding258.11 funding care in the communityat a cost the same or less than258.12nursing facility costs; and 258.13 (2) to maintain the moratorium on new construction of 258.14 nursing home beds. 258.15 Sec. 16. Minnesota Statutes 2000, section 256B.0913, 258.16 subdivision 2, is amended to read: 258.17 Subd. 2. [ELIGIBILITY FOR SERVICES.] Alternative care 258.18 services are available toall frail olderMinnesotans. This258.19includes:258.20(1) persons who are receiving medical assistance and served258.21under the medical assistance program or the Medicaid waiver258.22program;258.23(2) personsage 65 or older who are not eligible for 258.24 medical assistance without a spenddown or waiver obligation but 258.25 who would be eligible for medical assistance within 180 days of 258.26 admission to a nursing facility andserved undersubject to 258.27 subdivisions 4 to 13; and258.28(3) persons who are paying for their services out-of-pocket. 258.29 Sec. 17. Minnesota Statutes 2000, section 256B.0913, 258.30 subdivision 4, is amended to read: 258.31 Subd. 4. [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 258.32 NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 258.33 under the alternative care program is available to persons who 258.34 meet the following criteria: 258.35 (1) the person has beenscreened by the county screening258.36team or, if previously screened and served under the alternative259.1care program, assessed by the local county social worker or259.2public health nursedetermined by a community assessment under 259.3 section 256B.0911, to be a person who would require the level of 259.4 care provided in a nursing facility, but for the provision of 259.5 services under the alternative care program; 259.6 (2) the person is age 65 or older; 259.7 (3) the person would befinanciallyeligible for medical 259.8 assistance within 180 days of admission to a nursing facility; 259.9 (4) the personmeets the asset transfer requirements ofis 259.10 not ineligible for the medical assistance program due to an 259.11 asset transfer penalty; 259.12 (5)the screening team would recommend nursing facility259.13admission or continued stay for the person if alternative care259.14services were not available;259.15(6)the person needs services that are notavailable at259.16that time in the countyfunded through othercounty,state,or 259.17 federal fundingsources; and 259.18(7)(6) the monthly cost of the alternative care services 259.19 funded by the program for this person does not exceed 75 percent 259.20 of the statewideaverage monthly medical assistance payment for259.21nursing facility care at the individual's case mix259.22classificationweighted average monthly nursing facility rate of 259.23 the case mix resident class to which the individual alternative 259.24 care client would be assigned under Minnesota Rules, parts 259.25 9549.0050 to 9549.0059, less the recipient's maintenance needs 259.26 allowance as described in section 256B.0915, subdivision 1d, 259.27 paragraph (a), until the first day of the state fiscal year in 259.28 which the resident assessment system, under section 256B.437, 259.29 for nursing home rate determination is implemented. Effective 259.30 on the first day of the state fiscal year in which a resident 259.31 assessment system, under section 256B.437, for nursing home rate 259.32 determination is implemented and the first day of each 259.33 subsequent state fiscal year, the monthly cost of alternative 259.34 care services for this person shall not exceed the alternative 259.35 care monthly cap for the case mix resident class to which the 259.36 alternative care client would be assigned under Minnesota Rules, 260.1 parts 9549.0050 to 9549.0059, which was in effect on the last 260.2 day of the previous state fiscal year, and adjusted by the 260.3 greater of any legislatively adopted home and community-based 260.4 services cost-of-living percentage increase or any legislatively 260.5 adopted statewide percent rate increase for nursing facilities. 260.6 This monthly limit does not prohibit the alternative care client 260.7 from payment for additional services, but in no case may the 260.8 cost of additional services purchased under this section exceed 260.9 the difference between the client's monthly service limit 260.10 defined under section 256B.0915, subdivision 3, and the 260.11 alternative care program monthly service limit defined in this 260.12 paragraph. If medical supplies and equipment oradaptations260.13 environmental modifications are or will be purchased for an 260.14 alternative care services recipient, the costs may be prorated 260.15 on a monthly basisthroughout the year in which they are260.16purchasedfor up to 12 consecutive months beginning with the 260.17 month of purchase. If the monthly cost of a recipient's other 260.18 alternative care services exceeds the monthly limit established 260.19 in this paragraph, the annual cost of the alternative care 260.20 services shall be determined. In this event, the annual cost of 260.21 alternative care services shall not exceed 12 times the monthly 260.22 limitcalculateddescribed in this paragraph. 260.23 (b)Individuals who meet the criteria in paragraph (a) and260.24who have been approved for alternative care funding are called260.25180-day eligible clients.260.26(c) The statewide average payment for nursing facility care260.27is the statewide average monthly nursing facility rate in effect260.28on July 1 of the fiscal year in which the cost is incurred, less260.29the statewide average monthly income of nursing facility260.30residents who are age 65 or older and who are medical assistance260.31recipients in the month of March of the previous fiscal year.260.32This monthly limit does not prohibit the 180-day eligible client260.33from paying for additional services needed or desired.260.34(d) In determining the total costs of alternative care260.35services for one month, the costs of all services funded by the260.36alternative care program, including supplies and equipment, must261.1be included.261.2(e)Alternative care funding under this subdivision is not 261.3 available for a person who is a medical assistance recipient or 261.4 who would be eligible for medical assistance without a 261.5 spenddown, unless authorized by the commissioneror waiver 261.6 obligation. A person whose initial application for medical 261.7 assistance is being processed may be served under the 261.8 alternative care program for a period up to 60 days. If the 261.9 individual is found to be eligible for medical assistance,the261.10county must billmedical assistance must be billed for services 261.11 payable under the federally approved elderly waiver plan and 261.12 delivered from the date the individual was found eligible 261.13 forservices reimbursable underthe federally approved elderly 261.14 waiverprogramplan. Notwithstanding this provision, upon 261.15 federal approval, alternative care funds may not be used to pay 261.16 for any service the cost of which is payable by medical 261.17 assistance or which is used by a recipient to meet a medical 261.18 assistance income spenddown or waiver obligation. 261.19(f)(c) Alternative care funding is not available for a 261.20 person who resides in a licensed nursing homeor, certified 261.21 boarding care home, hospital, or intermediate care facility, 261.22 except for case management services which arebeingprovided in 261.23 support of the discharge planning process to a nursing home 261.24 resident or certified boarding care home resident who is 261.25 ineligible for case management funded by medical assistance. 261.26 Sec. 18. Minnesota Statutes 2000, section 256B.0913, 261.27 subdivision 5, is amended to read: 261.28 Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 261.29 Alternative care funding may be used for payment of costs of: 261.30 (1) adult foster care; 261.31 (2) adult day care; 261.32 (3) home health aide; 261.33 (4) homemaker services; 261.34 (5) personal care; 261.35 (6) case management; 261.36 (7) respite care; 262.1 (8) assisted living; 262.2 (9) residential care services; 262.3 (10) care-related supplies and equipment; 262.4 (11) meals delivered to the home; 262.5 (12) transportation; 262.6 (13) skilled nursing; 262.7 (14) chore services; 262.8 (15) companion services; 262.9 (16) nutrition services; 262.10 (17) training for direct informal caregivers; 262.11 (18) telemedicine devices to monitor recipients in their 262.12 own homes as an alternative to hospital care, nursing home care, 262.13 or home visits;and262.14 (19) other servicesincludingwhich includes discretionary 262.15 funds and direct cash payments to clients,approved by the262.16county agencyfollowing approval by the commissioner, subject to 262.17 the provisions of paragraph(m)(j). Total annual payments for " 262.18 other services" for all clients within a county may not exceed 262.19 either ten percent of that county's annual alternative care 262.20 program base allocation or $5,000, whichever is greater. In no 262.21 case shall this amount exceed the county's total annual 262.22 alternative care program base allocation; and 262.23 (20) environmental modifications. 262.24 (b) The county agency must ensure that the funds are not 262.25 usedonly to supplement and notto supplant services available 262.26 through other public assistance or services programs. 262.27 (c) Unless specified in statute, the service definitions 262.28 and standards for alternative care services shall be the same as 262.29 the service definitions and standardsdefinedspecified in the 262.30 federally approved elderly waiver plan. Except for the county 262.31 agencies' approval of direct cash payments to clients as 262.32 described in paragraph (j) or for a provider of supplies and 262.33 equipment when the monthly cost of the supplies and equipment is 262.34 less than $250, persons or agencies must be employed by or under 262.35 a contract with the county agency or the public health nursing 262.36 agency of the local board of health in order to receive funding 263.1 under the alternative care program. Supplies and equipment may 263.2 be purchased from a vendor not certified to participate in the 263.3 Medicaid program if the cost for the item is less than that of a 263.4 Medicaid vendor. 263.5 (d) The adult foster care rate shall be considered a 263.6 difficulty of care payment and shall not include room and 263.7 board. The adult foster caredailyrate shall be negotiated 263.8 between the county agency and the foster care provider.The263.9rate established under this section shall not exceed 75 percent263.10of the state average monthly nursing home payment for the case263.11mix classification to which the individual receiving foster care263.12is assigned, and it must allow for other alternative care263.13services to be authorized by the case manager.The alternative 263.14 care payment for the foster care service in combination with the 263.15 payment for other alternative care services, including case 263.16 management, must not exceed the limit specified in subdivision 263.17 4, paragraph (a), clause (6). 263.18 (e) Personal care servicesmay be provided by a personal263.19care provider organization.must meet the service standards 263.20 defined in the federally approved elderly waiver plan, except 263.21 that a county agency may contract with a client's relativeof263.22the clientwho meets the relative hardship waiver requirement as 263.23 defined in section 256B.0627, subdivision 4, paragraph (b), 263.24 clause (10), to provide personal care services, but must ensure263.25nursingif the county agency ensures supervision of this service 263.26 by a registered nurse or mental health practitioner.Covered263.27personal care services defined in section 256B.0627, subdivision263.284, must meet applicable standards in Minnesota Rules, part263.299505.0335.263.30 (f)A county may use alternative care funds to purchase263.31medical supplies and equipment without prior approval from the263.32commissioner when: (1) there is no other funding source; (2)263.33the supplies and equipment are specified in the individual's263.34care plan as medically necessary to enable the individual to263.35remain in the community according to the criteria in Minnesota263.36Rules, part 9505.0210, item A; and (3) the supplies and264.1equipment represent an effective and appropriate use of264.2alternative care funds. A county may use alternative care funds264.3to purchase supplies and equipment from a non-Medicaid certified264.4vendor if the cost for the items is less than that of a Medicaid264.5vendor. A county is not required to contract with a provider of264.6supplies and equipment if the monthly cost of the supplies and264.7equipment is less than $250.264.8(g)For purposes of this section, residential care services 264.9 are services which are provided to individuals living in 264.10 residential care homes. Residential care homes are currently 264.11 licensed as board and lodging establishments and are registered 264.12 with the department of health as providing special 264.13 services under section 157.17 and are not subject to 264.14 registration under chapter 144D. Residential care services are 264.15 defined as "supportive services" and "health-related services." 264.16 "Supportive services" means the provision of up to 24-hour 264.17 supervision and oversight. Supportive services includes: (1) 264.18 transportation, when provided by the residential carecenter264.19 home only; (2) socialization, when socialization is part of the 264.20 plan of care, has specific goals and outcomes established, and 264.21 is not diversional or recreational in nature; (3) assisting 264.22 clients in setting up meetings and appointments; (4) assisting 264.23 clients in setting up medical and social services; (5) providing 264.24 assistance with personal laundry, such as carrying the client's 264.25 laundry to the laundry room. Assistance with personal laundry 264.26 does not include any laundry, such as bed linen, that is 264.27 included in the room and board rate. "Health-related services" 264.28 are limited to minimal assistance with dressing, grooming, and 264.29 bathing and providing reminders to residents to take medications 264.30 that are self-administered or providing storage for medications, 264.31 if requested. Individuals receiving residential care services 264.32 cannot receive homemaking services funded under this section. 264.33(h)(g) For the purposes of this section, "assisted living" 264.34 refers to supportive services provided by a single vendor to 264.35 clients who reside in the same apartment building of three or 264.36 more units which are not subject to registration under chapter 265.1 144D and are licensed by the department of health as a class A 265.2 home care provider or a class E home care provider. Assisted 265.3 living services are defined as up to 24-hour supervision, and 265.4 oversight, supportive services as defined in clause (1), 265.5 individualized home care aide tasks as defined in clause (2), 265.6 and individualized home management tasks as defined in clause 265.7 (3) provided to residents of a residential center living in 265.8 their units or apartments with a full kitchen and bathroom. A 265.9 full kitchen includes a stove, oven, refrigerator, food 265.10 preparation counter space, and a kitchen utensil storage 265.11 compartment. Assisted living services must be provided by the 265.12 management of the residential center or by providers under 265.13 contract with the management or with the county. 265.14 (1) Supportive services include: 265.15 (i) socialization, when socialization is part of the plan 265.16 of care, has specific goals and outcomes established, and is not 265.17 diversional or recreational in nature; 265.18 (ii) assisting clients in setting up meetings and 265.19 appointments; and 265.20 (iii) providing transportation, when provided by the 265.21 residential center only. 265.22Individuals receiving assisted living services will not265.23receive both assisted living services and homemaking services.265.24Individualized means services are chosen and designed265.25specifically for each resident's needs, rather than provided or265.26offered to all residents regardless of their illnesses,265.27disabilities, or physical conditions.265.28 (2) Home care aide tasks means: 265.29 (i) preparing modified diets, such as diabetic or low 265.30 sodium diets; 265.31 (ii) reminding residents to take regularly scheduled 265.32 medications or to perform exercises; 265.33 (iii) household chores in the presence of technically 265.34 sophisticated medical equipment or episodes of acute illness or 265.35 infectious disease; 265.36 (iv) household chores when the resident's care requires the 266.1 prevention of exposure to infectious disease or containment of 266.2 infectious disease; and 266.3 (v) assisting with dressing, oral hygiene, hair care, 266.4 grooming, and bathing, if the resident is ambulatory, and if the 266.5 resident has no serious acute illness or infectious disease. 266.6 Oral hygiene means care of teeth, gums, and oral prosthetic 266.7 devices. 266.8 (3) Home management tasks means: 266.9 (i) housekeeping; 266.10 (ii) laundry; 266.11 (iii) preparation of regular snacks and meals; and 266.12 (iv) shopping. 266.13 Individuals receiving assisted living services shall not 266.14 receive both assisted living services and homemaking services. 266.15 Individualized means services are chosen and designed 266.16 specifically for each resident's needs, rather than provided or 266.17 offered to all residents regardless of their illnesses, 266.18 disabilities, or physical conditions. Assisted living services 266.19 as defined in this section shall not be authorized in boarding 266.20 and lodging establishments licensed according to sections 266.21 157.011 and 157.15 to 157.22. 266.22(i)(h) For establishments registered under chapter 144D, 266.23 assisted living services under this section means either the 266.24 services describedand licensedin paragraph (g) and delivered 266.25 by a class E home care provider licensed by the department of 266.26 health or the services described under section 144A.4605 and 266.27 delivered by an assisted living home care provider or a class A 266.28 home care provider licensed by the commissioner of health. 266.29(j) For the purposes of this section, reimbursement(i) 266.30 Payment for assisted living services and residential care 266.31 services shall be a monthly rate negotiated and authorized by 266.32 the county agency based on an individualized service plan for 266.33 each resident and may not cover direct rent or food costs.The266.34rate266.35 (1) The individualized monthly negotiated payment for 266.36 assisted living services as described in paragraph (g) or (h), 267.1 and residential care services as described in paragraph (f), 267.2 shall not exceed the nonfederal share in effect on July 1 of the 267.3 state fiscal year for which the rate limit is being calculated 267.4 of the greater of either the statewide or any of the geographic 267.5 groups' weighted average monthlymedical assistancenursing 267.6 facility payment rate of the case mix resident class to which 267.7 the180-dayalternative care eligible client would be assigned 267.8 under Minnesota Rules, parts 9549.0050 to 9549.0059,unless the267.9 less the maintenance needs allowance as described in section 267.10 256B.0915, subdivision 1d, paragraph (a), until the first day of 267.11 the state fiscal year in which a resident assessment system, 267.12 under section 256B.437, of nursing home rate determination is 267.13 implemented. Effective on the first day of the state fiscal 267.14 year in which a resident assessment system, under section 267.15 256B.437, of nursing home rate determination is implemented and 267.16 the first day of each subsequent state fiscal year, the 267.17 individualized monthly negotiated payment for the services 267.18 described in this clause shall not exceed the limit described in 267.19 this clause which was in effect on the last day of the previous 267.20 state fiscal year and which has been adjusted by the greater of 267.21 any legislatively adopted home and community-based services 267.22 cost-of-living percentage increase or any legislatively adopted 267.23 statewide percent rate increase for nursing facilities. 267.24 (2) The individualized monthly negotiated payment for 267.25 assisted living servicesare provided by a home caredescribed 267.26 under section 144A.4605 and delivered by a provider licensed by 267.27 the department of health as a class A home care provider or an 267.28 assisted living home care provider andareprovided in a 267.29 building that is registered as a housing with services 267.30 establishment under chapter 144D and that provides 24-hour 267.31 supervision in combination with the payment for other 267.32 alternative care services, including case management, must not 267.33 exceed the limit specified in subdivision 4, paragraph (a), 267.34 clause (6). 267.35(k) For purposes of this section, companion services are267.36defined as nonmedical care, supervision and oversight, provided268.1to a functionally impaired adult. Companions may assist the268.2individual with such tasks as meal preparation, laundry and268.3shopping, but do not perform these activities as discrete268.4services. The provision of companion services does not entail268.5hands-on medical care. Providers may also perform light268.6housekeeping tasks which are incidental to the care and268.7supervision of the recipient. This service must be approved by268.8the case manager as part of the care plan. Companion services268.9must be provided by individuals or organizations who are under268.10contract with the local agency to provide the service. Any268.11person related to the waiver recipient by blood, marriage or268.12adoption cannot be reimbursed under this service. Persons268.13providing companion services will be monitored by the case268.14manager.268.15(l) For purposes of this section, training for direct268.16informal caregivers is defined as a classroom or home course of268.17instruction which may include: transfer and lifting skills,268.18nutrition, personal and physical cares, home safety in a home268.19environment, stress reduction and management, behavioral268.20management, long-term care decision making, care coordination268.21and family dynamics. The training is provided to an informal268.22unpaid caregiver of a 180-day eligible client which enables the268.23caregiver to deliver care in a home setting with high levels of268.24quality. The training must be approved by the case manager as268.25part of the individual care plan. Individuals, agencies, and268.26educational facilities which provide caregiver training and268.27education will be monitored by the case manager.268.28(m)(j) A county agency may make payment from their 268.29 alternative care program allocation for "other services" 268.30provided to an alternative care program recipient if those268.31services prevent, shorten, or delay institutionalization. These268.32services maywhich include use of "discretionary funds" for 268.33 services that are not otherwise defined in this section and 268.34 direct cash payments to therecipientclient for the purpose of 268.35 purchasing therecipient'sservices. The following provisions 268.36 apply to payments under this paragraph: 269.1 (1) a cash payment to a client under this provision cannot 269.2 exceed 80 percent of the monthly payment limit for that client 269.3 as specified in subdivision 4, paragraph (a), clause(7)(6); 269.4 (2) a county may not approve any cash payment for a client 269.5 who meets either of the following: 269.6 (i) has been assessed as having a dependency in 269.7 orientation, unless the client has an authorized 269.8 representativeunder section 256.476, subdivision 2, paragraph269.9(g), or for a client who. An "authorized representative" means 269.10 an individual who is at least 18 years of age and is designated 269.11 by the person or the person's legal representative to act on the 269.12 person's behalf. This individual may be a family member, 269.13 guardian, representative payee, or other individual designated 269.14 by the person or the person's legal representative, if any, to 269.15 assist in purchasing and arranging for supports; or 269.16 (ii) is concurrently receiving adult foster care, 269.17 residential care, or assisted living services; 269.18 (3)any service approved under this section must be a269.19service which meets the purpose and goals of the program as269.20listed in subdivision 1;269.21(4) cash payments must also meet the criteria of and are269.22governed by the procedures and liability protection established269.23in section 256.476, subdivision 4, paragraphs (b) through (h),269.24and recipients of cash grants must meet the requirements in269.25section 256.476, subdivision 10; andcash payments to a person 269.26 or a person's family will be provided through a monthly payment 269.27 and be in the form of cash, voucher, or direct county payment to 269.28 a vendor. Fees or premiums assessed to the person for 269.29 eligibility for health and human services are not reimbursable 269.30 through this service option. Services and goods purchased 269.31 through cash payments must be identified in the person's 269.32 individualized care plan and must meet all of the following 269.33 criteria: 269.34 (i) they must be over and above the normal cost of caring 269.35 for the person if the person did not have functional 269.36 limitations; 270.1 (ii) they must be directly attributable to the person's 270.2 functional limitations; 270.3 (iii) they must have the potential to be effective at 270.4 meeting the goals of the program; 270.5 (iv) they must be consistent with the needs identified in 270.6 the individualized service plan. The service plan shall specify 270.7 the needs of the person and family, the form and amount of 270.8 payment, the items and services to be reimbursed, and the 270.9 arrangements for management of the individual grant; and 270.10 (v) the person, the person's family, or the legal 270.11 representative shall be provided sufficient information to 270.12 ensure an informed choice of alternatives. The local agency 270.13 shall document this information in the person's care plan, 270.14 including the type and level of expenditures to be reimbursed; 270.15 (4) the county, lead agency under contract, or tribal 270.16 government under contract to administer the alternative care 270.17 program shall not be liable for damages, injuries, or 270.18 liabilities sustained through the purchase of direct supports or 270.19 goods by the person, the person's family, or the authorized 270.20 representative with funds received through the cash payments 270.21 under this section. Liabilities include, but are not limited 270.22 to, workers' compensation, the Federal Insurance Contributions 270.23 Act (FICA), or the Federal Unemployment Tax Act (FUTA); 270.24 (5) persons receiving grants under this section shall have 270.25 the following responsibilities: 270.26 (i) spend the grant money in a manner consistent with their 270.27 individualized service plan with the local agency; 270.28 (ii) notify the local agency of any necessary changes in 270.29 the grant-expenditures; 270.30 (iii) arrange and pay for supports; and 270.31 (iv) inform the local agency of areas where they have 270.32 experienced difficulty securing or maintaining supports; and 270.33(5)(6) the county shall report client outcomes, services, 270.34 and costs under this paragraph in a manner prescribed by the 270.35 commissioner. 270.36 (k) Upon implementation of direct cash payments to clients 271.1 under this section, any person determined eligible for the 271.2 alternative care program who chooses a cash payment approved by 271.3 the county agency shall receive the cash payment under this 271.4 section and not under section 256.476 unless the person was 271.5 receiving a consumer support grant under section 256.476 before 271.6 implementation of direct cash payments under this section. 271.7 Sec. 19. Minnesota Statutes 2000, section 256B.0913, 271.8 subdivision 6, is amended to read: 271.9 Subd. 6. [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] The 271.10 alternative care program is administered by the county agency. 271.11 This agency is the lead agency responsible for the local 271.12 administration of the alternative care program as described in 271.13 this section. However, it may contract with the public health 271.14 nursing service to be the lead agency. The commissioner may 271.15 contract with federally recognized Indian tribes with a 271.16 reservation in Minnesota to serve as the lead agency responsible 271.17 for the local administration of the alternative care program as 271.18 described in the contract. 271.19 Sec. 20. Minnesota Statutes 2000, section 256B.0913, 271.20 subdivision 7, is amended to read: 271.21 Subd. 7. [CASE MANAGEMENT.] Providers of case management 271.22 services for persons receiving services funded by the 271.23 alternative care program must meet the qualification 271.24 requirements and standards specified in section 256B.0915, 271.25 subdivision 1b. The case manager mustensure the health and271.26safety of the individual client andnot approve alternative care 271.27 funding for a client in any setting in which the case manager 271.28 cannot reasonably ensure the client's health and safety. The 271.29 case manager is responsible for the cost-effectiveness of the 271.30 alternative care individual care plan and must not approve any 271.31 care plan in which the cost of services funded by alternative 271.32 care and client contributions exceeds the limit specified in 271.33 section 256B.0915, subdivision 3, paragraph (b). The county may 271.34 allow a case manager employed by the county to delegate certain 271.35 aspects of the case management activity to another individual 271.36 employed by the county provided there is oversight of the 272.1 individual by the case manager. The case manager may not 272.2 delegate those aspects which require professional judgment 272.3 including assessments, reassessments, and care plan development. 272.4 Sec. 21. Minnesota Statutes 2000, section 256B.0913, 272.5 subdivision 8, is amended to read: 272.6 Subd. 8. [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 272.7 case manager shall implement the plan of care for each180-day272.8eligiblealternative care client and ensure that a client's 272.9 service needs and eligibility are reassessed at least every 12 272.10 months. The plan shall include any services prescribed by the 272.11 individual's attending physician as necessary to allow the 272.12 individual to remain in a community setting. In developing the 272.13 individual's care plan, the case manager should include the use 272.14 of volunteers from families and neighbors, religious 272.15 organizations, social clubs, and civic and service organizations 272.16 to support the formal home care services. The county shall be 272.17 held harmless for damages or injuries sustained through the use 272.18 of volunteers under this subdivision including workers' 272.19 compensation liability.The lead agency shall provide272.20documentation to the commissioner verifying that the272.21individual's alternative care is not available at that time272.22through any other public assistance or service program.The 272.23 lead agency shall provide documentation in each individual's 272.24 plan of care and, if requested, to the commissioner that the 272.25 most cost-effective alternatives available have been offered to 272.26 the individual and that the individual was free to choose among 272.27 available qualified providers, both public and private. The 272.28 case manager must give the individual a ten-day written notice 272.29 of any decrease in or termination of alternative care services. 272.30 (b) If the county administering alternative care services 272.31 is different than the county of financial responsibility, the 272.32 care plan may be implemented without the approval of the county 272.33 of financial responsibility. 272.34 Sec. 22. Minnesota Statutes 2000, section 256B.0913, 272.35 subdivision 9, is amended to read: 272.36 Subd. 9. [CONTRACTING PROVISIONS FOR PROVIDERS.]The lead273.1agency shall document to the commissioner that the agency made273.2reasonable efforts to inform potential providers of the273.3anticipated need for services under the alternative care program273.4or waiver programs under sections 256B.0915 and 256B.49,273.5including a minimum of 14 days' written advance notice of the273.6opportunity to be selected as a service provider and an annual273.7public meeting with providers to explain and review the criteria273.8for selection. The lead agency shall also document to the273.9commissioner that the agency allowed potential providers an273.10opportunity to be selected to contract with the county agency.273.11Funds reimbursed to counties under this subdivisionAlternative 273.12 care funds paid to service providers are subject to audit by the 273.13 commissioner for fiscal and utilization control. 273.14 The lead agency must select providers for contracts or 273.15 agreements using the following criteria and other criteria 273.16 established by the county: 273.17 (1) the need for the particular services offered by the 273.18 provider; 273.19 (2) the population to be served, including the number of 273.20 clients, the length of time services will be provided, and the 273.21 medical condition of clients; 273.22 (3) the geographic area to be served; 273.23 (4) quality assurance methods, including appropriate 273.24 licensure, certification, or standards, and supervision of 273.25 employees when needed; 273.26 (5) rates for each service and unit of service exclusive of 273.27 county administrative costs; 273.28 (6) evaluation of services previously delivered by the 273.29 provider; and 273.30 (7) contract or agreement conditions, including billing 273.31 requirements, cancellation, and indemnification. 273.32 The county must evaluate its own agency services under the 273.33 criteria established for other providers.The county shall273.34provide a written statement of the reasons for not selecting273.35providers.273.36 Sec. 23. Minnesota Statutes 2000, section 256B.0913, 274.1 subdivision 10, is amended to read: 274.2 Subd. 10. [ALLOCATION FORMULA.] (a) The alternative care 274.3 appropriation for fiscal years 1992 and beyond shall cover 274.4 only180-dayalternative care eligible clients. Prior to July 1 274.5 of each year, the commissioner shall allocate to county agencies 274.6 the state funds available for alternative care for persons 274.7 eligible under subdivision 2. 274.8 (b)Prior to July 1 of each year, the commissioner shall274.9allocate to county agencies the state funds available for274.10alternative care for persons eligible under subdivision 2. The274.11allocation for fiscal year 1992 shall be calculated using a base274.12that is adjusted to exclude the medical assistance share of274.13alternative care expenditures. The adjusted base is calculated274.14by multiplying each county's allocation for fiscal year 1991 by274.15the percentage of county alternative care expenditures for274.16180-day eligible clients. The percentage is determined based on274.17expenditures for services rendered in fiscal year 1989 or274.18calendar year 1989, whichever is greater.The adjusted base for 274.19 each county is the county's current fiscal year base allocation 274.20 plus any targeted funds approved during the current fiscal 274.21 year. Calculations for paragraphs (c) and (d) are to be made as 274.22 follows: for each county, the determination of alternative care 274.23 program expenditures shall be based on payments for services 274.24 rendered from April 1 through March 31 in the base year, to the 274.25 extent that claims have been submitted and paid by June 1 of 274.26 that year. 274.27 (c) If thecountyalternative care program expendituresfor274.28180-day eligible clientsas defined in paragraph (b) are 95 274.29 percent or more ofitsthe county's adjusted base allocation, 274.30 the allocation for the next fiscal year is 100 percent of the 274.31 adjusted base, plus inflation to the extent that inflation is 274.32 included in the state budget. 274.33 (d) If thecountyalternative care program expendituresfor274.34180-day eligible clientsas defined in paragraph (b) are less 274.35 than 95 percent ofitsthe county's adjusted base allocation, 274.36 the allocation for the next fiscal year is the adjusted base 275.1 allocation less the amount of unspent funds below the 95 percent 275.2 level. 275.3 (e)For fiscal year 1992 only, a county may receive an275.4increased allocation if annualized service costs for the month275.5of May 1991 for 180-day eligible clients are greater than the275.6allocation otherwise determined. A county may apply for this275.7increase by reporting projected expenditures for May to the275.8commissioner by June 1, 1991. The amount of the allocation may275.9exceed the amount calculated in paragraph (b). The projected275.10expenditures for May must be based on actual 180-day eligible275.11client caseload and the individual cost of clients' care plans.275.12If a county does not report its expenditures for May, the amount275.13in paragraph (c) or (d) shall be used.275.14(f) Calculations for paragraphs (c) and (d) are to be made275.15as follows: for each county, the determination of expenditures275.16shall be based on payments for services rendered from April 1275.17through March 31 in the base year, to the extent that claims275.18have been submitted by June 1 of that year. Calculations for275.19paragraphs (c) and (d) must also include the funds transferred275.20to the consumer support grant program for clients who have275.21transferred to that program from April 1 through March 31 in the275.22base year.275.23(g) For the biennium ending June 30, 2001, the allocation275.24of state funds to county agencies shall be calculated as275.25described in paragraphs (c) and (d).If the annual legislative 275.26 appropriation for the alternative care program is inadequate to 275.27 fund the combined county allocations forfiscal year 2000 or275.282001a biennium, the commissioner shall distribute to each 275.29 county the entire annual appropriation as that county's 275.30 percentage of the computed base as calculated inparagraph275.31(f)paragraphs (c) and (d). 275.32 Sec. 24. Minnesota Statutes 2000, section 256B.0913, 275.33 subdivision 11, is amended to read: 275.34 Subd. 11. [TARGETED FUNDING.] (a) The purpose of targeted 275.35 funding is to make additional money available to counties with 275.36 the greatest need. Targeted funds are not intended to be 276.1 distributed equitably among all counties, but rather, allocated 276.2 to those with long-term care strategies that meet state goals. 276.3 (b) The funds available for targeted funding shall be the 276.4 total appropriation for each fiscal year minus county 276.5 allocations determined under subdivision 10 as adjusted for any 276.6 inflation increases provided in appropriations for the biennium. 276.7 (c) The commissioner shall allocate targeted funds to 276.8 counties that demonstrate to the satisfaction of the 276.9 commissioner that they have developed feasible plans to increase 276.10 alternative care spending. In making targeted funding 276.11 allocations, the commissioner shall use the following priorities: 276.12 (1) counties that received a lower allocation in fiscal 276.13 year 1991 than in fiscal year 1990. Counties remain in this 276.14 priority until they have been restored to their fiscal year 1990 276.15 level plus inflation; 276.16 (2) counties that sustain a base allocation reduction for 276.17 failure to spend 95 percent of the allocation if they 276.18 demonstrate that the base reduction should be restored; 276.19 (3) counties that propose projects to divert community 276.20 residents from nursing home placement or convert nursing home 276.21 residents to community living; and 276.22 (4) counties that can otherwise justify program growth by 276.23 demonstrating the existence of waiting lists, demographically 276.24 justified needs, or other unmet needs. 276.25 (d) Counties that would receive targeted funds according to 276.26 paragraph (c) must demonstrate to the commissioner's 276.27 satisfaction that the funds would be appropriately spent by 276.28 showing how the funds would be used to further the state's 276.29 alternative care goals as described in subdivision 1, and that 276.30 the county has the administrative and service delivery 276.31 capability to use them. 276.32 (e) The commissioner shall request applicationsby June 1276.33each year, for county agencies to applyfor targeted funds by 276.34 November 1 of each year. The counties selected for targeted 276.35 funds shall be notified of the amount of their additional 276.36 fundingby August 1 of each year. Targeted funds allocated to a 277.1 county agency in one year shall be treated as part of the 277.2 county's base allocation for that year in determining 277.3 allocations for subsequent years. No reallocations between 277.4 counties shall be made. 277.5(f) The allocation for each year after fiscal year 1992277.6shall be determined using the previous fiscal year's allocation,277.7including any targeted funds, as the base and then applying the277.8criteria under subdivision 10, paragraphs (c), (d), and (f), to277.9the current year's expenditures.277.10 Sec. 25. Minnesota Statutes 2000, section 256B.0913, 277.11 subdivision 12, is amended to read: 277.12 Subd. 12. [CLIENT PREMIUMS.] (a) A premium is required for 277.13 all180-dayalternative care eligible clients to help pay for 277.14 the cost of participating in the program. The amount of the 277.15 premium for the alternative care client shall be determined as 277.16 follows: 277.17 (1) when the alternative care client's income less 277.18 recurring and predictable medical expenses is greater than the 277.19medical assistance income standardrecipient's maintenance needs 277.20 allowance as defined in section 256B.0915, subdivision 1d, 277.21 paragraph (a), but less than 150 percent of the federal poverty 277.22 guideline effective on July 1 of the state fiscal year in which 277.23 the premium is being computed, and total assets are less than 277.24 $10,000, the fee is zero; 277.25 (2) when the alternative care client's income less 277.26 recurring and predictable medical expenses is greater than 150 277.27 percent of the federal poverty guideline effective on July 1 of 277.28 the state fiscal year in which the premium is being computed, 277.29 and total assets are less than $10,000, the fee is 25 percent of 277.30 the cost of alternative care services or the difference between 277.31 150 percent of the federal poverty guideline effective on July 1 277.32 of the state fiscal year in which the premium is being computed 277.33 and the client's income less recurring and predictable medical 277.34 expenses, whichever is less; and 277.35 (3) when the alternative care client's total assets are 277.36 greater than $10,000, the fee is 25 percent of the cost of 278.1 alternative care services. 278.2 For married persons, total assets are defined as the total 278.3 marital assets less the estimated community spouse asset 278.4 allowance, under section 256B.059, if applicable. For married 278.5 persons, total income is defined as the client's income less the 278.6 monthly spousal allotment, under section 256B.058. 278.7 All alternative care services except case management shall 278.8 be included in the estimated costs for the purpose of 278.9 determining 25 percent of the costs. 278.10 The monthly premium shall be calculated based on the cost 278.11 of the first full month of alternative care services and shall 278.12 continue unaltered until the next reassessment is completed or 278.13 at the end of 12 months, whichever comes first. Premiums are 278.14 due and payable each month alternative care services are 278.15 received unless the actual cost of the services is less than the 278.16 premium. 278.17 (b) The fee shall be waived by the commissioner when: 278.18 (1) a person who is residing in a nursing facility is 278.19 receiving case management only; 278.20 (2) a person is applying for medical assistance; 278.21 (3) a married couple is requesting an asset assessment 278.22 under the spousal impoverishment provisions; 278.23 (4)a person is a medical assistance recipient, but has278.24been approved for alternative care-funded assisted living278.25services;278.26(5)a person is found eligible for alternative care, but is 278.27 not yet receiving alternative care services; or 278.28(6)(5) a person's fee under paragraph (a) is less than $25. 278.29 (c) The county agency must record in the state's receivable 278.30 system the client's assessed premium amount or the reason the 278.31 premium has been waived. The commissioner will bill and collect 278.32 the premium from the clientand forward the amounts collected to278.33the commissioner in the manner and at the times prescribed by278.34the commissioner. Money collected must be deposited in the 278.35 general fund and is appropriated to the commissioner for the 278.36 alternative care program. The client must supply the county 279.1 with the client's social security number at the time of 279.2 application.If a client fails or refuses to pay the premium279.3due,The county shall supply the commissioner with the client's 279.4 social security number and other information the commissioner 279.5 requires to collect the premium from the client. The 279.6 commissioner shall collect unpaid premiums using the Revenue 279.7 Recapture Act in chapter 270A and other methods available to the 279.8 commissioner. The commissioner may require counties to inform 279.9 clients of the collection procedures that may be used by the 279.10 state if a premium is not paid. This paragraph does not apply 279.11 to alternative care pilot projects authorized in Laws 1993, 279.12 First Special Session chapter 1, article 5, section 133, if a 279.13 county operating under the pilot project reports the following 279.14 dollar amounts to the commissioner quarterly: 279.15 (1) total premiums billed to clients; 279.16 (2) total collections of premiums billed; and 279.17 (3) balance of premiums owed by clients. 279.18 If a county does not adhere to these reporting requirements, the 279.19 commissioner may terminate the billing, collecting, and 279.20 remitting portions of the pilot project and require the county 279.21 involved to operate under the procedures set forth in this 279.22 paragraph. 279.23 (d) The commissioner shall begin to adopt emergency or 279.24 permanent rules governing client premiums within 30 days after 279.25 July 1, 1991, including criteria for determining when services 279.26 to a client must be terminated due to failure to pay a premium. 279.27 Sec. 26. Minnesota Statutes 2000, section 256B.0913, 279.28 subdivision 13, is amended to read: 279.29 Subd. 13. [COUNTY BIENNIAL PLAN.] The county biennial plan 279.30 forthe preadmission screening programlong-term care 279.31 consultation services under section 256B.0911, the alternative 279.32 care program under this section, and waivers for the elderly 279.33 under section 256B.0915,and waivers for the disabled under279.34section 256B.49,shall be incorporated into the biennial 279.35 Community Social Services Act plan and shall meet the 279.36 regulations and timelines of that plan.This county biennial280.1plan shall include:280.2(1) information on the administration of the preadmission280.3screening program;280.4(2) information on the administration of the home and280.5community-based services waivers for the elderly under section280.6256B.0915, and for the disabled under section 256B.49; and280.7(3) information on the administration of the alternative280.8care program.280.9 Sec. 27. Minnesota Statutes 2000, section 256B.0913, 280.10 subdivision 14, is amended to read: 280.11 Subd. 14. [REIMBURSEMENTPAYMENT AND RATE ADJUSTMENTS.] (a) 280.12ReimbursementPayment forexpenditures for theprovided 280.13 alternative care services as approved by the client's case 280.14 manager shall be through the invoice processing procedures of 280.15 the department's Medicaid Management Information System (MMIS). 280.16 To receivereimbursementpayment, the county or vendor must 280.17 submit invoices within 12 months following the date of service. 280.18 The county agency and its vendors under contract shall not be 280.19 reimbursed for services which exceed the county allocation. 280.20 (b)If a county collects less than 50 percent of the client280.21premiums due under subdivision 12, the commissioner may withhold280.22up to three percent of the county's final alternative care280.23program allocation determined under subdivisions 10 and 11.280.24(c)The county shall negotiate individual rates with 280.25 vendors and maybe reimbursedauthorize service payment for 280.26 actual costs up tothe greater ofthe county's current approved 280.27 rateor 60 percent of the maximum rate in fiscal year 1994 and280.2865 percent of the maximum rate in fiscal year 1995 for each280.29alternative care service. Notwithstanding any other rule or 280.30 statutory provision to the contrary, the commissioner shall not 280.31 be authorized to increase rates by an annual inflation factor, 280.32 unless so authorized by the legislature. 280.33(d) On July 1, 1993, the commissioner shall increase the280.34maximum rate for home delivered meals to $4.50 per meal.To 280.35 improve access to community services and eliminate payment 280.36 disparities between the alternative care program and the elderly 281.1 waiver program, the commissioner shall establish statewide 281.2 maximum service rate limits and eliminate county-specific 281.3 service rate limits. 281.4 (1) Effective July 1, 2001, for service rate limits, except 281.5 those in subdivision 5, paragraphs (d) and (i), the rate limit 281.6 for each service shall be the greater of the alternative care 281.7 statewide maximum rate or the elderly waiver statewide maximum 281.8 rate. 281.9 (2) Counties may negotiate individual service rates with 281.10 vendors for actual costs up to the statewide maximum service 281.11 rate limit. 281.12 Sec. 28. Minnesota Statutes 2000, section 256B.0915, 281.13 subdivision 1d, is amended to read: 281.14 Subd. 1d. [POSTELIGIBILITY TREATMENT OF INCOME AND 281.15 RESOURCES FOR ELDERLY WAIVER.](a)Notwithstanding the 281.16 provisions of section 256B.056, the commissioner shall make the 281.17 following amendment to the medical assistance elderly waiver 281.18 program effective July 1, 1999, or upon federal approval, 281.19 whichever is later. 281.20 A recipient's maintenance needs will be an amount equal to 281.21 the Minnesota supplemental aid equivalent rate as defined in 281.22 section 256I.03, subdivision 5, plus the medical assistance 281.23 personal needs allowance as defined in section 256B.35, 281.24 subdivision 1, paragraph (a), when applying posteligibility 281.25 treatment of income rules to the gross income of elderly waiver 281.26 recipients, except for individuals whose income is in excess of 281.27 the special income standard according to Code of Federal 281.28 Regulations, title 42, section 435.236. Recipient maintenance 281.29 needs shall be adjusted under this provision each July 1. 281.30(b) The commissioner of human services shall secure281.31approval of additional elderly waiver slots sufficient to serve281.32persons who will qualify under the revised income standard281.33described in paragraph (a) before implementing section281.34256B.0913, subdivision 16.281.35(c) In implementing this subdivision, the commissioner281.36shall consider allowing persons who would otherwise be eligible282.1for the alternative care program but would qualify for the282.2elderly waiver with a spenddown to remain on the alternative282.3care program.282.4 Sec. 29. Minnesota Statutes 2000, section 256B.0915, 282.5 subdivision 3, is amended to read: 282.6 Subd. 3. [LIMITS OF CASES, RATES,REIMBURSEMENTPAYMENTS, 282.7 AND FORECASTING.] (a) The number of medical assistance waiver 282.8 recipients that a county may serve must be allocated according 282.9 to the number of medical assistance waiver cases open on July 1 282.10 of each fiscal year. Additional recipients may be served with 282.11 the approval of the commissioner. 282.12 (b) The monthly limit for the cost of waivered services to 282.13 an individual elderly waiver client shall be thestatewide282.14average paymentweighted average monthly nursing facility rate 282.15 of the case mix resident class to which the elderly waiver 282.16 client would be assigned underthe medical assistance case mix282.17reimbursement system.Minnesota Rules, parts 9549.0050 to 282.18 9549.0059, less the recipient's maintenance needs allowance as 282.19 described in subdivision 1d, paragraph (a), until the first day 282.20 of the state fiscal year in which the resident assessment system 282.21 as described in section 256B.437 for nursing home rate 282.22 determination is implemented. Effective on the first day of the 282.23 state fiscal year in which the resident assessment system as 282.24 described in section 256B.437 for nursing home rate 282.25 determination is implemented and the first day of each 282.26 subsequent state fiscal year, the monthly limit for the cost of 282.27 waivered services to an individual elderly waiver client shall 282.28 be the rate of the case mix resident class to which the waiver 282.29 client would be assigned under Minnesota Rules, parts 9549.0050 282.30 to 9549.0059, in effect on the last day of the previous state 282.31 fiscal year, adjusted by the greater of any legislatively 282.32 adopted home and community-based services cost-of-living 282.33 percentage increase or any legislatively adopted statewide 282.34 percent rate increase for nursing facilities. 282.35 (c) If extended medical supplies and equipment or 282.36adaptationsenvironmental modifications are or will be purchased 283.1 for an elderly waiverservices recipientclient, the costs may 283.2 be proratedon a monthly basis throughout the year in which they283.3are purchasedfor up to 12 consecutive months beginning with the 283.4 month of purchase. If the monthly cost of a recipient'sother283.5 waivered services exceeds the monthly limit established inthis283.6 paragraph (b), the annual cost oftheall waivered services 283.7 shall be determined. In this event, the annual cost of all 283.8 waivered services shall not exceed 12 times the monthly 283.9 limitcalculated in this paragraph. The statewide average283.10payment rate is calculated by determining the statewide average283.11monthly nursing home rate, effective July 1 of the fiscal year283.12in which the cost is incurred, less the statewide average283.13monthly income of nursing home residents who are age 65 or283.14older, and who are medical assistance recipients in the month of283.15March of the previous state fiscal year. The annual cost283.16divided by 12 of elderly or disabled waivered servicesof 283.17 waivered services as described in paragraph (b). 283.18 (d) For a person who is a nursing facility resident at the 283.19 time of requesting a determination of eligibility for elderlyor283.20disabledwaivered servicesshall be the greater of the monthly283.21payment for: (i), a monthly conversion limit for the cost of 283.22 elderly waivered services may be requested. The monthly 283.23 conversion limit for the cost of elderly waiver services shall 283.24 be the resident class assigned under Minnesota Rules, parts 283.25 9549.0050 to 9549.0059, for that resident in the nursing 283.26 facility where the resident currently resides; or (ii) the283.27statewide average payment of the case mix resident class to283.28which the resident would be assigned under the medical283.29assistance case mix reimbursement system, provided thatuntil 283.30 July 1 of the state fiscal year in which the resident assessment 283.31 system as described in section 256B.437 for nursing home rate 283.32 determination is implemented. Effective on July 1 of the state 283.33 fiscal year in which the resident assessment system as described 283.34 in section 256B.437 for nursing home rate determination is 283.35 implemented, the monthly conversion limit for the cost of 283.36 elderly waiver services shall be the per diem nursing facility 284.1 rate as determined by the resident assessment system as 284.2 described in section 256B.437 for that resident in the nursing 284.3 facility where the resident currently resides multiplied by 365 284.4 and divided by 12, less the recipient's maintenance needs 284.5 allowance as described in subdivision 1d. The limit under this 284.6 clause only applies to persons discharged from a nursing 284.7 facility after a minimum 30-day stay and found eligible for 284.8 waivered services on or after July 1, 1997. The following costs 284.9 must be included in determining the total monthly costs for the 284.10 waiver client: 284.11 (1) cost of all waivered services, including extended 284.12 medical supplies and equipment and environmental modifications; 284.13 and 284.14 (2) cost of skilled nursing, home health aide, and personal 284.15 care services reimbursable by medical assistance. 284.16(c)(e) Medical assistance funding for skilled nursing 284.17 services, private duty nursing, home health aide, and personal 284.18 care services for waiver recipients must be approved by the case 284.19 manager and included in the individual care plan. 284.20(d) For both the elderly waiver and the nursing facility284.21disabled waiver, a county may purchase extended supplies and284.22equipment without prior approval from the commissioner when284.23there is no other funding source and the supplies and equipment284.24are specified in the individual's care plan as medically284.25necessary to enable the individual to remain in the community284.26according to the criteria in Minnesota Rules, part 9505.0210,284.27items A and B.(f) A county is not required to contract with a 284.28 provider of supplies and equipment if the monthly cost of the 284.29 supplies and equipment is less than $250. 284.30(e)(g) The adult foster caredailyratefor the elderly284.31and disabled waiversshall be considered a difficulty of care 284.32 payment and shall not include room and board. The adult foster 284.33 care service rate shall be negotiated between the county agency 284.34 and the foster care provider.The rate established under this284.35section shall not exceed the state average monthly nursing home284.36payment for the case mix classification to which the individual285.1receiving foster care is assigned; the rate must allow for other285.2waiver and medical assistance home care services to be285.3authorized by the case manager.The elderly waiver payment for 285.4 the foster care service in combination with the payment for all 285.5 other elderly waiver services, including case management, must 285.6 not exceed the limit specified in paragraph (b). 285.7(f) The assisted living and residential care service rates285.8for elderly and community alternatives for disabled individuals285.9(CADI) waivers shall be made to the vendor as a monthly rate285.10negotiated with the county agency based on an individualized285.11service plan for each resident. The rate shall not exceed the285.12nonfederal share of the greater of either the statewide or any285.13of the geographic groups' weighted average monthly medical285.14assistance nursing facility payment rate of the case mix285.15resident class to which the elderly or disabled client would be285.16assigned under Minnesota Rules, parts 9549.0050 to 9549.0059,285.17unless the services are provided by a home care provider285.18licensed by the department of health and are provided in a285.19building that is registered as a housing with services285.20establishment under chapter 144D and that provides 24-hour285.21supervision. For alternative care assisted living projects285.22established under Laws 1988, chapter 689, article 2, section285.23256, monthly rates may not exceed 65 percent of the greater of285.24either the statewide or any of the geographic groups' weighted285.25average monthly medical assistance nursing facility payment rate285.26for the case mix resident class to which the elderly or disabled285.27client would be assigned under Minnesota Rules, parts 9549.0050285.28to 9549.0059. The rate may not cover direct rent or food costs.285.29 (h) Payment for assisted living service shall be a monthly 285.30 rate negotiated and authorized by the county agency based on an 285.31 individualized service plan for each resident and may not cover 285.32 direct rent or food costs. 285.33 (1) The individualized monthly negotiated payment for 285.34 assisted living services as described in section 256B.0913, 285.35 subdivision 5, paragraph (g) or (h), and residential care 285.36 services as described in section 256B.0913, subdivision 5, 286.1 paragraph (f), shall not exceed the nonfederal share, in effect 286.2 on July 1 of the state fiscal year for which the rate limit is 286.3 being calculated, of the greater of either the statewide or any 286.4 of the geographic groups' weighted average monthly nursing 286.5 facility rate of the case mix resident class to which the 286.6 elderly waiver eligible client would be assigned under Minnesota 286.7 Rules, parts 9549.0050 to 9549.0059, less the maintenance needs 286.8 allowance as described in subdivision 1d, paragraph (a), until 286.9 the July 1 of the state fiscal year in which the resident 286.10 assessment system as described in section 256B.437 for nursing 286.11 home rate determination is implemented. Effective on July 1 of 286.12 the state fiscal year in which the resident assessment system as 286.13 described in section 256B.437 for nursing home rate 286.14 determination is implemented and July 1 of each subsequent state 286.15 fiscal year, the individualized monthly negotiated payment for 286.16 the services described in this clause shall not exceed the limit 286.17 described in this clause which was in effect on June 30 of the 286.18 previous state fiscal year and which has been adjusted by the 286.19 greater of any legislatively adopted home and community-based 286.20 services cost-of-living percentage increase or any legislatively 286.21 adopted statewide percent rate increase for nursing facilities. 286.22 (2) The individualized monthly negotiated payment for 286.23 assisted living services described in section 144A.4605 and 286.24 delivered by a provider licensed by the department of health as 286.25 a class A home care provider or an assisted living home care 286.26 provider and provided in a building that is registered as a 286.27 housing with services establishment under chapter 144D and that 286.28 provides 24-hour supervision in combination with the payment for 286.29 other elderly waiver services, including case management, must 286.30 not exceed the limit specified in paragraph (b). 286.31(g)(i) The county shall negotiate individual service rates 286.32 with vendors and maybe reimbursedauthorize payment for actual 286.33 costs up to thegreater of thecounty's current approved rateor286.3460 percent of the maximum rate in fiscal year 1994 and 65286.35percent of the maximum rate in fiscal year 1995 for each service286.36within each program. Persons or agencies must be employed by or 287.1 under a contract with the county agency or the public health 287.2 nursing agency of the local board of health in order to receive 287.3 funding under the elderly waiver program, except as a provider 287.4 of supplies and equipment when the monthly cost of the supplies 287.5 and equipment is less than $250. 287.6(h) On July 1, 1993, the commissioner shall increase the287.7maximum rate for home-delivered meals to $4.50 per meal.287.8(i)(j) Reimbursement for the medical assistance recipients 287.9 under the approved waiver shall be made from the medical 287.10 assistance account through the invoice processing procedures of 287.11 the department's Medicaid Management Information System (MMIS), 287.12 only with the approval of the client's case manager. The budget 287.13 for the state share of the Medicaid expenditures shall be 287.14 forecasted with the medical assistance budget, and shall be 287.15 consistent with the approved waiver. 287.16 (k) To improve access to community services and eliminate 287.17 payment disparities between the alternative care program and the 287.18 elderly waiver, the commissioner shall establish statewide 287.19 maximum service rate limits and eliminate county-specific 287.20 service rate limits. 287.21 (1) Effective July 1, 2001, for service rate limits, except 287.22 those described or defined in paragraphs (g) and (h), the rate 287.23 limit for each service shall be the greater of the alternative 287.24 care statewide maximum rate or the elderly waiver statewide 287.25 maximum rate. 287.26 (2) Counties may negotiate individual service rates with 287.27 vendors for actual costs up to the statewide maximum service 287.28 rate limit. 287.29(j)(l) Beginning July 1, 1991, the state shall reimburse 287.30 counties according to the payment schedule in section 256.025 287.31 for the county share of costs incurred under this subdivision on 287.32 or after January 1, 1991, for individuals who are receiving 287.33 medical assistance. 287.34(k) For the community alternatives for disabled individuals287.35waiver, and nursing facility disabled waivers, county may use287.36waiver funds for the cost of minor adaptations to a client's288.1residence or vehicle without prior approval from the288.2commissioner if there is no other source of funding and the288.3adaptation:288.4(1) is necessary to avoid institutionalization;288.5(2) has no utility apart from the needs of the client; and288.6(3) meets the criteria in Minnesota Rules, part 9505.0210,288.7items A and B.288.8For purposes of this subdivision, "residence" means the client's288.9own home, the client's family residence, or a family foster288.10home. For purposes of this subdivision, "vehicle" means the288.11client's vehicle, the client's family vehicle, or the client's288.12family foster home vehicle.288.13(l) The commissioner shall establish a maximum rate unit288.14for baths provided by an adult day care provider that are not288.15included in the provider's contractual daily or hourly rate.288.16This maximum rate must equal the home health aide extended rate288.17and shall be paid for baths provided to clients served under the288.18elderly and disabled waivers.288.19 Sec. 30. Minnesota Statutes 2000, section 256B.0915, 288.20 subdivision 5, is amended to read: 288.21 Subd. 5. [REASSESSMENTS FOR WAIVER CLIENTS.] A 288.22 reassessment of a client served under the elderlyor disabled288.23 waiver must be conducted at least every 12 months and at other 288.24 times when the case manager determines that there has been 288.25 significant change in the client's functioning. This may 288.26 include instances where the client is discharged from the 288.27 hospital. 288.28 Sec. 31. Minnesota Statutes 2000, section 256B.0917, 288.29 subdivision 7, is amended to read: 288.30 Subd. 7. [CONTRACT.] (a) The commissioner of human 288.31 services shall execute a contract with Living at Home/Block 288.32 Nurse Program, Inc. (LAH/BN, Inc.). The contract shall require 288.33 LAH/BN, Inc. to: 288.34 (1) develop criteria for and award grants to establish 288.35 community-based organizations that will implement 288.36 living-at-home/block nurse programs throughout the state; 289.1 (2) award grants to enablecurrentliving-at-home/block 289.2 nurse programs to continue to implement the combined 289.3 living-at-home/block nurse program model; 289.4 (3) serve as a state technical assistance center to assist 289.5 and coordinate the living-at-home/block nurse programs 289.6 established; and 289.7 (4) manage contracts with individual living-at-home/block 289.8 nurse programs. 289.9 (b) The contract shall be effective July 1, 1997, and 289.10 section 16B.17 shall not apply. 289.11 Sec. 32. Minnesota Statutes 2000, section 256B.0917, is 289.12 amended by adding a subdivision to read: 289.13 Subd. 13. [COMMUNITY SERVICE GRANTS.] The commissioner 289.14 shall award contracts for grants to public and private nonprofit 289.15 agencies to establish services that strengthen a community's 289.16 ability to provide a system of home and community-based services 289.17 for elderly persons. The commissioner shall use a request for 289.18 proposal process. The commissioner shall give preference when 289.19 awarding grants under this section to areas where nursing 289.20 facility closures have occurred or are occurring. The 289.21 commissioner shall consider grants for: 289.22 (1) caregiver support and respite care projects under 289.23 subdivision 6; 289.24 (2) on-site coordination under section 256.9731; 289.25 (3) the living-at-home/block nurse grant under subdivisions 289.26 7 to 10; and 289.27 (4) services identified as needed for community transition. 289.28 Sec. 33. [RESPITE CARE.] 289.29 The Minnesota board on aging shall report to the 289.30 legislature by February 1, 2002, on the provision of in-home and 289.31 out-of-home respite care services on a sliding scale basis under 289.32 the federal Older Americans Act. 289.33 Sec. 34. [REPEALER.] 289.34 (a) Minnesota Statutes 2000, sections 256B.0911, 289.35 subdivisions 2, 2a, 4, and 9; 256B.0913, subdivisions 3, 15a, 289.36 15b, 15c, and 16; and 256B.0915, subdivisions 3a, 3b, and 3c, 290.1 are repealed. 290.2 (b) Minnesota Rules, parts 9505.2390; 9505.2395; 9505.2396; 290.3 9505.2400; 9505.2405; 9505.2410; 9505.2413; 9505.2415; 290.4 9505.2420; 9505.2425; 9505.2426; 9505.2430; 9505.2435; 290.5 9505.2440; 9505.2445; 9505.2450; 9505.2455; 9505.2458; 290.6 9505.2460; 9505.2465; 9505.2470; 9505.2473; 9505.2475; 290.7 9505.2480; 9505.2485; 9505.2486; 9505.2490; 9505.2495; 290.8 9505.2496; and 9505.2500, are repealed. 290.9 ARTICLE 5 290.10 LONG-TERM CARE SYSTEM REFORM AND REIMBURSEMENT 290.11 Section 1. Minnesota Statutes 2000, section 144.0721, 290.12 subdivision 1, is amended to read: 290.13 Subdivision 1. [APPROPRIATENESS AND QUALITY.] Until the 290.14 date of implementation of the revised case mix system based on 290.15 the minimum data set, the commissioner of health shall assess 290.16 the appropriateness and quality of care and services furnished 290.17 to private paying residents in nursing homes and boarding care 290.18 homes that are certified for participation in the medical 290.19 assistance program under United States Code, title 42, sections 290.20 1396-1396p. These assessments shall be conducted until the date 290.21 of implementation of the revised case mix system based on the 290.22 minimum data set, in accordance with section 144.072, with the 290.23 exception of provisions requiring recommendations for changes in 290.24 the level of care provided to the private paying residents. 290.25 Sec. 2. [144.0724] [RESIDENT REIMBURSEMENT 290.26 CLASSIFICATION.] 290.27 Subdivision 1. [RESIDENT REIMBURSEMENT 290.28 CLASSIFICATIONS.] The commissioner of health shall establish 290.29 resident reimbursement classifications based upon the 290.30 assessments of residents of nursing homes and boarding care 290.31 homes conducted under this section and according to section 290.32 256B.438. The reimbursement classifications established under 290.33 this section shall be implemented after June 30, 2002, but no 290.34 later than January 1, 2003. 290.35 Subd. 2. [DEFINITIONS.] For purposes of this section, the 290.36 following terms have the meanings given. 291.1 (a) [ASSESSMENT REFERENCE DATE.] "Assessment reference 291.2 date" means the last day of the minimum data set observation 291.3 period. The date sets the designated endpoint of the common 291.4 observation period, and all minimum data set items refer back in 291.5 time from that point. 291.6 (b) [CASE MIX INDEX.] "Case mix index" means the weighting 291.7 factors assigned to the RUG-III classifications. 291.8 (c) [INDEX MAXIMIZATION.] "Index maximization" means 291.9 classifying a resident who could be assigned to more than one 291.10 category, to the category with the highest case mix index. 291.11 (d) [MINIMUM DATA SET.] "Minimum data set" means the 291.12 assessment instrument specified by the Health Care Financing 291.13 Administration and designated by the Minnesota department of 291.14 health. 291.15 (e) [REPRESENTATIVE.] "Representative" means a person who 291.16 is the resident's guardian or conservator, the person authorized 291.17 to pay the nursing home expenses of the resident, a 291.18 representative of the nursing home ombudsman's office whose 291.19 assistance has been requested, or any other individual 291.20 designated by the resident. 291.21 (f) [RESOURCE UTILIZATION GROUPS OR RUG.] "Resource 291.22 utilization groups" or "RUG" means the system for grouping a 291.23 nursing facility's residents according to their clinical and 291.24 functional status identified in data supplied by the facility's 291.25 minimum data set. 291.26 Subd. 3. [RESIDENT REIMBURSEMENT CLASSIFICATIONS.] (a) 291.27 Resident reimbursement classifications shall be based on the 291.28 minimum data set, version 2.0 assessment instrument, or its 291.29 successor version mandated by the Health Care Financing 291.30 Administration that nursing facilities are required to complete 291.31 for all residents. The commissioner of health shall establish 291.32 resident classes according to the 34 group, resource utilization 291.33 groups, version III or RUG-III model. Resident classes must be 291.34 established based on the individual items on the minimum data 291.35 set and must be completed according to the facility manual for 291.36 case mix classification issued by the Minnesota department of 292.1 health. The facility manual for case mix classification shall 292.2 be drafted by the Minnesota department of health and presented 292.3 to the chairs of health and human services legislative 292.4 committees by December 31, 2001. 292.5 (b) Each resident must be classified based on the 292.6 information from the minimum data set according to general 292.7 domains in clauses (1) to (7): 292.8 (1) extensive services where a resident requires 292.9 intravenous feeding or medications, suctioning, tracheostomy 292.10 care, or is on a ventilator or respirator; 292.11 (2) rehabilitation where a resident requires physical, 292.12 occupational, or speech therapy; 292.13 (3) special care where a resident has cerebral palsy; 292.14 quadriplegia; multiple sclerosis; pressure ulcers; fever with 292.15 vomiting, weight loss, or dehydration; tube feeding and aphasia; 292.16 or is receiving radiation therapy; 292.17 (4) clinically complex status where a resident has burns, 292.18 coma, septicemia, pneumonia, internal bleeding, chemotherapy, 292.19 wounds, kidney failure, urinary tract infections, oxygen, or 292.20 transfusions; 292.21 (5) impaired cognition where a resident has poor cognitive 292.22 performance; 292.23 (6) behavior problems where a resident exhibits wandering, 292.24 has hallucinations, or is physically or verbally abusive toward 292.25 others, unless the resident's other condition would place the 292.26 resident in other categories; and 292.27 (7) reduced physical functioning where a resident has no 292.28 special clinical conditions. 292.29 (c) The commissioner of health shall establish resident 292.30 classification according to a 34 group model based on the 292.31 information on the minimum data set and within the general 292.32 domains listed in paragraph (b), clauses (1) to (7). Detailed 292.33 descriptions of each resource utilization group shall be defined 292.34 in the facility manual for case mix classification issued by the 292.35 Minnesota department of health. The 34 groups are described as 292.36 follows: 293.1 (1) SE3: requires four or five extensive services; 293.2 (2) SE2: requires two or three extensive services; 293.3 (3) SE1: requires one extensive service; 293.4 (4) RAD: requires rehabilitation services and is dependent 293.5 in activity of daily living (ADL) at a count of 17 or 18; 293.6 (5) RAC: requires rehabilitation services and ADL count is 293.7 14 to 16; 293.8 (6) RAB: requires rehabilitation services and ADL count is 293.9 ten to 13; 293.10 (7) RAA: requires rehabilitation services and ADL count is 293.11 four to nine; 293.12 (8) SSC: requires special care and ADL count is 17 or 18; 293.13 (9) SSB: requires special care and ADL count is 15 or 16; 293.14 (10) SSA: requires special care and ADL count is seven to 293.15 14; 293.16 (11) CC2: clinically complex with depression and ADL count 293.17 is 17 or 18; 293.18 (12) CC1: clinically complex with no depression and ADL 293.19 count is 17 or 18; 293.20 (13) CB2: clinically complex with depression and ADL count 293.21 is 12 to 16; 293.22 (14) CB1: clinically complex with no depression and ADL 293.23 count is 12 to 16; 293.24 (15) CA2: clinically complex with depression and ADL count 293.25 is four to 11; 293.26 (16) CA1: clinically complex with no depression and ADL 293.27 count is four to 11; 293.28 (17) IB2: impaired cognition with nursing rehabilitation 293.29 and ADL count is six to ten; 293.30 (18) IB1: impaired cognition with no nursing 293.31 rehabilitation and ADL count is six to ten; 293.32 (19) IA2: impaired cognition with nursing rehabilitation 293.33 and ADL count is four or five; 293.34 (20) IA1: impaired cognition with no nursing 293.35 rehabilitation and ADL count is four or five; 293.36 (21) BB2: behavior problems with nursing rehabilitation 294.1 and ADL count is six to ten; 294.2 (22) BB1: behavior problems with no nursing rehabilitation 294.3 and ADL count is six to ten; 294.4 (23) BA2: behavior problems with nursing rehabilitation 294.5 and ADL count is four to five; 294.6 (24) BA1: behavior problems with no nursing rehabilitation 294.7 and ADL count is four to five; 294.8 (25) PE2: reduced physical functioning with nursing 294.9 rehabilitation and ADL count is 16 to 18; 294.10 (26) PE1: reduced physical functioning with no nursing 294.11 rehabilitation and ADL count is 16 to 18; 294.12 (27) PD2: reduced physical functioning with nursing 294.13 rehabilitation and ADL count is 11 to 15; 294.14 (28) PD1: reduced physical functioning with no nursing 294.15 rehabilitation and ADL count is 11 to 15; 294.16 (29) PC2: reduced physical functioning with nursing 294.17 rehabilitation and ADL count is nine or ten; 294.18 (30) PC1: reduced physical functioning with no nursing 294.19 rehabilitation and ADL count is nine or ten; 294.20 (31) PB2: reduced physical functioning with nursing 294.21 rehabilitation and ADL count is six to eight; 294.22 (32) PB1: reduced physical functioning with no nursing 294.23 rehabilitation and ADL count is six to eight; 294.24 (33) PA2: reduced physical functioning with nursing 294.25 rehabilitation and ADL count is four or five; and 294.26 (34) PA1: reduced physical functioning with no nursing 294.27 rehabilitation and ADL count is four or five. 294.28 Subd. 4. [RESIDENT ASSESSMENT SCHEDULE.] (a) A facility 294.29 must conduct and electronically submit to the commissioner of 294.30 health case mix assessments that conform with the assessment 294.31 schedule defined by the Code of Federal Regulations, title 42, 294.32 section 483.20, and published by the United States Department of 294.33 Health and Human Services, Health Care Financing Administration, 294.34 in the Long Term Care Assessment Instrument User's Manual, 294.35 version 2.0, October 1995, and subsequent clarifications made in 294.36 the Long-Term Care Assessment Instrument Questions and Answers, 295.1 version 2.0, August 1996. The commissioner of health may 295.2 substitute successor manuals or question and answer documents 295.3 published by the United States Department of Health and Human 295.4 Services, Health Care Financing Administration, to replace or 295.5 supplement the current version of the manual or document. 295.6 (b) The assessments used to determine a case mix 295.7 classification for reimbursement include the following: 295.8 (1) a new admission assessment must be completed by day 14 295.9 following admission; 295.10 (2) an annual assessment must be completed within 366 days 295.11 of the last comprehensive assessment; 295.12 (3) a significant change assessment must be completed 295.13 within 14 days of the identification of a significant change; 295.14 and 295.15 (4) the second quarterly assessment following either a new 295.16 admission assessment, an annual assessment, or a significant 295.17 change assessment. Each quarterly assessment must be completed 295.18 within 92 days of the previous assessment. 295.19 Subd. 5. [SHORT STAYS.] (a) A facility must submit to the 295.20 commissioner of health an initial admission assessment for all 295.21 residents who stay in the facility less than 14 days. 295.22 (b) Notwithstanding the admission assessment requirements 295.23 of paragraph (a), a facility may elect to accept a default rate 295.24 with a case mix index of 1.0 for all facility residents who stay 295.25 less than 14 days in lieu of submitting an initial assessment. 295.26 Facilities may make this election to be effective on the day of 295.27 implementation of the revised case mix system. 295.28 (c) After implementation of the revised case mix system, 295.29 nursing facilities must elect one of the options described in 295.30 paragraphs (a) and (b) on the annual report to the commissioner 295.31 of human services filed for each report year ending September 295.32 30. The election shall be effective on the following July 1. 295.33 (d) For residents who are admitted or readmitted and leave 295.34 the facility on a frequent basis and for whom readmission is 295.35 expected, the resident may be discharged on an extended leave 295.36 status. This status does not require reassessment each time the 296.1 resident returns to the facility unless a significant change in 296.2 the resident's status has occurred since the last assessment. 296.3 The case mix classification for these residents is determined by 296.4 the facility election made in paragraphs (a) and (b). 296.5 Subd. 6. [PENALTIES FOR LATE OR NONSUBMISSION.] A facility 296.6 that fails to complete or submit an assessment for a RUG-III 296.7 classification within seven days of the time requirements in 296.8 subdivisions 4 and 5 is subject to a reduced rate for that 296.9 resident. The reduced rate shall be the lowest rate for that 296.10 facility. The reduced rate is effective on the day of admission 296.11 for new admission assessments or on the day that the assessment 296.12 was due for all other assessments and continues in effect until 296.13 the first day of the month following the date of submission of 296.14 the resident's assessment. 296.15 Subd. 7. [NOTICE OF RESIDENT REIMBURSEMENT 296.16 CLASSIFICATION.] (a) A facility must elect between the options 296.17 in clauses (1) and (2) to provide notice to a resident of the 296.18 resident's case mix classification. 296.19 (1) The commissioner of health shall provide to a nursing 296.20 facility a notice for each resident of the reimbursement 296.21 classification established under subdivision 1. The notice must 296.22 inform the resident of the classification that was assigned, the 296.23 opportunity to review the documentation supporting the 296.24 classification, the opportunity to obtain clarification from the 296.25 commissioner, and the opportunity to request a reconsideration 296.26 of the classification. The commissioner must send notice of 296.27 resident classification by first class mail. A nursing facility 296.28 is responsible for the distribution of the notice to each 296.29 resident, to the person responsible for the payment of the 296.30 resident's nursing home expenses, or to another person 296.31 designated by the resident. This notice must be distributed 296.32 within three working days after the facility's receipt of the 296.33 notice from the commissioner of health. 296.34 (2) A facility may choose to provide a classification 296.35 notice, as prescribed by the commissioner of health, to a 296.36 resident upon receipt of the confirmation of the case mix 297.1 classification calculated by a facility or a corrected case mix 297.2 classification as indicated on the final validation report from 297.3 the commissioner. A nursing facility is responsible for the 297.4 distribution of the notice to each resident, to the person 297.5 responsible for the payment of the resident's nursing home 297.6 expenses, or to another person designated by the resident. This 297.7 notice must be distributed within three working days after the 297.8 facility's receipt of the validation report from the 297.9 commissioner. If a facility elects this option, the 297.10 commissioner of health shall provide the facility with a list of 297.11 residents and their case mix classifications as determined by 297.12 the commissioner. A nursing facility may make this election to 297.13 be effective on the day of implementation of the revised case 297.14 mix system. 297.15 (3) After implementation of the revised case mix system, a 297.16 nursing facility shall elect a notice of resident reimbursement 297.17 classification procedure as described in clause (1) or (2) on 297.18 the annual report to the commissioner of human services filed 297.19 for each report year ending September 30. The election will be 297.20 effective the following July 1. 297.21 (b) If a facility submits a correction to an assessment 297.22 conducted under subdivision 3 that results in a change in case 297.23 mix classification, the facility shall give written notice to 297.24 the resident or the resident's representative about the item 297.25 that was corrected and the reason for the correction. The 297.26 notice of corrected assessment may be provided at the same time 297.27 that the resident or resident's representative is provided the 297.28 resident's corrected notice of classification. 297.29 Subd. 8. [REQUEST FOR RECONSIDERATION OF RESIDENT 297.30 CLASSIFICATIONS.] (a) The resident, or resident's 297.31 representative, or the nursing facility or boarding care home 297.32 may request that the commissioner of health reconsider the 297.33 assigned reimbursement classification. The request for 297.34 reconsideration must be submitted in writing to the commissioner 297.35 within 30 days of the day the resident or the resident's 297.36 representative receives the resident classification notice. The 298.1 request for reconsideration must include the name of the 298.2 resident, the name and address of the facility in which the 298.3 resident resides, the reasons for the reconsideration, the 298.4 requested classification changes, and documentation supporting 298.5 the requested classification. The documentation accompanying 298.6 the reconsideration request is limited to documentation which 298.7 establishes that the needs of the resident at the time of the 298.8 assessment justify a classification which is different than the 298.9 classification established by the commissioner of health. 298.10 (b) Upon request, the nursing facility must give the 298.11 resident or the resident's representative a copy of the 298.12 assessment form and the other documentation that was given to 298.13 the commissioner of health to support the assessment findings. 298.14 The nursing facility shall also provide access to and a copy of 298.15 other information from the resident's record that has been 298.16 requested by or on behalf of the resident to support a 298.17 resident's reconsideration request. A copy of any requested 298.18 material must be provided within three working days of receipt 298.19 of a written request for the information. If a facility fails 298.20 to provide the material within this time, it is subject to the 298.21 issuance of a correction order and penalty assessment under 298.22 sections 144.653 and 144A.10. Notwithstanding those sections, 298.23 any correction order issued under this subdivision must require 298.24 that the nursing facility immediately comply with the request 298.25 for information and that as of the date of the issuance of the 298.26 correction order, the facility shall forfeit to the state a $100 298.27 fine for the first day of noncompliance, and an increase in the 298.28 $100 fine by $50 increments for each day the noncompliance 298.29 continues. 298.30 (c) In addition to the information required under 298.31 paragraphs (a) and (b), a reconsideration request from a nursing 298.32 facility must contain the following information: (i) the date 298.33 the reimbursement classification notices were received by the 298.34 facility; (ii) the date the classification notices were 298.35 distributed to the resident or the resident's representative; 298.36 and (iii) a copy of a notice sent to the resident or to the 299.1 resident's representative. This notice must inform the resident 299.2 or the resident's representative that a reconsideration of the 299.3 resident's classification is being requested, the reason for the 299.4 request, that the resident's rate will change if the request is 299.5 approved by the commissioner, the extent of the change, that 299.6 copies of the facility's request and supporting documentation 299.7 are available for review, and that the resident also has the 299.8 right to request a reconsideration. If the facility fails to 299.9 provide the required information with the reconsideration 299.10 request, the request must be denied, and the facility may not 299.11 make further reconsideration requests on that specific 299.12 reimbursement classification. 299.13 (d) Reconsideration by the commissioner must be made by 299.14 individuals not involved in reviewing the assessment, audit, or 299.15 reconsideration that established the disputed classification. 299.16 The reconsideration must be based upon the initial assessment 299.17 and upon the information provided to the commissioner under 299.18 paragraphs (a) and (b). If necessary for evaluating the 299.19 reconsideration request, the commissioner may conduct on-site 299.20 reviews. Within 15 working days of receiving the request for 299.21 reconsideration, the commissioner shall affirm or modify the 299.22 original resident classification. The original classification 299.23 must be modified if the commissioner determines that the 299.24 assessment resulting in the classification did not accurately 299.25 reflect the needs or assessment characteristics of the resident 299.26 at the time of the assessment. The resident and the nursing 299.27 facility or boarding care home shall be notified within five 299.28 working days after the decision is made. A decision by the 299.29 commissioner under this subdivision is the final administrative 299.30 decision of the agency for the party requesting reconsideration. 299.31 (e) The resident classification established by the 299.32 commissioner shall be the classification that applies to the 299.33 resident while the request for reconsideration is pending. 299.34 (f) The commissioner may request additional documentation 299.35 regarding a reconsideration necessary to make an accurate 299.36 reconsideration determination. 300.1 Subd. 9. [AUDIT AUTHORITY.] (a) The commissioner shall 300.2 audit the accuracy of resident assessments performed under 300.3 section 256B.438 through desk audits, on-site review of 300.4 residents and their records, and interviews with staff and 300.5 families. The commissioner shall reclassify a resident if the 300.6 commissioner determines that the resident was incorrectly 300.7 classified. 300.8 (b) The commissioner is authorized to conduct on-site 300.9 audits on an unannounced basis. 300.10 (c) A facility must grant the commissioner access to 300.11 examine the medical records relating to the resident assessments 300.12 selected for audit under this subdivision. The commissioner may 300.13 also observe and speak to facility staff and residents. 300.14 (d) The commissioner shall consider documentation under the 300.15 time frames for coding items on the minimum data set as set out 300.16 in the Resident Assessment Instrument Manual published by the 300.17 Health Care Financing Administration. 300.18 (e) The commissioner shall develop an audit selection 300.19 procedure that includes the following factors: 300.20 (1) The commissioner may target facilities that demonstrate 300.21 an atypical pattern of scoring minimum data set items, 300.22 nonsubmission of assessments, late submission of assessments, or 300.23 a previous history of audit changes of greater than 35 percent. 300.24 The commissioner shall select at least 20 percent of the most 300.25 current assessments submitted to the state for audit. Audits of 300.26 assessments selected in the targeted facilities must focus on 300.27 the factors leading to the audit. If the number of targeted 300.28 assessments selected does not meet the threshold of 20 percent 300.29 of the facility residents, then a stratified sample of the 300.30 remainder of assessments shall be drawn to meet the quota. If 300.31 the total change exceeds 35 percent, the commissioner may 300.32 conduct an expanded audit up to 100 percent of the remaining 300.33 current assessments. 300.34 (2) Facilities that are not a part of the targeted group 300.35 shall be placed in a general pool from which facilities will be 300.36 selected on a random basis for audit. Every facility shall be 301.1 audited annually. If a facility has two successive audits in 301.2 which the percentage of change is five percent or less and the 301.3 facility has not been the subject of a targeted audit in the 301.4 past 36 months, the facility may be audited biannually. A 301.5 stratified sample of 15 percent of the most current assessments 301.6 shall be selected for audit. If more than 20 percent of the 301.7 RUGS-III classifications after the audit are changed, the audit 301.8 shall be expanded to a second 15 percent sample. If the total 301.9 change between the first and second samples exceed 35 percent, 301.10 the commissioner may expand the audit to all of the remaining 301.11 assessments. 301.12 (3) If a facility qualifies for an expanded audit, the 301.13 commissioner may audit the facility again within six months. If 301.14 a facility has two expanded audits within a 24-month period, 301.15 that facility will be audited at least every six months for the 301.16 next 18 months. 301.17 (4) The commissioner may conduct special audits if the 301.18 commissioner determines that circumstances exist that could 301.19 alter or affect the validity of case mix classifications of 301.20 residents. These circumstances include, but are not limited to, 301.21 the following: 301.22 (i) frequent changes in the administration or management of 301.23 the facility; 301.24 (ii) an unusually high percentage of residents in a 301.25 specific case mix classification; 301.26 (iii) a high frequency in the number of reconsideration 301.27 requests received from a facility; 301.28 (iv) frequent adjustments of case mix classifications as 301.29 the result of reconsiderations or audits; 301.30 (v) a criminal indictment alleging provider fraud; or 301.31 (vi) other similar factors that relate to a facility's 301.32 ability to conduct accurate assessments. 301.33 (f) Within 15 working days of completing the audit process, 301.34 the commissioner shall mail the written results of the audit to 301.35 the facility, along with a written notice for each resident 301.36 affected to be forwarded by the facility. The notice must 302.1 contain the resident's classification and a statement informing 302.2 the resident, the resident's authorized representative, and the 302.3 facility of their right to review the commissioner's documents 302.4 supporting the classification and to request a reconsideration 302.5 of the classification. This notice must also include the 302.6 address and telephone number of the area nursing home ombudsman. 302.7 Subd. 10. [TRANSITION.] After implementation of this 302.8 section, reconsiderations requested for classifications made 302.9 under section 144.0722, subdivision 1, shall be determined under 302.10 section 144.0722, subdivision 3. 302.11 Sec. 3. Minnesota Statutes 2000, section 144A.071, 302.12 subdivision 1, is amended to read: 302.13 Subdivision 1. [FINDINGS.] The legislature declares that a 302.14 moratorium on the licensure and medical assistance certification 302.15 of new nursing home beds and construction projects that 302.16 exceed$750,000$1,000,000 is necessary to control nursing home 302.17 expenditure growth and enable the state to meet the needs of its 302.18 elderly by providing high quality services in the most 302.19 appropriate manner along a continuum of care. 302.20 Sec. 4. Minnesota Statutes 2000, section 144A.071, 302.21 subdivision 1a, is amended to read: 302.22 Subd. 1a. [DEFINITIONS.] For purposes of sections 144A.071 302.23 to 144A.073, the following terms have the meanings given them: 302.24 (a) "attached fixtures" has the meaning given in Minnesota 302.25 Rules, part 9549.0020, subpart 6. 302.26 (b) "buildings" has the meaning given in Minnesota Rules, 302.27 part 9549.0020, subpart 7. 302.28 (c) "capital assets" has the meaning given in section 302.29 256B.421, subdivision 16. 302.30 (d) "commenced construction" means that all of the 302.31 following conditions were met: the final working drawings and 302.32 specifications were approved by the commissioner of health; the 302.33 construction contracts were let; a timely construction schedule 302.34 was developed, stipulating dates for beginning, achieving 302.35 various stages, and completing construction; and all zoning and 302.36 building permits were applied for. 303.1 (e) "completion date" means the date on which a certificate 303.2 of occupancy is issued for a construction project, or if a 303.3 certificate of occupancy is not required, the date on which the 303.4 construction project is available for facility use. 303.5 (f) "construction" means any erection, building, 303.6 alteration, reconstruction, modernization, or improvement 303.7 necessary to comply with the nursing home licensure rules. 303.8 (g) "construction project" means: 303.9 (1) a capital asset addition to, or replacement of a 303.10 nursing home or certified boarding care home that results in new 303.11 space or the remodeling of or renovations to existing facility 303.12 space; 303.13 (2) the remodeling or renovation of existing facility space 303.14 the use of which is modified as a result of the project 303.15 described in clause (1). This existing space and the project 303.16 described in clause (1) must be used for the functions as 303.17 designated on the construction plans on completion of the 303.18 project described in clause (1) for a period of not less than 24 303.19 months; or 303.20 (3) capital asset additions or replacements that are 303.21 completed within 12 months before or after the completion date 303.22 of the project described in clause (1). 303.23 (h) "new licensed" or "new certified beds" means: 303.24 (1) newly constructed beds in a facility or the 303.25 construction of a new facility that would increase the total 303.26 number of licensed nursing home beds or certified boarding care 303.27 or nursing home beds in the state; or 303.28 (2) newly licensed nursing home beds or newly certified 303.29 boarding care or nursing home beds that result from remodeling 303.30 of the facility that involves relocation of beds but does not 303.31 result in an increase in the total number of beds, except when 303.32 the project involves the upgrade of boarding care beds to 303.33 nursing home beds, as defined in section 144A.073, subdivision 303.34 1. "Remodeling" includes any of the type of conversion, 303.35 renovation, replacement, or upgrading projects as defined in 303.36 section 144A.073, subdivision 1. 304.1 (i) "project construction costs" means the cost of the 304.2 facility capital asset additions, replacements, renovations, or 304.3 remodeling projects, construction site preparation costs, and 304.4 related soft costs. Project construction costsalsoinclude the 304.5 cost of any remodeling or renovation of existing facility space 304.6 which is modified as a result of the construction 304.7 project. Project construction costs also includes the cost of 304.8 new technology implemented as part of the construction project. 304.9 (j) "technology" means information systems or devices that 304.10 make documentation, charting, and staff time more efficient or 304.11 encourage and allow for care through alternative settings 304.12 including, but not limited to, touch screens, monitors, 304.13 hand-helds, swipe cards, motion detectors, pagers, telemedicine, 304.14 medication dispensers, and equipment to monitor vital signs and 304.15 self-injections, and to observe skin and other conditions. 304.16 Sec. 5. Minnesota Statutes 2000, section 144A.071, 304.17 subdivision 2, is amended to read: 304.18 Subd. 2. [MORATORIUM.] The commissioner of health, in 304.19 coordination with the commissioner of human services, shall deny 304.20 each request for new licensed or certified nursing home or 304.21 certified boarding care beds except as provided in subdivision 3 304.22 or 4a, or section 144A.073. "Certified bed" means a nursing 304.23 home bed or a boarding care bed certified by the commissioner of 304.24 health for the purposes of the medical assistance program, under 304.25 United States Code, title 42, sections 1396 et seq. 304.26 The commissioner of human services, in coordination with 304.27 the commissioner of health, shall deny any request to issue a 304.28 license under section 252.28 and chapter 245A to a nursing home 304.29 or boarding care home, if that license would result in an 304.30 increase in the medical assistance reimbursement amount. 304.31 In addition, the commissioner of health must not approve 304.32 any construction project whose cost exceeds$750,000$1,000,000, 304.33 unless: 304.34 (a) any construction costs exceeding$750,000$1,000,000 304.35 are not added to the facility's appraised value and are not 304.36 included in the facility's payment rate for reimbursement under 305.1 the medical assistance program; or 305.2 (b) the project: 305.3 (1) has been approved through the process described in 305.4 section 144A.073; 305.5 (2) meets an exception in subdivision 3 or 4a; 305.6 (3) is necessary to correct violations of state or federal 305.7 law issued by the commissioner of health; 305.8 (4) is necessary to repair or replace a portion of the 305.9 facility that was damaged by fire, lightning, groundshifts, or 305.10 other such hazards, including environmental hazards, provided 305.11 that the provisions of subdivision 4a, clause (a), are met; 305.12 (5) as of May 1, 1992, the facility has submitted to the 305.13 commissioner of health written documentation evidencing that the 305.14 facility meets the "commenced construction" definition as 305.15 specified in subdivision 1a, clause (d), or that substantial 305.16 steps have been taken prior to April 1, 1992, relating to the 305.17 construction project. "Substantial steps" require that the 305.18 facility has made arrangements with outside parties relating to 305.19 the construction project and include the hiring of an architect 305.20 or construction firm, submission of preliminary plans to the 305.21 department of health or documentation from a financial 305.22 institution that financing arrangements for the construction 305.23 project have been made; or 305.24 (6) is being proposed by a licensed nursing facility that 305.25 is not certified to participate in the medical assistance 305.26 program and will not result in new licensed or certified beds. 305.27 Prior to the final plan approval of any construction 305.28 project, the commissioner of health shall be provided with an 305.29 itemized cost estimate for the project construction costs. If a 305.30 construction project is anticipated to be completed in phases, 305.31 the total estimated cost of all phases of the project shall be 305.32 submitted to the commissioner and shall be considered as one 305.33 construction project. Once the construction project is 305.34 completed and prior to the final clearance by the commissioner, 305.35 the total project construction costs for the construction 305.36 project shall be submitted to the commissioner. If the final 306.1 project construction cost exceeds the dollar threshold in this 306.2 subdivision, the commissioner of human services shall not 306.3 recognize any of the project construction costs or the related 306.4 financing costs in excess of this threshold in establishing the 306.5 facility's property-related payment rate. 306.6 The dollar thresholds for construction projects are as 306.7 follows: for construction projects other than those authorized 306.8 in clauses (1) to (6), the dollar threshold 306.9 is$750,000$1,000,000. For projects authorized after July 1, 306.10 1993, under clause (1), the dollar threshold is the cost 306.11 estimate submitted with a proposal for an exception under 306.12 section 144A.073, plus inflation as calculated according to 306.13 section 256B.431, subdivision 3f, paragraph (a). For projects 306.14 authorized under clauses (2) to (4), the dollar threshold is the 306.15 itemized estimate project construction costs submitted to the 306.16 commissioner of health at the time of final plan approval, plus 306.17 inflation as calculated according to section 256B.431, 306.18 subdivision 3f, paragraph (a). 306.19 The commissioner of health shall adopt rules to implement 306.20 this section or to amend the emergency rules for granting 306.21 exceptions to the moratorium on nursing homes under section 306.22 144A.073. 306.23 Sec. 6. Minnesota Statutes 2000, section 144A.071, 306.24 subdivision 4a, is amended to read: 306.25 Subd. 4a. [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the 306.26 best interest of the state to ensure that nursing homes and 306.27 boarding care homes continue to meet the physical plant 306.28 licensing and certification requirements by permitting certain 306.29 construction projects. Facilities should be maintained in 306.30 condition to satisfy the physical and emotional needs of 306.31 residents while allowing the state to maintain control over 306.32 nursing home expenditure growth. 306.33 The commissioner of health in coordination with the 306.34 commissioner of human services, may approve the renovation, 306.35 replacement, upgrading, or relocation of a nursing home or 306.36 boarding care home, under the following conditions: 307.1 (a) to license or certify beds in a new facility 307.2 constructed to replace a facility or to make repairs in an 307.3 existing facility that was destroyed or damaged after June 30, 307.4 1987, by fire, lightning, or other hazard provided: 307.5 (i) destruction was not caused by the intentional act of or 307.6 at the direction of a controlling person of the facility; 307.7 (ii) at the time the facility was destroyed or damaged the 307.8 controlling persons of the facility maintained insurance 307.9 coverage for the type of hazard that occurred in an amount that 307.10 a reasonable person would conclude was adequate; 307.11 (iii) the net proceeds from an insurance settlement for the 307.12 damages caused by the hazard are applied to the cost of the new 307.13 facility or repairs; 307.14 (iv) the new facility is constructed on the same site as 307.15 the destroyed facility or on another site subject to the 307.16 restrictions in section 144A.073, subdivision 5; 307.17 (v) the number of licensed and certified beds in the new 307.18 facility does not exceed the number of licensed and certified 307.19 beds in the destroyed facility; and 307.20 (vi) the commissioner determines that the replacement beds 307.21 are needed to prevent an inadequate supply of beds. 307.22 Project construction costs incurred for repairs authorized under 307.23 this clause shall not be considered in the dollar threshold 307.24 amount defined in subdivision 2; 307.25 (b) to license or certify beds that are moved from one 307.26 location to another within a nursing home facility, provided the 307.27 total costs of remodeling performed in conjunction with the 307.28 relocation of beds does not exceed$750,000$1,000,000; 307.29 (c) to license or certify beds in a project recommended for 307.30 approval under section 144A.073; 307.31 (d) to license or certify beds that are moved from an 307.32 existing state nursing home to a different state facility, 307.33 provided there is no net increase in the number of state nursing 307.34 home beds; 307.35 (e) to certify and license as nursing home beds boarding 307.36 care beds in a certified boarding care facility if the beds meet 308.1 the standards for nursing home licensure, or in a facility that 308.2 was granted an exception to the moratorium under section 308.3 144A.073, and if the cost of any remodeling of the facility does 308.4 not exceed$750,000$1,000,000. If boarding care beds are 308.5 licensed as nursing home beds, the number of boarding care beds 308.6 in the facility must not increase beyond the number remaining at 308.7 the time of the upgrade in licensure. The provisions contained 308.8 in section 144A.073 regarding the upgrading of the facilities do 308.9 not apply to facilities that satisfy these requirements; 308.10 (f) to license and certify up to 40 beds transferred from 308.11 an existing facility owned and operated by the Amherst H. Wilder 308.12 Foundation in the city of St. Paul to a new unit at the same 308.13 location as the existing facility that will serve persons with 308.14 Alzheimer's disease and other related disorders. The transfer 308.15 of beds may occur gradually or in stages, provided the total 308.16 number of beds transferred does not exceed 40. At the time of 308.17 licensure and certification of a bed or beds in the new unit, 308.18 the commissioner of health shall delicense and decertify the 308.19 same number of beds in the existing facility. As a condition of 308.20 receiving a license or certification under this clause, the 308.21 facility must make a written commitment to the commissioner of 308.22 human services that it will not seek to receive an increase in 308.23 its property-related payment rate as a result of the transfers 308.24 allowed under this paragraph; 308.25 (g) to license and certify nursing home beds to replace 308.26 currently licensed and certified boarding care beds which may be 308.27 located either in a remodeled or renovated boarding care or 308.28 nursing home facility or in a remodeled, renovated, newly 308.29 constructed, or replacement nursing home facility within the 308.30 identifiable complex of health care facilities in which the 308.31 currently licensed boarding care beds are presently located, 308.32 provided that the number of boarding care beds in the facility 308.33 or complex are decreased by the number to be licensed as nursing 308.34 home beds and further provided that, if the total costs of new 308.35 construction, replacement, remodeling, or renovation exceed ten 308.36 percent of the appraised value of the facility or $200,000, 309.1 whichever is less, the facility makes a written commitment to 309.2 the commissioner of human services that it will not seek to 309.3 receive an increase in its property-related payment rate by 309.4 reason of the new construction, replacement, remodeling, or 309.5 renovation. The provisions contained in section 144A.073 309.6 regarding the upgrading of facilities do not apply to facilities 309.7 that satisfy these requirements; 309.8 (h) to license as a nursing home and certify as a nursing 309.9 facility a facility that is licensed as a boarding care facility 309.10 but not certified under the medical assistance program, but only 309.11 if the commissioner of human services certifies to the 309.12 commissioner of health that licensing the facility as a nursing 309.13 home and certifying the facility as a nursing facility will 309.14 result in a net annual savings to the state general fund of 309.15 $200,000 or more; 309.16 (i) to certify, after September 30, 1992, and prior to July 309.17 1, 1993, existing nursing home beds in a facility that was 309.18 licensed and in operation prior to January 1, 1992; 309.19 (j) to license and certify new nursing home beds to replace 309.20 beds in a facility acquired by the Minneapolis community 309.21 development agency as part of redevelopment activities in a city 309.22 of the first class, provided the new facility is located within 309.23 three miles of the site of the old facility. Operating and 309.24 property costs for the new facility must be determined and 309.25 allowed under section 256B.431 or 256B.434; 309.26 (k) to license and certify up to 20 new nursing home beds 309.27 in a community-operated hospital and attached convalescent and 309.28 nursing care facility with 40 beds on April 21, 1991, that 309.29 suspended operation of the hospital in April 1986. The 309.30 commissioner of human services shall provide the facility with 309.31 the same per diem property-related payment rate for each 309.32 additional licensed and certified bed as it will receive for its 309.33 existing 40 beds; 309.34 (l) to license or certify beds in renovation, replacement, 309.35 or upgrading projects as defined in section 144A.073, 309.36 subdivision 1, so long as the cumulative total costs of the 310.1 facility's remodeling projects do not 310.2 exceed$750,000$1,000,000; 310.3 (m) to license and certify beds that are moved from one 310.4 location to another for the purposes of converting up to five 310.5 four-bed wards to single or double occupancy rooms in a nursing 310.6 home that, as of January 1, 1993, was county-owned and had a 310.7 licensed capacity of 115 beds; 310.8 (n) to allow a facility that on April 16, 1993, was a 310.9 106-bed licensed and certified nursing facility located in 310.10 Minneapolis to layaway all of its licensed and certified nursing 310.11 home beds. These beds may be relicensed and recertified in a 310.12 newly-constructed teaching nursing home facility affiliated with 310.13 a teaching hospital upon approval by the legislature. The 310.14 proposal must be developed in consultation with the interagency 310.15 committee on long-term care planning. The beds on layaway 310.16 status shall have the same status as voluntarily delicensed and 310.17 decertified beds, except that beds on layaway status remain 310.18 subject to the surcharge in section 256.9657. This layaway 310.19 provision expires July 1, 1998; 310.20 (o) to allow a project which will be completed in 310.21 conjunction with an approved moratorium exception project for a 310.22 nursing home in southern Cass county and which is directly 310.23 related to that portion of the facility that must be repaired, 310.24 renovated, or replaced, to correct an emergency plumbing problem 310.25 for which a state correction order has been issued and which 310.26 must be corrected by August 31, 1993; 310.27 (p) to allow a facility that on April 16, 1993, was a 310.28 368-bed licensed and certified nursing facility located in 310.29 Minneapolis to layaway, upon 30 days prior written notice to the 310.30 commissioner, up to 30 of the facility's licensed and certified 310.31 beds by converting three-bed wards to single or double 310.32 occupancy. Beds on layaway status shall have the same status as 310.33 voluntarily delicensed and decertified beds except that beds on 310.34 layaway status remain subject to the surcharge in section 310.35 256.9657, remain subject to the license application and renewal 310.36 fees under section 144A.07 and shall be subject to a $100 per 311.1 bed reactivation fee. In addition, at any time within three 311.2 years of the effective date of the layaway, the beds on layaway 311.3 status may be: 311.4 (1) relicensed and recertified upon relocation and 311.5 reactivation of some or all of the beds to an existing licensed 311.6 and certified facility or facilities located in Pine River, 311.7 Brainerd, or International Falls; provided that the total 311.8 project construction costs related to the relocation of beds 311.9 from layaway status for any facility receiving relocated beds 311.10 may not exceed the dollar threshold provided in subdivision 2 311.11 unless the construction project has been approved through the 311.12 moratorium exception process under section 144A.073; 311.13 (2) relicensed and recertified, upon reactivation of some 311.14 or all of the beds within the facility which placed the beds in 311.15 layaway status, if the commissioner has determined a need for 311.16 the reactivation of the beds on layaway status. 311.17 The property-related payment rate of a facility placing 311.18 beds on layaway status must be adjusted by the incremental 311.19 change in its rental per diem after recalculating the rental per 311.20 diem as provided in section 256B.431, subdivision 3a, paragraph 311.21 (c). The property-related payment rate for a facility 311.22 relicensing and recertifying beds from layaway status must be 311.23 adjusted by the incremental change in its rental per diem after 311.24 recalculating its rental per diem using the number of beds after 311.25 the relicensing to establish the facility's capacity day 311.26 divisor, which shall be effective the first day of the month 311.27 following the month in which the relicensing and recertification 311.28 became effective. Any beds remaining on layaway status more 311.29 than three years after the date the layaway status became 311.30 effective must be removed from layaway status and immediately 311.31 delicensed and decertified; 311.32 (q) to license and certify beds in a renovation and 311.33 remodeling project to convert 12 four-bed wards into 24 two-bed 311.34 rooms, expand space, and add improvements in a nursing home 311.35 that, as of January 1, 1994, met the following conditions: the 311.36 nursing home was located in Ramsey county; had a licensed 312.1 capacity of 154 beds; and had been ranked among the top 15 312.2 applicants by the 1993 moratorium exceptions advisory review 312.3 panel. The total project construction cost estimate for this 312.4 project must not exceed the cost estimate submitted in 312.5 connection with the 1993 moratorium exception process; 312.6 (r) to license and certify up to 117 beds that are 312.7 relocated from a licensed and certified 138-bed nursing facility 312.8 located in St. Paul to a hospital with 130 licensed hospital 312.9 beds located in South St. Paul, provided that the nursing 312.10 facility and hospital are owned by the same or a related 312.11 organization and that prior to the date the relocation is 312.12 completed the hospital ceases operation of its inpatient 312.13 hospital services at that hospital. After relocation, the 312.14 nursing facility's status under section 256B.431, subdivision 312.15 2j, shall be the same as it was prior to relocation. The 312.16 nursing facility's property-related payment rate resulting from 312.17 the project authorized in this paragraph shall become effective 312.18 no earlier than April 1, 1996. For purposes of calculating the 312.19 incremental change in the facility's rental per diem resulting 312.20 from this project, the allowable appraised value of the nursing 312.21 facility portion of the existing health care facility physical 312.22 plant prior to the renovation and relocation may not exceed 312.23 $2,490,000; 312.24 (s) to license and certify two beds in a facility to 312.25 replace beds that were voluntarily delicensed and decertified on 312.26 June 28, 1991; 312.27 (t) to allow 16 licensed and certified beds located on July 312.28 1, 1994, in a 142-bed nursing home and 21-bed boarding care home 312.29 facility in Minneapolis, notwithstanding the licensure and 312.30 certification after July 1, 1995, of the Minneapolis facility as 312.31 a 147-bed nursing home facility after completion of a 312.32 construction project approved in 1993 under section 144A.073, to 312.33 be laid away upon 30 days' prior written notice to the 312.34 commissioner. Beds on layaway status shall have the same status 312.35 as voluntarily delicensed or decertified beds except that they 312.36 shall remain subject to the surcharge in section 256.9657. The 313.1 16 beds on layaway status may be relicensed as nursing home beds 313.2 and recertified at any time within five years of the effective 313.3 date of the layaway upon relocation of some or all of the beds 313.4 to a licensed and certified facility located in Watertown, 313.5 provided that the total project construction costs related to 313.6 the relocation of beds from layaway status for the Watertown 313.7 facility may not exceed the dollar threshold provided in 313.8 subdivision 2 unless the construction project has been approved 313.9 through the moratorium exception process under section 144A.073. 313.10 The property-related payment rate of the facility placing 313.11 beds on layaway status must be adjusted by the incremental 313.12 change in its rental per diem after recalculating the rental per 313.13 diem as provided in section 256B.431, subdivision 3a, paragraph 313.14 (c). The property-related payment rate for the facility 313.15 relicensing and recertifying beds from layaway status must be 313.16 adjusted by the incremental change in its rental per diem after 313.17 recalculating its rental per diem using the number of beds after 313.18 the relicensing to establish the facility's capacity day 313.19 divisor, which shall be effective the first day of the month 313.20 following the month in which the relicensing and recertification 313.21 became effective. Any beds remaining on layaway status more 313.22 than five years after the date the layaway status became 313.23 effective must be removed from layaway status and immediately 313.24 delicensed and decertified; 313.25 (u) to license and certify beds that are moved within an 313.26 existing area of a facility or to a newly constructed addition 313.27 which is built for the purpose of eliminating three- and 313.28 four-bed rooms and adding space for dining, lounge areas, 313.29 bathing rooms, and ancillary service areas in a nursing home 313.30 that, as of January 1, 1995, was located in Fridley and had a 313.31 licensed capacity of 129 beds; 313.32 (v) to relocate 36 beds in Crow Wing county and four beds 313.33 from Hennepin county to a 160-bed facility in Crow Wing county, 313.34 provided all the affected beds are under common ownership; 313.35 (w) to license and certify a total replacement project of 313.36 up to 49 beds located in Norman county that are relocated from a 314.1 nursing home destroyed by flood and whose residents were 314.2 relocated to other nursing homes. The operating cost payment 314.3 rates for the new nursing facility shall be determined based on 314.4 the interim and settle-up payment provisions of Minnesota Rules, 314.5 part 9549.0057, and the reimbursement provisions of section 314.6 256B.431, except that subdivision 26, paragraphs (a) and (b), 314.7 shall not apply until the second rate year after the settle-up 314.8 cost report is filed. Property-related reimbursement rates 314.9 shall be determined under section 256B.431, taking into account 314.10 any federal or state flood-related loans or grants provided to 314.11 the facility; 314.12 (x) to license and certify a total replacement project of 314.13 up to 129 beds located in Polk county that are relocated from a 314.14 nursing home destroyed by flood and whose residents were 314.15 relocated to other nursing homes. The operating cost payment 314.16 rates for the new nursing facility shall be determined based on 314.17 the interim and settle-up payment provisions of Minnesota Rules, 314.18 part 9549.0057, and the reimbursement provisions of section 314.19 256B.431, except that subdivision 26, paragraphs (a) and (b), 314.20 shall not apply until the second rate year after the settle-up 314.21 cost report is filed. Property-related reimbursement rates 314.22 shall be determined under section 256B.431, taking into account 314.23 any federal or state flood-related loans or grants provided to 314.24 the facility; 314.25 (y) to license and certify beds in a renovation and 314.26 remodeling project to convert 13 three-bed wards into 13 two-bed 314.27 rooms and 13 single-bed rooms, expand space, and add 314.28 improvements in a nursing home that, as of January 1, 1994, met 314.29 the following conditions: the nursing home was located in 314.30 Ramsey county, was not owned by a hospital corporation, had a 314.31 licensed capacity of 64 beds, and had been ranked among the top 314.32 15 applicants by the 1993 moratorium exceptions advisory review 314.33 panel. The total project construction cost estimate for this 314.34 project must not exceed the cost estimate submitted in 314.35 connection with the 1993 moratorium exception process; 314.36 (z) to license and certify up to 150 nursing home beds to 315.1 replace an existing 285 bed nursing facility located in St. 315.2 Paul. The replacement project shall include both the renovation 315.3 of existing buildings and the construction of new facilities at 315.4 the existing site. The reduction in the licensed capacity of 315.5 the existing facility shall occur during the construction 315.6 project as beds are taken out of service due to the construction 315.7 process. Prior to the start of the construction process, the 315.8 facility shall provide written information to the commissioner 315.9 of health describing the process for bed reduction, plans for 315.10 the relocation of residents, and the estimated construction 315.11 schedule. The relocation of residents shall be in accordance 315.12 with the provisions of law and rule; 315.13 (aa) to allow the commissioner of human services to license 315.14 an additional 36 beds to provide residential services for the 315.15 physically handicapped under Minnesota Rules, parts 9570.2000 to 315.16 9570.3400, in a 198-bed nursing home located in Red Wing, 315.17 provided that the total number of licensed and certified beds at 315.18 the facility does not increase; 315.19 (bb) to license and certify a new facility in St. Louis 315.20 county with 44 beds constructed to replace an existing facility 315.21 in St. Louis county with 31 beds, which has resident rooms on 315.22 two separate floors and an antiquated elevator that creates 315.23 safety concerns for residents and prevents nonambulatory 315.24 residents from residing on the second floor. The project shall 315.25 include the elimination of three- and four-bed rooms; 315.26 (cc) to license and certify four beds in a 16-bed certified 315.27 boarding care home in Minneapolis to replace beds that were 315.28 voluntarily delicensed and decertified on or before March 31, 315.29 1992. The licensure and certification is conditional upon the 315.30 facility periodically assessing and adjusting its resident mix 315.31 and other factors which may contribute to a potential 315.32 institution for mental disease declaration. The commissioner of 315.33 human services shall retain the authority to audit the facility 315.34 at any time and shall require the facility to comply with any 315.35 requirements necessary to prevent an institution for mental 315.36 disease declaration, including delicensure and decertification 316.1 of beds, if necessary;or316.2 (dd) to license and certify 72 beds in an existing facility 316.3 in Mille Lacs county with 80 beds as part of a renovation 316.4 project. The renovation must include construction of an 316.5 addition to accommodate ten residents with beginning and 316.6 midstage dementia in a self-contained living unit; creation of 316.7 three resident households where dining, activities, and support 316.8 spaces are located near resident living quarters; designation of 316.9 four beds for rehabilitation in a self-contained area; 316.10 designation of 30 private rooms; and other improvements.; 316.11 (ee) to license and certify beds in a facility that has 316.12 undergone replacement or remodeling as part of a planned closure 316.13 under section 256B.437; 316.14 (ff) to license and certify a total replacement project of 316.15 up to 124 beds located in Wilkin county that are in need of 316.16 relocation from a nursing home significantly damaged by flood. 316.17 The operating cost payment rates for the new nursing facility 316.18 shall be determined based on the interim and settle-up payment 316.19 provisions of Minnesota Rules, part 9549.0057, and the 316.20 reimbursement provisions of section 256B.431, except that 316.21 section 256B.431, subdivision 26, paragraphs (a) and (b), shall 316.22 not apply until the second rate year after the settle-up cost 316.23 report is filed. Property-related reimbursement rates shall be 316.24 determined under section 256B.431, taking into account any 316.25 federal or state flood-related loans or grants provided to the 316.26 facility; 316.27 (gg) to allow the commissioner of human services to license 316.28 an additional nine beds to provide residential services for the 316.29 physically handicapped under Minnesota Rules, parts 9570.2000 to 316.30 9570.3400, in a 240-bed nursing home located in Duluth, provided 316.31 that the total number of licensed and certified beds at the 316.32 facility does not increase; 316.33 (hh) to license and certify up to 120 new nursing facility 316.34 beds to replace beds in a facility in Anoka county, which was 316.35 licensed for 98 beds as of July 1, 2000, provided the new 316.36 facility is located within four miles of the existing facility 317.1 and is in Anoka county. Operating and property rates shall be 317.2 determined and allowed under section 256B.431 and Minnesota 317.3 Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or 317.4 256B.435. The provisions of section 256B.431, subdivision 26, 317.5 paragraphs (a) and (b), do not apply until the second rate year 317.6 following settle-up; or 317.7 (ii) to transfer up to 98 beds of a 129-licensed bed 317.8 facility located in Anoka county that, as of March 25, 2001, is 317.9 in the active process of closing, to a 122-licensed bed 317.10 nonprofit nursing facility located in the city of Columbia 317.11 Heights or its affiliate. The transfer is effective when the 317.12 receiving facility notifies the commissioner in writing of the 317.13 number of beds accepted. The commissioner shall place all 317.14 transferred beds on layaway status held in the name of the 317.15 receiving facility. The layaway adjustment provisions of 317.16 section 256B.431, subdivision 30, do not apply to this layaway. 317.17 The receiving facility may only remove the beds from layaway for 317.18 recertification and relicensure at the receiving facility's 317.19 current site, or at a newly constructed facility located in 317.20 Anoka county. The receiving facility must receive statutory 317.21 authorization before removing these beds from layaway status. 317.22 Sec. 7. Minnesota Statutes 2000, section 144A.073, 317.23 subdivision 2, as amended by Laws 2001, chapter 161, section 22, 317.24 is amended to read: 317.25 Subd. 2. [REQUEST FOR PROPOSALS.] At the authorization by 317.26 the legislature of additional medical assistance expenditures 317.27 for exceptions to the moratorium on nursing homes, the 317.28 commissioner shall publish in the State Register a request for 317.29 proposals for nursing home projects to be licensed or certified 317.30 under section 144A.071, subdivision 4a, clause (c). The public 317.31 notice of this funding and the request for proposals must 317.32 specify how the approval criteria will be prioritized by the 317.33 commissioner. The notice must describe the information that 317.34 must accompany a request and state that proposals must be 317.35 submitted to the commissioner within 90 days of the date of 317.36 publication. The notice must include the amount of the 318.1 legislative appropriation available for the additional costs to 318.2 the medical assistance program of projects approved under this 318.3 section. If no money is appropriated for a year, the 318.4 commissioner shall publish a notice to that effect, and no 318.5 proposals shall be requested. If money is appropriated, the 318.6 commissioner shall initiate the application and review process 318.7 described in this section at least twice each biennium and up to 318.8 four times each biennium, according to dates established by 318.9 rule. Authorized funds shall be allocated proportionally to the 318.10 number of processes. Funds not encumbered by an earlier process 318.11 within a biennium shall carry forward to subsequent iterations 318.12 of the process. Authorization for expenditures does not carry 318.13 forward into the following biennium. To be considered for 318.14 approval, a proposal must include the following information: 318.15 (1) whether the request is for renovation, replacement, 318.16 upgrading, conversion, or relocation; 318.17 (2) a description of the problem the project is designed to 318.18 address; 318.19 (3) a description of the proposed project; 318.20 (4) an analysis of projected costs of the nursing facility 318.21 proposal, which are not required to exceed the cost threshold 318.22 referred to in section 144A.071, subdivision 1, to be considered 318.23 under this section, including initial construction and 318.24 remodeling costs; site preparation costs; technology costs; 318.25 financing costs, including the current estimated long-term 318.26 financing costs of the proposal, which consists of estimates of 318.27 the amount and sources of money, reserves if required under the 318.28 proposed funding mechanism, annual payments schedule, interest 318.29 rates, length of term, closing costs and fees, insurance costs, 318.30 and any completed marketing study or underwriting review; and 318.31 estimated operating costs during the first two years after 318.32 completion of the project; 318.33 (5) for proposals involving replacement of all or part of a 318.34 facility, the proposed location of the replacement facility and 318.35 an estimate of the cost of addressing the problem through 318.36 renovation; 319.1 (6) for proposals involving renovation, an estimate of the 319.2 cost of addressing the problem through replacement; 319.3 (7) the proposed timetable for commencing construction and 319.4 completing the project; 319.5 (8) a statement of any licensure or certification issues, 319.6 such as certification survey deficiencies; 319.7 (9) the proposed relocation plan for current residents if 319.8 beds are to be closed so that the department of human services 319.9 can estimate the total costs of a proposal; and 319.10 (10) other information required by permanent rule of the 319.11 commissioner of health in accordance with subdivisions 4 and 8. 319.12 Sec. 8. Minnesota Statutes 2000, section 144A.073, 319.13 subdivision 4, is amended to read: 319.14 Subd. 4. [CRITERIA FOR REVIEW.] The following criteria 319.15 shall be used in a consistent manner to compare, evaluate, and 319.16 rank all proposals submitted. Except for the criteria specified 319.17 in clause (3), the application of criteria listed under this 319.18 subdivision shall not reflect any distinction based on the 319.19 geographic location of the proposed project: 319.20 (1) the extent to which the proposal furthers state 319.21 long-term care goals,including the goals stated in section319.22144A.31, andincluding the goal of enhancing the availability 319.23 and use of alternative care services and the goal of reducing 319.24 the number of long-term care resident rooms with more than two 319.25 beds; 319.26 (2) the proposal's long-term effects on state costs 319.27 including the cost estimate of the project according to section 319.28 144A.071, subdivision 5a; 319.29 (3) the extent to which the proposal promotes equitable 319.30 access to long-term care services in nursing homes through 319.31 redistribution of the nursing home bed supply, as measured by 319.32 the number of beds relative to the population 85 or older, 319.33 projected to the year 2000 by the state demographer, and 319.34 according to items (i) to (iv): 319.35 (i) reduce beds in counties where the supply is high, 319.36 relative to the statewide mean, and increase beds in counties 320.1 where the supply is low, relative to the statewide mean; 320.2 (ii) adjust the bed supply so as to create the greatest 320.3 benefits in improving the distribution of beds; 320.4 (iii) adjust the existing bed supply in counties so that 320.5 the bed supply in a county moves toward the statewide mean; and 320.6 (iv) adjust the existing bed supply so that the 320.7 distribution of beds as projected for the year 2020 would be 320.8 consistent with projected need, based on the methodology 320.9 outlined in the interagency long-term care committee's1993320.10 nursing home bed distribution study; 320.11 (4) the extent to which the project improves conditions 320.12 that affect the health or safety of residents, such as narrow 320.13 corridors, narrow door frames, unenclosed fire exits, and wood 320.14 frame construction, and similar provisions contained in fire and 320.15 life safety codes and licensure and certification rules; 320.16 (5) the extent to which the project improves conditions 320.17 that affect the comfort or quality of life of residents in a 320.18 facility or the ability of the facility to provide efficient 320.19 care, such as a relatively high number of residents in a room; 320.20 inadequate lighting or ventilation; poor access to bathing or 320.21 toilet facilities; a lack of available ancillary space for 320.22 dining rooms, day rooms, or rooms used for other activities; 320.23 problems relating to heating, cooling, or energy efficiency; 320.24 inefficient location of nursing stations; narrow corridors; or 320.25 other provisions contained in the licensure and certification 320.26 rules; 320.27 (6) the extent to which the applicant demonstrates the 320.28 delivery of quality care, as defined in state and federal 320.29 statutes and rules, to residents as evidenced by the two most 320.30 recent state agency certification surveys and the applicants' 320.31 response to those surveys; 320.32 (7) the extent to which the project removes the need for 320.33 waivers or variances previously granted by either the licensing 320.34 agency, certifying agency, fire marshal, or local government 320.35 entity;and320.36 (8) the extent to which the project increases the number of 321.1 private or single bed rooms; and 321.2 (9) other factors that may be developed in permanent rule 321.3 by the commissioner of health that evaluate and assess how the 321.4 proposed project will further promote or protect the health, 321.5 safety, comfort, treatment, or well-being of the facility's 321.6 residents. 321.7 Sec. 9. [144A.161] [NURSING FACILITY RESIDENT RELOCATION.] 321.8 Subdivision 1. [DEFINITIONS.] The definitions in this 321.9 subdivision apply to subdivisions 2 to 10. 321.10 (a) "Closure" means the cessation of operations of a 321.11 facility and the delicensure and decertification of all beds 321.12 within the facility. 321.13 (b) "Curtailment," "reduction," or "change" refers to any 321.14 change in operations which would result in or encourage the 321.15 relocation of residents. 321.16 (c) "Facility" means a nursing home licensed pursuant to 321.17 this chapter, or a certified boarding care home licensed 321.18 pursuant to sections 144.50 to 144.56. 321.19 (d) "Licensee" means the owner of the facility or the 321.20 owner's designee or the commissioner of health for a facility in 321.21 receivership. 321.22 (e) "Local agency" means the county or multicounty social 321.23 service agency authorized under sections 393.01 and 393.07, as 321.24 the agency responsible for providing social services for the 321.25 county in which the nursing home is located. 321.26 (f) "Plan" means a process developed under subdivision 3, 321.27 paragraph (b), for the closure, curtailment, reduction, or 321.28 change in operations in a facility and the subsequent relocation 321.29 of residents. 321.30 (g) "Relocation" means the discharge of a resident and 321.31 movement of the resident to another facility or living 321.32 arrangement as a result of the closing, curtailment, reduction, 321.33 or change in operations of a nursing home or boarding care home. 321.34 Subd. 2. [INITIAL NOTICE FROM LICENSEE.] (a) A licensee 321.35 shall notify the following parties in writing when there is an 321.36 intent to close or curtail, reduce, or change operations which 322.1 would result in or encourage the relocation of residents: 322.2 (1) the commissioner of health; 322.3 (2) the commissioner of human services; 322.4 (3) the local agency; 322.5 (4) the office of the ombudsman for older Minnesotans; and 322.6 (5) the office of the ombudsman for mental health and 322.7 mental retardation. 322.8 (b) The written notice shall include the names, telephone 322.9 numbers, facsimile numbers, and e-mail addresses of the persons 322.10 in the facility responsible for coordinating the licensee's 322.11 efforts in the planning process, and the number of residents 322.12 potentially affected by the closure or curtailment, reduction, 322.13 or change in operations. 322.14 Subd. 3. [PLANNING PROCESS.] (a) The local agency shall, 322.15 within five working days of receiving initial notice of the 322.16 licensee's intent to close or curtail, reduce, or change 322.17 operations, provide the licensee and all parties identified in 322.18 subdivision 2, paragraph (a), with the names, telephone numbers, 322.19 facsimile numbers, and e-mail addresses of those persons 322.20 responsible for coordinating local agency efforts in the 322.21 planning process. 322.22 (b) Within ten working days of receipt of the notice under 322.23 paragraph (a), the local agency and licensee shall meet to 322.24 develop the relocation plan. The local agency shall inform the 322.25 departments of health and human services, the office of the 322.26 ombudsman for older Minnesotans, and the office of the ombudsman 322.27 for mental health and mental retardation of the date, time, and 322.28 location of the meeting so that their representatives may 322.29 attend. The relocation plan must be completed within 45 days of 322.30 receipt of the initial notice. However, the plan may be 322.31 finalized on an earlier schedule agreed to by all parties. To 322.32 the extent practicable, consistent with requirements to protect 322.33 the safety and health of residents, the commissioner may 322.34 authorize the planning process under this subdivision to occur 322.35 concurrent with the 60-day notice required under subdivision 322.36 5a. The plan shall: 323.1 (1) identify the expected date of closure, curtailment, 323.2 reduction, or change in operations; 323.3 (2) outline the process for public notification of the 323.4 closure, curtailment, reduction, or change in operations; 323.5 (3) identify efforts that will be made to include other 323.6 stakeholders in the relocation process; 323.7 (4) outline the process to ensure 60-day advance written 323.8 notice to residents, family members, and designated 323.9 representatives; 323.10 (5) present an aggregate description of the resident 323.11 population remaining to be relocated and the population's needs; 323.12 (6) outline the individual resident assessment process to 323.13 be utilized; 323.14 (7) identify an inventory of available relocation options, 323.15 including home and community-based services; 323.16 (8) identify a timeline for submission of the list 323.17 identified in subdivision 5c, paragraph (b); and 323.18 (9) identify a schedule for the timely completion of each 323.19 element of the plan. 323.20 (c) All parties to the plan shall refrain from any public 323.21 notification of the intent to close or curtail, reduce, or 323.22 change operations until a relocation plan has been established. 323.23 If the planning process occurs concurrently with the 60-day 323.24 notice period, this requirement does not apply once 60-day 323.25 notice is given. 323.26 Subd. 4. [RESPONSIBILITIES OF LICENSEE FOR RESIDENT 323.27 RELOCATIONS.] The licensee shall provide for the safe, orderly, 323.28 and appropriate relocation of residents. The licensee and 323.29 facility staff shall cooperate with representatives from the 323.30 local agency, the department of health, the department of human 323.31 services, the office of ombudsman for older Minnesotans, and 323.32 ombudsman for mental health and mental retardation in planning 323.33 for and implementing the relocation of residents. 323.34 Subd. 5. [LICENSEE RESPONSIBILITIES PRIOR TO 323.35 RELOCATION.] (a) The licensee shall establish an 323.36 interdisciplinary team responsible for coordinating and 324.1 implementing the plan. The interdisciplinary team shall include 324.2 representatives from the local agency, the office of ombudsman 324.3 for older Minnesotans, facility staff that provide direct care 324.4 services to the residents, and facility administration. 324.5 (b) The licensee shall provide a list to the local agency 324.6 that includes the following information on each resident to be 324.7 relocated: 324.8 (1) name; 324.9 (2) date of birth; 324.10 (3) social security number; 324.11 (4) medical assistance identification number; 324.12 (5) all diagnoses; and 324.13 (6) the name and contact information for the resident's 324.14 family or other designated representative. 324.15 (c) The licensee shall consult with the local agency on the 324.16 availability and development of available resources and on the 324.17 resident relocation process. 324.18 Subd. 5a. [LICENSEE RESPONSIBILITIES TO PROVIDE 324.19 NOTICE.] At least 60 days before the proposed date of closing, 324.20 curtailment, reduction, or change in operations as agreed to in 324.21 the plan, the licensee shall send a written notice of closure or 324.22 curtailment, reduction, or change in operations to each resident 324.23 being relocated, the resident's family member or designated 324.24 representative, and the resident's attending physician. The 324.25 notice must include the following: 324.26 (1) the date of the proposed closure, curtailment, 324.27 reduction, or change in operations; 324.28 (2) the name, address, telephone number, facsimile number, 324.29 and e-mail address of the individual or individuals in the 324.30 facility responsible for providing assistance and information; 324.31 (3) notification of upcoming meetings for residents, 324.32 families and designated representatives, and resident and family 324.33 councils to discuss the relocation of residents; 324.34 (4) the name, address, and telephone number of the local 324.35 agency contact person; and 324.36 (5) the name, address, and telephone number of the office 325.1 of ombudsman for older Minnesotans and the ombudsman for mental 325.2 health and mental retardation. 325.3 The notice must comply with all applicable state and 325.4 federal requirements for notice of transfer or discharge of 325.5 nursing home residents. 325.6 Subd. 5b. [LICENSEE RESPONSIBILITY REGARDING MEDICAL 325.7 INFORMATION.] The licensee shall request the attending physician 325.8 provide or arrange for the release of medical information needed 325.9 to update resident medical records and prepare all required 325.10 forms and discharge summaries. 325.11 Subd. 5c. [LICENSEE RESPONSIBILITY REGARDING PLACEMENT 325.12 INFORMATION.] (a) The licensee shall provide sufficient 325.13 preparation to residents to ensure safe, orderly, and 325.14 appropriate discharge and relocation. The licensee shall assist 325.15 residents in finding placements that respond to personal 325.16 preferences, such as desired geographic location. 325.17 (b) The licensee shall prepare a resource list with several 325.18 relocation options for each resident. The list must contain the 325.19 following information for each relocation option, when 325.20 applicable: 325.21 (1) the name, address, and telephone and facsimile numbers 325.22 of each facility with appropriate, available beds or services; 325.23 (2) the certification level of the available beds; 325.24 (3) the types of services available; and 325.25 (4) the name, address, and telephone and facsimile numbers 325.26 of appropriate available home and community-based placements, 325.27 services, and settings or other options for individuals with 325.28 special needs. 325.29 The list shall be made available to residents and their families 325.30 or designated representatives, and upon request to the office of 325.31 ombudsman for older Minnesotans, the ombudsman for mental health 325.32 and mental retardation, and the local agency. 325.33 (c) The Senior LinkAge line may make available via a Web 325.34 site the name, address, and telephone and facsimile numbers of 325.35 each facility with available beds, the certification level of 325.36 the available beds, the types of services available, and the 326.1 number of beds that are available as updated daily by the listed 326.2 facilities. The licensee must provide residents, their families 326.3 or designated representatives, the office of the ombudsman for 326.4 older Minnesotans, the office of the ombudsman for mental health 326.5 and mental retardation, and the local agency with the toll-free 326.6 number and Web site address for the Senior LinkAge line. 326.7 Subd. 5d. [LICENSEE RESPONSIBILITY TO MEET WITH RESIDENTS 326.8 AND FAMILIES.] Following the establishment of the plan, the 326.9 licensee shall conduct meetings with residents, families and 326.10 designated representatives, and resident and family councils to 326.11 notify them of the process for resident relocation. 326.12 Representatives from the local county social services agency, 326.13 the office of ombudsman for older Minnesotans, the ombudsman for 326.14 mental health and mental retardation, the commissioner of 326.15 health, and the commissioner of human services shall receive 326.16 advance notice of the meetings. 326.17 Subd. 5e. [LICENSEE RESPONSIBILITY FOR SITE VISITS.] The 326.18 licensee shall assist residents desiring to make site visits to 326.19 facilities with available beds or other appropriate living 326.20 options to which the resident may relocate, unless it is 326.21 medically inadvisable, as documented by the attending physician 326.22 in the resident's care record. The licensee shall provide or 326.23 arrange transportation for site visits to facilities or other 326.24 living options within a 50-mile radius to which the resident may 326.25 relocate, or within a larger radius if no suitable options are 326.26 available within 50 miles. The licensee shall provide available 326.27 written materials to residents on a potential new facility or 326.28 living option. 326.29 Subd. 5f. [LICENSEE RESPONSIBILITY FOR PERSONAL PROPERTY, 326.30 PERSONAL FUNDS, AND TELEPHONE SERVICE.] (a) The licensee shall 326.31 complete an inventory of resident personal possessions and 326.32 provide a copy of the final inventory to the resident and the 326.33 resident's designated representative prior to relocation. The 326.34 licensee shall be responsible for the transfer of the resident's 326.35 possessions for all relocations within a 50-mile radius of the 326.36 facility, or within a larger radius if no suitable options are 327.1 available within 50 miles. The licensee shall complete the 327.2 transfer of resident possessions in a timely manner, but no 327.3 later than the date of the actual physical relocation of the 327.4 resident. 327.5 (b) The licensee shall complete a final accounting of 327.6 personal funds held in trust by the facility and provide a copy 327.7 of this accounting to the resident and the resident's family or 327.8 the resident's designated representative. The licensee shall be 327.9 responsible for the transfer of all personal funds held in trust 327.10 by the facility. The licensee shall complete the transfer of 327.11 all personal funds in a timely manner. 327.12 (c) The licensee shall assist residents with the transfer 327.13 and reconnection of service for telephones or, for residents who 327.14 are deaf or blind, other personal communication devices or 327.15 services. The licensee shall pay the costs associated with 327.16 reestablishing service for telephones or other personal 327.17 communication devices or services, such as connection fees or 327.18 other one-time charges. The transfer or reconnection of 327.19 personal communication devices or services shall be completed in 327.20 a timely manner. 327.21 Subd. 5g. [LICENSEE RESPONSIBILITIES FOR FINAL NOTICE AND 327.22 RECORDS TRANSFER.] (a) The licensee shall provide the resident, 327.23 the resident's family or designated representative, and the 327.24 resident's attending physician final written notice prior to the 327.25 relocation of the resident. The notice must: 327.26 (1) be provided seven days prior to the actual relocation, 327.27 unless the resident agrees to waive the right to advance notice; 327.28 and 327.29 (2) identify the date of the anticipated relocation and the 327.30 destination to which the resident is being relocated. 327.31 (b) The licensee shall provide the receiving facility or 327.32 other health, housing, or care entity with complete and accurate 327.33 resident records including information on family members, 327.34 designated representatives, guardians, social service 327.35 caseworkers, or other contact information. These records must 327.36 also include all information necessary to provide appropriate 328.1 medical care and social services. This includes, but is not 328.2 limited to, information on preadmission screening, Level I and 328.3 Level II screening, minimum data set (MDS), and all other 328.4 assessments, resident diagnoses, social, behavioral, and 328.5 medication information. 328.6 (c) For residents with special care needs, the licensee 328.7 shall consult with the receiving facility or other placement 328.8 entity and provide staff training or other preparation as needed 328.9 to assist in providing for the special needs. 328.10 Subd. 6. [RESPONSIBILITIES OF THE LICENSEE DURING 328.11 RELOCATION.] (a) The licensee shall make arrangements or provide 328.12 for the transportation of residents to the new facility or 328.13 placement within a 50-mile radius, or within a larger radius if 328.14 no suitable options are available within 50 miles. The licensee 328.15 shall provide a staff person to accompany the resident during 328.16 transportation, upon request of the resident, the resident's 328.17 family, or designated representative. The discharge and 328.18 relocation of residents must comply with all applicable state 328.19 and federal requirements and must be conducted in a safe, 328.20 orderly, and appropriate manner. The licensee must ensure that 328.21 there is no disruption in providing meals, medications, or 328.22 treatments of a resident during the relocation process. 328.23 (b) Beginning the week following development of the initial 328.24 relocation plan, the licensee shall submit biweekly status 328.25 reports to the commissioners of health and human services or 328.26 their designees and to the local agency. The initial status 328.27 report must identify: 328.28 (1) the relocation plan developed; 328.29 (2) the interdisciplinary team members; and 328.30 (3) the number of residents to be relocated. 328.31 (c) Subsequent status reports must identify: 328.32 (1) any modifications to the plan; 328.33 (2) any change of interdisciplinary team members; 328.34 (3) the number of residents relocated; 328.35 (4) the destination to which residents have been relocated; 328.36 (5) the number of residents remaining to be relocated; and 329.1 (6) issues or problems encountered during the process and 329.2 resolution of these issues. 329.3 Subd. 7. [RESPONSIBILITIES OF THE LICENSEE FOLLOWING 329.4 RELOCATION.] The licensee shall retain or make arrangements for 329.5 the retention of all remaining resident records for the period 329.6 required by law. The licensee shall provide the department of 329.7 health access to these records. The licensee shall notify the 329.8 department of health of the location of any resident records 329.9 that have not been transferred to the new facility or other 329.10 health care entity. 329.11 Subd. 8. [RESPONSIBILITIES OF THE LOCAL AGENCY.] (a) The 329.12 local agency shall participate in the meeting as outlined in 329.13 subdivision 3, paragraph (b), to develop a relocation plan. 329.14 (b) The local agency shall designate a representative to 329.15 the interdisciplinary team established by the licensee 329.16 responsible for coordinating the relocation efforts. 329.17 (c) The local agency shall serve as a resource in the 329.18 relocation process. 329.19 (d) Concurrent with the notice sent to residents from the 329.20 licensee as provided in subdivision 5a, the local agency shall 329.21 provide written notice to residents, family, or designated 329.22 representatives describing: 329.23 (1) the county's role in the relocation process and in the 329.24 follow-up to relocations; 329.25 (2) a local agency contact name, address, and telephone 329.26 number; and 329.27 (3) the name, address, and telephone number of the office 329.28 of ombudsman for older Minnesotans and the ombudsman for mental 329.29 health and mental retardation. 329.30 (e) The local agency designee shall meet with appropriate 329.31 facility staff to coordinate any assistance in the relocation 329.32 process. This coordination shall include participating in group 329.33 meetings with residents, families, and designated 329.34 representatives to explain the relocation process. 329.35 (f) The local agency shall monitor compliance with all 329.36 components of the plan. If the licensee is not in compliance, 330.1 the local agency shall notify the commissioners of the 330.2 department of health and the department of human services. 330.3 (g) Except as requested by the resident, family member, or 330.4 designated representative and within the parameters of the 330.5 Vulnerable Adults Act, the local agency may halt a relocation 330.6 that it deems inappropriate or dangerous to the health or safety 330.7 of a resident. The local agency shall pursue remedies to 330.8 protect the resident during the relocation process, including, 330.9 but not limited to, assisting the resident with filing an appeal 330.10 of transfer or discharge, notification of all appropriate 330.11 licensing boards and agencies, and other remedies available to 330.12 the county under section 626.557, subdivision 10. 330.13 (h) A member of the local agency staff shall visit 330.14 residents relocated within 100 miles of the county within 30 330.15 days after the relocation. Local agency staff shall interview 330.16 the resident and family or designated representative, observe 330.17 the resident on site, and review and discuss pertinent medical 330.18 or social records with appropriate facility staff to: 330.19 (1) assess the adjustment of the resident to the new 330.20 placement; 330.21 (2) recommend services or methods to meet any special needs 330.22 of the resident; and 330.23 (3) identify residents at risk. 330.24 (i) The local agency may conduct subsequent follow-up 330.25 visits in cases where the adjustment of the resident to the new 330.26 placement is in question. 330.27 (j) Within 60 days of the completion of the follow-up 330.28 visits, the local agency shall submit a written summary of the 330.29 follow-up work to the department of health and the department of 330.30 human services in a manner approved by the commissioners. 330.31 (k) The local agency shall submit to the department of 330.32 health and the department of human services a report of any 330.33 issues that may require further review or monitoring. 330.34 (l) The local agency shall be responsible for the safe and 330.35 orderly relocation of residents in cases where an emergent need 330.36 arises or when the licensee has abrogated its responsibilities 331.1 under the plan. 331.2 Subd. 9. [PENALTIES.] Upon the recommendation of the 331.3 commissioner of health, the commissioner of human services may 331.4 eliminate a closure rate adjustment under subdivision 10 for 331.5 violations of this section. 331.6 Subd. 10. [FACILITY CLOSURE RATE ADJUSTMENT.] Upon the 331.7 request of a closing facility, the commissioner of human 331.8 services must allow the facility a closure rate adjustment equal 331.9 to a 50 percent payment rate increase to reimburse relocation 331.10 costs or other costs related to facility closure. This rate 331.11 increase is effective on the date the facility's occupancy 331.12 decreases to 90 percent of capacity days after the written 331.13 notice of closure is distributed under subdivision 5 and shall 331.14 remain in effect for a period of up to 60 days. The 331.15 commissioner shall delay the implementation of rate adjustments 331.16 under section 256B.437, subdivisions 3, paragraph (b), and 6, 331.17 paragraph (a), to offset the cost of this rate adjustment. 331.18 Subd. 11. [COUNTY COSTS.] The commissioner of human 331.19 services shall allocate up to $450 in total state and federal 331.20 funds per nursing facility bed that is closing, within the 331.21 limits of the appropriation specified for this purpose, to be 331.22 used for relocation costs incurred by counties for resident 331.23 relocation under this section or planned closures under section 331.24 256B.437. To be eligible for this allocation, a county in which 331.25 a nursing facility closes must provide to the commissioner a 331.26 detailed statement in a form provided by the commissioner of 331.27 additional costs, not to exceed $450 in total state and federal 331.28 funds per bed closed, that are directly incurred related to the 331.29 county's role in the relocation process. 331.30 Sec. 10. [144A.162] [TRANSFER OF RESIDENTS WITHIN 331.31 FACILITIES.] 331.32 The licensee shall provide for the safe, orderly, and 331.33 appropriate transfer of residents within the facility. In 331.34 situations where there is a curtailment, reduction, capital 331.35 improvement, or change in operations within a facility, the 331.36 licensee shall minimize the number of intra-facility transfers 332.1 needed to complete the project or change in operations, consider 332.2 individual resident needs and preferences, and provide 332.3 reasonable accommodation for individual resident requests 332.4 regarding their room transfer. The licensee shall provide 332.5 notice to the office of ombudsman for older Minnesotans and, 332.6 when appropriate, the office of ombudsman for mental health and 332.7 mental retardation, in advance of any notice to residents and 332.8 family, when all of the following circumstances apply: 332.9 (1) the transfers of residents within the facility are 332.10 being proposed due to curtailment, reduction, capital 332.11 improvements or change in operations; 332.12 (2) the transfers of residents within the facility are not 332.13 temporary moves to accommodate physical plan upgrades or 332.14 renovation; and 332.15 (3) the transfers involve multiple residents being moved 332.16 simultaneously. 332.17 Sec. 11. [144A.1888] [REUSE OF FACILITIES.] 332.18 Notwithstanding any local ordinance related to development, 332.19 planning, or zoning to the contrary, the conversion or reuse of 332.20 a nursing home that closes or that curtails, reduces, or changes 332.21 operations shall be considered a conforming use permitted under 332.22 local law, provided that the facility is converted to another 332.23 long-term care service approved by a regional planning group 332.24 under section 256B.437 that serves a smaller number of persons 332.25 than the number of persons served before the closure or 332.26 curtailment, reduction, or change in operations. 332.27 Sec. 12. [144A.36] [TRANSITION PLANNING GRANTS.] 332.28 Subdivision 1. [DEFINITIONS.] "Eligible nursing home" 332.29 means any nursing home licensed under sections 144A.01 to 332.30 144A.16 and certified by the appropriate authority under United 332.31 States Code, title 42, sections 1396-1396p, to participate as a 332.32 vendor in the medical assistance program established under 332.33 chapter 256B. 332.34 Subd. 2. [GRANTS AUTHORIZED.] (a) The commissioner shall 332.35 establish a program of transition planning grants to assist 332.36 eligible nursing homes in implementing the provisions in 333.1 paragraphs (b) and (c). 333.2 (b) Transition planning grants may be used by nursing homes 333.3 to develop strategic plans which identify the appropriate 333.4 institutional and noninstitutional settings necessary to meet 333.5 the older adult service needs of the community. 333.6 (c) At a minimum, a strategic plan must consist of: 333.7 (1) a needs assessment to determine what older adult 333.8 services are needed and desired by the community; 333.9 (2) an assessment of the appropriate settings in which to 333.10 provide needed older adult services; 333.11 (3) an assessment identifying currently available services 333.12 and their settings in the community; and 333.13 (4) a transition plan to achieve the needed outcome 333.14 identified by the assessment. 333.15 Subd. 3. [ALLOCATION OF GRANTS.] (a) Eligible nursing 333.16 homes must apply to the commissioner no later than September 1 333.17 of each fiscal year for grants awarded in that fiscal year. A 333.18 grant shall be awarded upon signing of a grant contract. 333.19 (b) The commissioner must make a final decision on the 333.20 funding of each application within 60 days of the deadline for 333.21 receiving applications. 333.22 Subd. 4. [EVALUATION.] The commissioner shall evaluate the 333.23 overall effectiveness of the grant program. The commissioner 333.24 may collect, from the nursing homes receiving grants, the 333.25 information necessary to evaluate the grant program. 333.26 Information related to the financial condition of individual 333.27 nursing homes shall be classified as nonpublic data. 333.28 Sec. 13. [144A.37] [ALTERNATIVE NURSING HOME SURVEY 333.29 PROCESS.] 333.30 Subdivision 1. [ALTERNATIVE NURSING HOME SURVEY 333.31 SCHEDULES.] (a) The commissioner of health shall implement 333.32 alternative procedures for the nursing home survey process as 333.33 authorized under this section. 333.34 (b) These alternative survey process procedures seek to: 333.35 (1) use department resources more effectively and efficiently to 333.36 target problem areas; (2) use other existing or new mechanisms 334.1 to provide objective assessments of quality and to measure 334.2 quality improvement; (3) provide for frequent collaborative 334.3 interaction of facility staff and surveyors rather than a 334.4 punitive approach; and (4) reward a nursing home that has 334.5 performed very well by extending intervals between full surveys. 334.6 (c) The commissioner shall pursue changes in federal law 334.7 necessary to accomplish this process and shall apply for any 334.8 necessary federal waivers or approval. If a federal waiver is 334.9 approved, the commissioner shall promptly submit, to the house 334.10 and senate committees with jurisdiction over health and human 334.11 services policy and finance, fiscal estimates for implementing 334.12 the alternative survey process waiver. The commissioner shall 334.13 also pursue any necessary federal law changes during the 107th 334.14 Congress. 334.15 (d) The alternative nursing home survey schedule and 334.16 related educational activities shall not be implemented until 334.17 funding is appropriated by the legislature. 334.18 Subd. 2. [SURVEY INTERVALS.] The commissioner of health 334.19 must extend the time period between standard surveys up to 30 334.20 months based on the criteria established in subdivision 4. In 334.21 using the alternative survey schedule, the requirement for the 334.22 statewide average to not exceed 12 months does not apply. 334.23 Subd. 3. [COMPLIANCE HISTORY.] The commissioner shall 334.24 develop a process for identifying the survey cycles for skilled 334.25 nursing facilities based upon the compliance history of the 334.26 facility. This process can use a range of months for survey 334.27 intervals. At a minimum, the process must be based on 334.28 information from the last two survey cycles and shall take into 334.29 consideration any deficiencies issued as the result of a survey 334.30 or a complaint investigation during the interval. A skilled 334.31 nursing facility with a finding of substandard quality of care 334.32 or a finding of immediate jeopardy is not entitled to a survey 334.33 interval greater than 12 months. The commissioner shall alter 334.34 the survey cycle for a specific skilled nursing facility based 334.35 on findings identified through the completion of a survey, a 334.36 monitoring visit, or a complaint investigation. The 335.1 commissioner must also take into consideration information other 335.2 than the facility's compliance history. 335.3 Subd. 4. [CRITERIA FOR SURVEY INTERVAL 335.4 CLASSIFICATION.] (a) The commissioner shall provide public 335.5 notice of the classification process and shall identify the 335.6 selected survey cycles for each skilled nursing facility. The 335.7 classification system must be based on an analysis of the 335.8 findings made during the past two standard survey intervals, but 335.9 it only takes one survey or complaint finding to modify the 335.10 interval. 335.11 (b) The commissioner shall also take into consideration 335.12 information obtained from residents and family members in each 335.13 skilled nursing facility and from other sources such as 335.14 employees and ombudsmen in determining the appropriate survey 335.15 intervals for facilities. 335.16 Subd. 5. [REQUIRED MONITORING.] (a) The commissioner shall 335.17 conduct at least one monitoring visit on an annual basis for 335.18 every skilled nursing facility which has been selected for a 335.19 survey cycle greater than 12 months. The commissioner shall 335.20 develop protocols for the monitoring visits which shall be less 335.21 extensive than the requirements for a standard survey. The 335.22 commissioner shall use the criteria in paragraph (b) to 335.23 determine whether additional monitoring visits to a facility 335.24 will be required. 335.25 (b) The criteria shall include, but not be limited to, the 335.26 following: 335.27 (1) changes in ownership, administration of the facility, 335.28 or direction of the facility's nursing service; 335.29 (2) changes in the facility's quality indicators which 335.30 might evidence a decline in the facility's quality of care; 335.31 (3) reductions in staffing or an increase in the 335.32 utilization of temporary nursing personnel; and 335.33 (4) complaint information or other information that 335.34 identifies potential concerns for the quality of the care and 335.35 services provided in the skilled nursing facility. 335.36 Subd. 6. [SURVEY REQUIREMENTS FOR FACILITIES NOT APPROVED 336.1 FOR EXTENDED SURVEY INTERVALS.] The commissioner shall establish 336.2 a process for surveying and monitoring of facilities which 336.3 require a survey interval of less than 15 months. This 336.4 information shall identify the steps that the commissioner must 336.5 take to monitor the facility in addition to the standard survey. 336.6 Subd. 7. [IMPACT ON SURVEY AGENCY'S BUDGET.] The 336.7 implementation of an alternative survey process for the state 336.8 must not result in any reduction of funding that would have been 336.9 provided to the state survey agency for survey and enforcement 336.10 activity based upon the completion of full standard surveys for 336.11 each skilled nursing facility in the state. 336.12 Subd. 8. [EDUCATIONAL ACTIVITIES.] The commissioner shall 336.13 expand the state survey agency's ability to conduct training and 336.14 educational efforts for skilled nursing facilities, residents 336.15 and family members, residents and family councils, long-term 336.16 care ombudsman programs, and the general public. 336.17 Subd. 9. [EVALUATION.] The commissioner shall develop a 336.18 process for the evaluation of the effectiveness of an 336.19 alternative survey process conducted under this section. 336.20 [EFFECTIVE DATE.] This section is effective the day 336.21 following final enactment. 336.22 Sec. 14. [144A.38] [INNOVATIONS IN QUALITY DEMONSTRATION 336.23 GRANTS.] 336.24 Subdivision 1. [PROGRAM ESTABLISHED.] The commissioner of 336.25 health and the commissioner of human services shall establish a 336.26 long-term care grant program that demonstrates best practices 336.27 and innovation for long-term care service delivery and housing. 336.28 The grants must fund demonstrations that create new means and 336.29 models for serving the elderly or demonstrate creativity in 336.30 service provision through the scope of their program or service. 336.31 Subd. 2. [ELIGIBILITY.] Grants may only be made to those 336.32 who provide direct service or housing to the elderly within the 336.33 state. Grants may only be made for projects that show 336.34 innovations and measurable improvement in resident care, quality 336.35 of life, use of technology, or customer satisfaction. 336.36 Subd. 3. [AWARDING OF GRANTS.] (a) Applications for grants 337.1 must be made to the commissioners on forms prescribed by the 337.2 commissioners. 337.3 (b) The commissioners shall review applications and award 337.4 grants based on the following criteria: 337.5 (1) improvement in direct care to residents; 337.6 (2) increase in efficiency through the use of technology; 337.7 (3) increase in quality of care through the use of 337.8 technology; 337.9 (4) increase in the access and delivery of service; 337.10 (5) enhancement of nursing staff training; 337.11 (6) the effectiveness of the project as a demonstration; 337.12 and 337.13 (7) the immediate transferability of the project to scale. 337.14 (c) In reviewing applications and awarding grants, the 337.15 commissioners shall consult with long-term care providers, 337.16 consumers of long-term care, long-term care researchers, and 337.17 staff of other state agencies. 337.18 (d) Grants for eligible projects may not exceed $100,000. 337.19 Sec. 15. Minnesota Statutes 2000, section 256B.431, 337.20 subdivision 2e, is amended to read: 337.21 Subd. 2e. [CONTRACTS FOR SERVICES FOR VENTILATOR-DEPENDENT 337.22 PERSONS.] The commissioner may contract with a nursing facility 337.23 eligible to receive medical assistance payments to provide 337.24 services to a ventilator-dependent person identified by the 337.25 commissioner according to criteria developed by the 337.26 commissioner, including: 337.27 (1) nursing facility care has been recommended for the 337.28 person by a preadmission screening team; 337.29 (2)the person has been assessed at case mix classification337.30K;337.31(3)the person has been hospitalizedfor at least six337.32monthsand no longer requires inpatient acute care hospital 337.33 services; and 337.34(4)(3) the commissioner has determined that necessary 337.35 services for the person cannot be provided under existing 337.36 nursing facility rates. 338.1 The commissioner may issue a request for proposals to 338.2 provide services to a ventilator-dependent person to nursing 338.3 facilities eligible to receive medical assistance payments and 338.4 shall select nursing facilities from among respondents according 338.5 to criteria developed by the commissioner, including: 338.6 (1) the cost-effectiveness and appropriateness of services; 338.7 (2) the nursing facility's compliance with federal and 338.8 state licensing and certification standards; and 338.9 (3) the proximity of the nursing facility to a 338.10 ventilator-dependent person identified by the commissioner who 338.11 requires nursing facility placement. 338.12 The commissioner may negotiate an adjustment to the 338.13 operating cost payment rate for a nursing facility selected by 338.14 the commissioner from among respondents to the request for 338.15 proposals. The negotiated adjustment must reflect only the 338.16 actual additional cost of meeting the specialized care needs of 338.17 a ventilator-dependent person identified by the commissioner for 338.18 whom necessary services cannot be provided under existing 338.19 nursing facility rates and which are not otherwise covered under 338.20 Minnesota Rules, parts 9549.0010 to 9549.0080 or 9505.0170 to 338.21 9505.0475. For persons who are initially admitted to a nursing 338.22 facility before July 1, 2001, and have their payment rate under 338.23 this subdivision negotiated after July 1, 2001, the negotiated 338.24 payment rate must not exceed 200 percent of the highest multiple 338.25 bedroom payment rate fora Minnesota nursingthe facility, as 338.26 initially established by the commissioner for the rate year for 338.27 case mix classification K. For persons initially admitted to a 338.28 nursing facility on or after July 1, 2001, the negotiated 338.29 payment rate must not exceed 300 percent of the facility's 338.30 multiple bedroom payment rate for case mix classification K. 338.31 The negotiated adjustment shall not affect the payment rate 338.32 charged to private paying residents under the provisions of 338.33 section 256B.48, subdivision 1. 338.34 Sec. 16. Minnesota Statutes 2000, section 256B.431, 338.35 subdivision 17, is amended to read: 338.36 Subd. 17. [SPECIAL PROVISIONS FOR MORATORIUM EXCEPTIONS.] 339.1 (a) Notwithstanding Minnesota Rules, part 9549.0060, subpart 3, 339.2 for rate periods beginning on October 1, 1992, and for rate 339.3 years beginning after June 30, 1993, a nursing facility that (1) 339.4 has completed a construction project approved under section 339.5 144A.071, subdivision 4a, clause (m); (2) has completed a 339.6 construction project approved under section 144A.071, 339.7 subdivision 4a, and effective after June 30, 1995; or (3) has 339.8 completed a renovation, replacement, or upgrading project 339.9 approved under the moratorium exception process in section 339.10 144A.073 shall be reimbursed for costs directly identified to 339.11 that project as provided in subdivision 16 and this subdivision. 339.12 (b) Notwithstanding Minnesota Rules, part 9549.0060, 339.13 subparts 5, item A, subitems (1) and (3), and 7, item D, 339.14 allowable interest expense on debt shall include: 339.15 (1) interest expense on debt related to the cost of 339.16 purchasing or replacing depreciable equipment, excluding 339.17 vehicles, not to exceed six percent of the total historical cost 339.18 of the project; and 339.19 (2) interest expense on debt related to financing or 339.20 refinancing costs, including costs related to points, loan 339.21 origination fees, financing charges, legal fees, and title 339.22 searches; and issuance costs including bond discounts, bond 339.23 counsel, underwriter's counsel, corporate counsel, printing, and 339.24 financial forecasts. Allowable debt related to items in this 339.25 clause shall not exceed seven percent of the total historical 339.26 cost of the project. To the extent these costs are financed, 339.27 the straight-line amortization of the costs in this clause is 339.28 not an allowable cost; and 339.29 (3) interest on debt incurred for the establishment of a 339.30 debt reserve fund, net of the interest earned on the debt 339.31 reserve fund. 339.32 (c) Debt incurred for costs under paragraph (b) is not 339.33 subject to Minnesota Rules, part 9549.0060, subpart 5, item A, 339.34 subitem (5) or (6). 339.35 (d) The incremental increase in a nursing facility's rental 339.36 rate, determined under Minnesota Rules, parts 9549.0010 to 340.1 9549.0080, and this section, resulting from the acquisition of 340.2 allowable capital assets, and allowable debt and interest 340.3 expense under this subdivision shall be added to its 340.4 property-related payment rate and shall be effective on the 340.5 first day of the month following the month in which the 340.6 moratorium project was completed. 340.7 (e) Notwithstanding subdivision 3f, paragraph (a), for rate 340.8 periods beginning on October 1, 1992, and for rate years 340.9 beginning after June 30, 1993, the replacement-costs-new per bed 340.10 limit to be used in Minnesota Rules, part 9549.0060, subpart 4, 340.11 item B, for a nursing facility that has completed a renovation, 340.12 replacement, or upgrading project that has been approved under 340.13 the moratorium exception process in section 144A.073, or that 340.14 has completed an addition to or replacement of buildings, 340.15 attached fixtures, or land improvements for which the total 340.16 historical cost exceeds the lesser of $150,000 or ten percent of 340.17 the most recent appraised value, must be $47,500 per licensed 340.18 bed in multiple-bed rooms and $71,250 per licensed bed in a 340.19 single-bed room. These amounts must be adjusted annually as 340.20 specified in subdivision 3f, paragraph (a), beginning January 1, 340.21 1993. 340.22 (f) For purposes of this paragraph, a total replacement 340.23 means the complete replacement of the nursing facility's 340.24 physical plant through the construction of a new physical plant, 340.25 the transfer of the nursing facility's license from one physical 340.26 plant location to another, or a new building addition to 340.27 relocate beds from three- and four-bed wards. For total 340.28 replacement projects completed on or after July 1, 1992, the 340.29 commissioner shall compute the incremental change in the nursing 340.30 facility's rental per diem, for rate years beginning on or after 340.31 July 1, 1995, by replacing its appraised value, including the 340.32 historical capital asset costs, and the capital debt and 340.33 interest costs with the new nursing facility's allowable capital 340.34 asset costs and the related allowable capital debt and interest 340.35 costs. If the new nursing facility has decreased its licensed 340.36 capacity, the aggregate investment per bed limit in subdivision 341.1 3a, paragraph (c), shall apply. If the new nursing facility has 341.2 retained a portion of the original physical plant for nursing 341.3 facility usage, then a portion of the appraised value prior to 341.4 the replacement must be retained and included in the calculation 341.5 of the incremental change in the nursing facility's rental per 341.6 diem. For purposes of this part, the original nursing facility 341.7 means the nursing facility prior to the total replacement 341.8 project. The portion of the appraised value to be retained 341.9 shall be calculated according to clauses (1) to (3): 341.10 (1) The numerator of the allocation ratio shall be the 341.11 square footage of the area in the original physical plant which 341.12 is being retained for nursing facility usage. 341.13 (2) The denominator of the allocation ratio shall be the 341.14 total square footage of the original nursing facility physical 341.15 plant. 341.16 (3) Each component of the nursing facility's allowable 341.17 appraised value prior to the total replacement project shall be 341.18 multiplied by the allocation ratio developed by dividing clause 341.19 (1) by clause (2). 341.20 In the case of either type of total replacement as 341.21 authorized under section 144A.071 or 144A.073, the provisions of 341.22 this subdivision shall also apply. For purposes of the 341.23 moratorium exception authorized under section 144A.071, 341.24 subdivision 4a, paragraph (s), if the total replacement involves 341.25 the renovation and use of an existing health care facility 341.26 physical plant, the new allowable capital asset costs and 341.27 related debt and interest costs shall include first the 341.28 allowable capital asset costs and related debt and interest 341.29 costs of the renovation, to which shall be added the allowable 341.30 capital asset costs of the existing physical plant prior to the 341.31 renovation, and if reported by the facility, the related 341.32 allowable capital debt and interest costs. 341.33 (g) Notwithstanding Minnesota Rules, part 9549.0060, 341.34 subpart 11, item C, subitem (2), for a total replacement, as 341.35 defined in paragraph (f), authorized under section 144A.071 or 341.36 144A.073 after July 1, 1999, or any building project that is a 342.1 relocation, renovation, upgrading, or conversionauthorized342.2under section 144A.073,completed on or after July 1, 2001, the 342.3 replacement-costs-new per bed limit shall be $74,280 per 342.4 licensed bed in multiple-bed rooms, $92,850 per licensed bed in 342.5 semiprivate rooms with a fixed partition separating the resident 342.6 beds, and $111,420 per licensed bed in single rooms. Minnesota 342.7 Rules, part 9549.0060, subpart 11, item C, subitem (2), does not 342.8 apply. These amounts must be adjusted annually as specified in 342.9 subdivision 3f, paragraph (a), beginning January 1, 2000. 342.10 (h) For a total replacement, as defined in paragraph (f), 342.11 authorized under section 144A.073 for a 96-bed nursing home in 342.12 Carlton county, the replacement-costs-new per bed limit shall be 342.13 $74,280 per licensed bed in multiple-bed rooms, $92,850 per 342.14 licensed bed in semiprivate rooms with a fixed partition 342.15 separating the resident's beds, and $111,420 per licensed bed in 342.16 a single room. Minnesota Rules, part 9549.0060, subpart 11, 342.17 item C, subitem (2), does not apply. The resulting maximum 342.18 allowable replacement-costs-new multiplied by 1.25 shall 342.19 constitute the project's dollar threshold for purposes of 342.20 application of the limit set forth in section 144A.071, 342.21 subdivision 2. The commissioner of health may waive the 342.22 requirements of section 144A.073, subdivision 3b, paragraph (b), 342.23 clause (2), on the condition that the other requirements of that 342.24 paragraph are met. 342.25 (i) For a renovation authorized under section 144A.073 for 342.26 a 65-bed nursing home in St. Louis county, the incremental 342.27 increase in rental rate for purposes of paragraph (d) shall be 342.28 $8.16, and the total replacement cost, allowable appraised 342.29 value, allowable debt, and allowable interest shall be increased 342.30 according to the incremental increase. 342.31 (j) For a total replacement, as defined in paragraph (f), 342.32 authorized under section 144A.073 involving a new building 342.33 addition that relocates beds from three-bed wards for an 80-bed 342.34 nursing home in Redwood county, the replacement-costs-new per 342.35 bed limit shall be $74,280 per licensed bed for multiple-bed 342.36 rooms; $92,850 per licensed bed for semiprivate rooms with a 343.1 fixed partition separating the beds; and $111,420 per licensed 343.2 bed for single rooms. These amounts shall be adjusted annually, 343.3 beginning January 1, 2001. Minnesota Rules, part 9549.0060, 343.4 subpart 11, item C, subitem (2), does not apply. The resulting 343.5 maximum allowable replacement-costs-new multiplied by 1.25 shall 343.6 constitute the project's dollar threshold for purposes of 343.7 application of the limit set forth in section 144A.071, 343.8 subdivision 2. The commissioner of health may waive the 343.9 requirements of section 144A.073, subdivision 3b, paragraph (b), 343.10 clause (2), on the condition that the other requirements of that 343.11 paragraph are met. 343.12 Sec. 17. Minnesota Statutes 2000, section 256B.431, is 343.13 amended by adding a subdivision to read: 343.14 Subd. 31. [NURSING FACILITY RATE INCREASES BEGINNING JULY 343.15 1, 2001, AND JULY 1, 2002.] For the rate years beginning July 1, 343.16 2001, and July 1, 2002, the commissioner shall provide to each 343.17 nursing facility reimbursed under this section or section 343.18 256B.434 an adjustment equal to 3.0 percent of the total 343.19 operating payment rate. The operating payment rates in effect 343.20 on June 30, 2001, shall include the adjustment in subdivision 343.21 2i, paragraph (c). 343.22 Sec. 18. Minnesota Statutes 2000, section 256B.431, is 343.23 amended by adding a subdivision to read: 343.24 Subd. 32. [PAYMENT DURING FIRST 90 DAYS.] (a) For rate 343.25 years beginning on or after July 1, 2001, the total payment rate 343.26 for a facility reimbursed under this section, section 256B.434, 343.27 or any other section for the first 90 paid days after admission 343.28 shall be: 343.29 (1) for the first 30 paid days, the rate shall be 120 343.30 percent of the facility's medical assistance rate for each case 343.31 mix class; and 343.32 (2) for the next 60 paid days after the first 30 paid days, 343.33 the rate shall be 110 percent of the facility's medical 343.34 assistance rate for each case mix class. 343.35 (b) Beginning with the 91st paid day after admission, the 343.36 payment rate shall be the rate otherwise determined under this 344.1 section, section 256B.434, or any other section. 344.2 (c) This subdivision applies to admissions occurring on or 344.3 after July 1, 2001. 344.4 Sec. 19. Minnesota Statutes 2000, section 256B.431, is 344.5 amended by adding a subdivision to read: 344.6 Subd. 33. [STAGED REDUCTION IN RATE DISPARITIES.] (a) For 344.7 the rate years beginning July 1, 2001, and July 1, 2002, the 344.8 commissioner shall adjust the operating payment rates for 344.9 low-rate nursing facilities reimbursed under this section or 344.10 section 256B.434. 344.11 (b) For the rate year beginning July 1, 2001, for each case 344.12 mix level, if the amount computed under subdivision 32 is less 344.13 than the amount in clause (1), the commissioner shall make 344.14 available the lesser of the amount in clause (1) or an increase 344.15 of ten percent over the rate in effect on June 30, 2001, as an 344.16 adjustment to the operating payment rate. For the rate year 344.17 beginning July 1, 2002, for each case mix level, if the amount 344.18 computed under subdivision 32 is less than the amount in clause 344.19 (2), the commissioner shall make available the lesser of the 344.20 amount in clause (2) or an increase of ten percent over the rate 344.21 in effect on June 30, 2002, as an adjustment to the operating 344.22 payment rate. For purposes of this subdivision, nursing 344.23 facilities shall be considered to be metro if they are located 344.24 in Anoka, Carver, Dakota, Hennepin, Olmsted, Ramsey, Scott, or 344.25 Washington counties; or in the cities of Moorhead or 344.26 Breckenridge; or in St. Louis county, north of Toivola and south 344.27 of Cook; or in Itasca county, east of a north south line two 344.28 miles west of Grand Rapids: 344.29 (1) Operating Payment Rate Target Level for July 1, 2001: 344.30 Case Mix Classification Metro Nonmetro 344.31 A $ 76.00 $ 68.13 344.32 B $ 83.40 $ 74.46 344.33 C $ 91.67 $ 81.63 344.34 D $ 99.51 $ 88.04 344.35 E $107.46 $ 94.87 344.36 F $107.96 $ 95.29 345.1 G $114.67 $100.98 345.2 H $126.99 $111.31 345.3 I $131.42 $115.06 345.4 J $138.34 $120.85 345.5 K $152.26 $133.10 345.6 (2) Operating Payment Rate Target Level for July 1, 2002: 345.7 Case Mix Classification Metro Nonmetro 345.8 A $ 78.28 $ 70.51 345.9 B $ 85.91 $ 77.16 345.10 C $ 94.42 $ 84.62 345.11 D $102.50 $ 91.42 345.12 E $110.68 $ 98.40 345.13 F $111.20 $ 98.84 345.14 G $118.11 $104.77 345.15 H $130.80 $115.64 345.16 I $135.38 $119.50 345.17 J $142.49 $125.38 345.18 K $156.85 $137.77 345.19 Sec. 20. Minnesota Statutes 2000, section 256B.431, is 345.20 amended by adding a subdivision to read: 345.21 Subd. 34. [NURSING FACILITY RATE INCREASES BEGINNING JULY 345.22 1, 2001, AND JULY 1, 2002.] (a) For the rate years beginning 345.23 July 1, 2001, and July 1, 2002, two-thirds of the money 345.24 resulting from the rate adjustment under subdivision 31 and 345.25 one-half of the money resulting from the rate adjustment under 345.26 subdivisions 32 and 33 must be used to increase the wages and 345.27 benefits and pay associated costs of all employees except 345.28 management fees, the administrator, and central office staff. 345.29 (b) Money received by a facility as a result of the rate 345.30 adjustments provided in subdivisions 31 to 33, which must be 345.31 used as provided in paragraph (a), must be used only for wage 345.32 and benefit increases implemented on or after July 1, 2001, or 345.33 July 1, 2002, respectively, and must not be used for wage 345.34 increases implemented prior to those dates. 345.35 (c) Nursing facilities may apply for the portions of the 345.36 rate adjustments under subdivisions 31 to 33, which must be used 346.1 as provided in paragraph (a). The application must be made to 346.2 the commissioner and contain a plan by which the nursing 346.3 facility will distribute to employees of the nursing facility 346.4 the funds, which must be used as provided in paragraph (a). For 346.5 nursing facilities in which the employees are represented by an 346.6 exclusive bargaining representative, an agreement negotiated and 346.7 agreed to by the employer and the exclusive bargaining 346.8 representative constitutes the plan. A negotiated agreement may 346.9 constitute the plan only if the agreement is finalized after the 346.10 date of enactment of all increases for the rate year. The 346.11 commissioner shall review the plan to ensure that the rate 346.12 adjustments are used as provided in paragraph (a). To be 346.13 eligible, a facility must submit its plan for the wage and 346.14 benefit distribution by December 31 each year. If a facility's 346.15 plan for wage and benefit distribution is effective for its 346.16 employees after July 1 of the year that the funds are available, 346.17 the portion of the rate adjustments, which must be used as 346.18 provided in paragraph (a), are effective the same date as its 346.19 plan. 346.20 (d) A hospital-attached nursing facility may include costs 346.21 in their distribution plan for wages and benefits and associated 346.22 costs of employees in the organization's shared services 346.23 departments, provided that: 346.24 (1) the nursing facility and the hospital share common 346.25 ownership; and 346.26 (2) adjustments for hospital services using the 346.27 diagnostic-related grouping payment rates per admission under 346.28 Medicare are less than three percent during the 12 months prior 346.29 to the effective date of these rate adjustments. 346.30 If a hospital-attached facility meets the qualifications in 346.31 this paragraph, the difference between the rate adjustments 346.32 approved for nursing facility services and the rate increase 346.33 approved for hospital services may be permitted as a 346.34 distribution in the hospital-attached facility's plan regardless 346.35 of whether the use of those funds is shown as being attributable 346.36 to employee hours worked in the nursing facility or employee 347.1 hours worked in the hospital. 347.2 For the purposes of this paragraph, a hospital-attached 347.3 347.4 nursing facility is one that meets the definition under 347.5 subdivision 2j, or, in the case of a facility reimbursed under 347.6 section 256B.434, met this definition at the time their last 347.7 payment rate was established under Minnesota Rules, parts 347.8 9549.0010 to 9549.0080, and this section. 347.9 (e) A copy of the approved distribution plan must be made 347.10 available to all employees by giving each employee a copy or by 347.11 posting it in an area of the nursing facility to which all 347.12 employees have access. If an employee does not receive the wage 347.13 and benefit adjustment described in the facility's approved plan 347.14 and is unable to resolve the problem with the facility's 347.15 management or through the employee's union representative, the 347.16 employee may contact the commissioner at an address or telephone 347.17 number provided by the commissioner and included in the approved 347.18 plan. 347.19 (f) Notwithstanding section 256B.48, subdivision 1, clause 347.20 (a), upon the request of a nursing facility, the commissioner 347.21 may authorize the facility to raise per diem rates for 347.22 private-pay residents on July 1 by the amount anticipated to be 347.23 required upon implementation of the rate adjustments allowable 347.24 under subdivisions 31 to 33. The commissioner shall require any 347.25 amounts collected under this paragraph, which must be used as 347.26 provided in paragraph (a), to be placed in an escrow account 347.27 established for this purpose with a financial institution that 347.28 provides deposit insurance until the medical assistance rate is 347.29 finalized. The commissioner shall conduct audits as necessary 347.30 to ensure that: 347.31 (1) the amounts collected are retained in escrow until 347.32 medical assistance rates are increased to reflect the 347.33 wage-related adjustment; and 347.34 (2) any amounts collected from private-pay residents in 347.35 excess of the final medical assistance rate are repaid to the 347.36 private-pay residents with interest at the rate used by the 347.37 commissioner of revenue for the late payment of taxes and in 348.1 effect on the date the distribution plan is approved by the 348.2 commissioner of human services. 348.3 Sec. 21. Minnesota Statutes 2000, section 256B.431, is 348.4 amended by adding a subdivision to read: 348.5 Subd. 35. [EXCLUSION OF RAW FOOD COST ADJUSTMENT.] For 348.6 rate years beginning on or after July 1, 2001, in calculating a 348.7 nursing facility's operating cost per diem for the purposes of 348.8 constructing an array, determining a median, or otherwise 348.9 performing a statistical measure of nursing facility payment 348.10 rates to be used to determine future rate increases under this 348.11 section, section 256B.434, or any other section, the 348.12 commissioner shall exclude adjustments for raw food costs under 348.13 subdivision 2b, paragraph (h), that are related to providing 348.14 special diets based on religious beliefs. 348.15 Sec. 22. Minnesota Statutes 2000, section 256B.433, 348.16 subdivision 3a, is amended to read: 348.17 Subd. 3a. [EXEMPTION FROM REQUIREMENT FOR SEPARATE THERAPY 348.18 BILLING.] The provisions of subdivision 3 do not apply to 348.19 nursing facilities that are reimbursed according to the 348.20 provisions of section 256B.431and are located in a county348.21participating in the prepaid medical assistance program. 348.22 Nursing facilities that are reimbursed according to the 348.23 provisions of section 256B.434 and are located in a county 348.24 participating in the prepaid medical assistance program are 348.25 exempt from the maximum therapy rent revenue provisions of 348.26 subdivision 3, paragraph (c). 348.27 [EFFECTIVE DATE.] This section is effective the day 348.28 following final enactment. 348.29 Sec. 23. Minnesota Statutes 2000, section 256B.434, 348.30 subdivision 4, is amended to read: 348.31 Subd. 4. [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 348.32 nursing facilities which have their payment rates determined 348.33 under this section rather than section 256B.431, the 348.34 commissioner shall establish a rate under this subdivision. The 348.35 nursing facility must enter into a written contract with the 348.36 commissioner. 349.1 (b) A nursing facility's case mix payment rate for the 349.2 first rate year of a facility's contract under this section is 349.3 the payment rate the facility would have received under section 349.4 256B.431. 349.5 (c) A nursing facility's case mix payment rates for the 349.6 second and subsequent years of a facility's contract under this 349.7 section are the previous rate year's contract payment rates plus 349.8 an inflation adjustment and, for facilities reimbursed under 349.9 this section or section 256B.431, an adjustment to include the 349.10 cost of any increase in health department licensing fees for the 349.11 facility taking effect on or after July 1, 2001. The index for 349.12 the inflation adjustment must be based on the change in the 349.13 Consumer Price Index-All Items (United States City average) 349.14 (CPI-U) forecasted by Data Resources, Inc., as forecasted in the 349.15 fourth quarter of the calendar year preceding the rate year. 349.16 The inflation adjustment must be based on the 12-month period 349.17 from the midpoint of the previous rate year to the midpoint of 349.18 the rate year for which the rate is being determined. For the 349.19 rate years beginning on July 1, 1999,andJuly 1, 2000, July 1, 349.20 2001, and July 1, 2002, this paragraph shall apply only to the 349.21 property-related payment rate, except that adjustments to 349.22 include the cost of any increase in health department licensing 349.23 fees taking effect on or after July 1, 2001, shall be provided. 349.24 In determining the amount of the property-related payment rate 349.25 adjustment under this paragraph, the commissioner shall 349.26 determine the proportion of the facility's rates that are 349.27 property-related based on the facility's most recent cost report. 349.28 (d) The commissioner shall develop additional 349.29 incentive-based payments of up to five percent above the 349.30 standard contract rate for achieving outcomes specified in each 349.31 contract. The specified facility-specific outcomes must be 349.32 measurable and approved by the commissioner. The commissioner 349.33 may establish, for each contract, various levels of achievement 349.34 within an outcome. After the outcomes have been specified the 349.35 commissioner shall assign various levels of payment associated 349.36 with achieving the outcome. Any incentive-based payment cancels 350.1 if there is a termination of the contract. In establishing the 350.2 specified outcomes and related criteria the commissioner shall 350.3 consider the following state policy objectives: 350.4 (1) improved cost effectiveness and quality of life as 350.5 measured by improved clinical outcomes; 350.6 (2) successful diversion or discharge to community 350.7 alternatives; 350.8 (3) decreased acute care costs; 350.9 (4) improved consumer satisfaction; 350.10 (5) the achievement of quality; or 350.11 (6) any additional outcomes proposed by a nursing facility 350.12 that the commissioner finds desirable. 350.13 Sec. 24. Minnesota Statutes 2000, section 256B.434, is 350.14 amended by adding a subdivision to read: 350.15 Subd. 4c. [FACILITY RATE INCREASES EFFECTIVE JANUARY 1, 350.16 2002.] For the rate period beginning January 1, 2002, and for 350.17 the rate year beginning July 1, 2002, a nursing facility in 350.18 Morrison county licensed for 83 beds as of March 1, 2001, shall 350.19 receive an increase of $2.54 in each case mix payment rate to 350.20 offset property tax payments due as a result of the facility's 350.21 conversion from nonprofit to for-profit status. The increase 350.22 under this subdivision shall be added following the 350.23 determination under this chapter of the payment rate for the 350.24 rate year beginning July 1, 2001, and shall be included in the 350.25 facility's total payment rates for the purposes of determining 350.26 future rates under this section or any other section. 350.27 Sec. 25. Minnesota Statutes 2000, section 256B.434, is 350.28 amended by adding a subdivision to read: 350.29 Subd. 4d. [FACILITY RATE INCREASES EFFECTIVE JULY 1, 350.30 2001.] For the rate year beginning July 1, 2001, a nursing 350.31 facility in Hennepin county licensed for 302 beds shall receive 350.32 an increase of 29 cents in each case mix payment rate to correct 350.33 an error in the cost-reporting system that occurred prior to the 350.34 date that the facility entered the alternative payment 350.35 demonstration project. The increase under this subdivision 350.36 shall be added following the determination under this chapter of 351.1 the payment rate for the rate year beginning July 1, 2001, and 351.2 shall be included in the facility's total payment rates for the 351.3 purposes of determining future rates under this section or any 351.4 other section. 351.5 Sec. 26. Minnesota Statutes 2000, section 256B.434, is 351.6 amended by adding a subdivision to read: 351.7 Subd. 4e. [RATE INCREASE EFFECTIVE JULY 1, 2001.] A 351.8 nursing facility in Anoka county licensed for 98 beds as of July 351.9 1, 2000, shall receive a total increase of $10 in each case mix 351.10 rate for the rate year beginning July 1, 2001, as a result of 351.11 increases provided under this subdivision and section 256B.431, 351.12 subdivision 33. The increases under this subdivision shall be 351.13 added prior to the determination under section 256B.431, 351.14 subdivision 33, of the payment rate for the rate year beginning 351.15 July 1, 2001, and shall be included in the facility's total 351.16 payment rate for purposes of determining future rates under this 351.17 section or any other section through June 30, 2004. 351.18 Sec. 27. [256B.437] [NURSING FACILITY VOLUNTARY CLOSURES; 351.19 PLANNING AND DEVELOPMENT OF COMMUNITY-BASED ALTERNATIVES.] 351.20 Subdivision 1. [DEFINITIONS.] (a) The definitions in this 351.21 subdivision apply to subdivisions 2 to 9. 351.22 (b) "Closure" means the cessation of operations of a 351.23 nursing facility and delicensure and decertification of all beds 351.24 within the facility. 351.25 (c) "Closure plan" means a plan to close a nursing facility 351.26 and reallocate a portion of the resulting savings to provide 351.27 planned closure rate adjustments at other facilities. 351.28 (d) "Commencement of closure" means the date on which 351.29 residents and designated representatives are notified of a 351.30 planned closure as provided in section 144A.161, subdivision 5a, 351.31 as part of an approved closure plan. 351.32 (e) "Completion of closure" means the date on which the 351.33 final resident of the nursing facility designated for closure in 351.34 an approved closure plan is discharged from the facility. 351.35 (f) "Partial closure" means the delicensure and 351.36 decertification of a portion of the beds within the facility. 352.1 (g) "Planned closure rate adjustment" means an increase in 352.2 a nursing facility's operating rates resulting from a planned 352.3 closure or a planned partial closure of another facility. 352.4 Subd. 2. [PLANNING AND DEVELOPMENT OF COMMUNITY-BASED 352.5 SERVICES.] (a) The commissioner of human services shall 352.6 establish a process to adjust the capacity and distribution of 352.7 long-term care services to equalize the supply and demand for 352.8 different types of services. This process must include 352.9 community planning, expansion or establishment of needed 352.10 services, and analysis of voluntary nursing facility closures. 352.11 (b) The purpose of this process is to support the planning 352.12 and development of community-based services. This process must 352.13 support early intervention, advocacy, and consumer protection 352.14 while providing resources and incentives for expanded county 352.15 planning and for nursing facilities to transition to meet 352.16 community needs. 352.17 (c) The process shall support and facilitate expansion of 352.18 community-based services under the county-administered 352.19 alternative care program under section 256B.0913 and waivers for 352.20 elderly under section 256B.0915, including, but not limited to, 352.21 the development of supportive services such as housing and 352.22 transportation. The process shall utilize community assessments 352.23 and planning developed for the community health services plan 352.24 and plan update and for the community social services act plan, 352.25 and other relevant information. 352.26 (d) The commissioners of health and human services as 352.27 appropriate shall provide, by July 15, 2001, available data 352.28 necessary for the county, including, but not limited to, data on 352.29 nursing facility bed distribution, housing with services 352.30 options, the closure of nursing facilities that occur outside of 352.31 the planned closure process, and approval of planned closures in 352.32 the county and contiguous counties. 352.33 (e) Each county shall submit to the commissioner of human 352.34 services, by October 15, 2001, a gaps analysis that identifies 352.35 local service needs, pending development of services, and any 352.36 other issues that would contribute to or impede further 353.1 development of community-based services. The gaps analysis must 353.2 also be sent to the local area agency on aging and, if 353.3 applicable, local SAIL projects, for review and comment. The 353.4 review and comment must assess needs across county boundaries. 353.5 The area agencies on aging and SAIL projects must provide the 353.6 commissioner and the counties with their review and analyses by 353.7 November 15, 2001. 353.8 (f) The addendum to the biennial plan shall be submitted 353.9 annually, beginning December 31, 2001, and each December 31 353.10 thereafter, and shall include recommendations for development of 353.11 community-based services. Both planning and implementation 353.12 shall be implemented within the amount of funding made available 353.13 to the county board for these purposes. 353.14 (g) The plan, within the funding allocated, shall: 353.15 (1) include the gaps analysis required by paragraph (e); 353.16 (2) involve providers, consumers, cities, townships, 353.17 businesses, and area agencies on aging in the planning process; 353.18 (3) address the availability of alternative care and 353.19 elderly waiver services for eligible recipients; 353.20 (4) address the development of other supportive services, 353.21 such as transit, housing, and workforce and economic 353.22 development; and 353.23 (5) estimate the cost and timelines for development. 353.24 (h) The biennial plan addendum shall be coordinated with 353.25 the county mental health plan for inclusion in the community 353.26 health services plan and included as an addendum to the 353.27 community social services plan. 353.28 (i) The county board having financial responsibility for 353.29 persons present in another county shall cooperate with that 353.30 county for planning and development of services. 353.31 (j) The county board shall cooperate in planning and 353.32 development of community-based services with other counties, as 353.33 necessary, and coordinate planning for long-term care services 353.34 that involve more than one county, within the funding allocated 353.35 for these purposes. 353.36 (k) The commissioners of health and human services, in 354.1 cooperation with county boards, shall report to the legislature 354.2 by February 1 of each year, beginning February 1, 2002, 354.3 regarding the development of community-based services, 354.4 transition or closure of nursing facilities, and specific gaps 354.5 in services in identified geographic areas that may require 354.6 additional resources or flexibility, as documented by the 354.7 process in this subdivision and reported to the commissioners by 354.8 December 31 of each year. 354.9 Subd. 3. [APPLICATIONS FOR PLANNED CLOSURE OF NURSING 354.10 FACILITIES.] (a) By August 15, 2001, the commissioner of human 354.11 services shall implement and announce a program for closure or 354.12 partial closure of nursing facilities. Names and identifying 354.13 information provided in response to the announcement shall 354.14 remain private unless approved, according to the timelines 354.15 established in the plan. The announcement must specify: 354.16 (1) the criteria in subdivision 4 that will be used by the 354.17 commissioner to approve or reject applications; 354.18 (2) a requirement for the submission of a letter of intent 354.19 before the submission of an application; 354.20 (3) the information that must accompany an application; and 354.21 (4) that applications may combine planned closure rate 354.22 adjustments with moratorium exception funding, in which case a 354.23 single application may serve both purposes. 354.24 Between August 1, 2001, and June 30, 2003, the commissioner may 354.25 approve planned closures of up to 5,140 nursing facility beds, 354.26 less the number of licensed beds in facilities that close during 354.27 the same time period without approved closure plans or that have 354.28 notified the commissioner of health of their intent to close 354.29 without an approved closure plan. 354.30 (b) A facility or facilities reimbursed under section 354.31 256B.431 or 256B.434 with a closure plan approved by the 354.32 commissioner under subdivision 5 may assign a planned closure 354.33 rate adjustment to another facility or facilities that are not 354.34 closing or in the case of a partial closure, to the facility 354.35 undertaking the partial closure. A facility may also elect to 354.36 have a planned closure rate adjustment shared equally by the 355.1 five nursing facilities with the lowest total operating payment 355.2 rates in the state development region designated under section 355.3 462.385, in which the facility that is closing is located. The 355.4 planned closure rate adjustment must be calculated under 355.5 subdivision 6. Facilities that close without a closure plan, or 355.6 whose closure plan is not approved by the commissioner, are not 355.7 eligible to assign a planned closure rate adjustment under 355.8 subdivision 6. The commissioner shall calculate the amount the 355.9 facility would have been eligible to assign under subdivision 6, 355.10 and shall use this amount to provide equal rate adjustments to 355.11 the five nursing facilities with the lowest total operating 355.12 payment rates in the state development region designated under 355.13 section 462.385, in which the facility that closed is located. 355.14 (c) To be considered for approval, an application must 355.15 include: 355.16 (1) a description of the proposed closure plan, which must 355.17 include identification of the facility or facilities to receive 355.18 a planned closure rate adjustment and the amount and timing of a 355.19 planned closure rate adjustment proposed for each facility; 355.20 (2) the proposed timetable for any proposed closure, 355.21 including the proposed dates for announcement to residents, 355.22 commencement of closure, and completion of closure; 355.23 (3) the proposed relocation plan for current residents of 355.24 any facility designated for closure. The proposed relocation 355.25 plan must be designed to comply with all applicable state and 355.26 federal statutes and regulations, including, but not limited to, 355.27 section 144A.161; 355.28 (4) a description of the relationship between the nursing 355.29 facility that is proposed for closure and the nursing facility 355.30 or facilities proposed to receive the planned closure rate 355.31 adjustment. If these facilities are not under common ownership, 355.32 copies of any contracts, purchase agreements, or other documents 355.33 establishing a relationship or proposed relationship must be 355.34 provided; 355.35 (5) documentation, in a format approved by the 355.36 commissioner, that all the nursing facilities receiving a 356.1 planned closure rate adjustment under the plan have accepted 356.2 joint and several liability for recovery of overpayments under 356.3 section 256B.0641, subdivision 2, for the facilities designated 356.4 for closure under the plan; and 356.5 (6) an explanation of how the application coordinates with 356.6 planning efforts under subdivision 2. If the planning group 356.7 does not support a level of nursing facility closures that the 356.8 commissioner considers to be reasonable, the commissioner may 356.9 approve a planned closure proposal without its support. 356.10 (d) The application must address the criteria listed in 356.11 subdivision 4. 356.12 Subd. 4. [CRITERIA FOR REVIEW OF APPLICATION.] In 356.13 reviewing and approving closure proposals, the commissioner 356.14 shall consider, but not be limited to, the following criteria: 356.15 (1) improved quality of care and quality of life for 356.16 consumers; 356.17 (2) closure of a nursing facility that has a poor physical 356.18 plant, which may be evidenced by the conditions referred to in 356.19 section 144A.073, subdivision 4, clauses (4) and (5); 356.20 (3) the existence of excess nursing facility beds, measured 356.21 in terms of beds per thousand persons aged 85 or older. The 356.22 excess must be measured in reference to: 356.23 (i) the county in which the facility is located; 356.24 (ii) the county and all contiguous counties; 356.25 (iii) the region in which the facility is located; or 356.26 (iv) the facility's service area; 356.27 the facility shall indicate in its application the service area 356.28 it believes is appropriate for this measurement. A facility in 356.29 a county that is in the lowest quartile of counties with 356.30 reference to beds per thousand persons aged 85 or older is not 356.31 in an area of excess capacity; 356.32 (4) low-occupancy rates, provided that the unoccupied beds 356.33 are not the result of a personnel shortage. In analyzing 356.34 occupancy rates, the commissioner shall examine waiting lists in 356.35 the applicant facility and at facilities in the surrounding 356.36 area, as determined under clause (3); 357.1 (5) evidence of coordination between the community planning 357.2 process and the facility application. If the planning group 357.3 does not support a level of nursing facility closures that the 357.4 commissioner considers to be reasonable, the commissioner may 357.5 approve a planned closure proposal without its support; 357.6 (6) proposed usage of funds available from a planned 357.7 closure rate adjustment for care-related purposes; 357.8 (7) innovative use planned for the closed facility's 357.9 physical plant; 357.10 (8) evidence that the proposal serves the interests of the 357.11 state; and 357.12 (9) evidence of other factors that affect the viability of 357.13 the facility, including excessive nursing pool costs. 357.14 Subd. 5. [REVIEW AND APPROVAL OF APPLICATIONS.] (a) The 357.15 commissioner of human services, in consultation with the 357.16 commissioner of health, shall approve or disapprove an 357.17 application within 30 days after receiving it. The commissioner 357.18 may appoint an advisory review panel composed of representatives 357.19 of counties, SAIL projects, consumers, and providers to review 357.20 proposals and provide comments and recommendations to the 357.21 committee. The commissioners of human services and health shall 357.22 provide staff and technical assistance to the committee for the 357.23 review and analysis of proposals. 357.24 (b) Approval of a planned closure expires 18 months after 357.25 approval by the commissioner of human services, unless 357.26 commencement of closure has begun. 357.27 (c) The commissioner of human services may change any 357.28 provision of the application to which the applicant, the 357.29 regional planning group, and the commissioner agree. 357.30 Subd. 6. [PLANNED CLOSURE RATE ADJUSTMENT.] (a) The 357.31 commissioner of human services shall calculate the amount of the 357.32 planned closure rate adjustment available under subdivision 3, 357.33 paragraph (b), for up to 5,140 beds according to clauses (1) to 357.34 (4): 357.35 (1) the amount available is the net reduction of nursing 357.36 facility beds multiplied by $2,080; 358.1 (2) the total number of beds in the nursing facility or 358.2 facilities receiving the planned closure rate adjustment must be 358.3 identified; 358.4 (3) capacity days are determined by multiplying the number 358.5 determined under clause (2) by 365; and 358.6 (4) the planned closure rate adjustment is the amount 358.7 available in clause (1), divided by capacity days determined 358.8 under clause (3). 358.9 (b) A planned closure rate adjustment under this section is 358.10 effective on the first day of the month following completion of 358.11 closure of the facility designated for closure in the 358.12 application and becomes part of the nursing facility's total 358.13 operating payment rate. 358.14 (c) Applicants may use the planned closure rate adjustment 358.15 to allow for a property payment for a new nursing facility or an 358.16 addition to an existing nursing facility or as an operating 358.17 payment rate adjustment. Applications approved under this 358.18 subdivision are exempt from other requirements for moratorium 358.19 exceptions under section 144A.073, subdivisions 2 and 3. 358.20 (d) Upon the request of a closing facility, the 358.21 commissioner must allow the facility a closure rate adjustment 358.22 as provided under section 144A.161, subdivision 10. 358.23 Subd. 7. [OTHER RATE ADJUSTMENTS.] Facilities receiving 358.24 planned closure rate adjustments remain eligible for any 358.25 applicable rate adjustments provided under section 256B.431, 358.26 256B.434, or any other section. 358.27 Subd. 8. [COUNTY COSTS.] The commissioner of human 358.28 services shall allocate funds for relocation costs incurred by 358.29 counties for planned closures under this section as provided 358.30 under section 144A.161, subdivision 11. 358.31 Sec. 28. [256B.438] [IMPLEMENTATION OF A CASE MIX SYSTEM 358.32 FOR NURSING FACILITIES BASED ON THE MINIMUM DATA SET.] 358.33 Subdivision 1. [SCOPE.] This section establishes the 358.34 method and criteria used to determine resident reimbursement 358.35 classifications based upon the assessments of residents of 358.36 nursing homes and boarding care homes whose payment rates are 359.1 established under section 256B.431, 256B.434, or 256B.435. 359.2 Resident reimbursement classifications shall be established 359.3 according to the 34 group, resource utilization groups, version 359.4 III or RUG-III model as described in section 144.0724. 359.5 Reimbursement classifications established under this section 359.6 shall be implemented after June 30, 2002, but no later than 359.7 January 1, 2003. 359.8 Subd. 2. [DEFINITIONS.] For purposes of this section, the 359.9 following terms have the meanings given. 359.10 (a) [ASSESSMENT REFERENCE DATE.] "Assessment reference 359.11 date" has the meaning given in section 144.0724, subdivision 2, 359.12 paragraph (a). 359.13 (b) [CASE MIX INDEX.] "Case mix index" has the meaning 359.14 given in section 144.0724, subdivision 2, paragraph (b). 359.15 (c) [INDEX MAXIMIZATION.] "Index maximization" has the 359.16 meaning given in section 144.0724, subdivision 2, paragraph (c). 359.17 (d) [MINIMUM DATA SET.] "Minimum data set" has the meaning 359.18 given in section 144.0724, subdivision 2, paragraph (d). 359.19 (e) [REPRESENTATIVE.] "Representative" has the meaning 359.20 given in section 144.0724, subdivision 2, paragraph (e). 359.21 (f) [RESOURCE UTILIZATION GROUPS OR RUG.] "Resource 359.22 utilization groups" or "RUG" has the meaning given in section 359.23 144.0724, subdivision 2, paragraph (f). 359.24 Subd. 3. [CASE MIX INDICES.] (a) The commissioner of human 359.25 services shall assign a case mix index to each resident class 359.26 based on the Health Care Financing Administration's staff time 359.27 measurement study and adjusted for Minnesota-specific wage 359.28 indices. The case mix indices assigned to each resident class 359.29 shall be published in the Minnesota State Register at least 120 359.30 days prior to the implementation of the 34 group, RUG-III 359.31 resident classification system. 359.32 (b) An index maximization approach shall be used to 359.33 classify residents. 359.34 (c) After implementation of the revised case mix system, 359.35 the commissioner of human services may annually rebase case mix 359.36 indices and base rates using more current data on average wage 360.1 rates and staff time measurement studies. This rebasing shall 360.2 be calculated under subdivision 7, paragraph (b). The 360.3 commissioner shall publish in the Minnesota State Register 360.4 adjusted case mix indices at least 45 days prior to the 360.5 effective date of the adjusted case mix indices. 360.6 Subd. 4. [RESIDENT ASSESSMENT SCHEDULE.] (a) Nursing 360.7 facilities shall conduct and submit case mix assessments 360.8 according to the schedule established by the commissioner of 360.9 health under section 144.0724, subdivisions 4 and 5. 360.10 (b) The resident reimbursement classifications established 360.11 under section 144.0724, subdivision 3, shall be effective the 360.12 day of admission for new admission assessments. The effective 360.13 date for significant change assessments shall be the assessment 360.14 reference date. The effective date for annual and second 360.15 quarterly assessments shall be the first day of the month 360.16 following assessment reference date. 360.17 Subd. 5. [NOTICE OF RESIDENT REIMBURSEMENT 360.18 CLASSIFICATION.] Nursing facilities shall provide notice to a 360.19 resident of the resident's case mix classification according to 360.20 procedures established by the commissioner of health under 360.21 section 144.0724, subdivision 7. 360.22 Subd. 6. [RECONSIDERATION OF RESIDENT CLASSIFICATION.] Any 360.23 request for reconsideration of a resident classification must be 360.24 made under section 144.0724, subdivision 8. 360.25 Subd. 7. [RATE DETERMINATION UPON TRANSITION TO RUG-III 360.26 PAYMENT RATES.] (a) The commissioner of human services shall 360.27 determine payment rates at the time of transition to the RUG 360.28 based payment model in a facility-specific, budget-neutral 360.29 manner. The case mix indices as defined in subdivision 3 shall 360.30 be used to allocate the case mix adjusted component of total 360.31 payment across all case mix groups. To transition from the 360.32 current calculation methodology to the RUG based methodology, 360.33 the commissioner of health shall report to the commissioner of 360.34 human services the resident days classified according to the 360.35 categories defined in subdivision 3 for the 12-month reporting 360.36 period ending September 30, 2001, for each nursing facility. 361.1 The commissioner of human services shall use this data to 361.2 compute the standardized days for the reporting period under the 361.3 RUG system. 361.4 (b) The commissioner of human services shall determine the 361.5 case mix adjusted component of the rate as follows: 361.6 (1) determine the case mix portion of the 11 case mix rates 361.7 in effect on June 30, 2002, or the 34 case mix rates in effect 361.8 on or after June 30, 2003; 361.9 (2) multiply each amount in clause (1) by the number of 361.10 resident days assigned to each group for the reporting period 361.11 ending September 30, 2001, or the most recent year for which 361.12 data is available; 361.13 (3) compute the sum of the amounts in clause (2); 361.14 (4) determine the total RUG standardized days for the 361.15 reporting period ending September 30, 2001, or the most recent 361.16 year for which data is available using the new indices 361.17 calculated under subdivision 3, paragraph (c); 361.18 (5) divide the amount in clause (3) by the amount in clause 361.19 (4) which shall be the average case mix adjusted component of 361.20 the rate under the RUG method; and 361.21 (6) multiply this average rate by the case mix weight in 361.22 subdivision 3 for each RUG group. 361.23 (c) The noncase mix component will be allocated to each RUG 361.24 group as a constant amount to determine the transition payment 361.25 rate. Any other rate adjustments that are effective on or after 361.26 July 1, 2002, shall be applied to the transition rates 361.27 determined under this section. 361.28 Sec. 29. [256B.439] [LONG-TERM CARE QUALITY PROFILES.] 361.29 Subdivision l. [DEVELOPMENT AND IMPLEMENTATION OF QUALITY 361.30 PROFILES.] (a) The commissioner of human services, in 361.31 cooperation with the commissioner of health, shall develop and 361.32 implement a quality profile system for nursing facilities and, 361.33 beginning not later than July 1, 2003, other providers of 361.34 long-term care services, except when the quality profile system 361.35 would duplicate requirements under section 256B.5011, 256B.5012, 361.36 or 256B.5013. The system must be developed and implemented to 362.1 the extent possible without the collection of significant 362.2 amounts of new data. To the extent possible, the system must 362.3 incorporate or be coordinated with information on quality 362.4 maintained by area agencies on aging, long-term care trade 362.5 associations, and other entities. The system must be designed 362.6 to provide information on quality to: 362.7 (1) consumers and their families to facilitate informed 362.8 choices of service providers; 362.9 (2) providers to enable them to measure the results of 362.10 their quality improvement efforts and compare quality 362.11 achievements with other service providers; and 362.12 (3) public and private purchasers of long-term care 362.13 services to enable them to purchase high-quality care. 362.14 (b) The system must be developed in consultation with the 362.15 long-term care task force, area agencies on aging, and 362.16 representatives of consumers, providers, and labor unions. 362.17 Within the limits of available appropriations, the commissioners 362.18 may employ consultants to assist with this project. 362.19 Subd. 2. [QUALITY MEASUREMENT TOOLS.] The commissioners 362.20 shall identify and apply existing quality measurement tools to: 362.21 (1) emphasize quality of care and its relationship to 362.22 quality of life; and 362.23 (2) address the needs of various users of long-term care 362.24 services, including, but not limited to, short-stay residents, 362.25 persons with behavioral problems, persons with dementia, and 362.26 persons who are members of minority groups. 362.27 The tools must be identified and applied, to the extent 362.28 possible, without requiring providers to supply information 362.29 beyond current state and federal requirements. 362.30 Subd. 3. [CONSUMER SURVEYS.] Following identification of 362.31 the quality measurement tool, the commissioners shall conduct 362.32 surveys of long-term care service consumers to develop quality 362.33 profiles of providers. To the extent possible, surveys must be 362.34 conducted face-to-face by state employees or contractors. At 362.35 the discretion of the commissioners, surveys may be conducted by 362.36 telephone or by provider staff. Surveys must be conducted 363.1 periodically to update quality profiles of individual service 363.2 providers. 363.3 Subd. 4. [DISSEMINATION OF QUALITY PROFILES.] By July 1, 363.4 2002, the commissioners shall implement a system to disseminate 363.5 the quality profiles developed from consumer surveys using the 363.6 quality measurement tool. Profiles may be disseminated to the 363.7 Senior LinkAge line and to consumers, providers, and purchasers 363.8 of long-term care services through all feasible printed and 363.9 electronic outlets. The commissioners may conduct a public 363.10 awareness campaign to inform potential users regarding profile 363.11 contents and potential uses. 363.12 Sec. 30. Minnesota Statutes 2000, section 256B.5012, is 363.13 amended by adding a subdivision to read: 363.14 Subd. 4. [ICF/MR RATE INCREASES BEGINNING JULY 1, 2001, 363.15 AND JULY 1, 2002.] (a) For the rate years beginning July 1, 363.16 2001, and July 1, 2002, the commissioner shall make available to 363.17 each facility reimbursed under this section an adjustment to the 363.18 total operating payment rate of 3.5 percent. Of this 363.19 adjustment, two-thirds must be used as provided under paragraph 363.20 (b) and one-third must be used for operating costs. 363.21 (b) The adjustment under this paragraph must be used to 363.22 increase the wages and benefits and pay associated costs of all 363.23 employees except administrative and central office employees, 363.24 provided that this increase must be used only for wage and 363.25 benefit increases implemented on or after the first day of the 363.26 rate year and must not be used for increases implemented prior 363.27 to that date. 363.28 (c) For each facility, the commissioner shall make 363.29 available an adjustment using the percentage specified in 363.30 paragraph (a) multiplied by the total payment rate, excluding 363.31 the property-related payment rate, in effect on the preceding 363.32 June 30. The total payment rate shall include the adjustment 363.33 provided in section 256B.501, subdivision 12. 363.34 (d) A facility whose payment rates are governed by closure 363.35 agreements, receivership agreements, or Minnesota Rules, part 363.36 9553.0075, is not eligible for an adjustment otherwise granted 364.1 under this subdivision. 364.2 (e) A facility may apply for the payment rate adjustment 364.3 provided under paragraph (b). The application must be made to 364.4 the commissioner and contain a plan by which the facility will 364.5 distribute the adjustment in paragraph (b) to employees of the 364.6 facility. For facilities in which the employees are represented 364.7 by an exclusive bargaining representative, an agreement 364.8 negotiated and agreed to by the employer and the exclusive 364.9 bargaining representative constitutes the plan. A negotiated 364.10 agreement may constitute the plan only if the agreement is 364.11 finalized after the date of enactment of all rate increases for 364.12 the rate year. The commissioner shall review the plan to ensure 364.13 that the payment rate adjustment per diem is used as provided in 364.14 this subdivision. To be eligible, a facility must submit its 364.15 plan by March 31, 2002, and March 31, 2003, respectively. If a 364.16 facility's plan is effective for its employees after the first 364.17 day of the applicable rate year that the funds are available, 364.18 the payment rate adjustment per diem is effective the same date 364.19 as its plan. 364.20 (f) A copy of the approved distribution plan must be made 364.21 available to all employees by giving each employee a copy or by 364.22 posting it in an area of the facility to which all employees 364.23 have access. If an employee does not receive the wage and 364.24 benefit adjustment described in the facility's approved plan and 364.25 is unable to resolve the problem with the facility's management 364.26 or through the employee's union representative, the employee may 364.27 contact the commissioner at an address or telephone number 364.28 provided by the commissioner and included in the approved plan. 364.29 Sec. 31. Minnesota Statutes 2000, section 626.557, 364.30 subdivision 12b, is amended to read: 364.31 Subd. 12b. [DATA MANAGEMENT.] (a) [COUNTY DATA.] In 364.32 performing any of the duties of this section as a lead agency, 364.33 the county social service agency shall maintain appropriate 364.34 records. Data collected by the county social service agency 364.35 under this section are welfare data under section 13.46. 364.36 Notwithstanding section 13.46, subdivision 1, paragraph (a), 365.1 data under this paragraph that are inactive investigative data 365.2 on an individual who is a vendor of services are private data on 365.3 individuals, as defined in section 13.02. The identity of the 365.4 reporter may only be disclosed as provided in paragraph (c). 365.5 Data maintained by the common entry point are confidential 365.6 data on individuals or protected nonpublic data as defined in 365.7 section 13.02. Notwithstanding section 138.163, the common 365.8 entry point shall destroy data three calendar years after date 365.9 of receipt. 365.10 (b) [LEAD AGENCY DATA.] The commissioners of health and 365.11 human services shall prepare an investigation memorandum for 365.12 each report alleging maltreatment investigated under this 365.13 section. During an investigation by the commissioner of health 365.14 or the commissioner of human services, data collected under this 365.15 section are confidential data on individuals or protected 365.16 nonpublic data as defined in section 13.02. Upon completion of 365.17 the investigation, the data are classified as provided in 365.18 clauses (1) to (3) and paragraph (c). 365.19 (1) The investigation memorandum must contain the following 365.20 data, which are public: 365.21 (i) the name of the facility investigated; 365.22 (ii) a statement of the nature of the alleged maltreatment; 365.23 (iii) pertinent information obtained from medical or other 365.24 records reviewed; 365.25 (iv) the identity of the investigator; 365.26 (v) a summary of the investigation's findings; 365.27 (vi) statement of whether the report was found to be 365.28 substantiated, inconclusive, false, or that no determination 365.29 will be made; 365.30 (vii) a statement of any action taken by the facility; 365.31 (viii) a statement of any action taken by the lead agency; 365.32 and 365.33 (ix) when a lead agency's determination has substantiated 365.34 maltreatment, a statement of whether an individual, individuals, 365.35 or a facility were responsible for the substantiated 365.36 maltreatment, if known. 366.1 The investigation memorandum must be written in a manner 366.2 which protects the identity of the reporter and of the 366.3 vulnerable adult and may not contain the names or, to the extent 366.4 possible, data on individuals or private data listed in clause 366.5 (2). 366.6 (2) Data on individuals collected and maintained in the 366.7 investigation memorandum are private data, including: 366.8 (i) the name of the vulnerable adult; 366.9 (ii) the identity of the individual alleged to be the 366.10 perpetrator; 366.11 (iii) the identity of the individual substantiated as the 366.12 perpetrator; and 366.13 (iv) the identity of all individuals interviewed as part of 366.14 the investigation. 366.15 (3) Other data on individuals maintained as part of an 366.16 investigation under this section are private data on individuals 366.17 upon completion of the investigation. 366.18 (c) [IDENTITY OF REPORTER.] The subject of the report may 366.19 compel disclosure of the name of the reporter only with the 366.20 consent of the reporter or upon a written finding by a court 366.21 that the report was false and there is evidence that the report 366.22 was made in bad faith. This subdivision does not alter 366.23 disclosure responsibilities or obligations under the rules of 366.24 criminal procedure, except that where the identity of the 366.25 reporter is relevant to a criminal prosecution, the district 366.26 court shall do an in-camera review prior to determining whether 366.27 to order disclosure of the identity of the reporter. 366.28 (d) [DESTRUCTION OF DATA.] Notwithstanding section 366.29 138.163, data maintained under this section by the commissioners 366.30 of health and human services must be destroyed under the 366.31 following schedule: 366.32 (1) data from reports determined to be false, two years 366.33 after the finding was made; 366.34 (2) data from reports determined to be inconclusive, four 366.35 years after the finding was made; 366.36 (3) data from reports determined to be substantiated, seven 367.1 years after the finding was made; and 367.2 (4) data from reports which were not investigated by a lead 367.3 agency and for which there is no final disposition, two years 367.4 from the date of the report. 367.5 (e) [SUMMARY OF REPORTS.] The commissioners of health and 367.6 human services shall each annuallyprepare a summary ofreport 367.7 to the legislature and the governor on the number and type of 367.8 reports of alleged maltreatment involving licensed facilities 367.9 reported under this section, the number of those requiring 367.10 investigation under this section, and the resolution of those 367.11 investigations. The report shall identify: 367.12 (1) whether and where backlogs of cases result in a failure 367.13 to conform with statutory time frames; 367.14 (2) where adequate coverage requires additional 367.15 appropriations and staffing; and 367.16 (3) any other trends that affect the safety of vulnerable 367.17 adults. 367.18 (f) [RECORD RETENTION POLICY.] Each lead agency must have 367.19 a record retention policy. 367.20 (g) [EXCHANGE OF INFORMATION.] Lead agencies, prosecuting 367.21 authorities, and law enforcement agencies may exchange not 367.22 public data, as defined in section 13.02, if the agency or 367.23 authority requesting the data determines that the data are 367.24 pertinent and necessary to the requesting agency in initiating, 367.25 furthering, or completing an investigation under this section. 367.26 Data collected under this section must be made available to 367.27 prosecuting authorities and law enforcement officials, local 367.28 county agencies, and licensing agencies investigating the 367.29 alleged maltreatment under this section. The lead agency shall 367.30 exchange not public data with the vulnerable adult maltreatment 367.31 review panel established in section 256.021 if the data are 367.32 pertinent and necessary for a review requested under that 367.33 section. Upon completion of the review, not public data 367.34 received by the review panel must be returned to the lead agency. 367.35 (h) [COMPLETION TIME.] Each lead agency shall keep records 367.36 of the length of time it takes to complete its investigations. 368.1 (i) [NOTIFICATION OF OTHER AFFECTED PARTIES.] A lead 368.2 agency may notify other affected parties and their authorized 368.3 representative if the agency has reason to believe maltreatment 368.4 has occurred and determines the information will safeguard the 368.5 well-being of the affected parties or dispel widespread rumor or 368.6 unrest in the affected facility. 368.7 (j) [FEDERAL REQUIREMENTS.] Under any notification 368.8 provision of this section, where federal law specifically 368.9 prohibits the disclosure of patient identifying information, a 368.10 lead agency may not provide any notice unless the vulnerable 368.11 adult has consented to disclosure in a manner which conforms to 368.12 federal requirements. 368.13 Sec. 32. Laws 1995, chapter 207, article 3, section 21, as 368.14 amended by Laws 1999, chapter 245, article 3, section 43, is 368.15 amended to read: 368.16 Sec. 21. [FACILITY CERTIFICATION.] 368.17 (a) Notwithstanding Minnesota Statutes, section 252.291, 368.18 subdivisions 1 and 2, the commissioner of health shall inspect 368.19 to certify a large community-based facility currently licensed 368.20 under Minnesota Rules, parts 9525.0215 to 9525.0355, for more 368.21 than 16 beds and located in Northfield. The facility may be 368.22 certified for up to 44 beds. The commissioner of health must 368.23 inspect to certify the facility as soon as possible after the 368.24 effective date of this section. The commissioner of human 368.25 services shall work with the facility and affected counties to 368.26 relocate any current residents of the facility who do not meet 368.27 the admission criteria for an ICF/MR. Until January 1, 1999, in 368.28 order to fund the ICF/MR services and relocations of current 368.29 residents authorized, the commissioner of human services may 368.30 transfer on a quarterly basis to the medical assistance account 368.31 from each affected county's community social service allocation, 368.32 an amount equal to the state share of medical assistance 368.33 reimbursement for the residential and day habilitation services 368.34 funded by medical assistance and provided to clients for whom 368.35 the county is financially responsible. 368.36 (b) After January 1, 1999, the commissioner of human 369.1 services shall fund the services under the state medical 369.2 assistance program and may transfer on a quarterly basis to the 369.3 medical assistance account from each affected county's community 369.4 social service allocation, an amount equal to one-half of the 369.5 state share of medical assistance reimbursement for the 369.6 residential and day habilitation services funded by medical 369.7 assistance and provided to clients for whom the county is 369.8 financially responsible. 369.9 (c) Effective July 1, 2001, the commissioner of human 369.10 services shall fund the entire state share of medical assistance 369.11 reimbursement for the residential and day habilitation services 369.12 funded by medical assistance and provided to clients for whom 369.13 counties are financially responsible from the medical assistance 369.14 account, and shall not make any transfer from the community 369.15 social service allocations of affected counties. 369.16 (d) For nonresidents of Minnesota seeking admission to the 369.17 facility, Rice county shall be notified in order to assure that 369.18 appropriate funding is guaranteed from their state or country of 369.19 residence. 369.20 Sec. 33. Laws 1999, chapter 245, article 3, section 45, as 369.21 amended by Laws 2000, chapter 312, section 3, is amended to read: 369.22 Sec. 45. [STATE LICENSURE CONFLICTS WITH FEDERAL 369.23 REGULATIONS.] 369.24 (a) Notwithstanding the provisions of Minnesota Rules, part 369.25 4658.0520, an incontinent resident must be checked according to 369.26 a specific time interval written in the resident's care plan. 369.27 The resident's attending physician must authorize in writing any 369.28 interval longer than two hours unless the resident, if 369.29 competent, or a family member or legally appointed conservator, 369.30 guardian, or health care agent of a resident who is not 369.31 competent, agrees in writing to waive physician involvement in 369.32 determining this interval. 369.33 (b) This section expires July 1,20012003. 369.34 Sec. 34. Laws 2000, chapter 364, section 2, is amended to 369.35 read: 369.36 Sec. 2. [MORATORIUM EXCEPTION PROCESS.] 370.1 Forfiscal yearthe biennium beginning July 1,20002001, 370.2 when approving nursing home moratorium exception projects under 370.3 Minnesota Statutes, section 144A.073, the commissioner of health 370.4 shall give priority toproposalsa proposal to build a 370.5 replacementfacilitiesfacility in the city of Anoka or within 370.6 ten miles of the city of Anoka. 370.7 Sec. 35. [DEVELOPMENT OF NEW NURSING FACILITY 370.8 REIMBURSEMENT SYSTEM.] 370.9 (a) The commissioner of human services shall develop and 370.10 report to the legislature by January 15, 2003, a system to 370.11 replace the current nursing facility reimbursement system 370.12 established under Minnesota Statutes, sections 256B.431, 370.13 256B.434, and 256B.435. 370.14 (b) The system must be developed in consultation with the 370.15 long-term care task force and with representatives of consumers, 370.16 providers, and labor unions. Within the limits of available 370.17 appropriations, the commissioner may employ consultants to 370.18 assist with this project. 370.19 (c) The new reimbursement system must: 370.20 (1) provide incentives to enhance quality of life and 370.21 quality of care; 370.22 (2) recognize cost differences in the care of different 370.23 types of populations, including subacute care and dementia care; 370.24 (3) establish rates that are sufficient without being 370.25 excessive; 370.26 (4) be affordable for the state and for private-pay 370.27 residents; 370.28 (5) be sensitive to changing conditions in the long-term 370.29 care environment; 370.30 (6) avoid creating access problems related to insufficient 370.31 funding; 370.32 (7) allow providers maximum flexibility in their business 370.33 operations; 370.34 (8) recognize the need for capital investment to improve 370.35 physical plants; and 370.36 (9) provide incentives for the development and use of 371.1 private rooms. 371.2 (d) Notwithstanding Minnesota Statutes, section 256B.435, 371.3 the commissioner must not implement a performance-based 371.4 contracting system for nursing facilities prior to July 1, 2003. 371.5 The commissioner shall continue to reimburse nursing facilities 371.6 under Minnesota Statutes, section 256B.431 or 256B.434, until 371.7 otherwise directed by law. 371.8 (e) The commissioner of human services, in consultation 371.9 with the commissioner of health, shall conduct or contract for a 371.10 time study to determine staff time being spent on various case 371.11 mix categories; recommend adjustments to the case mix weights 371.12 based on the time study data; and determine whether current 371.13 staffing standards are adequate for providing quality care based 371.14 on professional best practice and consumer experience. If the 371.15 commissioner determines the current standards are inadequate, 371.16 the commissioner shall determine an appropriate staffing 371.17 standard for the various case mix categories and the financial 371.18 implications of phasing into this standard over the next four 371.19 years. 371.20 Sec. 36. [MINIMUM STAFFING STANDARDS REPORT.] 371.21 By January 15, 2002, the commissioner of health and the 371.22 commissioner of human services shall report to the legislature 371.23 on whether they should translate the minimum nurse staffing 371.24 requirement in Minnesota Statutes, section 144A.04, subdivision 371.25 7, paragraph (a), upon the transition to the RUG-III 371.26 classification system, or whether they should establish 371.27 different time-based standards, and how to accomplish either. 371.28 Sec. 37. [PROVIDER RATE INCREASES.] 371.29 (a) The commissioner of human services shall increase 371.30 reimbursement rates by three percent each year of the biennium 371.31 for the providers listed in paragraph (b) and 3.5 percent for 371.32 the providers listed in paragraph (c). The increases are 371.33 effective for services rendered on or after July 1 of each year. 371.34 (b) The three percent rate increases described in this 371.35 section must be provided to: 371.36 (1) home and community-based waivered services for persons 372.1 with mental retardation or related conditions under Minnesota 372.2 Statutes, section 256B.501; 372.3 (2) home and community-based waivered services for the 372.4 elderly under Minnesota Statutes, section 256B.0915; 372.5 (3) waivered services under community alternatives for 372.6 disabled individuals under Minnesota Statutes, section 256B.49; 372.7 (4) community alternative care waivered services under 372.8 Minnesota Statutes, section 256B.49; 372.9 (5) traumatic brain injury waivered services under 372.10 Minnesota Statutes, section 256B.49; 372.11 (6) nursing services and home health services under 372.12 Minnesota Statutes, section 256B.0625, subdivision 6a; 372.13 (7) personal care services and nursing supervision of 372.14 personal care services under Minnesota Statutes, section 372.15 256B.0625, subdivision 19a; 372.16 (8) private duty nursing services under Minnesota Statutes, 372.17 section 256B.0625, subdivision 7; 372.18 (9) day training and habilitation services for adults with 372.19 mental retardation or related conditions under Minnesota 372.20 Statutes, sections 252.40 to 252.46; 372.21 (10) alternative care services under Minnesota Statutes, 372.22 section 256B.0913; 372.23 (11) adult residential program grants under Minnesota 372.24 Rules, parts 9535.2000 to 9535.3000; 372.25 (12) adult and family community support grants under 372.26 Minnesota Rules, parts 9535.1700 to 9535.1760; 372.27 (13) the group residential housing supplementary service 372.28 rate under Minnesota Statutes, section 256I.05, subdivision 1a; 372.29 (14) adult mental health integrated fund grants under 372.30 Minnesota Statutes, section 245.4661; 372.31 (15) semi-independent living services under Minnesota 372.32 Statutes, section 252.275, including SILS funding under county 372.33 social services grants formerly funded under Minnesota Statutes, 372.34 chapter 256I; 372.35 (16) community support services for deaf and 372.36 hard-of-hearing adults with mental illness who use or wish to 373.1 use sign language as their primary means of communication; and 373.2 (17) living skills training programs for persons with 373.3 intractable epilepsy who need assistance in the transition to 373.4 independent living. 373.5 (c) The 3.5 percent rate increases described in this 373.6 section must be provided to day training and habilitation 373.7 services under Minnesota Statutes, chapter 256B. 373.8 (d) Providers that receive a rate increase under this 373.9 section shall use one-third of the additional revenue for 373.10 operating cost increases and two-thirds of the additional 373.11 revenue to increase wages and benefits and pay associated costs 373.12 for all employees other than the administrator and central 373.13 office staff. For public employees, the portion of this 373.14 increase reserved to increase wages and benefits for certain 373.15 staff is available and pay rates shall be increased only to the 373.16 extent that they comply with laws governing public employees 373.17 collective bargaining. Money received by a provider for pay 373.18 increases under this section must be used only for increases 373.19 implemented on or after the first day of the state fiscal year 373.20 in which the increase is available and must not be used for 373.21 increases implemented prior to that date. 373.22 (e) A copy of the provider's plan for complying with 373.23 paragraph (d) must be made available to all employees by giving 373.24 each employee a copy or by posting it in an area of the 373.25 provider's operation to which all employees have access. If an 373.26 employee does not receive the adjustment described in the plan 373.27 and is unable to resolve the problem with the provider, the 373.28 employee may contact the employee's union representative. If 373.29 the employee is not covered by a collective bargaining 373.30 agreement, the employee may contact the commissioner at a phone 373.31 number provided by the commissioner and included in the 373.32 provider's plan. 373.33 Sec. 38. [REGULATORY FLEXIBILITY.] 373.34 (a) By September 1, 2001, the commissioners of health and 373.35 human services shall: 373.36 (1) develop a summary of federal nursing facility and 374.1 community long-term care regulations that hamper state 374.2 flexibility and place burdens on the goal of achieving 374.3 high-quality care and optimum outcomes for consumers of 374.4 services; and 374.5 (2) share this summary with the legislature, other states, 374.6 national groups that advocate for state interests with Congress, 374.7 and the Minnesota congressional delegation. 374.8 (b) The commissioners shall conduct ongoing follow-up with 374.9 the entities to which this summary is provided and with the 374.10 health care financing administration to achieve maximum 374.11 regulatory flexibility, including the possibility of pilot 374.12 projects to demonstrate regulatory flexibility on less than a 374.13 statewide basis. 374.14 Sec. 39. [REPORT.] 374.15 By January 15, 2003, the commissioner of health and the 374.16 commissioner of human services shall report to the senate health 374.17 and family security committee and the house health and human 374.18 services policy committee on the number of closures that have 374.19 taken place under Minnesota Statutes, section 256B.437, and any 374.20 other nursing facility closures that may have taken place, 374.21 alternatives to nursing facility care that have been developed, 374.22 any problems with access to long-term care services that have 374.23 resulted, and any recommendations for continuation of the 374.24 regional long-term care planning process and the closure process 374.25 after June 30, 2003. 374.26 Sec. 40. [INSTRUCTION TO REVISOR.] 374.27 The revisor of statutes shall delete any reference to 374.28 Minnesota Statutes, section 144A.16, in Minnesota Statutes and 374.29 Minnesota Rules. 374.30 Sec. 41. [REPEALER.] 374.31 (a) Minnesota Statutes 2000, sections 144A.16; and 374.32 256B.434, subdivision 5, are repealed. 374.33 (b) Minnesota Rules, parts 4655.6810; 4655.6820; 4655.6830; 374.34 4658.1600; 4658.1605; 4658.1610; 4658.1690; 9546.0010; 374.35 9546.0020; 9546.0030; 9546.0040; 9546.0050; and 9546.0060, are 374.36 repealed. 375.1 ARTICLE 6 375.2 WORKFORCE RECRUITMENT AND RETENTION 375.3 Section 1. Minnesota Statutes 2000, section 116L.11, 375.4 subdivision 4, is amended to read: 375.5 Subd. 4. [QUALIFYING CONSORTIUM.] "Qualifying consortium" 375.6 means an entity thatmay includeincludes a public or private 375.7 institution of higher education, work force center, county,and 375.8 oneor moreeligibleemployers, but must include a public or375.9private institution of higher education and one or more eligible375.10employersemployer. 375.11 Sec. 2. Minnesota Statutes 2000, section 116L.12, 375.12 subdivision 4, is amended to read: 375.13 Subd. 4. [GRANTS.] Within the limits of available 375.14 appropriations, the board shall make grants not to exceed 375.15 $400,000 each to qualifying consortia to operate local, 375.16 regional, or statewide training and retention programs. Grants 375.17 may be made from TANF funds, general fund appropriations, and 375.18 any other funding sources available to the board, provided the 375.19 requirements of those funding sources are satisfied. Grant 375.20 awards must establish specific, measurable outcomes and 375.21 timelines for achieving those outcomes. 375.22 Sec. 3. Minnesota Statutes 2000, section 116L.12, 375.23 subdivision 5, is amended to read: 375.24 Subd. 5. [LOCAL MATCH REQUIREMENTS.] A consortium must 375.25provide at least a 50 percent match from local resources for375.26money appropriated under this section. The local match375.27requirement must be satisfied on an overall program basis but375.28need not be satisfied for each particular client. The local375.29match requirement may be reduced for consortia that include a375.30relatively large number of small employers whose financial375.31contribution has been reduced in accordance with section 116L.15.375.32In-kind services and expenditures under section 116L.13,375.33subdivision 2, may be used to meet this local match375.34requirement. The grant application must specify the financial375.35contribution from each member of the consortiumsatisfy the 375.36 match requirements established in section 116L.02, paragraph (a). 376.1 Sec. 4. Minnesota Statutes 2000, section 116L.13, 376.2 subdivision 1, is amended to read: 376.3 Subdivision 1. [MARKETING AND RECRUITMENT.] A qualifying 376.4 consortium must implement a marketing and outreach strategy to 376.5 recruit into the health care and human services fields persons 376.6 from one or more of the potential employee target groups. 376.7 Recruitment strategies must include: 376.8 (1) a screening process to evaluate whether potential 376.9 employees may be disqualified as the result of a required 376.10 background check or are otherwise unlikely to succeed in the 376.11 position for which they are being recruited; and 376.12 (2) a process for modifying course work to meet the 376.13 training needs of non-English-speaking persons, when appropriate. 376.14 Sec. 5. [116L.146] [EXPEDITED GRANT PROCESS.] 376.15 (a) The board may authorize grants not to exceed $50,000 376.16 each through an expedited grant approval process to: 376.17 (1) eligible employers to provide training programs for up 376.18 to 50 workers; or 376.19 (2) a public or private institution of higher education to: 376.20 (i) do predevelopment or curriculum development for 376.21 training programs prior to submission for program funding under 376.22 section 116L.12; 376.23 (ii) convert an existing curriculum for distance learning 376.24 through interactive television or other communication methods; 376.25 or 376.26 (iii) enable a training program to be offered when it would 376.27 otherwise be canceled due to an enrollment shortfall of one or 376.28 two students when the program is offered in a health-related 376.29 field with a documented worker shortage and is part of a 376.30 training program not exceeding two years in length. 376.31 (b) The board shall develop application procedures and 376.32 evaluation policies for grants made under this section. 376.33 Sec. 6. Minnesota Statutes 2000, section 256B.431, is 376.34 amended by adding a subdivision to read: 376.35 Subd. 35. [EMPLOYEE SCHOLARSHIP COSTS AND TRAINING IN 376.36 ENGLISH AS A SECOND LANGUAGE.] (a) For the period between July 377.1 1, 2001, and June 30, 2003, the commissioner shall provide to 377.2 each nursing facility reimbursed under this section, section 377.3 256B.434, or any other section, a scholarship per diem of 25 377.4 cents to the total operating payment rate to be used: 377.5 (1) for employee scholarships that satisfy the following 377.6 requirements: 377.7 (i) scholarships are available to all employees who work an 377.8 average of at least 20 hours per week at the facility except the 377.9 administrator, department supervisors, and registered nurses; 377.10 and 377.11 (ii) the course of study is expected to lead to career 377.12 advancement with the facility or in long-term care, including 377.13 medical care interpreter services and social work; and 377.14 (2) to provide job-related training in English as a second 377.15 language. 377.16 (b) A facility receiving a rate adjustment under this 377.17 subdivision may submit to the commissioner on a schedule 377.18 determined by the commissioner and on a form supplied by the 377.19 commissioner a calculation of the scholarship per diem, 377.20 including: the amount received from this rate adjustment; the 377.21 amount used for training in English as a second language; the 377.22 number of persons receiving the training; the name of the person 377.23 or entity providing the training; and for each scholarship 377.24 recipient, the name of the recipient, the amount awarded, the 377.25 educational institution attended, the nature of the educational 377.26 program, the program completion date, and a determination of the 377.27 per diem amount of these costs based on actual resident days. 377.28 (c) On July 1, 2003, the commissioner shall remove the 25 377.29 cent scholarship per diem from the total operating payment rate 377.30 of each facility. 377.31 (d) For rate years beginning after June 30, 2003, the 377.32 commissioner shall provide to each facility the scholarship per 377.33 diem determined in paragraph (b). 377.34 Sec. 7. [CHIP WAIVER.] 377.35 The commissioner of human services shall seek all waivers 377.36 necessary to obtain enhanced matching funds under the state 378.1 children's health insurance program established as title XXI of 378.2 the Social Security Act, United States Code, title 42, section 378.3 1397aa et seq. for a program to develop a long-term care 378.4 employee health insurance program. Upon receipt of federal 378.5 approval, the commissioner, in consultation with the long-term 378.6 care task force, shall report to the legislature with 378.7 recommendations on implementing the program. 378.8 [EFFECTIVE DATE.] This section is effective the day 378.9 following final enactment. 378.10 Sec. 8. [REPEALER.] 378.11 Minnesota Statutes 2000, section 116L.12, subdivisions 2 378.12 and 7, are repealed. 378.13 ARTICLE 7 378.14 REGULATION OF SUPPLEMENTAL 378.15 NURSING SERVICES AGENCIES 378.16 Section 1. Minnesota Statutes 2000, section 144.057, is 378.17 amended to read: 378.18 144.057 [BACKGROUND STUDIES ON LICENSEES AND SUPPLEMENTAL 378.19 NURSING SERVICES AGENCY PERSONNEL.] 378.20 Subdivision 1. [BACKGROUND STUDIES REQUIRED.] The 378.21 commissioner of health shall contract with the commissioner of 378.22 human services to conduct background studies of: 378.23 (1) individuals providing services which have direct 378.24 contact, as defined under section 245A.04, subdivision 3, with 378.25 patients and residents in hospitals, boarding care homes, 378.26 outpatient surgical centers licensed under sections 144.50 to 378.27 144.58; nursing homes and home care agencies licensed under 378.28 chapter 144A; residential care homes licensed under chapter 378.29 144B, and board and lodging establishments that are registered 378.30 to provide supportive or health supervision services under 378.31 section 157.17;and378.32 (2) beginning July 1, 1999, all other employees in nursing 378.33 homes licensed under chapter 144A, and boarding care homes 378.34 licensed under sections 144.50 to 144.58. A disqualification of 378.35 an individual in this section shall disqualify the individual 378.36 from positions allowing direct contact or access to patients or 379.1 residents receiving services; 379.2 (3) individuals employed by a supplemental nursing services 379.3 agency, as defined under section 144A.70, who are providing 379.4 services in health care facilities; and 379.5 (4) controlling persons of a supplemental nursing services 379.6 agency, as defined under section 144A.70. 379.7 If a facility or program is licensed by the department of 379.8 human services and subject to the background study provisions of 379.9 chapter 245A and is also licensed by the department of health, 379.10 the department of human services is solely responsible for the 379.11 background studies of individuals in the jointly licensed 379.12 programs. 379.13 Subd. 2. [RESPONSIBILITIES OF DEPARTMENT OF HUMAN 379.14 SERVICES.] The department of human services shall conduct the 379.15 background studies required by subdivision 1 in compliance with 379.16 the provisions of chapter 245A and Minnesota Rules, parts 379.17 9543.3000 to 9543.3090. For the purpose of this section, the 379.18 term "residential program" shall include all facilities 379.19 described in subdivision 1. The department of human services 379.20 shall provide necessary forms and instructions, shall conduct 379.21 the necessary background studies of individuals, and shall 379.22 provide notification of the results of the studies to the 379.23 facilities, supplemental nursing services agencies, individuals, 379.24 and the commissioner of health. Individuals shall be 379.25 disqualified under the provisions of chapter 245A and Minnesota 379.26 Rules, parts 9543.3000 to 9543.3090. If an individual is 379.27 disqualified, the department of human services shall notify the 379.28 facility, the supplemental nursing services agency, and the 379.29 individual and shall inform the individual of the right to 379.30 request a reconsideration of the disqualification by submitting 379.31 the request to the department of health. 379.32 Subd. 3. [RECONSIDERATIONS.] The commissioner of health 379.33 shall review and decide reconsideration requests, including the 379.34 granting of variances, in accordance with the procedures and 379.35 criteria contained in chapter 245A and Minnesota Rules, parts 379.36 9543.3000 to 9543.3090. The commissioner's decision shall be 380.1 provided to the individual and to the department of human 380.2 services. The commissioner's decision to grant or deny a 380.3 reconsideration of disqualification is the final administrative 380.4 agency action, except for the provisions under section 245A.04, 380.5 subdivisions 3b, paragraphs (e) and (f); and 3c, paragraph (a). 380.6 [EFFECTIVE DATE.] This subdivision is effective January 1, 380.7 2002. 380.8 Subd. 4. [RESPONSIBILITIES OF FACILITIES AND AGENCIES.] 380.9 Facilities and agencies described in subdivision 1 shall be 380.10 responsible for cooperating with the departments in implementing 380.11 the provisions of this section. The responsibilities imposed on 380.12 applicants and licensees under chapter 245A and Minnesota Rules, 380.13 parts 9543.3000 to 9543.3090, shall apply to these 380.14 facilities and supplemental nursing services agencies. The 380.15 provision of section 245A.04, subdivision 3, paragraph (e), 380.16 shall apply to applicants, licensees, registrants, or an 380.17 individual's refusal to cooperate with the completion of the 380.18 background studies. Supplemental nursing services agencies 380.19 subject to the registration requirements in section 144A.71 must 380.20 maintain records verifying compliance with the background study 380.21 requirements under this section. 380.22 Sec. 2. [144A.70] [REGISTRATION OF SUPPLEMENTAL NURSING 380.23 SERVICES AGENCIES; DEFINITIONS.] 380.24 Subdivision 1. [SCOPE.] As used in sections 144A.70 to 380.25 144A.74, the terms defined in this section have the meanings 380.26 given them. 380.27 Subd. 2. [COMMISSIONER.] "Commissioner" means the 380.28 commissioner of health. 380.29 Subd. 3. [CONTROLLING PERSON.] "Controlling person" means 380.30 a business entity, officer, program administrator, or director 380.31 whose responsibilities include the direction of the management 380.32 or policies of a supplemental nursing services agency. 380.33 Controlling person also means an individual who, directly or 380.34 indirectly, beneficially owns an interest in a corporation, 380.35 partnership, or other business association that is a controlling 380.36 person. 381.1 Subd. 4. [HEALTH CARE FACILITY.] "Health care facility" 381.2 means a hospital, boarding care home, or outpatient surgical 381.3 center licensed under sections 144.50 to 144.58; a nursing home 381.4 or home care agency licensed under this chapter; a housing with 381.5 services establishment registered under chapter 144D; or a board 381.6 and lodging establishment that is registered to provide 381.7 supportive or health supervision services under section 157.17. 381.8 Subd. 5. [PERSON.] "Person" includes an individual, firm, 381.9 corporation, partnership, or association. 381.10 Subd. 6. [SUPPLEMENTAL NURSING SERVICES 381.11 AGENCY.] "Supplemental nursing services agency" means a person, 381.12 firm, corporation, partnership, or association engaged for hire 381.13 in the business of providing or procuring temporary employment 381.14 in health care facilities for nurses, nursing assistants, nurse 381.15 aides, and orderlies. Supplemental nursing services agency does 381.16 not include an individual who only engages in providing the 381.17 individual's services on a temporary basis to health care 381.18 facilities. Supplemental nursing services agency also does not 381.19 include any nursing service agency that is limited to providing 381.20 temporary nursing personnel solely to one or more health care 381.21 facilities owned or operated by the same person, firm, 381.22 corporation, or partnership. 381.23 Sec. 3. [144A.71] [SUPPLEMENTAL NURSING SERVICES AGENCY 381.24 REGISTRATION.] 381.25 Subdivision 1. [DUTY TO REGISTER.] A person who operates a 381.26 supplemental nursing services agency shall register the agency 381.27 with the commissioner. Each separate location of the business 381.28 of a supplemental nursing services agency shall register the 381.29 agency with the commissioner. Each separate location of the 381.30 business of a supplemental nursing services agency shall have a 381.31 separate registration. 381.32 Subd. 2. [APPLICATION INFORMATION AND FEE.] The 381.33 commissioner shall establish forms and procedures for processing 381.34 each supplemental nursing services agency registration 381.35 application. An application for a supplemental nursing services 381.36 agency registration must include at least the following: 382.1 (1) the names and addresses of the owner or owners of the 382.2 supplemental nursing services agency; 382.3 (2) if the owner is a corporation, copies of its articles 382.4 of incorporation and current bylaws, together with the names and 382.5 addresses of its officers and directors; 382.6 (3) any other relevant information that the commissioner 382.7 determines is necessary to properly evaluate an application for 382.8 registration; and 382.9 (4) the annual registration fee for a supplemental nursing 382.10 services agency, which is $891. 382.11 Subd. 3. [REGISTRATION NOT TRANSFERABLE.] A registration 382.12 issued by the commissioner according to this section is 382.13 effective for a period of one year from the date of its issuance 382.14 unless the registration is revoked or suspended under section 382.15 144A.72, subdivision 2, or unless the supplemental nursing 382.16 services agency is sold or ownership or management is 382.17 transferred. When a supplemental nursing services agency is 382.18 sold or ownership or management is transferred, the registration 382.19 of the agency must be voided and the new owner or operator may 382.20 apply for a new registration. 382.21 Sec. 4. [144A.72] [REGISTRATION REQUIREMENTS; PENALTIES.] 382.22 Subdivision 1. [MINIMUM CRITERIA.] The commissioner shall 382.23 require that, as a condition of registration: 382.24 (1) the supplemental nursing services agency shall document 382.25 that each temporary employee provided to health care facilities 382.26 currently meets the minimum licensing, training, and continuing 382.27 education standards for the position in which the employee will 382.28 be working; 382.29 (2) the supplemental nursing services agency shall comply 382.30 with all pertinent requirements relating to the health and other 382.31 qualifications of personnel employed in health care facilities; 382.32 (3) the supplemental nursing services agency must not 382.33 restrict in any manner the employment opportunities of its 382.34 employees; 382.35 (4) the supplemental nursing services agency, when 382.36 supplying temporary employees to a health care facility, and 383.1 when requested by the facility to do so, shall agree that at 383.2 least 30 percent of the total personnel hours supplied are 383.3 during night, holiday, or weekend shifts; 383.4 (5) the supplemental nursing services agency shall carry 383.5 medical malpractice insurance to insure against the loss, 383.6 damage, or expense incident to a claim arising out of the death 383.7 or injury of any person as the result of negligence or 383.8 malpractice in the provision of health care services by the 383.9 supplemental nursing services agency or by any employee of the 383.10 agency; and 383.11 (6) the supplemental nursing services agency must not, in 383.12 any contract with any employee or health care facility, require 383.13 the payment of liquidated damages, employment fees, or other 383.14 compensation should the employee be hired as a permanent 383.15 employee of a health care facility. 383.16 Subd. 2. [PENALTIES.] A pattern of failure to comply with 383.17 this section shall subject the supplemental nursing services 383.18 agency to revocation or nonrenewal of its registration. 383.19 Violations of section 144A.74 are subject to a fine equal to 200 383.20 percent of the amount billed or received in excess of the 383.21 maximum permitted under that section. 383.22 Sec. 5. [144A.73] [COMPLAINT SYSTEM.] 383.23 The commissioner shall establish a system for reporting 383.24 complaints against a supplemental nursing services agency or its 383.25 employees. Complaints may be made by any member of the public. 383.26 Written complaints must be forwarded to the employer of each 383.27 person against whom a complaint is made. The employer shall 383.28 promptly report to the commissioner any corrective action taken. 383.29 Sec. 6. [144A.74] [MAXIMUM CHARGES.] 383.30 A supplemental nursing services agency must not bill or 383.31 receive payments from a nursing home licensed under this chapter 383.32 at a rate higher than 150 percent of the weighted average wage 383.33 rate for the applicable employee classification for the 383.34 geographic group to which the nursing home is assigned under 383.35 Minnesota Rules, part 9549.0052. The weighted average wage 383.36 rates must be determined by the commissioner of human services 384.1 and reported to the commissioner of health on an annual basis. 384.2 Facilities shall provide information necessary to determine 384.3 weighted average wage rates to the commissioner of human 384.4 services in a format requested by the commissioner. The maximum 384.5 rate must include all charges for administrative fees, contract 384.6 fees, or other special charges in addition to the hourly rates 384.7 for the temporary nursing pool personnel supplied to a nursing 384.8 home. 384.9 [EFFECTIVE DATE.] This section is effective August 31, 2001. 384.10 Sec. 7. [256B.039] [REPORTING OF SUPPLEMENTAL NURSING 384.11 SERVICES AGENCY USE.] 384.12 Beginning March 1, 2002, the commissioner shall to report 384.13 to the legislature annually on the use of supplemental nursing 384.14 services, including the number of hours worked by supplemental 384.15 nursing services agency personnel and payments to supplemental 384.16 nursing services agencies. 384.17 ARTICLE 8 384.18 LONG-TERM CARE INSURANCE 384.19 Section 1. Minnesota Statutes 2000, section 62A.48, 384.20 subdivision 4, is amended to read: 384.21 Subd. 4. [LOSS RATIO.] The anticipated loss ratio for 384.22 long-term care policies must not be less than 65 percent for 384.23 policies issued on a group basis or 60 percent for policies 384.24 issued on an individual or mass-market basis. This subdivision 384.25 does not apply to policies issued on or after January 1, 2002, 384.26 that comply with sections 62S.021 and 62S.081. 384.27 [EFFECTIVE DATE.] This section is effective the day 384.28 following final enactment. 384.29 Sec. 2. Minnesota Statutes 2000, section 62A.48, is 384.30 amended by adding a subdivision to read: 384.31 Subd. 10. [REGULATION OF PREMIUMS AND PREMIUM 384.32 INCREASES.] Policies issued under sections 62A.46 to 62A.56 on 384.33 or after January 1, 2002, must comply with sections 62S.021, 384.34 62S.081, 62S.265, and 62S.266 to the same extent as policies 384.35 issued under chapter 62S. 384.36 [EFFECTIVE DATE.] This section is effective the day 385.1 following final enactment. 385.2 Sec. 3. Minnesota Statutes 2000, section 62A.48, is 385.3 amended by adding a subdivision to read: 385.4 Subd. 11. [NONFORFEITURE BENEFITS.] Policies issued under 385.5 sections 62A.46 to 62A.56 on or after January 1, 2002, must 385.6 comply with section 62S.02, subdivision 2, to the same extent as 385.7 policies issued under chapter 62S. 385.8 [EFFECTIVE DATE.] This section is effective the day 385.9 following final enactment. 385.10 Sec. 4. Minnesota Statutes 2000, section 62S.01, is 385.11 amended by adding a subdivision to read: 385.12 Subd. 13a. [EXCEPTIONAL INCREASE.] (a) "Exceptional 385.13 increase" means only those premium rate increases filed by an 385.14 insurer as exceptional for which the commissioner determines 385.15 that the need for the premium rate increase is justified due to 385.16 changes in laws or rules applicable to long-term care coverage 385.17 in this state, or due to increased and unexpected utilization 385.18 that affects the majority of insurers of similar products. 385.19 (b) Except as provided in section 62S.265, exceptional 385.20 increases are subject to the same requirements as other premium 385.21 rate schedule increases. The commissioner may request a review 385.22 by an independent actuary or a professional actuarial body of 385.23 the basis for a request that an increase be considered an 385.24 exceptional increase. The commissioner, in determining that the 385.25 necessary basis for an exceptional increase exists, shall also 385.26 determine any potential offsets to higher claims costs. 385.27 [EFFECTIVE DATE.] This section is effective the day 385.28 following final enactment. 385.29 Sec. 5. Minnesota Statutes 2000, section 62S.01, is 385.30 amended by adding a subdivision to read: 385.31 Subd. 17a. [INCIDENTAL.] "Incidental," as used in section 385.32 62S.265, subdivision 10, means that the value of the long-term 385.33 care benefits provided is less than ten percent of the total 385.34 value of the benefits provided over the life of the policy. 385.35 These values must be measured as of the date of issue. 385.36 [EFFECTIVE DATE.] This section is effective the day 386.1 following final enactment. 386.2 Sec. 6. Minnesota Statutes 2000, section 62S.01, is 386.3 amended by adding a subdivision to read: 386.4 Subd. 23a. [QUALIFIED ACTUARY.] "Qualified actuary" means 386.5 a member in good standing of the American Academy of Actuaries. 386.6 [EFFECTIVE DATE.] This section is effective the day 386.7 following final enactment. 386.8 Sec. 7. Minnesota Statutes 2000, section 62S.01, is 386.9 amended by adding a subdivision to read: 386.10 Subd. 25a. [SIMILAR POLICY FORMS.] "Similar policy forms" 386.11 means all of the long-term care insurance policies and 386.12 certificates issued by an insurer in the same long-term care 386.13 benefit classification as the policy form being considered. 386.14 Certificates of groups that meet the definition in section 386.15 62S.01, subdivision 15, clause (1), are not considered similar 386.16 to certificates or policies otherwise issued as long-term care 386.17 insurance, but are similar to other comparable certificates with 386.18 the same long-term care benefit classifications. For purposes 386.19 of determining similar policy forms, long-term care benefit 386.20 classifications are defined as follows: institutional long-term 386.21 care benefits only, noninstitutional long-term care benefits 386.22 only, or comprehensive long-term care benefits. 386.23 [EFFECTIVE DATE.] This section is effective the day 386.24 following final enactment. 386.25 Sec. 8. [62S.021] [LONG-TERM CARE INSURANCE; INITIAL 386.26 FILING.] 386.27 Subdivision 1. [APPLICABILITY.] This section applies to 386.28 any long-term care policy issued in this state on or after 386.29 January 1, 2002, under this chapter or sections 62A.46 to 62A.56. 386.30 Subd. 2. [REQUIRED SUBMISSION TO COMMISSIONER.] An insurer 386.31 shall provide the following information to the commissioner 30 386.32 days prior to making a long-term care insurance form available 386.33 for sale: 386.34 (1) a copy of the disclosure documents required in section 386.35 62S.081; and 386.36 (2) an actuarial certification consisting of at least the 387.1 following: 387.2 (i) a statement that the initial premium rate schedule is 387.3 sufficient to cover anticipated costs under moderately adverse 387.4 experience and that the premium rate schedule is reasonably 387.5 expected to be sustainable over the life of the form with no 387.6 future premium increases anticipated; 387.7 (ii) a statement that the policy design and coverage 387.8 provided have been reviewed and taken into consideration; 387.9 (iii) a statement that the underwriting and claims 387.10 adjudication processes have been reviewed and taken into 387.11 consideration; and 387.12 (iv) a complete description of the basis for contract 387.13 reserves that are anticipated to be held under the form, to 387.14 include: 387.15 (A) sufficient detail or sample calculations provided so as 387.16 to have a complete depiction of the reserve amounts to be held; 387.17 (B) a statement that the assumptions used for reserves 387.18 contain reasonable margins for adverse experience; 387.19 (C) a statement that the net valuation premium for renewal 387.20 years does not increase, except for attained age rating where 387.21 permitted; 387.22 (D) a statement that the difference between the gross 387.23 premium and the net valuation premium for renewal years is 387.24 sufficient to cover expected renewal expenses, or if such a 387.25 statement cannot be made, a complete description of the 387.26 situations in which this does not occur. An aggregate 387.27 distribution of anticipated issues may be used as long as the 387.28 underlying gross premiums maintain a reasonably consistent 387.29 relationship. If the gross premiums for certain age groups 387.30 appear to be inconsistent with this requirement, the 387.31 commissioner may request a demonstration under item (i) based on 387.32 a standard age distribution; and 387.33 (E) either a statement that the premium rate schedule is 387.34 not less than the premium rate schedule for existing similar 387.35 policy forms also available from the insurer except for 387.36 reasonable differences attributable to benefits, or a comparison 388.1 of the premium schedules for similar policy forms that are 388.2 currently available from the insurer with an explanation of the 388.3 differences. 388.4 Subd. 3. [ACTUARIAL DEMONSTRATION.] The commissioner may 388.5 request an actuarial demonstration that benefits are reasonable 388.6 in relation to premiums. The actuarial demonstration must 388.7 include either premium and claim experience on similar policy 388.8 forms, adjusted for any premium or benefit differences, relevant 388.9 and credible data from other studies, or both. If the 388.10 commissioner asks for additional information under this 388.11 subdivision, the 30-day time limit in subdivision 2 does not 388.12 include the time during which the insurer is preparing the 388.13 requested information. 388.14 [EFFECTIVE DATE.] This section is effective the day 388.15 following final enactment. 388.16 Sec. 9. [62S.081] [REQUIRED DISCLOSURE OF RATING PRACTICES 388.17 TO CONSUMERS.] 388.18 Subdivision 1. [APPLICATION.] This section applies as 388.19 follows: 388.20 (a) Except as provided in paragraph (b), this section 388.21 applies to any long-term care policy or certificate issued in 388.22 this state on or after January 1, 2002. 388.23 (b) For certificates issued on or after the effective date 388.24 of this section under a policy of group long-term care insurance 388.25 as defined in section 62S.01, subdivision 15, that was in force 388.26 on the effective date of this section, this section applies on 388.27 the policy anniversary following June 30, 2002. 388.28 Subd. 2. [REQUIRED DISCLOSURES.] Other than policies for 388.29 which no applicable premium rate or rate schedule increases can 388.30 be made, insurers shall provide all of the information listed in 388.31 this subdivision to the applicant at the time of application or 388.32 enrollment, unless the method of application does not allow for 388.33 delivery at that time; in this case, an insurer shall provide 388.34 all of the information listed in this subdivision to the 388.35 applicant no later than at the time of delivery of the policy or 388.36 certificate: 389.1 (1) a statement that the policy may be subject to rate 389.2 increases in the future; 389.3 (2) an explanation of potential future premium rate 389.4 revisions and the policyholder's or certificate holder's option 389.5 in the event of a premium rate revision; 389.6 (3) the premium rate or rate schedules applicable to the 389.7 applicant that will be in effect until a request is made for an 389.8 increase; 389.9 (4) a general explanation of applying premium rate or rate 389.10 schedule adjustments that must include: 389.11 (i) a description of when premium rate or rate schedule 389.12 adjustments will be effective, for example the next anniversary 389.13 date or the next billing date; and 389.14 (ii) the right to a revised premium rate or rate schedule 389.15 as provided in clause (3) if the premium rate or rate schedule 389.16 is changed; and 389.17 (5)(i) information regarding each premium rate increase on 389.18 this policy form or similar policy forms over the past ten years 389.19 for this state or any other state that, at a minimum, identifies: 389.20 (A) the policy forms for which premium rates have been 389.21 increased; 389.22 (B) the calendar years when the form was available for 389.23 purchase; and 389.24 (C) the amount or percent of each increase. The percentage 389.25 may be expressed as a percentage of the premium rate prior to 389.26 the increase and may also be expressed as minimum and maximum 389.27 percentages if the rate increase is variable by rating 389.28 characteristics; 389.29 (ii) the insurer may, in a fair manner, provide additional 389.30 explanatory information related to the rate increases; 389.31 (iii) an insurer has the right to exclude from the 389.32 disclosure premium rate increases that apply only to blocks of 389.33 business acquired from other nonaffiliated insurers or the 389.34 long-term care policies acquired from other nonaffiliated 389.35 insurers when those increases occurred prior to the acquisition; 389.36 (iv) if an acquiring insurer files for a rate increase on a 390.1 long-term care policy form acquired from nonaffiliated insurers 390.2 or a block of policy forms acquired from nonaffiliated insurers 390.3 on or before the later of the effective date of this section, or 390.4 the end of a 24-month period following the acquisition of the 390.5 block of policies, the acquiring insurer may exclude that rate 390.6 increase from the disclosure. However, the nonaffiliated 390.7 selling company must include the disclosure of that rate 390.8 increase according to item (i); and 390.9 (v) if the acquiring insurer in item (iv) files for a 390.10 subsequent rate increase, even within the 24-month period, on 390.11 the same policy form acquired from nonaffiliated insurers or 390.12 block of policy forms acquired from nonaffiliated insurers 390.13 referenced in item (iv), the acquiring insurer shall make all 390.14 disclosures required by this subdivision, including disclosure 390.15 of the earlier rate increase referenced in item (iv). 390.16 Subd. 3. [ACKNOWLEDGMENT.] An applicant shall sign an 390.17 acknowledgment at the time of application, unless the method of 390.18 application does not allow for signature at that time, that the 390.19 insurer made the disclosure required under subdivision 2. If, 390.20 due to the method of application, the applicant cannot sign an 390.21 acknowledgment at the time of application, the applicant shall 390.22 sign no later than at the time of delivery of the policy or 390.23 certificate. 390.24 Subd. 4. [FORMS.] An insurer shall use the forms in 390.25 Appendices B and F of the Long-term Care Insurance Model 390.26 Regulation adopted by the National Association of Insurance 390.27 Commissioners to comply with the requirements of subdivisions 1 390.28 and 2. 390.29 Subd. 5. [NOTICE OF INCREASE.] An insurer shall provide 390.30 notice of an upcoming premium rate schedule increase, after the 390.31 increase has been approved by the commissioner, to all 390.32 policyholders or certificate holders, if applicable, at least 45 390.33 days prior to the implementation of the premium rate schedule 390.34 increase by the insurer. The notice must include the 390.35 information required by subdivision 2 when the rate increase is 390.36 implemented. 391.1 [EFFECTIVE DATE.] This section is effective the day 391.2 following final enactment. 391.3 Sec. 10. Minnesota Statutes 2000, section 62S.26, is 391.4 amended to read: 391.5 62S.26 [LOSS RATIO.] 391.6 (a) The minimum loss ratio must be at least 60 percent, 391.7 calculated in a manner which provides for adequate reserving of 391.8 the long-term care insurance risk. In evaluating the expected 391.9 loss ratio, the commissioner shall give consideration to all 391.10 relevant factors, including: 391.11 (1) statistical credibility of incurred claims experience 391.12 and earned premiums; 391.13 (2) the period for which rates are computed to provide 391.14 coverage; 391.15 (3) experienced and projected trends; 391.16 (4) concentration of experience within early policy 391.17 duration; 391.18 (5) expected claim fluctuation; 391.19 (6) experience refunds, adjustments, or dividends; 391.20 (7) renewability features; 391.21 (8) all appropriate expense factors; 391.22 (9) interest; 391.23 (10) experimental nature of the coverage; 391.24 (11) policy reserves; 391.25 (12) mix of business by risk classification; and 391.26 (13) product features such as long elimination periods, 391.27 high deductibles, and high maximum limits. 391.28 (b) This section does not apply to policies or certificates 391.29 that are subject to sections 62S.021, 62S.081, and 62S.265, and 391.30 that comply with those sections. 391.31 [EFFECTIVE DATE.] This section is effective the day 391.32 following final enactment. 391.33 Sec. 11. [62S.265] [PREMIUM RATE SCHEDULE INCREASES.] 391.34 Subdivision 1. [APPLICABILITY.] (a) Except as provided in 391.35 paragraph (b), this section applies to any long-term care policy 391.36 or certificate issued in this state on or after January 1, 2002, 392.1 under this chapter or sections 62A.46 to 62A.56. 392.2 (b) For certificates issued on or after the effective date 392.3 of this section under a group long-term care insurance policy as 392.4 defined in section 62S.01, subdivision 15, issued under this 392.5 chapter, that was in force on the effective date of this 392.6 section, this section applies on the policy anniversary 392.7 following June 30, 2002. 392.8 Subd. 2. [NOTICE.] An insurer shall file a requested 392.9 premium rate schedule increase, including an exceptional 392.10 increase, to the commissioner for prior approval at least 60 392.11 days prior to the notice to the policyholders and shall include: 392.12 (1) all information required by section 62S.081; 392.13 (2) certification by a qualified actuary that: 392.14 (i) if the requested premium rate schedule increase is 392.15 implemented and the underlying assumptions, which reflect 392.16 moderately adverse conditions, are realized, no further premium 392.17 rate schedule increases are anticipated; and 392.18 (ii) the premium rate filing complies with this section; 392.19 (3) an actuarial memorandum justifying the rate schedule 392.20 change request that includes: 392.21 (i) lifetime projections of earned premiums and incurred 392.22 claims based on the filed premium rate schedule increase and the 392.23 method and assumptions used in determining the projected values, 392.24 including reflection of any assumptions that deviate from those 392.25 used for pricing other forms currently available for sale; 392.26 (A) annual values for the five years preceding and the 392.27 three years following the valuation date must be provided 392.28 separately; 392.29 (B) the projections must include the development of the 392.30 lifetime loss ratio, unless the rate increase is an exceptional 392.31 increase; 392.32 (C) the projections must demonstrate compliance with 392.33 subdivision 3; and 392.34 (D) for exceptional increases, the projected experience 392.35 must be limited to the increases in claims expenses attributable 392.36 to the approved reasons for the exceptional increase and, if the 393.1 commissioner determines that offsets to higher claim costs may 393.2 exist, the insurer shall use appropriate net projected 393.3 experience; 393.4 (ii) disclosure of how reserves have been incorporated in 393.5 this rate increase whenever the rate increase will trigger 393.6 contingent benefit upon lapse; 393.7 (iii) disclosure of the analysis performed to determine why 393.8 a rate adjustment is necessary, which pricing assumptions were 393.9 not realized and why, and what other actions taken by the 393.10 company have been relied upon by the actuary; 393.11 (iv) a statement that policy design, underwriting, and 393.12 claims adjudication practices have been taken into 393.13 consideration; and 393.14 (v) if it is necessary to maintain consistent premium rates 393.15 for new certificates and certificates receiving a rate increase, 393.16 the insurer shall file composite rates reflecting projections of 393.17 new certificates; 393.18 (4) a statement that renewal premium rate schedules are not 393.19 greater than new business premium rate schedules except for 393.20 differences attributable to benefits, unless sufficient 393.21 justification is provided to the commissioner; and 393.22 (5) sufficient information for review and approval of the 393.23 premium rate schedule increase by the commissioner. 393.24 Subd. 3. [REQUIREMENTS PERTAINING TO RATE INCREASES.] All 393.25 premium rate schedule increases must be determined according to 393.26 the following requirements: 393.27 (1) exceptional increases must provide that 70 percent of 393.28 the present value of projected additional premiums from the 393.29 exceptional increase will be returned to policyholders in 393.30 benefits; 393.31 (2) premium rate schedule increases must be calculated so 393.32 that the sum of the accumulated value of incurred claims, 393.33 without the inclusion of active life reserves, and the present 393.34 value of future projected incurred claims, without the inclusion 393.35 of active life reserves, will not be less than the sum of the 393.36 following: 394.1 (i) the accumulated value of the initial earned premium 394.2 times 58 percent; 394.3 (ii) 85 percent of the accumulated value of prior premium 394.4 rate schedule increases on an earned basis; 394.5 (iii) the present value of future projected initial earned 394.6 premiums times 58 percent; and 394.7 (iv) 85 percent of the present value of future projected 394.8 premiums not in item (iii) on an earned basis; 394.9 (3) if a policy form has both exceptional and other 394.10 increases, the values in clause (2), items (ii) and (iv), must 394.11 also include 70 percent for exceptional rate increase amounts; 394.12 and 394.13 (4) all present and accumulated values used to determine 394.14 rate increases must use the maximum valuation interest rate for 394.15 contract reserves permitted for valuation of whole life 394.16 insurance policies issued in this state on the same date. The 394.17 actuary shall disclose as part of the actuarial memorandum the 394.18 use of any appropriate averages. 394.19 Subd. 4. [PROJECTIONS.] For each rate increase that is 394.20 implemented, the insurer shall file for approval by the 394.21 commissioner updated projections, as described in subdivision 2, 394.22 clause (3), item (i), annually for the next three years and 394.23 include a comparison of actual results to projected values. The 394.24 commissioner may extend the period to greater than three years 394.25 if actual results are not consistent with projected values from 394.26 prior projections. For group insurance policies that meet the 394.27 conditions in subdivision 11, the projections required by this 394.28 subdivision must be provided to the policyholder in lieu of 394.29 filing with the commissioner. 394.30 Subd. 5. [LIFETIME PROJECTIONS.] If any premium rate in 394.31 the revised premium rate schedule is greater than 200 percent of 394.32 the comparable rate in the initial premium schedule, lifetime 394.33 projections, as described in subdivision 2, clause (3), item 394.34 (i), must be filed for approval by the commissioner every five 394.35 years following the end of the required period in subdivision 394.36 4. For group insurance policies that meet the conditions in 395.1 subdivision 11, the projections required by this subdivision 395.2 must be provided to the policyholder in lieu of filing with the 395.3 commissioner. 395.4 Subd. 6. [EFFECT OF ACTUAL EXPERIENCE.] (a) If the 395.5 commissioner has determined that the actual experience following 395.6 a rate increase does not adequately match the projected 395.7 experience and that the current projections under moderately 395.8 adverse conditions demonstrate that incurred claims will not 395.9 exceed proportions of premiums specified in subdivision 3, the 395.10 commissioner may require the insurer to implement any of the 395.11 following: 395.12 (1) premium rate schedule adjustments; or 395.13 (2) other measures to reduce the difference between the 395.14 projected and actual experience. 395.15 (b) In determining whether the actual experience adequately 395.16 matches the projected experience, consideration must be given to 395.17 subdivision 2, clause (3), item (v), if applicable. 395.18 Subd. 7. [CONTINGENT BENEFIT UPON LAPSE.] If the majority 395.19 of the policies or certificates to which the increase is 395.20 applicable are eligible for the contingent benefit upon lapse, 395.21 the insurer shall file: 395.22 (1) a plan, subject to commissioner approval, for improved 395.23 administration or claims processing designed to eliminate the 395.24 potential for further deterioration of the policy form requiring 395.25 further premium rate schedule increases, or both, or a 395.26 demonstration that appropriate administration and claims 395.27 processing have been implemented or are in effect; otherwise, 395.28 the commissioner may impose the condition in subdivision 8, 395.29 paragraph (b); and 395.30 (2) the original anticipated lifetime loss ratio, and the 395.31 premium rate schedule increase that would have been calculated 395.32 according to subdivision 3 had the greater of the original 395.33 anticipated lifetime loss ratio or 58 percent been used in the 395.34 calculations described in subdivision 3, clause (2), items (i) 395.35 and (iii). 395.36 Subd. 8. [PROJECTED LAPSE RATES.] (a) For a rate increase 396.1 filing that meets the following criteria, the commissioner shall 396.2 review, for all policies included in the filing, the projected 396.3 lapse rates and past lapse rates during the 12 months following 396.4 each increase to determine if significant adverse lapsation has 396.5 occurred or is anticipated: 396.6 (1) the rate increase is not the first rate increase 396.7 requested for the specific policy form or forms; 396.8 (2) the rate increase is not an exceptional increase; and 396.9 (3) the majority of the policies or certificates to which 396.10 the increase is applicable are eligible for the contingent 396.11 benefit upon lapse. 396.12 (b) If significant adverse lapsation has occurred, is 396.13 anticipated in the filing, or is evidenced in the actual results 396.14 as presented in the updated projections provided by the insurer 396.15 following the requested rate increase, the commissioner may 396.16 determine that a rate spiral exists. Following the 396.17 determination that a rate spiral exists, the commissioner may 396.18 require the insurer to offer, without underwriting, to all 396.19 in-force insureds subject to the rate increase, the option to 396.20 replace existing coverage with one or more reasonably comparable 396.21 products being offered by the insurer or its affiliates. The 396.22 offer must: 396.23 (1) be subject to the approval of the commissioner; 396.24 (2) be based upon actuarially sound principles, but not be 396.25 based upon attained age; and 396.26 (3) provide that maximum benefits under any new policy 396.27 accepted by an insured are reduced by comparable benefits 396.28 already paid under the existing policy. 396.29 (c) The insurer shall maintain the experience of all the 396.30 replacement insureds separate from the experience of insureds 396.31 originally issued the policy forms. In the event of a request 396.32 for a rate increase on the policy form, the rate increase must 396.33 be limited to the lesser of the maximum rate increase determined 396.34 based on the combined experience and the maximum rate increase 396.35 determined based only upon the experience of the insureds 396.36 originally issued the form plus ten percent. 397.1 Subd. 9. [PERSISTENT PRACTICE OF INADEQUATE INITIAL 397.2 RATES.] If the commissioner determines that the insurer has 397.3 exhibited a persistent practice of filing inadequate initial 397.4 premium rates for long-term care insurance, the commissioner 397.5 may, in addition to the provisions of subdivision 8, prohibit 397.6 the insurer from either of the following: 397.7 (1) filing and marketing comparable coverage for a period 397.8 of up to five years; or 397.9 (2) offering all other similar coverages and limiting 397.10 marketing of new applications to the products subject to recent 397.11 premium rate schedule increases. 397.12 Subd. 10. [INCIDENTAL LONG-TERM CARE 397.13 BENEFITS.] Subdivisions 1 to 9 do not apply to policies for 397.14 which the long-term care benefits provided by the policy are 397.15 incidental, as defined in section 62S.01, subdivision 17a, if 397.16 the policy complies with all of the following provisions: 397.17 (1) the interest credited internally to determine cash 397.18 value accumulations, including long-term care, if any, are 397.19 guaranteed not to be less than the minimum guaranteed interest 397.20 rate for cash value accumulations without long-term care set 397.21 forth in the policy; 397.22 (2) the portion of the policy that provides insurance 397.23 benefits other than long-term care coverage meets the 397.24 nonforfeiture requirements as applicable in any of the following: 397.25 (i) for life insurance, section 61A.25; 397.26 (ii) for individual deferred annuities, section 61A.245; 397.27 and 397.28 (iii) for variable annuities, section 61A.21; 397.29 (3) the policy meets the disclosure requirements of 397.30 sections 62S.10 and 62S.11 if the policy is governed by chapter 397.31 62S and of section 62A.50 if the policy is governed by sections 397.32 62A.46 to 62A.56; 397.33 (4) the portion of the policy that provides insurance 397.34 benefits other than long-term care coverage meets the 397.35 requirements as applicable in the following: 397.36 (i) policy illustrations to the extent required by state 398.1 law applicable to life insurance; 398.2 (ii) disclosure requirements in state law applicable to 398.3 annuities; and 398.4 (iii) disclosure requirements applicable to variable 398.5 annuities; and 398.6 (5) an actuarial memorandum is filed with the commissioner 398.7 that includes: 398.8 (i) a description of the basis on which the long-term care 398.9 rates were determined; 398.10 (ii) a description of the basis for the reserves; 398.11 (iii) a summary of the type of policy, benefits, 398.12 renewability, general marketing method, and limits on ages of 398.13 issuance; 398.14 (iv) a description and a table of each actuarial assumption 398.15 used. For expenses, an insurer must include percent of premium 398.16 dollars per policy and dollars per unit of benefits, if any; 398.17 (v) a description and a table of the anticipated policy 398.18 reserves and additional reserves to be held in each future year 398.19 for active lives; 398.20 (vi) the estimated average annual premium per policy and 398.21 the average issue age; 398.22 (vii) a statement as to whether underwriting is performed 398.23 at the time of application. The statement must indicate whether 398.24 underwriting is used and, if used, the statement shall include a 398.25 description of the type or types of underwriting used, such as 398.26 medical underwriting or functional assessment underwriting. 398.27 Concerning a group policy, the statement must indicate whether 398.28 the enrollee or any dependent will be underwritten and when 398.29 underwriting occurs; and 398.30 (viii) a description of the effect of the long-term care 398.31 policy provision on the required premiums, nonforfeiture values, 398.32 and reserves on the underlying insurance policy, both for active 398.33 lives and those in long-term care claim status. 398.34 Subd. 11. [LARGE GROUP POLICIES.] Subdivisions 6 and 9 do 398.35 not apply to group long-term care insurance policies as defined 398.36 in section 62S.01, subdivision 15, where: 399.1 (1) the policies insure 250 or more persons, and the 399.2 policyholder has 5,000 or more eligible employees of a single 399.3 employer; or 399.4 (2) the policyholder, and not the certificate holders, pays 399.5 a material portion of the premium, which is not less than 20 399.6 percent of the total premium for the group in the calendar year 399.7 prior to the year in which a rate increase is filed. 399.8 [EFFECTIVE DATE.] This section is effective the day 399.9 following final enactment. 399.10 Sec. 12. [62S.266] [NONFORFEITURE BENEFIT REQUIREMENT.] 399.11 Subdivision 1. [APPLICABILITY.] This section does not 399.12 apply to life insurance policies or riders containing 399.13 accelerated long-term care benefits. 399.14 Subd. 2. [REQUIREMENT.] An insurer must offer each 399.15 prospective policyholder a nonforfeiture benefit in compliance 399.16 with the following requirements: 399.17 (1) a policy or certificate offered with nonforfeiture 399.18 benefits must have coverage elements, eligibility, benefit 399.19 triggers, and benefit length that are the same as coverage to be 399.20 issued without nonforfeiture benefits. The nonforfeiture 399.21 benefit included in the offer must be the benefit described in 399.22 subdivision 5; and 399.23 (2) the offer must be in writing if the nonforfeiture 399.24 benefit is not otherwise described in the outline of coverage or 399.25 other materials given to the prospective policyholder. 399.26 Subd. 3. [EFFECT OF REJECTION OF OFFER.] If the offer 399.27 required to be made under subdivision 2 is rejected, the insurer 399.28 shall provide the contingent benefit upon lapse described in 399.29 this section. 399.30 Subd. 4. [CONTINGENT BENEFIT UPON LAPSE.] (a) After 399.31 rejection of the offer required under subdivision 2, for 399.32 individual and group policies without nonforfeiture benefits 399.33 issued after the effective date of this section, the insurer 399.34 shall provide a contingent benefit upon lapse. 399.35 (b) If a group policyholder elects to make the 399.36 nonforfeiture benefit an option to the certificate holder, a 400.1 certificate shall provide either the nonforfeiture benefit or 400.2 the contingent benefit upon lapse. 400.3 (c) The contingent benefit on lapse must be triggered every 400.4 time an insurer increases the premium rates to a level which 400.5 results in a cumulative increase of the annual premium equal to 400.6 or exceeding the percentage of the insured's initial annual 400.7 premium based on the insured's issue age provided in this 400.8 paragraph, and the policy or certificate lapses within 120 days 400.9 of the due date of the premium increase. Unless otherwise 400.10 required, policyholders shall be notified at least 30 days prior 400.11 to the due date of the premium reflecting the rate increase. 400.12 Triggers for a Substantial Premium Increase 400.13 Percent Increase 400.14 Issue Age Over Initial Premium 400.15 29 and Under 200 400.16 30-34 190 400.17 35-39 170 400.18 40-44 150 400.19 45-49 130 400.20 50-54 110 400.21 55-59 90 400.22 60 70 400.23 61 66 400.24 62 62 400.25 63 58 400.26 64 54 400.27 65 50 400.28 66 48 400.29 67 46 400.30 68 44 400.31 69 42 400.32 70 40 400.33 71 38 400.34 72 36 400.35 73 34 400.36 74 32 401.1 75 30 401.2 76 28 401.3 77 26 401.4 78 24 401.5 79 22 401.6 80 20 401.7 81 19 401.8 82 18 401.9 83 17 401.10 84 16 401.11 85 15 401.12 86 14 401.13 87 13 401.14 88 12 401.15 89 11 401.16 90 and over 10 401.17 (d) On or before the effective date of a substantial 401.18 premium increase as defined in paragraph (c), the insurer shall: 401.19 (1) offer to reduce policy benefits provided by the current 401.20 coverage without the requirement of additional underwriting so 401.21 that required premium payments are not increased; 401.22 (2) offer to convert the coverage to a paid-up status with 401.23 a shortened benefit period according to the terms of subdivision 401.24 5. This option may be elected at any time during the 120-day 401.25 period referenced in paragraph (c); and 401.26 (3) notify the policyholder or certificate holder that a 401.27 default or lapse at any time during the 120-day period 401.28 referenced in paragraph (c) is deemed to be the election of the 401.29 offer to convert in clause (2). 401.30 Subd. 5. [NONFORFEITURE BENEFITS; REQUIREMENTS.] (a) 401.31 Benefits continued as nonforfeiture benefits, including 401.32 contingent benefits upon lapse, must be as described in this 401.33 subdivision. 401.34 (b) For purposes of this subdivision, "attained age rating" 401.35 is defined as a schedule of premiums starting from the issue 401.36 date which increases with age at least one percent per year 402.1 prior to age 50, and at least three percent per year beyond age 402.2 50. 402.3 (c) For purposes of this subdivision, the nonforfeiture 402.4 benefit must be of a shortened benefit period providing paid-up, 402.5 long-term care insurance coverage after lapse. The same 402.6 benefits, amounts, and frequency in effect at the time of lapse, 402.7 but not increased thereafter, will be payable for a qualifying 402.8 claim, but the lifetime maximum dollars or days of benefits must 402.9 be determined as specified in paragraph (d). 402.10 (d) The standard nonforfeiture credit will be equal to 100 402.11 percent of the sum of all premiums paid, including the premiums 402.12 paid prior to any changes in benefits. The insurer may offer 402.13 additional shortened benefit period options, so long as the 402.14 benefits for each duration equal or exceed the standard 402.15 nonforfeiture credit for that duration. However, the minimum 402.16 nonforfeiture credit must not be less than 30 times the daily 402.17 nursing home benefit at the time of lapse. In either event, the 402.18 calculation of the nonforfeiture credit is subject to the 402.19 limitation of this subdivision. 402.20 (e) The nonforfeiture benefit must begin not later than the 402.21 end of the third year following the policy or certificate issue 402.22 date. The contingent benefit upon lapse must be effective 402.23 during the first three years as well as thereafter. 402.24 (f) Notwithstanding paragraph (e), for a policy or 402.25 certificate with attained age rating, the nonforfeiture benefit 402.26 must begin on the earlier of: 402.27 (1) the end of the tenth year following the policy or 402.28 certificate issue date; or 402.29 (2) the end of the second year following the date the 402.30 policy or certificate is no longer subject to attained age 402.31 rating. 402.32 (g) Nonforfeiture credits may be used for all care and 402.33 services qualifying for benefits under the terms of the policy 402.34 or certificate, up to the limits specified in the policy or 402.35 certificate. 402.36 Subd. 6. [BENEFIT LIMIT.] All benefits paid by the insurer 403.1 while the policy or certificate is in premium-paying status and 403.2 in the paid-up status will not exceed the maximum benefits which 403.3 would be payable if the policy or certificate had remained in 403.4 premium-paying status. 403.5 Subd. 7. [MINIMUM BENEFITS; INDIVIDUAL AND GROUP 403.6 POLICIES.] There must be no difference in the minimum 403.7 nonforfeiture benefits as required under this section for group 403.8 and individual policies. 403.9 Subd. 8. [APPLICATION; EFFECTIVE DATES.] This section 403.10 becomes effective January 1, 2002, and applies as follows: 403.11 (a) Except as provided in paragraph (b), this section 403.12 applies to any long-term care policy issued in this state on or 403.13 after the effective date of this section. 403.14 (b) For certificates issued on or after the effective date 403.15 of this section, under a group long-term care insurance policy 403.16 that was in force on the effective date of this section, the 403.17 provisions of this section do not apply. 403.18 Subd. 9. [EFFECT ON LOSS RATIO.] Premiums charged for a 403.19 policy or certificate containing nonforfeiture benefits or a 403.20 contingent benefit on lapse are subject to the loss ratio 403.21 requirements of section 62A.48, subdivision 4, or 62S.26, 403.22 treating the policy as a whole, except for policies or 403.23 certificates that are subject to sections 62S.021, 62S.081, and 403.24 62S.265 and that comply with those sections. 403.25 Subd. 10. [PURCHASED BLOCKS OF BUSINESS.] To determine 403.26 whether contingent nonforfeiture upon lapse provisions are 403.27 triggered under subdivision 4, paragraph (c), a replacing 403.28 insurer that purchased or otherwise assumed a block or blocks of 403.29 long-term care insurance policies from another insurer shall 403.30 calculate the percentage increase based on the initial annual 403.31 premium paid by the insured when the policy was first purchased 403.32 from the original insurer. 403.33 Subd. 11. [LEVEL PREMIUM CONTRACTS.] A nonforfeiture 403.34 benefit for qualified long-term care insurance contracts that 403.35 are level premium contracts must be offered that meets the 403.36 following requirements: 404.1 (1) the nonforfeiture provision must be appropriately 404.2 captioned; 404.3 (2) the nonforfeiture provision must provide a benefit 404.4 available in the event of a default in the payment of any 404.5 premiums and must state that the amount of the benefit may be 404.6 adjusted subsequent to being initially granted only as necessary 404.7 to reflect changes in claims, persistency, and interest as 404.8 reflected in changes in rates for premium paying contracts 404.9 approved by the commissioner for the same contract form; and 404.10 (3) the nonforfeiture provision must provide at least one 404.11 of the following: 404.12 (i) reduced paid-up insurance; 404.13 (ii) extended term insurance; 404.14 (iii) shortened benefit period; or 404.15 (iv) other similar offerings approved by the commissioner. 404.16 [EFFECTIVE DATE.] This section is effective the day 404.17 following final enactment. 404.18 Sec. 13. Minnesota Statutes 2000, section 256.975, is 404.19 amended by adding a subdivision to read: 404.20 Subd. 8. [PROMOTION OF LONG-TERM CARE INSURANCE.] Within 404.21 the limits of appropriations specifically for this purpose, the 404.22 Minnesota board on aging, either directly or through contract, 404.23 shall promote the provision of employer-sponsored, long-term 404.24 care insurance. The board shall encourage private and public 404.25 sector employers to make long-term care insurance available to 404.26 employees, provide interested employers with information on the 404.27 long-term care insurance product offered to state employees, and 404.28 provide technical assistance to employers in designing long-term 404.29 care insurance products and contacting companies offering 404.30 long-term care insurance products. 404.31 ARTICLE 9 404.32 MENTAL HEALTH AND CIVIL COMMITMENT 404.33 Section 1. [62Q.471] [EXCLUSION FOR SUICIDE ATTEMPTS 404.34 PROHIBITED.] 404.35 (a) No health plan may exclude or reduce coverage for 404.36 health care for an enrollee that is otherwise covered under the 405.1 health plan, on the basis that the need for the health care 405.2 arose out of a suicide or suicide attempt by the enrollee. 405.3 (b) For purposes of this section, "health plan" has the 405.4 meaning given in section 62Q.01, subdivision 3, but includes the 405.5 coverages described in section 62A.011, clauses (7) and (10). 405.6 [EFFECTIVE DATE.] This section is effective January 1, 405.7 2002, and applies to contracts issued or renewed on or after 405.8 that date. 405.9 Sec. 2. [62Q.527] [COVERAGE OF NONFORMULARY DRUGS FOR 405.10 MENTAL ILLNESS AND EMOTIONAL DISTURBANCE.] 405.11 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 405.12 section, the following terms have the meanings given to them. 405.13 (b) "Emotional disturbance" has the meaning given in 405.14 section 245.4871, subdivision 15. 405.15 (c) "Mental illness" has the meaning given in section 405.16 245.462, subdivision 20, paragraph (a). 405.17 (d) "Health plan" has the meaning given in section 62Q.01, 405.18 subdivision 3, but includes the coverages described in section 405.19 62A.011, subdivision 3, clauses (7) and (10). 405.20 Subd. 2. [REQUIRED COVERAGE FOR ANTIPSYCHOTIC DRUGS.] (a) 405.21 A health plan that provides prescription drug coverage must 405.22 provide coverage for an antipsychotic drug prescribed to treat 405.23 emotional disturbance or mental illness regardless of whether 405.24 the drug is in the health plan's drug formulary, if the health 405.25 care provider prescribing the drug: 405.26 (1) indicates to the dispensing pharmacist, orally or in 405.27 writing according to section 151.21, that the prescription must 405.28 be dispensed as communicated; and 405.29 (2) certifies in writing to the health plan company that 405.30 the health care provider has considered all equivalent drugs in 405.31 the health plan's drug formulary and has determined that the 405.32 drug prescribed will best treat the patient's condition. 405.33 (b) The health plan is not required to provide coverage for 405.34 a drug if the drug was removed from the health plan's drug 405.35 formulary for safety reasons. 405.36 (c) For drugs covered under this section, no health plan 406.1 company that has received a certification from the health care 406.2 provider as described in paragraph (a), may: 406.3 (1) impose a special deductible, co-payment, coinsurance, 406.4 or other special payment requirement that the health plan does 406.5 not apply to drugs that are in the health plan's drug formulary; 406.6 or 406.7 (2) require written certification from the prescribing 406.8 provider each time a prescription is refilled or renewed that 406.9 the drug prescribed will best treat the patient's condition. 406.10 Subd. 3. [CONTINUING CARE.] (a) Enrollees receiving a 406.11 prescribed drug to treat a diagnosed mental illness or emotional 406.12 disturbance, may continue to receive the prescribed drug for up 406.13 to one year without the imposition of a special deductible, 406.14 co-payment, coinsurance, or other special payment requirements, 406.15 when a health plan's drug formulary changes or an enrollee 406.16 changes health plans and the medication has been shown to 406.17 effectively treat the patient's condition. In order to be 406.18 eligible for this continuing care benefit: 406.19 (1) the patient must have been treated with the drug for 90 406.20 days prior to a change in a health plan's drug formulary or a 406.21 change in the enrollee's health plan; 406.22 (2) the health care provider prescribing the drug indicates 406.23 to the dispensing pharmacist, orally or in writing according to 406.24 section 151.21, that the prescription must be dispensed as 406.25 communicated; and 406.26 (3) the health care provider prescribing the drug certifies 406.27 in writing to the health plan company that the drug prescribed 406.28 will best treat the patient's condition. 406.29 (b) The continuing care benefit shall be extended annually 406.30 when the health care provider prescribing the drug: 406.31 (1) indicates to the dispensing pharmacist, orally or in 406.32 writing according to section 151.21, that the prescription must 406.33 be dispensed as communicated; and 406.34 (2) certifies in writing to the health plan company that 406.35 the drug prescribed will best treat the patient's condition. 406.36 (c) The health plan company is not required to provide 407.1 coverage for a drug if the drug was removed from the health 407.2 plan's drug formulary for safety reasons. 407.3 Subd. 4. [EXCEPTION TO FORMULARY.] A health plan company 407.4 must promptly grant an exception to the health plan's drug 407.5 formulary for an enrollee when the health care provider 407.6 prescribing the drug indicates to the health plan company that: 407.7 (1) the formulary drug causes an adverse reaction in the 407.8 patient; 407.9 (2) the formulary drug is contraindicated for the patient; 407.10 or 407.11 (3) the health care provider demonstrates to the health 407.12 plan that the prescription drug must be dispensed as written to 407.13 provide maximum medical benefit to the patient. 407.14 [EFFECTIVE DATE.] This section is effective January 1, 407.15 2002, and applies to contracts issued or renewed on or after 407.16 that date. 407.17 Sec. 3. [62Q.535] [COVERAGE FOR COURT-ORDERED MENTAL 407.18 HEALTH SERVICES.] 407.19 Subdivision 1. [MENTAL HEALTH SERVICES.] For purposes of 407.20 this section, mental health services means all covered services 407.21 that are intended to treat or ameliorate an emotional, 407.22 behavioral, or psychiatric condition and that are covered by the 407.23 policy, contract, or certificate of coverage of the enrollee's 407.24 health plan company or by law. 407.25 Subd. 2. [COVERAGE REQUIRED.] (a) All health plan 407.26 companies that provide coverage for mental health services must 407.27 cover or provide mental health services ordered by a court of 407.28 competent jurisdiction under a court order that is issued on the 407.29 basis of a behavioral care evaluation performed by a licensed 407.30 psychiatrist or a doctoral level licensed psychologist, which 407.31 includes a diagnosis and an individual treatment plan for care 407.32 in the most appropriate, least restrictive environment. The 407.33 health plan company must be given a copy of the court order and 407.34 the behavioral care evaluation. The health plan company shall 407.35 be financially liable for the evaluation if performed by a 407.36 participating provider of the health plan company and shall be 408.1 financially liable for the care included in the court-ordered 408.2 individual treatment plan if the care is covered by the health 408.3 plan and ordered to be provided by a participating provider or 408.4 another provider as required by rule or law. This court-ordered 408.5 coverage must not be subject to a separate medical necessity 408.6 determination by a health plan company under its utilization 408.7 procedures. 408.8 (b) A party or interested person, including a health plan 408.9 company or its designee, may make a motion for modification of 408.10 the court-ordered plan of care pursuant to the applicable rules 408.11 of procedure for modification of the court's order. The motion 408.12 may include a request for a new behavioral care evaluation 408.13 according to this section. 408.14 [EFFECTIVE DATE.] This section is effective July 1, 2001, 408.15 and applies to contracts issued or renewed on or after that date. 408.16 Sec. 4. [244.054] [DISCHARGE PLANS; OFFENDERS WITH SERIOUS 408.17 AND PERSISTENT MENTAL ILLNESS.] 408.18 Subdivision 1. [OFFER TO DEVELOP PLAN.] The commissioner 408.19 of human services, in collaboration with the commissioner of 408.20 corrections, shall offer to develop a discharge plan for 408.21 community-based services for every offender with serious and 408.22 persistent mental illness, as defined in section 245.462, 408.23 subdivision 20, paragraph (c), who is being released from a 408.24 correctional facility. If an offender is being released 408.25 pursuant to section 244.05, the offender may choose to have the 408.26 discharge plan made one of the conditions of the offender's 408.27 supervised release and shall follow the conditions to the extent 408.28 that services are available and offered to the offender. 408.29 Subd. 2. [CONTENT OF PLAN.] If an offender chooses to have 408.30 a discharge plan developed, the commissioner of human services 408.31 shall develop and implement a discharge plan, which must include 408.32 at least the following: 408.33 (1) at least 90 days before the offender is due to be 408.34 discharged, the commissioner of human services shall designate 408.35 an agent of the department of human services with mental health 408.36 training to serve as the primary person responsible for carrying 409.1 out discharge planning activities; 409.2 (2) at least 75 days before the offender is due to be 409.3 discharged, the offender's designated agent shall: 409.4 (i) obtain informed consent and releases of information 409.5 from the offender that are needed for transition services; 409.6 (ii) contact the county human services department in the 409.7 community where the offender expects to reside following 409.8 discharge, and inform the department of the offender's impending 409.9 discharge and the planned date of the offender's return to the 409.10 community; determine whether the county or a designated 409.11 contracted provider will provide case management services to the 409.12 offender; refer the offender to the case management services 409.13 provider; and confirm that the case management services provider 409.14 will have opened the offender's case prior to the offender's 409.15 discharge; and 409.16 (iii) refer the offender to appropriate staff in the county 409.17 human services department in the community where the offender 409.18 expects to reside following discharge, for enrollment of the 409.19 offender if eligible in medical assistance or general assistance 409.20 medical care, using special procedures established by process 409.21 and department of human services bulletin; 409.22 (3) at least 2-1/2 months before discharge, the offender's 409.23 designated agent shall secure timely appointments for the 409.24 offender with a psychiatrist no later than 30 days following 409.25 discharge, and with other program staff at a community mental 409.26 health provider that is able to serve former offenders with 409.27 serious and persistent mental illness; 409.28 (4) at least 30 days before discharge, the offender's 409.29 designated agent shall convene a predischarge assessment and 409.30 planning meeting of key staff from the programs in which the 409.31 offender has participated while in the correctional facility, 409.32 the offender, and the supervising agent assigned to the 409.33 offender. At the meeting, attendees shall provide background 409.34 information and continuing care recommendations for the 409.35 offender, including information on the offender's risk for 409.36 relapse; current medications, including dosage and frequency; 410.1 therapy and behavioral goals; diagnostic and assessment 410.2 information, including results of a chemical dependency 410.3 evaluation; confirmation of appointments with a psychiatrist and 410.4 other program staff in the community; a relapse prevention plan; 410.5 continuing care needs; needs for housing, employment, and 410.6 finance support and assistance; and recommendations for 410.7 successful community integration, including chemical dependency 410.8 treatment or support if chemical dependency is a risk factor. 410.9 Immediately following this meeting, the offender's designated 410.10 agent shall summarize this background information and continuing 410.11 care recommendations in a written report; 410.12 (5) immediately following the predischarge assessment and 410.13 planning meeting, the provider of mental health case management 410.14 services who will serve the offender following discharge shall 410.15 offer to make arrangements and referrals for housing, financial 410.16 support, benefits assistance, employment counseling, and other 410.17 services required in sections 245.461 to 245.486; 410.18 (6) at least ten days before the offender's first scheduled 410.19 postdischarge appointment with a mental health provider, the 410.20 offender's designated agent shall transfer the following records 410.21 to the offender's case management services provider and 410.22 psychiatrist: the predischarge assessment and planning report, 410.23 medical records, and pharmacy records. These records may be 410.24 transferred only if the offender provides informed consent for 410.25 their release; 410.26 (7) upon discharge, the offender's designated agent shall 410.27 ensure that the offender leaves the correctional facility with 410.28 at least a ten-day supply of all necessary medications; and 410.29 (8) upon discharge, the prescribing authority at the 410.30 offender's correctional facility shall telephone in 410.31 prescriptions for all necessary medications to a pharmacy in the 410.32 community where the offender plans to reside. The prescriptions 410.33 must provide at least a 30-day supply of all necessary 410.34 medications, and must be able to be refilled once for one 410.35 additional 30-day supply. 410.36 Sec. 5. Minnesota Statutes 2000, section 245.462, 411.1 subdivision 8, is amended to read: 411.2 Subd. 8. [DAY TREATMENT SERVICES.] "Day treatment," "day 411.3 treatment services," or "day treatment program" means a 411.4 structured program of treatment and care provided to an adult in 411.5 or by: (1) a hospital accredited by the joint commission on 411.6 accreditation of health organizations and licensed under 411.7 sections 144.50 to 144.55; (2) a community mental health center 411.8 under section 245.62; or (3) an entity that is under contract 411.9 with the county board to operate a program that meets the 411.10 requirements of section 245.4712, subdivision 2, and Minnesota 411.11 Rules, parts 9505.0170 to 9505.0475. Day treatment consists of 411.12 group psychotherapy and other intensive therapeutic services 411.13 that are provided at least one day a week by a multidisciplinary 411.14 staff under the clinical supervision of a mental health 411.15 professional. Day treatment may include education and 411.16 consultation provided to families and other individuals as part 411.17 of the treatment process. The services are aimed at stabilizing 411.18 the adult's mental health status, providing mental health 411.19 services, and developing and improving the adult's independent 411.20 living and socialization skills. The goal of day treatment is 411.21 to reduce or relieve mental illness and to enable the adult to 411.22 live in the community. Day treatment services are not a part of 411.23 inpatient or residential treatment services. Day treatment 411.24 services are distinguished from day care by their structured 411.25 therapeutic program of psychotherapy services. The commissioner 411.26 may limit medical assistance reimbursement for day treatment to 411.27 15 hours per week per person instead of the three hours per day 411.28 per person specified in Minnesota Rules, part 9505.0323, subpart 411.29 15. 411.30 Sec. 6. Minnesota Statutes 2000, section 245.462, is 411.31 amended by adding a subdivision to read: 411.32 Subd. 14c. [MENTAL HEALTH CRISIS SERVICES.] "Mental health 411.33 crisis services" means crisis assessment, crisis intervention, 411.34 and crisis stabilization services. 411.35 Sec. 7. Minnesota Statutes 2000, section 245.462, 411.36 subdivision 18, is amended to read: 412.1 Subd. 18. [MENTAL HEALTH PROFESSIONAL.] "Mental health 412.2 professional" means a person providing clinical services in the 412.3 treatment of mental illness who is qualified in at least one of 412.4 the following ways: 412.5 (1) in psychiatric nursing: a registered nurse who is 412.6 licensed under sections 148.171 to 148.285, and who is certified 412.7 as a clinical specialist in adult psychiatric and mental health 412.8 nursing by a national nurse certification organization or who 412.9 has a master's degree in nursing or one of the behavioral 412.10 sciences or related fields from an accredited college or 412.11 university or its equivalent, with at least 4,000 hours of 412.12 post-master's supervised experience in the delivery of clinical 412.13 services in the treatment of mental illness; 412.14 (2) in clinical social work: a person licensed as an 412.15 independent clinical social worker under section 148B.21, 412.16 subdivision 6, or a person with a master's degree in social work 412.17 from an accredited college or university, with at least 4,000 412.18 hours of post-master's supervised experience in the delivery of 412.19 clinical services in the treatment of mental illness; 412.20 (3) in psychology:a psychologistan individual licensed 412.21 by the board of psychology under sections 148.88 to 148.98 who 412.22 has stated to the board of psychology competencies in the 412.23 diagnosis and treatment of mental illness; 412.24 (4) in psychiatry: a physician licensed under chapter 147 412.25 and certified by the American board of psychiatry and neurology 412.26 or eligible for board certification in psychiatry; 412.27 (5) in marriage and family therapy: the mental health 412.28 professional must be a marriage and family therapist licensed 412.29 under sections 148B.29 to 148B.39 with at least two years of 412.30 post-master's supervised experience in the delivery of clinical 412.31 services in the treatment of mental illness; or 412.32 (6) in allied fields: a person with a master's degree from 412.33 an accredited college or university in one of the behavioral 412.34 sciences or related fields, with at least 4,000 hours of 412.35 post-master's supervised experience in the delivery of clinical 412.36 services in the treatment of mental illness. 413.1 Sec. 8. Minnesota Statutes 2000, section 245.462, is 413.2 amended by adding a subdivision to read: 413.3 Subd. 25a. [SIGNIFICANT IMPAIRMENT IN FUNCTIONING.] 413.4 "Significant impairment in functioning" means a condition, 413.5 including significant suicidal ideation or thoughts of harming 413.6 self or others, which harmfully affects, recurrently or 413.7 consistently, a person's activities of daily living in 413.8 employment, housing, family, and social relationships, or 413.9 education. 413.10 Sec. 9. Minnesota Statutes 2000, section 245.474, is 413.11 amended by adding a subdivision to read: 413.12 Subd. 4. [STAFF SAFETY TRAINING.] The commissioner shall 413.13 by rule require all staff in mental health and support units at 413.14 regional treatment centers who have contact with persons with 413.15 mental illness or severe emotional disturbance to be 413.16 appropriately trained in violence reduction and violence 413.17 prevention, and shall establish criteria for such training. 413.18 Training programs shall be developed with input from consumer 413.19 advocacy organizations, and shall employ violence prevention 413.20 techniques as preferable to physical interaction. 413.21 Sec. 10. Minnesota Statutes 2000, section 245.4871, 413.22 subdivision 10, is amended to read: 413.23 Subd. 10. [DAY TREATMENT SERVICES.] "Day treatment," "day 413.24 treatment services," or "day treatment program" means a 413.25 structured program of treatment and care provided to a child in: 413.26 (1) an outpatient hospital accredited by the joint 413.27 commission on accreditation of health organizations and licensed 413.28 under sections 144.50 to 144.55; 413.29 (2) a community mental health center under section 245.62; 413.30 (3) an entity that is under contract with the county board 413.31 to operate a program that meets the requirements of section 413.32 245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170 to 413.33 9505.0475; or 413.34 (4) an entity that operates a program that meets the 413.35 requirements of section 245.4884, subdivision 2, and Minnesota 413.36 Rules, parts 9505.0170 to 9505.0475, that is under contract with 414.1 an entity that is under contract with a county board. 414.2 Day treatment consists of group psychotherapy and other 414.3 intensive therapeutic services that are provided for a minimum 414.4 three-hour time block by a multidisciplinary staff under the 414.5 clinical supervision of a mental health professional. Day 414.6 treatment may include education and consultation provided to 414.7 families and other individuals as an extension of the treatment 414.8 process. The services are aimed at stabilizing the child's 414.9 mental health status, and developing and improving the child's 414.10 daily independent living and socialization skills. Day 414.11 treatment services are distinguished from day care by their 414.12 structured therapeutic program of psychotherapy services. Day 414.13 treatment services are not a part of inpatient hospital or 414.14 residential treatment services. Day treatment services for a 414.15 child are an integrated set of education, therapy, and family 414.16 interventions. 414.17 A day treatment service must be available to a child at 414.18 least five days a week throughout the year and must be 414.19 coordinated with, integrated with, or part of an education 414.20 program offered by the child's school. 414.21 Sec. 11. Minnesota Statutes 2000, section 245.4871, is 414.22 amended by adding a subdivision to read: 414.23 Subd. 24c. [MENTAL HEALTH CRISIS SERVICES.] "Mental health 414.24 crisis services" means crisis assessment, crisis intervention, 414.25 and crisis stabilization services. 414.26 Sec. 12. Minnesota Statutes 2000, section 245.4871, 414.27 subdivision 27, is amended to read: 414.28 Subd. 27. [MENTAL HEALTH PROFESSIONAL.] "Mental health 414.29 professional" means a person providing clinical services in the 414.30 diagnosis and treatment of children's emotional disorders. A 414.31 mental health professional must have training and experience in 414.32 working with children consistent with the age group to which the 414.33 mental health professional is assigned. A mental health 414.34 professional must be qualified in at least one of the following 414.35 ways: 414.36 (1) in psychiatric nursing, the mental health professional 415.1 must be a registered nurse who is licensed under sections 415.2 148.171 to 148.285 and who is certified as a clinical specialist 415.3 in child and adolescent psychiatric or mental health nursing by 415.4 a national nurse certification organization or who has a 415.5 master's degree in nursing or one of the behavioral sciences or 415.6 related fields from an accredited college or university or its 415.7 equivalent, with at least 4,000 hours of post-master's 415.8 supervised experience in the delivery of clinical services in 415.9 the treatment of mental illness; 415.10 (2) in clinical social work, the mental health professional 415.11 must be a person licensed as an independent clinical social 415.12 worker under section 148B.21, subdivision 6, or a person with a 415.13 master's degree in social work from an accredited college or 415.14 university, with at least 4,000 hours of post-master's 415.15 supervised experience in the delivery of clinical services in 415.16 the treatment of mental disorders; 415.17 (3) in psychology, the mental health professional must bea415.18psychologistan individual licensed by the board of psychology 415.19 under sections 148.88 to 148.98 who has stated to the board of 415.20 psychology competencies in the diagnosis and treatment of mental 415.21 disorders; 415.22 (4) in psychiatry, the mental health professional must be a 415.23 physician licensed under chapter 147 and certified by the 415.24 American board of psychiatry and neurology or eligible for board 415.25 certification in psychiatry; 415.26 (5) in marriage and family therapy, the mental health 415.27 professional must be a marriage and family therapist licensed 415.28 under sections 148B.29 to 148B.39 with at least two years of 415.29 post-master's supervised experience in the delivery of clinical 415.30 services in the treatment of mental disorders or emotional 415.31 disturbances; or 415.32 (6) in allied fields, the mental health professional must 415.33 be a person with a master's degree from an accredited college or 415.34 university in one of the behavioral sciences or related fields, 415.35 with at least 4,000 hours of post-master's supervised experience 415.36 in the delivery of clinical services in the treatment of 416.1 emotional disturbances. 416.2 Sec. 13. Minnesota Statutes 2000, section 245.4875, 416.3 subdivision 2, is amended to read: 416.4 Subd. 2. [CHILDREN'S MENTAL HEALTH SERVICES.] The 416.5 children's mental health service system developed by each county 416.6 board must include the following services: 416.7 (1) education and prevention services according to section 416.8 245.4877; 416.9 (2) mental health identification and intervention services 416.10 according to section 245.4878; 416.11 (3) emergency services according to section 245.4879; 416.12 (4) outpatient services according to section 245.488; 416.13 (5) family community support services according to section 416.14 245.4881; 416.15 (6) day treatment services according to section 245.4884, 416.16 subdivision 2; 416.17 (7) residential treatment services according to section 416.18 245.4882; 416.19 (8) acute care hospital inpatient treatment services 416.20 according to section 245.4883; 416.21 (9) screening according to section 245.4885; 416.22 (10) case management according to section 245.4881; 416.23 (11) therapeutic support of foster care according to 416.24 section 245.4884, subdivision 4;and416.25 (12) professional home-based family treatment according to 416.26 section 245.4884, subdivision 4; and 416.27 (13) mental health crisis services according to section 416.28 245.488, subdivision 3. 416.29 Sec. 14. Minnesota Statutes 2000, section 245.4876, 416.30 subdivision 1, is amended to read: 416.31 Subdivision 1. [CRITERIA.] Children's mental health 416.32 services required by sections 245.487 to 245.4888 must be: 416.33 (1) based, when feasible, on research findings; 416.34 (2) based on individual clinical, cultural, and ethnic 416.35 needs, and other special needs of the children being served; 416.36 (3) delivered in a manner that improves family functioning 417.1 when clinically appropriate; 417.2 (4) provided in the most appropriate, least restrictive 417.3 setting that meets the requirements in subdivision 1a, and that 417.4 is available to the county board to meet the child's treatment 417.5 needs; 417.6 (5) accessible to all age groups of children; 417.7 (6) appropriate to the developmental age of the child being 417.8 served; 417.9 (7) delivered in a manner that provides accountability to 417.10 the child for the quality of service delivered and continuity of 417.11 services to the child during the years the child needs services 417.12 from the local system of care; 417.13 (8) provided by qualified individuals as required in 417.14 sections 245.487 to 245.4888; 417.15 (9) coordinated with children's mental health services 417.16 offered by other providers; 417.17 (10) provided under conditions that protect the rights and 417.18 dignity of the individuals being served; and 417.19 (11) provided in a manner and setting most likely to 417.20 facilitate progress toward treatment goals. 417.21 Sec. 15. Minnesota Statutes 2000, section 245.4876, is 417.22 amended by adding a subdivision to read: 417.23 Subd. 1a. [APPROPRIATE SETTING TO RECEIVE SERVICES.] A 417.24 child must be provided with mental health services in the least 417.25 restrictive setting that is appropriate to the needs and current 417.26 condition of the individual child. For a child to receive 417.27 mental health services in a residential treatment or acute care 417.28 hospital inpatient setting, the family may not be required to 417.29 demonstrate that services were first provided in a less 417.30 restrictive setting and that the child failed to make progress 417.31 toward or meet treatment goals in the less restrictive setting. 417.32 Sec. 16. Minnesota Statutes 2000, section 245.488, is 417.33 amended by adding a subdivision to read: 417.34 Subd. 3. [MENTAL HEALTH CRISIS SERVICES.] County boards 417.35 must provide or contract for mental health crisis services 417.36 within the county to meet the needs of children with emotional 418.1 disturbance residing in the county who are determined, through 418.2 an assessment by a mental health professional, to be 418.3 experiencing a mental health crisis or mental health emergency. 418.4 The mental health crisis services provided must be medically 418.5 necessary, as defined in section 62Q.53, subdivision 2, and 418.6 necessary for the safety of the child or others regardless of 418.7 the setting. 418.8 Sec. 17. Minnesota Statutes 2000, section 245.4885, 418.9 subdivision 1, is amended to read: 418.10 Subdivision 1. [SCREENING REQUIRED.] The county board 418.11 shall, prior to admission, except in the case of emergency 418.12 admission, screen all children referred for treatment of severe 418.13 emotional disturbance to a residential treatment facility or 418.14 informally admitted to a regional treatment center if public 418.15 funds are used to pay for the services. The county board shall 418.16 also screen all children admitted to an acute care hospital for 418.17 treatment of severe emotional disturbance if public funds other 418.18 than reimbursement under chapters 256B and 256D are used to pay 418.19 for the services. If a child is admitted to a residential 418.20 treatment facility or acute care hospital for emergency 418.21 treatment or held for emergency care by a regional treatment 418.22 center under section 253B.05, subdivision 1, screening must 418.23 occur within three working days of admission. Screening shall 418.24 determine whether the proposed treatment: 418.25 (1) is necessary; 418.26 (2) is appropriate to the child's individual treatment 418.27 needs; 418.28 (3) cannot be effectively provided in the child's home; and 418.29 (4) provides a length of stay as short as possible 418.30 consistent with the individual child's need. 418.31 When a screening is conducted, the county board may not 418.32 determine that referral or admission to a residential treatment 418.33 facility or acute care hospital is not appropriate solely 418.34 because services were not first provided to the child in a less 418.35 restrictive setting and the child failed to make progress toward 418.36 or meet treatment goals in the less restrictive setting. 419.1 Screening shall include both a diagnostic assessment and a 419.2 functional assessment which evaluates family, school, and 419.3 community living situations. If a diagnostic assessment or 419.4 functional assessment has been completed by a mental health 419.5 professional within 180 days, a new diagnostic or functional 419.6 assessment need not be completed unless in the opinion of the 419.7 current treating mental health professional the child's mental 419.8 health status has changed markedly since the assessment was 419.9 completed. The child's parent shall be notified if an 419.10 assessment will not be completed and of the reasons. A copy of 419.11 the notice shall be placed in the child's file. Recommendations 419.12 developed as part of the screening process shall include 419.13 specific community services needed by the child and, if 419.14 appropriate, the child's family, and shall indicate whether or 419.15 not these services are available and accessible to the child and 419.16 family. 419.17 During the screening process, the child, child's family, or 419.18 child's legal representative, as appropriate, must be informed 419.19 of the child's eligibility for case management services and 419.20 family community support services and that an individual family 419.21 community support plan is being developed by the case manager, 419.22 if assigned. 419.23 Screening shall be in compliance with section 256F.07 or 419.24 260C.212, whichever applies. Wherever possible, the parent 419.25 shall be consulted in the screening process, unless clinically 419.26 inappropriate. 419.27 The screening process, and placement decision, and 419.28 recommendations for mental health services must be documented in 419.29 the child's record. 419.30 An alternate review process may be approved by the 419.31 commissioner if the county board demonstrates that an alternate 419.32 review process has been established by the county board and the 419.33 times of review, persons responsible for the review, and review 419.34 criteria are comparable to the standards in clauses (1) to (4). 419.35 Sec. 18. Minnesota Statutes 2000, section 245.4886, 419.36 subdivision 1, is amended to read: 420.1 Subdivision 1. [STATEWIDE PROGRAM; ESTABLISHMENT.] The 420.2 commissioner shall establish a statewide program to assist 420.3 counties in providing services to children with severe emotional 420.4 disturbance as defined in section 245.4871, subdivision 15, and 420.5 their families; and to young adults meeting the criteria for 420.6 transition services in section 245.4875, subdivision 8, and 420.7 their families. Services must be designed to help each child to 420.8 function and remain with the child's family in the community. 420.9 Transition services to eligible young adults must be designed to 420.10 foster independent living in the community. The commissioner 420.11 shall make grants to counties to establish, operate, or contract 420.12 with private providers to provide the following services in the 420.13 following order of priority when these cannot be reimbursed 420.14 under section 256B.0625: 420.15 (1) family community support services including crisis 420.16 placement and crisis respite care as specified in section 420.17 245.4871, subdivision 17; 420.18 (2) case management services as specified in section 420.19 245.4871, subdivision 3; 420.20 (3) day treatment services as specified in section 420.21 245.4871, subdivision 10; 420.22 (4) professional home-based family treatment as specified 420.23 in section 245.4871, subdivision 31; and 420.24 (5) therapeutic support of foster care as specified in 420.25 section 245.4871, subdivision 34. 420.26 Funding appropriated beginning July 1, 1991, must be used 420.27 by county boards to provide family community support services 420.28 and case management services. Additional services shall be 420.29 provided in the order of priority as identified in this 420.30 subdivision. 420.31 Sec. 19. Minnesota Statutes 2000, section 245.99, 420.32 subdivision 4, is amended to read: 420.33 Subd. 4. [ADMINISTRATION OF CRISIS HOUSING ASSISTANCE.] 420.34 The commissioner may contract with organizations or government 420.35 units experienced in housing assistance to operate the program 420.36 under this section. This program is not an entitlement. The 421.1 commissioner may take any of the following steps whenever the 421.2 commissioner projects that funds will be inadequate to meet 421.3 demand in a given fiscal year: 421.4 (1) transfer funds from mental health grants in the same 421.5 appropriation; and 421.6 (2) impose statewide restrictions as to the type and amount 421.7 of assistance available to each recipient under this program, 421.8 including reducing the income eligibility level, limiting 421.9 reimbursement to a percentage of each recipient's costs, 421.10 limiting housing assistance to 60 days per recipient, or closing 421.11 the program for the remainder of the fiscal year. 421.12 Sec. 20. Minnesota Statutes 2000, section 253B.02, 421.13 subdivision 10, is amended to read: 421.14 Subd. 10. [INTERESTED PERSON.] "Interested person" means: 421.15 (1) an adult, including but not limited to, a public 421.16 official, including a local welfare agency acting under section 421.17 626.5561, and the legal guardian, spouse, parent, legal counsel, 421.18 adult child, next of kin, or other person designated by a 421.19 proposed patient; or 421.20 (2) a health plan company that is providing coverage for a 421.21 proposed patient. 421.22 Sec. 21. Minnesota Statutes 2000, section 253B.02, 421.23 subdivision 13, is amended to read: 421.24 Subd. 13. [MENTALLY ILL PERSON.] (a) "Mentally ill person" 421.25 means any person who has an organic disorder of the brain or a 421.26 substantial psychiatric disorder of thought, mood, perception, 421.27 orientation, or memory which grossly impairs judgment, behavior, 421.28 capacity to recognize reality, or to reason or understand, which 421.29 is manifested by instances of grossly disturbed behavior or 421.30 faulty perceptions and poses a substantial likelihood of 421.31 physical harm to self or others as demonstrated by: 421.32 (1) a failure to obtain necessary food, clothing, shelter, 421.33 or medical care as a result of the impairment;or421.34 (2) an inability for reasons other than indigence to obtain 421.35 necessary food, clothing, shelter, or medical care as a result 421.36 of the impairment and it is more probable than not that the 422.1 person will suffer substantial harm, significant psychiatric 422.2 deterioration or debilitation, or serious illness, unless 422.3 appropriate treatment and services are provided; 422.4(2)(3) a recent attempt or threat to physically harm self 422.5 or others; or 422.6 (4) recent and volitional conduct involving significant 422.7 damage to substantial property. 422.8 (b) A person is not mentally ill under this section if the 422.9 impairment is solely due to: 422.10 (1) epilepsy; 422.11 (2) mental retardation; 422.12 (3) brief periods of intoxication caused by alcohol, drugs, 422.13 or other mind-altering substances; or 422.14 (4) dependence upon or addiction to any alcohol, drugs, or 422.15 other mind-altering substances. 422.16 [EFFECTIVE DATE.] This section is effective July 1, 2002. 422.17 Sec. 22. Minnesota Statutes 2000, section 253B.03, 422.18 subdivision 5, is amended to read: 422.19 Subd. 5. [PERIODIC ASSESSMENT.] A patient has the right to 422.20 periodic medical assessment, including assessment of the medical 422.21 necessity of continuing care and, if the treatment facility 422.22 declines to provide continuing care, the right to receive 422.23 specific written reasons why continuing care is declined at the 422.24 time of the assessment. The treatment facility shall assess the 422.25 physical and mental condition of every patient as frequently as 422.26 necessary, but not less often than annually. If the patient 422.27 refuses to be examined, the facility shall document in the 422.28 patient's chart its attempts to examine the patient. If a 422.29 person is committed as mentally retarded for an indeterminate 422.30 period of time, the three-year judicial review must include the 422.31 annual reviews for each year as outlined in Minnesota Rules, 422.32 part 9525.0075, subpart 6. 422.33 Sec. 23. Minnesota Statutes 2000, section 253B.03, 422.34 subdivision 10, is amended to read: 422.35 Subd. 10. [NOTIFICATION.] All persons admitted or 422.36 committed to a treatment facility shall be notified in writing 423.1 of their rightsunder this chapterregarding hospitalization and 423.2 other treatment at the time of admission. This notification 423.3 must include: 423.4 (1) patient rights specified in this section and section 423.5 144.651, including nursing home discharge rights; 423.6 (2) the right to obtain treatment and services voluntarily 423.7 under this chapter; 423.8 (3) the right to voluntary admission and release under 423.9 section 253B.04; 423.10 (4) rights in case of an emergency admission under section 423.11 253B.05, including the right to documentation in support of an 423.12 emergency hold and the right to a summary hearing before a judge 423.13 if the patient believes an emergency hold is improper; 423.14 (5) the right to request expedited review under section 423.15 62M.05 if additional days of inpatient stay are denied; 423.16 (6) the right to continuing benefits pending appeal and to 423.17 an expedited administrative hearing under section 256.045 if the 423.18 patient is a recipient of medical assistance, general assistance 423.19 medical care, or MinnesotaCare; and 423.20 (7) the right to an external appeal process under section 423.21 62Q.73, including the right to a second opinion. 423.22 Sec. 24. Minnesota Statutes 2000, section 253B.03, is 423.23 amended by adding a subdivision to read: 423.24 Subd. 11. [PROXY.] A legally authorized health care proxy, 423.25 agent, guardian, or conservator may exercise the patient's 423.26 rights on the patient's behalf. 423.27 Sec. 25. Minnesota Statutes 2000, section 253B.04, 423.28 subdivision 1, is amended to read: 423.29 Subdivision 1. [VOLUNTARY ADMISSION AND TREATMENT.] (a) 423.30 Voluntary admission is preferred over involuntary commitment and 423.31 treatment. Any person 16 years of age or older may request to 423.32 be admitted to a treatment facility as a voluntary patient for 423.33 observation, evaluation, diagnosis, care and treatment without 423.34 making formal written application. Any person under the age of 423.35 16 years may be admitted as a patient with the consent of a 423.36 parent or legal guardian if it is determined by independent 424.1 examination that there is reasonable evidence that (1) the 424.2 proposed patient has a mental illness, or is mentally retarded 424.3 or chemically dependent; and (2) the proposed patient is 424.4 suitable for treatment. The head of the treatment facility 424.5 shall not arbitrarily refuse any person seeking admission as a 424.6 voluntary patient. In making decisions regarding admissions, 424.7 the facility shall use clinical admission criteria consistent 424.8 with the current applicable inpatient admission standards 424.9 established by the American Psychiatric Association or the 424.10 American Academy of Child and Adolescent Psychiatry. These 424.11 criteria must be no more restrictive than, and must be 424.12 consistent with, the requirements of section 62Q.53. The 424.13 facility may not refuse to admit a person voluntarily solely 424.14 because the person does not meet the criteria for involuntary 424.15 holds under section 253B.05 or the definition of mental illness 424.16 under section 253B.02, subdivision 13. 424.17 (b) In addition to the consent provisions of paragraph (a), 424.18 a person who is 16 or 17 years of age who refuses to consent 424.19 personally to admission may be admitted as a patient for mental 424.20 illness or chemical dependency treatment with the consent of a 424.21 parent or legal guardian if it is determined by an independent 424.22 examination that there is reasonable evidence that the proposed 424.23 patient is chemically dependent or has a mental illness and is 424.24 suitable for treatment. The person conducting the examination 424.25 shall notify the proposed patient and the parent or legal 424.26 guardian of this determination. 424.27 Sec. 26. Minnesota Statutes 2000, section 253B.04, 424.28 subdivision 1a, is amended to read: 424.29 Subd. 1a. [VOLUNTARY TREATMENT OR ADMISSION FOR PERSONS 424.30 WITH MENTAL ILLNESS.] (a) A person with a mental illness may 424.31 seek or voluntarily agree to accept treatment or admission to a 424.32 facility. If the mental health provider determines that the 424.33 person lacks the capacity to give informed consent for the 424.34 treatment or admission, and in the absence of a health care 424.35 power of attorney that authorizes consent, the designated agency 424.36 or its designee may give informed consent for mental health 425.1 treatment or admission to a treatment facility on behalf of the 425.2 person. 425.3 (b) The designated agency shall apply the following 425.4 criteria in determining the person's ability to give informed 425.5 consent: 425.6 (1) whether the person demonstrates an awareness of the 425.7 person's illness, and the reasons for treatment, its risks, 425.8 benefits and alternatives, and the possible consequences of 425.9 refusing treatment; and 425.10 (2) whether the person communicates verbally or nonverbally 425.11 a clear choice concerning treatment that is a reasoned one, not 425.12 based on delusion, even though it may not be in the person's 425.13 best interests. 425.14 (c) The basis for the designated agency's decision that the 425.15 person lacks the capacity to give informed consent for treatment 425.16 or admission, and that the patient has voluntarily accepted 425.17 treatment or admission, must be documented in writing. 425.18 (d) A mental health provider that provides treatment in 425.19 reliance on the written consent given by the designated agency 425.20 under this subdivision or by a substitute decision maker 425.21 appointed by the court is not civilly or criminally liable for 425.22 performing treatment without consent. This paragraph does not 425.23 affect any other liability that may result from the manner in 425.24 which the treatment is performed. 425.25 (e) A person who receives treatment or is admitted to a 425.26 facility under this subdivision or subdivision 1b has the right 425.27 to refuse treatment at any time or to be released from a 425.28 facility as provided under subdivision 2. The person or any 425.29 interested person acting on the person's behalf may seek court 425.30 review within five days for a determination of whether the 425.31 person's agreement to accept treatment or admission is 425.32 voluntary. At the time a person agrees to treatment or 425.33 admission to a facility under this subdivision, the designated 425.34 agency or its designee shall inform the person in writing of the 425.35 person's rights under this paragraph. 425.36 (f) This subdivision does not authorize the administration 426.1 of neuroleptic medications. Neuroleptic medications may be 426.2 administered only as provided in section 253B.092. 426.3 Sec. 27. Minnesota Statutes 2000, section 253B.04, is 426.4 amended by adding a subdivision to read: 426.5 Subd. 1b. [COURT APPOINTMENT OF SUBSTITUTE DECISION 426.6 MAKER.] If the designated agency or its designee declines or 426.7 refuses to give informed consent under subdivision 1a, the 426.8 person who is seeking treatment or admission, or an interested 426.9 person acting on behalf of the person, may petition the court 426.10 for appointment of a substitute decision maker who may give 426.11 informed consent for voluntary treatment and services. In 426.12 making this determination, the court shall apply the criteria in 426.13 subdivision 1a, paragraph (b). 426.14 Sec. 28. Minnesota Statutes 2000, section 253B.045, 426.15 subdivision 6, is amended to read: 426.16 Subd. 6. [COVERAGE.]A health plan company must provide426.17coverage, according to the terms of the policy, contract, or426.18certificate of coverage, for all medically necessary covered426.19services as determined by section 62Q.53 provided to an enrollee426.20that are ordered by the court under this chapter.(a) For 426.21 purposes of this section, "mental health services" means all 426.22 covered services that are intended to treat or ameliorate an 426.23 emotional, behavioral, or psychiatric condition and that are 426.24 covered by the policy, contract, or certificate of coverage of 426.25 the enrollee's health plan company or by law. 426.26 (b) All health plan companies that provide coverage for 426.27 mental health services must cover or provide mental health 426.28 services ordered by a court of competent jurisdiction under a 426.29 court order that is issued on the basis of a behavioral care 426.30 evaluation performed by a licensed psychiatrist or a doctoral 426.31 level licensed psychologist, which includes a diagnosis and an 426.32 individual treatment plan for care in the most appropriate, 426.33 least restrictive environment. The health plan company must be 426.34 given a copy of the court order and the behavioral care 426.35 evaluation. The health plan company shall be financially liable 426.36 for the evaluation if performed by a participating provider of 427.1 the health plan company and shall be financially liable for the 427.2 care included in the court-ordered individual treatment plan if 427.3 the care is covered by the health plan company and ordered to be 427.4 provided by a participating provider or another provider as 427.5 required by rule or law. This court-ordered coverage must not 427.6 be subject to a separate medical necessity determination by a 427.7 health plan company under its utilization procedures. 427.8 Sec. 29. Minnesota Statutes 2000, section 253B.05, 427.9 subdivision 1, is amended to read: 427.10 Subdivision 1. [EMERGENCY HOLD.] (a) Any person may be 427.11 admitted or held for emergency care and treatment in a treatment 427.12 facility with the consent of the head of the treatment facility 427.13 upon a written statement by an examiner that: 427.14 (1) the examiner has examined the person not more than 15 427.15 days prior to admission,; 427.16 (2) the examiner is of the opinion, for stated reasons, 427.17 that the person is mentally ill, mentally retarded or chemically 427.18 dependent, and is inimminentdanger of causing injury to self 427.19 or others if not immediatelyrestrained,detained; and 427.20 (3) an order of the court cannot be obtained in time to 427.21 prevent the anticipated injury. 427.22 (b) If the proposed patient has been brought to the 427.23 treatment facility by another person, the examiner shall make a 427.24 good faith effort to obtain a statement of information that is 427.25 available from that person, which must be taken into 427.26 consideration in deciding whether to place the proposed patient 427.27 on an emergency hold. The statement of information must 427.28 include, to the extent available, direct observations of the 427.29 proposed patient's behaviors, reliable knowledge of recent and 427.30 past behavior, and information regarding psychiatric history, 427.31 past treatment, and current mental health providers. The 427.32 examiner shall also inquire into the existence of health care 427.33 directives under chapter 145, and advance psychiatric directives 427.34 under section 253B.03, subdivision 6d. 427.35 (c) The examiner's statement shall be: (1) sufficient 427.36 authority for a peace or health officer to transport a patient 428.1 to a treatment facility, (2) stated in behavioral terms and not 428.2 in conclusory language, and (3) of sufficient specificity to 428.3 provide an adequate record for review. Ifimminentdanger to 428.4 specific individuals is a basis for the emergency hold, the 428.5 statement must identify those individuals, to the extent 428.6 practicable. A copy of the examiner's statement shall be 428.7 personally served on the person immediately upon admission and a 428.8 copy shall be maintained by the treatment facility. 428.9 Sec. 30. Minnesota Statutes 2000, section 253B.065, 428.10 subdivision 5, is amended to read: 428.11 Subd. 5. [EARLY INTERVENTION CRITERIA.] (a) A court shall 428.12 order early intervention treatment of a proposed patient who 428.13 meets the criteria under paragraph (b). The early intervention 428.14 treatment must be less intrusive than long-term inpatient 428.15 commitment and must be the least restrictive treatment program 428.16 available that can meet the patient's treatment needs. 428.17 (b) The court shall order early intervention treatment if 428.18 the court finds all of the elements of the following factors by 428.19 clear and convincing evidence: 428.20 (1) the proposed patient is mentally ill; 428.21 (2) the proposed patient refuses to accept appropriate 428.22 mental health treatment; and 428.23 (3) the proposed patient's mental illness is manifested by 428.24 instances of grossly disturbed behavior or faulty perceptions 428.25 and either: 428.26 (i) the grossly disturbed behavior or faulty perceptions 428.27 significantly interfere with the proposed patient's ability to 428.28 care for self and the proposed patient, when competent, would 428.29 have chosen substantially similar treatment under the same 428.30 circumstances; or 428.31 (ii) due to the mental illness, the proposed patient 428.32 received court-ordered inpatient treatment under section 253B.09 428.33 at least two times in the previous three years; the patient is 428.34 exhibiting symptoms or behavior substantially similar to those 428.35 that precipitated one or more of the court-ordered treatments; 428.36 and the patient is reasonably expected to physically or mentally 429.1 deteriorate to the point of meeting the criteria for commitment 429.2 under section 253B.09 unless treated. 429.3 For purposes of this paragraph, a proposed patient who was 429.4 released under section 253B.095 and whose release was not 429.5 revoked is not considered to have received court-ordered 429.6 inpatient treatment under section 253B.09. 429.7 (c) For purposes of paragraph (b), none of the following 429.8 constitute a refusal to accept appropriate mental health 429.9 treatment: 429.10 (1) a willingness to take medication but a reasonable 429.11 disagreement about type or dosage; 429.12 (2) a good-faith effort to follow a reasonable alternative 429.13 treatment plan, including treatment as specified in a valid 429.14 advance directive under chapter 145C or section 253B.03, 429.15 subdivision 6d; 429.16 (3) an inability to obtain access to appropriate treatment 429.17 because of inadequate health care coverage or an insurer's 429.18 refusal or delay in providing coverage for the treatment; or 429.19 (4) an inability to obtain access to needed mental health 429.20 services because the provider will only accept patients who are 429.21 under a court order or because the provider gives persons under 429.22 a court order a priority over voluntary patients in obtaining 429.23 treatment and services. 429.24 Sec. 31. Minnesota Statutes 2000, section 253B.066, 429.25 subdivision 1, is amended to read: 429.26 Subdivision 1. [TREATMENT ALTERNATIVES.] If the court 429.27 orders early intervention under section 253B.065, subdivision 5, 429.28 the court may include in its order a variety of treatment 429.29 alternatives including, but not limited to, day treatment, 429.30 medication compliance monitoring, and short-term hospitalization 429.31 not to exceedten21 days. 429.32 If the court orders short-term hospitalization and the 429.33 proposed patient will not go voluntarily, the court may direct a 429.34 health officer, peace officer, or other person to take the 429.35 person into custody and transport the person to the hospital. 429.36 Sec. 32. Minnesota Statutes 2000, section 253B.07, 430.1 subdivision 1, is amended to read: 430.2 Subdivision 1. [PREPETITION SCREENING.] (a) Prior to 430.3 filing a petition for commitment of or early intervention for a 430.4 proposed patient, an interested person shall apply to the 430.5 designated agency in the county of the proposed patient's 430.6 residence or presence for conduct of a preliminary 430.7 investigation, except when the proposed patient has been 430.8 acquitted of a crime under section 611.026 and the county 430.9 attorney is required to file a petition for commitment. The 430.10 designated agency shall appoint a screening team to conduct an 430.11 investigationwhich shall include. The petitioner may not be a 430.12 member of the screening team. The investigation must include: 430.13 (i) a personal interview with the proposed patient and 430.14 other individuals who appear to have knowledge of the condition 430.15 of the proposed patient. If the proposed patient is not 430.16 interviewed, specific reasons must be documented; 430.17 (ii) identification and investigation of specific alleged 430.18 conduct which is the basis for application; 430.19 (iii) identification, exploration, and listing of 430.20 the specific reasons for rejecting or recommending alternatives 430.21 to involuntary placement; 430.22 (iv) in the case of a commitment based on mental illness, 430.23 the following information, if it is known or available:430.24information, that may be relevant to the administration of 430.25 neuroleptic medications,if necessary,including the existence 430.26 of a declaration under section 253B.03, subdivision 6d, or a 430.27 health care directive under chapter 145C or a guardian, 430.28 conservator, proxy, or agent with authority to make health care 430.29 decisions for the proposed patient; information regarding the 430.30 capacity of the proposed patient to make decisions regarding 430.31 administration of neuroleptic medication; and whether the 430.32 proposed patient is likely to consent or refuse consent to 430.33 administration of the medication;and430.34 (v) seeking input from the proposed patient's health plan 430.35 company to provide the court with information about services the 430.36 enrollee needs and the least restrictive alternatives.; and 431.1 (vi) in the case of a commitment based on mental illness, 431.2 information listed in clause (iv) for other purposes relevant to 431.3 treatment. 431.4 (b) In conducting the investigation required by this 431.5 subdivision, the screening team shall have access to all 431.6 relevant medical records of proposed patients currently in 431.7 treatment facilities. The interviewer shall inform the proposed 431.8 patient that any information provided by the proposed patient 431.9 may be included in the prepetition screening report and may be 431.10 considered in the commitment proceedings. Data collected 431.11 pursuant to this clause shall be considered private data on 431.12 individuals. The prepetition screening report is not admissible 431.13 as evidence except by agreement of counsel or as permitted by 431.14 this chapter or the rules of court, and is not admissible in any 431.15 court proceedings unrelated to the commitment proceedings. 431.16 (c) The prepetition screening team shall provide a notice, 431.17 written in easily understood language, to the proposed patient, 431.18 the petitioner, persons named in a declaration under chapter 431.19 145C or section 253B.03, subdivision 6d, and, with the proposed 431.20 patient's consent, other interested parties. The team shall ask 431.21 the patient if the patient wants the notice read and shall read 431.22 the notice to the patient upon request. The notice must contain 431.23 information regarding the process, purpose, and legal effects of 431.24 civil commitment and early intervention. The notice must inform 431.25 the proposed patient that: 431.26 (1) if a petition is filed, the patient has certain rights, 431.27 including the right to a court-appointed attorney, the right to 431.28 request a second examiner, the right to attend hearings, and the 431.29 right to oppose the proceeding and to present and contest 431.30 evidence; and 431.31 (2) if the proposed patient is committed to a state 431.32 regional treatment center or group home, the patient may be 431.33 billed for the cost of care and the state has the right to make 431.34 a claim against the patient's estate for this cost. 431.35 The ombudsman for mental health and mental retardation 431.36 shall develop a form for the notice, which includes the 432.1 requirements of this paragraph. 432.2 (d) When the prepetition screening team recommends 432.3 commitment, a written report shall be sent to the county 432.4 attorney for the county in which the petition is to be 432.5 filed. The statement of facts contained in the written report 432.6 must meet the requirements of subdivision 2, paragraph (b). 432.7(d)(e) The prepetition screening team shall refuse to 432.8 support a petition if the investigation does not disclose 432.9 evidence sufficient to support commitment. Notice of the 432.10 prepetition screening team's decision shall be provided to the 432.11 prospective petitioner and to the proposed patient. 432.12(e)(f) If the interested person wishes to proceed with a 432.13 petition contrary to the recommendation of the prepetition 432.14 screening team, application may be made directly to the county 432.15 attorney, whomayshall determine whether or not to proceed with 432.16 the petition. Notice of the county attorney's determination 432.17 shall be provided to the interested party. 432.18(f)(g) If the proposed patient has been acquitted of a 432.19 crime under section 611.026, the county attorney shall apply to 432.20 the designated county agency in the county in which the 432.21 acquittal took place for a preliminary investigation unless 432.22 substantially the same information relevant to the proposed 432.23 patient's current mental condition, as could be obtained by a 432.24 preliminary investigation, is part of the court record in the 432.25 criminal proceeding or is contained in the report of a mental 432.26 examination conducted in connection with the criminal 432.27 proceeding. If a court petitions for commitment pursuant to the 432.28 rules of criminal or juvenile procedure or a county attorney 432.29 petitions pursuant to acquittal of a criminal charge under 432.30 section 611.026, the prepetition investigation, if required by 432.31 this section, shall be completed within seven days after the 432.32 filing of the petition. 432.33 Sec. 33. Minnesota Statutes 2000, section 253B.07, 432.34 subdivision 2, is amended to read: 432.35 Subd. 2. [THE PETITION.] (a) Any interested person, except 432.36 a member of the prepetition screening team, may file a petition 433.1 for commitment in the district court of the county of the 433.2 proposed patient's residence or presence. If the head of the 433.3 treatment facility believes that commitment is required and no 433.4 petition has been filed, the head of the treatment facility 433.5 shall petition for the commitment of the person. 433.6 (b) The petition shall set forth the name and address of 433.7 the proposed patient, the name and address of the patient's 433.8 nearest relatives, and the reasons for the petition. The 433.9 petition must contain factual descriptions of the proposed 433.10 patient's recent behavior, including a description of the 433.11 behavior, where it occurred, and the time period over which it 433.12 occurred. Each factual allegation must be supported by 433.13 observations of witnesses named in the petition. Petitions 433.14 shall be stated in behavioral terms and shall not contain 433.15 judgmental or conclusory statements. 433.16 (c) The petition shall be accompanied by a written 433.17 statement by an examiner stating that the examiner has examined 433.18 the proposed patient within the 15 days preceding the filing of 433.19 the petition and is of the opinion that the proposed patient is 433.20 suffering a designated disability and should be committed to a 433.21 treatment facility. The statement shall include the reasons for 433.22 the opinion. In the case of a commitment based on mental 433.23 illness, the petition and the examiner's statementmayshall 433.24 include, to the extent this information is available, a 433.25 statement and opinion regarding the proposed patient's need for 433.26 treatment with neuroleptic medication and the patient's capacity 433.27 to make decisions regarding the administration of neuroleptic 433.28 medications, and the reasons for the opinion. If use of 433.29 neuroleptic medications is recommended by the treating 433.30 physician, the petition for commitment must, if applicable, 433.31 include or be accompanied by a request for proceedings under 433.32 section 253B.092. Failure to include the required information 433.33 regarding neuroleptic medications in the examiner's statement, 433.34 or to include a request for an order regarding neuroleptic 433.35 medications with the commitment petition, is not a basis for 433.36 dismissing the commitment petition. If a petitioner has been 434.1 unable to secure a statement from an examiner, the petition 434.2 shall include documentation that a reasonable effort has been 434.3 made to secure the supporting statement. 434.4 Sec. 34. Minnesota Statutes 2000, section 253B.07, 434.5 subdivision 7, is amended to read: 434.6 Subd. 7. [PRELIMINARY HEARING.] (a) No proposed patient 434.7 may be held in a treatment facility under a judicial hold 434.8 pursuant to subdivision 6 longer than 72 hours, exclusive of 434.9 Saturdays, Sundays, and legal holidays, unless the court holds a 434.10 preliminary hearing and determines that the standard is met to 434.11 hold the person. 434.12 (b) The proposed patient, patient's counsel, the 434.13 petitioner, the county attorney, and any other persons as the 434.14 court directs shall be given at least 24 hours written notice of 434.15 the preliminary hearing. The notice shall include the alleged 434.16 grounds for confinement. The proposed patient shall be 434.17 represented at the preliminary hearing by counsel. The court 434.18 may admit reliable hearsay evidence, including written reports, 434.19 for the purpose of the preliminary hearing. 434.20 (c) The court, on its motion or on the motion of any party, 434.21 may exclude or excuse a proposed patient who is seriously 434.22 disruptive or who is incapable of comprehending and 434.23 participating in the proceedings. In such instances, the court 434.24 shall, with specificity on the record, state the behavior of the 434.25 proposed patient or other circumstances which justify proceeding 434.26 in the absence of the proposed patient. 434.27 (d) The court may continue the judicial hold of the 434.28 proposed patient if it finds, by a preponderance of the 434.29 evidence, that seriousimminentphysical harm to the proposed 434.30 patient or others is likely if the proposed patient is not 434.31 immediately confined. If a proposed patient was acquitted of a 434.32 crime against the person under section 611.026 immediately 434.33 preceding the filing of the petition, the court may presume that 434.34 seriousimminentphysical harm to the patient or others is 434.35 likely if the proposed patient is not immediately confined. 434.36 (e) Upon a showing that a person subject to a petition for 435.1 commitment may need treatment with neuroleptic medications and 435.2 that the person may lack capacity to make decisions regarding 435.3 that treatment, the court may appoint a substitute 435.4 decision-maker as provided in section 253B.092, subdivision 6. 435.5 The substitute decision-maker shall meet with the proposed 435.6 patient and provider and make a report to the court at the 435.7 hearing under section 253B.08 regarding whether the 435.8 administration of neuroleptic medications is appropriate under 435.9 the criteria of section 253B.092, subdivision 7. If the 435.10 substitute decision-maker consents to treatment with neuroleptic 435.11 medications and the proposed patient does not refuse the 435.12 medication, neuroleptic medication may be administered to the 435.13 patient. If the substitute decision-maker does not consent or 435.14 the patient refuses, neuroleptic medication may not be 435.15 administered without a court order, or in an emergency as set 435.16 forth in section 253B.092, subdivision 3. 435.17 Sec. 35. Minnesota Statutes 2000, section 253B.09, 435.18 subdivision 1, is amended to read: 435.19 Subdivision 1. [STANDARD OF PROOF.] (a) If the court finds 435.20 by clear and convincing evidence that the proposed patient is a 435.21 mentally ill, mentally retarded, or chemically dependent person 435.22 and after careful consideration of reasonable alternative 435.23 dispositions, including but not limited to, dismissal of 435.24 petition, voluntary outpatient care, voluntary admission to a 435.25 treatment facility, appointment of a guardian or conservator, or 435.26 release before commitment as provided for in subdivision 4, it 435.27 finds that there is no suitable alternative to judicial 435.28 commitment, the court shall commit the patient to the least 435.29 restrictive treatment program or alternative programs which can 435.30 meet the patient's treatment needs consistent with section 435.31 253B.03, subdivision 7. 435.32 (b) In deciding on the least restrictive program, the court 435.33 shall consider a range of treatment alternatives including, but 435.34 not limited to, community-based nonresidential treatment, 435.35 community residential treatment, partial hospitalization, acute 435.36 care hospital, and regional treatment center services. The 436.1 court shall also consider the proposed patient's treatment 436.2 preferences and willingness to participate voluntarily in the 436.3 treatment ordered. The court may not commit a patient to a 436.4 facility or program that is not capable of meeting the patient's 436.5 needs. 436.6 (c) If the court finds a proposed patient to be a mentally 436.7 ill person under section 253B.02, subdivision 13, paragraph (a), 436.8 clause (2) or (4), the court shall commit to a community-based 436.9 program that meets the proposed patient's needs. 436.10 [EFFECTIVE DATE.] This section is effective July 1, 2002. 436.11 Sec. 36. Minnesota Statutes 2000, section 253B.10, 436.12 subdivision 4, is amended to read: 436.13 Subd. 4. [PRIVATE TREATMENT.] Patients or other 436.14 responsible persons are required to pay the necessary charges 436.15 for patients committed or transferred to private treatment 436.16 facilities. Private treatment facilities may not refuse to 436.17 accept a committed person solely based on the person's 436.18 court-ordered status. Insurers must provide treatment and 436.19 services as ordered by the court under section 253B.045, 436.20 subdivision 6, or as required under chapter 62M. 436.21 Sec. 37. Minnesota Statutes 2000, section 256.969, 436.22 subdivision 3a, is amended to read: 436.23 Subd. 3a. [PAYMENTS.] Acute care hospital billings under 436.24 the medical assistance program must not be submitted until the 436.25 recipient is discharged. However, the commissioner shall 436.26 establish monthly interim payments for inpatient hospitals that 436.27 have individual patient lengths of stay over 30 days regardless 436.28 of diagnostic category. Except as provided in section 256.9693, 436.29 medical assistance reimbursement for treatment of mental illness 436.30 shall be reimbursed based on diagnostic classifications.The436.31commissioner may selectively contract with hospitals for436.32services within the diagnostic categories relating to mental436.33illness and chemical dependency under competitive bidding when436.34reasonable geographic access by recipients can be assured. No436.35physician shall be denied the privilege of treating a recipient436.36required to use a hospital under contract with the commissioner,437.1as long as the physician meets credentialing standards of the437.2individual hospital.Individual hospital payments established 437.3 under this section and sections 256.9685, 256.9686, and 437.4 256.9695, in addition to third party and recipient liability, 437.5 for discharges occurring during the rate year shall not exceed, 437.6 in aggregate, the charges for the medical assistance covered 437.7 inpatient services paid for the same period of time to the 437.8 hospital. This payment limitation shall be calculated 437.9 separately for medical assistance and general assistance medical 437.10 care services. The limitation on general assistance medical 437.11 care shall be effective for admissions occurring on or after 437.12 July 1, 1991. Services that have rates established under 437.13 subdivision 11 or 12, must be limited separately from other 437.14 services. After consulting with the affected hospitals, the 437.15 commissioner may consider related hospitals one entity and may 437.16 merge the payment rates while maintaining separate provider 437.17 numbers. The operating and property base rates per admission or 437.18 per day shall be derived from the best Medicare and claims data 437.19 available when rates are established. The commissioner shall 437.20 determine the best Medicare and claims data, taking into 437.21 consideration variables of recency of the data, audit 437.22 disposition, settlement status, and the ability to set rates in 437.23 a timely manner. The commissioner shall notify hospitals of 437.24 payment rates by December 1 of the year preceding the rate 437.25 year. The rate setting data must reflect the admissions data 437.26 used to establish relative values. Base year changes from 1981 437.27 to the base year established for the rate year beginning January 437.28 1, 1991, and for subsequent rate years, shall not be limited to 437.29 the limits ending June 30, 1987, on the maximum rate of increase 437.30 under subdivision 1. The commissioner may adjust base year 437.31 cost, relative value, and case mix index data to exclude the 437.32 costs of services that have been discontinued by the October 1 437.33 of the year preceding the rate year or that are paid separately 437.34 from inpatient services. Inpatient stays that encompass 437.35 portions of two or more rate years shall have payments 437.36 established based on payment rates in effect at the time of 438.1 admission unless the date of admission preceded the rate year in 438.2 effect by six months or more. In this case, operating payment 438.3 rates for services rendered during the rate year in effect and 438.4 established based on the date of admission shall be adjusted to 438.5 the rate year in effect by the hospital cost index. 438.6 [EFFECTIVE DATE.] This section is effective July 1, 2002. 438.7 Sec. 38. [256.9693] [CONTINUING CARE PROGRAM FOR PERSONS 438.8 WITH MENTAL ILLNESS.] 438.9 The commissioner shall establish a continuing care benefit 438.10 program for persons with mental illness, in which persons with 438.11 mental illness may obtain acute care hospital inpatient 438.12 treatment for mental illness for up to 45 days beyond that 438.13 allowed by section 256.969. Persons with mental illness who are 438.14 eligible for medical assistance may obtain inpatient treatment 438.15 under this program in hospital beds for which the commissioner 438.16 contracts under this section. The commissioner may selectively 438.17 contract with hospitals to provide this benefit through 438.18 competitive bidding when reasonable geographic access by 438.19 recipients can be assured. Payments under this section shall 438.20 not affect payments under section 256.969. The commissioner may 438.21 contract externally with a utilization review organization to 438.22 authorize persons with mental illness to access the continuing 438.23 care benefit program. The commissioner, as part of the 438.24 contracts with hospitals, shall establish admission criteria to 438.25 allow persons with mental illness to access the continuing care 438.26 benefit program. If a court orders acute care hospital 438.27 inpatient treatment for mental illness for a person, the person 438.28 may obtain the treatment under the continuing care benefit 438.29 program. The commissioner shall not require, as part of the 438.30 admission criteria, any commitment or petition under chapter 438.31 253B as a condition of accessing the program. This benefit is 438.32 not available for people who are also eligible for Medicare and 438.33 who have not exhausted their annual or lifetime inpatient 438.34 psychiatric benefit under Medicare. If a recipient is enrolled 438.35 in a prepaid plan, this program is included in the plan's 438.36 coverage. 439.1 [EFFECTIVE DATE.] This section is effective July 1, 2002. 439.2 Sec. 39. [256B.0623] [ADULT REHABILITATIVE MENTAL HEALTH 439.3 SERVICES.] 439.4 Subdivision 1. [SCOPE.] Medical assistance covers adult 439.5 rehabilitative mental health services as defined in subdivision 439.6 2, subject to federal approval, if provided to recipients as 439.7 defined in subdivision 3 and provided by a qualified provider 439.8 entity meeting the standards in this section and by a qualified 439.9 individual provider working within the provider's scope of 439.10 practice and identified in the recipient's individual treatment 439.11 plan as defined in section 245.462, subdivision 14, and if 439.12 determined to be medically necessary according to section 62Q.53. 439.13 Subd. 2. [DEFINITIONS.] For purposes of this section, the 439.14 following terms have the meanings given them. 439.15 (a) "Adult rehabilitative mental health services" means 439.16 mental health services which are rehabilitative and enable the 439.17 recipient to develop and enhance psychiatric stability, social 439.18 competencies, personal and emotional adjustment, and independent 439.19 living and community skills, when these abilities are impaired 439.20 by the symptoms of mental illness. Adult rehabilitative mental 439.21 health services are also appropriate when provided to enable a 439.22 recipient to retain stability and functioning, if the recipient 439.23 would be at risk of significant functional decompensation or 439.24 more restrictive service settings without these services. 439.25 (1) Adult rehabilitative mental health services instruct, 439.26 assist, and support the recipient in areas such as: 439.27 interpersonal communication skills, community resource 439.28 utilization and integration skills, crisis assistance, relapse 439.29 prevention skills, health care directives, budgeting and 439.30 shopping skills, healthy lifestyle skills and practices, cooking 439.31 and nutrition skills, transportation skills, medication 439.32 education and monitoring, mental illness symptom management 439.33 skills, household management skills, employment-related skills, 439.34 and transition to community living services. 439.35 (2) These services shall be provided to the recipient on a 439.36 one-to-one basis in the recipient's home or another community 440.1 setting or in groups. 440.2 (b) "Medication education services" means services provided 440.3 individually or in groups which focus on educating the recipient 440.4 about mental illness and symptoms; the role and effects of 440.5 medications in treating symptoms of mental illness; and the side 440.6 effects of medications. Medication education is coordinated 440.7 with medication management services, and does not duplicate it. 440.8 Medication education services are provided by physicians, 440.9 pharmacists, or registered nurses. 440.10 (c) "Transition to community living services" means 440.11 services which maintain continuity of contact between the 440.12 rehabilitation services provider and the recipient and which 440.13 facilitate discharge from a hospital, residential treatment 440.14 program under Minnesota Rules, chapter 9505, board and lodging 440.15 facility, or nursing home. Transition to community living 440.16 services are not intended to provide other areas of adult 440.17 rehabilitative mental health services. 440.18 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 440.19 individual who: 440.20 (1) is age 18 or older; 440.21 (2) is diagnosed with a medical condition, such as mental 440.22 illness or traumatic brain injury, for which adult 440.23 rehabilitative mental health services are needed; 440.24 (3) has substantial disability and functional impairment in 440.25 three or more of the areas listed in section 245.462, 440.26 subdivision 11a, so that self-sufficiency is markedly reduced; 440.27 and 440.28 (4) has had a recent diagnostic assessment by a qualified 440.29 professional that documents adult rehabilitative mental health 440.30 services are medically necessary to address identified 440.31 disability and functional impairments and individual recipient 440.32 goals. 440.33 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) The provider 440.34 entity must be: 440.35 (1) a county operated entity certified by the state; or 440.36 (2) a noncounty entity certified by the entity's host 441.1 county. 441.2 (b) The certification process is a determination as to 441.3 whether the entity meets the standards in this subdivision. The 441.4 certification must specify which adult rehabilitative mental 441.5 health services the entity is qualified to provide. 441.6 (c) If an entity seeks to provide services outside its host 441.7 county, it must obtain additional certification from each county 441.8 in which it will provide services. The additional certification 441.9 must be based on the adequacy of the entity's knowledge of that 441.10 county's local health and human service system, and the ability 441.11 of the entity to coordinate its services with the other services 441.12 available in that county. 441.13 (d) Recertification must occur at least every two years. 441.14 (e) The commissioner may intervene at any time and 441.15 decertify providers with cause. The decertification is subject 441.16 to appeal to the state. A county board may recommend that the 441.17 state decertify a provider for cause. 441.18 (f) The adult rehabilitative mental health services 441.19 provider entity must meet the following standards: 441.20 (1) have capacity to recruit, hire, manage, and train 441.21 mental health professionals, mental health practitioners, and 441.22 mental health rehabilitation workers; 441.23 (2) have adequate administrative ability to ensure 441.24 availability of services; 441.25 (3) ensure adequate preservice and inservice training for 441.26 staff; 441.27 (4) ensure that mental health professionals, mental health 441.28 practitioners, and mental health rehabilitation workers are 441.29 skilled in the delivery of the specific adult rehabilitative 441.30 mental health services provided to the individual eligible 441.31 recipient; 441.32 (5) ensure that staff is capable of implementing culturally 441.33 specific services that are culturally competent and appropriate 441.34 as determined by the recipient's culture, beliefs, values, and 441.35 language as identified in the individual treatment plan; 441.36 (6) ensure enough flexibility in service delivery to 442.1 respond to the changing and intermittent care needs of a 442.2 recipient as identified by the recipient and the individual 442.3 treatment plan; 442.4 (7) ensure that the mental health professional or mental 442.5 health practitioner, who is under the clinical supervision of a 442.6 mental health professional, involved in a recipient's services 442.7 participates in the development of the individual treatment 442.8 plan; 442.9 (8) assist the recipient in arranging needed crisis 442.10 assessment, intervention, and stabilization services; 442.11 (9) ensure that services are coordinated with other 442.12 recipient mental health services providers and the county mental 442.13 health authority and the federally recognized American Indian 442.14 authority and necessary others after obtaining the consent of 442.15 the recipient. Services must also be coordinated with the 442.16 recipient's case manager or care coordinator, if the recipient 442.17 is receiving case management or care coordination services; 442.18 (10) develop and maintain recipient files, individual 442.19 treatment plans, and contact charting; 442.20 (11) develop and maintain staff training and personnel 442.21 files; 442.22 (12) submit information as required by the state; 442.23 (13) establish and maintain a quality assurance plan to 442.24 evaluate the outcome of services provided; 442.25 (14) keep all necessary records required by law; 442.26 (15) deliver services as required by section 245.461; 442.27 (16) comply with all applicable laws; 442.28 (17) be an enrolled Medicaid provider; 442.29 (18) maintain a quality assurance plan to determine 442.30 specific service outcomes and the recipient's satisfaction with 442.31 services; and 442.32 (19) develop and maintain written policies and procedures 442.33 regarding service provision and administration of the provider 442.34 entity. 442.35 (g) The commissioner shall develop statewide procedures for 442.36 provider certification, including timelines for counties to 443.1 certify qualified providers. 443.2 Subd. 5. [QUALIFICATIONS OF PROVIDER STAFF.] Adult 443.3 rehabilitative mental health services must be provided by 443.4 qualified individual provider staff of a certified provider 443.5 entity. Individual provider staff must be qualified under one 443.6 of the following criteria: 443.7 (1) a mental health professional as defined in section 443.8 245.462, subdivision 18, clauses (1) to (5); 443.9 (2) a mental health practitioner as defined in section 443.10 245.462, subdivision 17. The mental health practitioner must 443.11 work under the clinical supervision of a mental health 443.12 professional; or 443.13 (3) a mental health rehabilitation worker. A mental health 443.14 rehabilitation worker means a staff person working under the 443.15 direction of a mental health practitioner or mental health 443.16 professional, and under the clinical supervision of a mental 443.17 health professional in the implementation of rehabilitative 443.18 mental health services as identified in the recipient's 443.19 individual treatment plan; and who: 443.20 (i) is at least 21 years of age; 443.21 (ii) has a high school diploma or equivalent; 443.22 (iii) has successfully completed 30 hours of training 443.23 during the past two years in all of the following areas: 443.24 recipient rights, recipient-centered individual treatment 443.25 planning, behavioral terminology, mental illness, co-occurring 443.26 mental illness and substance abuse, psychotropic medications and 443.27 side effects, functional assessment, local community resources, 443.28 adult vulnerability, recipient confidentiality; and 443.29 (iv) meets the qualifications in (A) or (B): 443.30 (A) has an associate of arts degree in one of the 443.31 behavioral sciences or human services, or is a registered nurse 443.32 without a bachelor's degree, or who within the previous ten 443.33 years has: 443.34 (1) three years of personal life experience with serious 443.35 and persistent mental illness; 443.36 (2) three years of life experience as a primary caregiver 444.1 to an adult with a serious mental illness or traumatic brain 444.2 injury; or 444.3 (3) 4,000 hours of supervised paid work experience in the 444.4 delivery of mental health services to adults with a serious 444.5 mental illness or traumatic brain injury; or 444.6 (B)(1) be fluent in the non-English language or competent 444.7 in the culture of the ethnic group to which at least 50 percent 444.8 of the mental health rehabilitation worker's clients belong; 444.9 (2) receives during the first 2,000 hours of work, monthly 444.10 documented individual clinical supervision by a mental health 444.11 professional; 444.12 (3) has 18 hours of documented field supervision by a 444.13 mental health professional or practitioner during the first 160 444.14 hours of contact work with recipients, and at least six hours of 444.15 field supervision quarterly during the following year; 444.16 (4) has review and cosignature of charting of recipient 444.17 contacts during field supervision by a mental health 444.18 professional or practitioner; and 444.19 (5) has 40 hours of additional continuing education on 444.20 mental health topics during the first year of employment. 444.21 Subd. 6. [REQUIRED TRAINING AND SUPERVISION.] (a) Mental 444.22 health rehabilitation workers must receive ongoing continuing 444.23 education training of at least 30 hours every two years in areas 444.24 of mental illness and mental health services and other areas 444.25 specific to the population being served. Mental health 444.26 rehabilitation workers must also be subject to the ongoing 444.27 direction and clinical supervision standards in paragraphs (c) 444.28 and (d). 444.29 (b) Mental health practitioners must receive ongoing 444.30 continuing education training as required by their professional 444.31 license; or if the practitioner is not licensed, the 444.32 practitioner must receive ongoing continuing education training 444.33 of at least 30 hours every two years in areas of mental illness 444.34 and mental health services. Mental health practitioners must 444.35 meet the ongoing clinical supervision standards in paragraph (c). 444.36 (c) A mental health professional providing clinical 445.1 supervision of staff delivering adult rehabilitative mental 445.2 health services must provide the following guidance: 445.3 (1) review the information in the recipient's file; 445.4 (2) review and approve initial and updates of individual 445.5 treatment plans; 445.6 (3) meet with mental health rehabilitation workers and 445.7 practitioners, individually or in small groups, at least monthly 445.8 to discuss treatment topics of interest to the workers and 445.9 practitioners; 445.10 (4) meet with mental health rehabilitation workers and 445.11 practitioners, individually or in small groups, at least monthly 445.12 to discuss treatment plans of recipients, and approve by 445.13 signature and document in the recipient's file any resulting 445.14 plan updates; 445.15 (5) meet at least twice a month with the directing mental 445.16 health practitioner, if there is one, to review needs of the 445.17 adult rehabilitative mental health services program, review 445.18 staff on-site observations and evaluate mental health 445.19 rehabilitation workers, plan staff training, review program 445.20 evaluation and development, and consult with the directing 445.21 practitioner; 445.22 (6) be available for urgent consultation as the individual 445.23 recipient needs or the situation necessitates; and 445.24 (7) provide clinical supervision by full- or part-time 445.25 mental health professionals employed by or under contract with 445.26 the provider entity. 445.27 (d) An adult rehabilitative mental health services provider 445.28 entity must have a treatment director who is a mental health 445.29 practitioner or mental health professional. The treatment 445.30 director must ensure the following: 445.31 (1) while delivering direct services to recipients, a newly 445.32 hired mental health rehabilitation worker must be directly 445.33 observed delivering services to recipients by the mental health 445.34 practitioner or mental health professional for at least six 445.35 hours per 40 hours worked during the first 160 hours that the 445.36 mental health rehabilitation worker works; 446.1 (2) the mental health rehabilitation worker must receive 446.2 ongoing on-site direct service observation by a mental health 446.3 professional or mental health practitioner for at least six 446.4 hours for every six months of employment; 446.5 (3) progress notes are reviewed from on-site service 446.6 observation prepared by the mental health rehabilitation worker 446.7 and mental health practitioner for accuracy and consistency with 446.8 actual recipient contact and the individual treatment plan and 446.9 goals; 446.10 (4) immediate availability by phone or in person for 446.11 consultation by a mental health professional or a mental health 446.12 practitioner to the mental health rehabilitation services worker 446.13 during service provision; 446.14 (5) oversee the identification of changes in individual 446.15 recipient treatment strategies, revise the plan and communicate 446.16 treatment instructions and methodologies as appropriate to 446.17 ensure that treatment is implemented correctly; 446.18 (6) model service practices which: respect the recipient, 446.19 include the recipient in planning and implementation of the 446.20 individual treatment plan, recognize the recipient's strengths, 446.21 collaborate and coordinate with other involved parties and 446.22 providers; 446.23 (7) ensure that mental health practitioners and mental 446.24 health rehabilitation workers are able to effectively 446.25 communicate with the recipients, significant others, and 446.26 providers; and 446.27 (8) oversee the record of the results of on-site 446.28 observation and charting evaluation and corrective actions taken 446.29 to modify the work of the mental health practitioners and mental 446.30 health rehabilitation workers. 446.31 (e) A mental health practitioner who is providing treatment 446.32 direction for a provider entity must receive supervision at 446.33 least monthly from a mental health professional to: 446.34 (1) identify and plan for general needs of the recipient 446.35 population served; 446.36 (2) identify and plan to address provider entity program 447.1 needs and effectiveness; 447.2 (3) identify and plan provider entity staff training and 447.3 personnel needs and issues; and 447.4 (4) plan, implement, and evaluate provider entity quality 447.5 improvement programs. 447.6 Subd. 7. [PERSONNEL FILE.] The adult rehabilitative mental 447.7 health services provider entity must maintain a personnel file 447.8 on each staff. Each file must contain: 447.9 (1) an annual performance review; 447.10 (2) a summary of on-site service observations and charting 447.11 review; 447.12 (3) a criminal background check of all direct service 447.13 staff; 447.14 (4) evidence of academic degree and qualifications; 447.15 (5) a copy of professional license; 447.16 (6) any job performance recognition and disciplinary 447.17 actions; 447.18 (7) any individual staff written input into own personnel 447.19 file; 447.20 (8) all clinical supervision provided; and 447.21 (9) documentation of compliance with continuing education 447.22 requirements. 447.23 Subd. 8. [DIAGNOSTIC ASSESSMENT.] Providers of adult 447.24 rehabilitative mental health services must complete a diagnostic 447.25 assessment as defined in section 245.462, subdivision 9, within 447.26 five days after the recipient's second visit or within 30 days 447.27 after intake, whichever occurs first. In cases where a 447.28 diagnostic assessment is available that reflects the recipient's 447.29 current status, and has been completed within 180 days preceding 447.30 admission, an update must be completed. An update shall include 447.31 a written summary by a mental health professional of the 447.32 recipient's current mental health status and service needs. If 447.33 the recipient's mental health status has changed significantly 447.34 since the adult's most recent diagnostic assessment, a new 447.35 diagnostic assessment is required. 447.36 Subd. 9. [FUNCTIONAL ASSESSMENT.] Providers of adult 448.1 rehabilitative mental health services must complete a written 448.2 functional assessment as defined in section 245.462, subdivision 448.3 11a, for each recipient. The functional assessment must be 448.4 completed within 30 days of intake, and reviewed and updated at 448.5 least every six months after it is developed, unless there is a 448.6 significant change in the functioning of the recipient. If 448.7 there is a significant change in functioning, the assessment 448.8 must be updated. A single functional assessment can meet case 448.9 management and adult rehabilitative mental health services 448.10 requirements, if agreed to by the recipient. Unless the 448.11 recipient refuses, the recipient must have significant 448.12 participation in the development of the functional assessment. 448.13 Subd. 10. [INDIVIDUAL TREATMENT PLAN.] All providers of 448.14 adult rehabilitative mental health services must develop and 448.15 implement an individual treatment plan for each recipient. The 448.16 provisions in clauses (1) and (2) apply: 448.17 (1) Individual treatment plan means a plan of intervention, 448.18 treatment, and services for an individual recipient written by a 448.19 mental health professional or by a mental health practitioner 448.20 under the clinical supervision of a mental health professional. 448.21 The individual treatment plan must be based on diagnostic and 448.22 functional assessments. To the extent possible, the development 448.23 and implementation of a treatment plan must be a collaborative 448.24 process involving the recipient, and with the permission of the 448.25 recipient, the recipient's family and others in the recipient's 448.26 support system. Providers of adult rehabilitative mental health 448.27 services must develop the individual treatment plan within 30 448.28 calendar days of intake. The treatment plan must be updated at 448.29 least every six months thereafter, or more often when there is 448.30 significant change in the recipient's situation or functioning, 448.31 or in services or service methods to be used, or at the request 448.32 of the recipient or the recipient's legal guardian. 448.33 (2) The individual treatment plan must include: 448.34 (i) a list of problems identified in the assessment; 448.35 (ii) the recipient's strengths and resources; 448.36 (iii) concrete, measurable goals to be achieved, including 449.1 time frames for achievement; 449.2 (iv) specific objectives directed toward the achievement of 449.3 each one of the goals; 449.4 (v) documentation of participants in the treatment planning. 449.5 The recipient, if possible, must be a participant. The 449.6 recipient or the recipient's legal guardian must sign the 449.7 treatment plan, or documentation must be provided why this was 449.8 not possible. A copy of the plan must be given to the recipient 449.9 or legal guardian. Referral to formal services must be 449.10 arranged, including specific providers where applicable; 449.11 (vi) cultural considerations, resources, and needs of the 449.12 recipient must be included; 449.13 (vii) planned frequency and type of services must be 449.14 initiated; and 449.15 (viii) clear progress notes on outcome of goals. 449.16 (3) The individual community support plan defined in 449.17 section 245.462, subdivision 12, may serve as the individual 449.18 treatment plan if there is involvement of a mental health case 449.19 manager, and with the approval of the recipient. The individual 449.20 community support plan must include the criteria in clause (2). 449.21 Subd. 11. [RECIPIENT FILE.] Providers of adult 449.22 rehabilitative mental health services must maintain a file for 449.23 each recipient that contains the following information: 449.24 (1) diagnostic assessment or verification of its location, 449.25 that is current and that was reviewed by a mental health 449.26 professional who is employed by or under contract with the 449.27 provider entity; 449.28 (2) functional assessments; 449.29 (3) individual treatment plans signed by the recipient and 449.30 the mental health professional, or if the recipient refused to 449.31 sign the plan, the date and reason stated by the recipient as to 449.32 why the recipient would not sign the plan; 449.33 (4) recipient history; 449.34 (5) signed release forms; 449.35 (6) recipient health information and current medications; 449.36 (7) emergency contacts for the recipient; 450.1 (8) case records which document the date of service, the 450.2 place of service delivery, signature of the person providing the 450.3 service, nature, extent and units of service, and place of 450.4 service delivery; 450.5 (9) contacts, direct or by telephone, with recipient's 450.6 family or others, other providers, or other resources for 450.7 service coordination; 450.8 (10) summary of recipient case reviews by staff; and 450.9 (11) written information by the recipient that the 450.10 recipient requests be included in the file. 450.11 Subd. 12. [ADDITIONAL REQUIREMENTS.] (a) Providers of 450.12 adult rehabilitative mental health services must comply with the 450.13 requirements relating to referrals for case management in 450.14 section 245.467, subdivision 4. 450.15 (b) Adult rehabilitative mental health services are 450.16 provided for most recipients in the recipient's home and 450.17 community. Services may also be provided at the home of a 450.18 relative or significant other, job site, psychosocial clubhouse, 450.19 drop-in center, social setting, classroom, or other places in 450.20 the community. Except for "transition to community services," 450.21 the place of service does not include a regional treatment 450.22 center, nursing home, residential treatment facility licensed 450.23 under Minnesota Rules, parts 9520.0500 to 9520.0670 (Rule 36), 450.24 or an acute care hospital. 450.25 (c) Adult rehabilitative mental health services may be 450.26 provided in group settings if appropriate to each participating 450.27 recipient's needs and treatment plan. A group is defined as two 450.28 to ten clients, at least one of whom is a recipient, who is 450.29 concurrently receiving a service which is identified in this 450.30 section. The service and group must be specified in the 450.31 recipient's treatment plan. No more than two qualified staff 450.32 may bill Medicaid for services provided to the same group of 450.33 recipients. If two adult rehabilitative mental health workers 450.34 bill for recipients in the same group session, they must each 450.35 bill for different recipients. 450.36 Subd. 13. [EXCLUDED SERVICES.] The following services are 451.1 excluded from reimbursement as adult rehabilitative mental 451.2 health services: 451.3 (1) recipient transportation services; 451.4 (2) a service provided and billed by a provider who is not 451.5 enrolled to provide adult rehabilitative mental health service; 451.6 (3) adult rehabilitative mental health services performed 451.7 by volunteers; 451.8 (4) provider performance of household tasks, chores, or 451.9 related activities, such as laundering clothes, moving the 451.10 recipient's household, housekeeping, and grocery shopping for 451.11 the recipient; 451.12 (5) direct billing of time spent "on call" when not 451.13 delivering services to recipients; 451.14 (6) activities which are primarily social or recreational 451.15 in nature, rather than rehabilitative, for the individual 451.16 recipient, as determined by the individual's needs and treatment 451.17 plan; 451.18 (7) job-specific skills services, such as on-the-job 451.19 training; 451.20 (8) provider service time included in case management 451.21 reimbursement; 451.22 (9) outreach services to potential recipients; 451.23 (10) a mental health service that is not medically 451.24 necessary; and 451.25 (11) any services provided by a hospital, board and 451.26 lodging, or residential facility to an individual who is a 451.27 patient in or resident of that facility. 451.28 Subd. 14. [BILLING WHEN SERVICES ARE PROVIDED BY QUALIFIED 451.29 STATE STAFF.] When rehabilitative services are provided by 451.30 qualified state staff who are assigned to pilot projects under 451.31 section 245.4661, the county or other local entity to which the 451.32 qualified state staff are assigned may consider these staff part 451.33 of the local provider entity for which certification is sought 451.34 under this section, and may bill the medical assistance program 451.35 for qualifying services provided by the qualified state staff. 451.36 Notwithstanding section 256.025, subdivision 2, payments for 452.1 services provided by state staff who are assigned to adult 452.2 mental health initiatives shall only be made from federal funds. 452.3 Sec. 40. [256B.0624] [ADULT MENTAL HEALTH CRISIS RESPONSE 452.4 SERVICES.] 452.5 Subdivision 1. [SCOPE.] Medical assistance covers adult 452.6 mental health crisis response services as defined in subdivision 452.7 2, paragraphs (c) to (e), subject to federal approval, if 452.8 provided to a recipient as defined in subdivision 3 and provided 452.9 by a qualified provider entity as defined in this section and by 452.10 a qualified individual provider working within the provider's 452.11 scope of practice and as defined in this subdivision and 452.12 identified in the recipient's individual crisis treatment plan 452.13 as defined in subdivision 11 and if determined to be medically 452.14 necessary. 452.15 Subd. 2. [DEFINITIONS.] For purposes of this section, the 452.16 following terms have the meanings given them. 452.17 (a) "Mental health crisis" is an adult behavioral, 452.18 emotional, or psychiatric situation which, but for the provision 452.19 of crisis response services, would likely result in 452.20 significantly reduced levels of functioning in primary 452.21 activities of daily living, or in an emergency situation, or in 452.22 the placement of the recipient in a more restrictive setting, 452.23 including, but not limited to, inpatient hospitalization. 452.24 (b) "Mental health emergency" is an adult behavioral, 452.25 emotional, or psychiatric situation which causes an immediate 452.26 need for mental health services and is consistent with section 452.27 62Q.55. 452.28 A mental health crisis or emergency is determined for 452.29 medical assistance service reimbursement by a physician, a 452.30 mental health professional, or crisis mental health practitioner 452.31 with input from the recipient whenever possible. 452.32 (c) "Mental health crisis assessment" means an immediate 452.33 face-to-face assessment by a physician, a mental health 452.34 professional, or mental health practitioner under the clinical 452.35 supervision of a mental health professional, following a 452.36 screening that suggests that the adult may be experiencing a 453.1 mental health crisis or mental health emergency situation. 453.2 (d) "Mental health mobile crisis intervention services" 453.3 means face-to-face, short-term intensive mental health services 453.4 initiated during a mental health crisis or mental health 453.5 emergency to help the recipient cope with immediate stressors, 453.6 identify and utilize available resources and strengths, and 453.7 begin to return to the recipient's baseline level of functioning. 453.8 (1) This service is provided on-site by a mobile crisis 453.9 intervention team outside of an inpatient hospital setting. 453.10 Mental health mobile crisis intervention services must be 453.11 available 24 hours a day, seven days a week. 453.12 (2) The initial screening must consider other available 453.13 services to determine which service intervention would best 453.14 address the recipient's needs and circumstances. 453.15 (3) The mobile crisis intervention team must be available 453.16 to meet promptly face-to-face with a person in mental health 453.17 crisis or emergency in a community setting. 453.18 (4) The intervention must consist of a mental health crisis 453.19 assessment and a crisis treatment plan. 453.20 (5) The treatment plan must include recommendations for any 453.21 needed crisis stabilization services for the recipient. 453.22 (e) "Mental health crisis stabilization services" means 453.23 individualized mental health services provided to a recipient 453.24 following crisis intervention services which are designed to 453.25 restore the recipient to the recipient's prior functional 453.26 level. Mental health crisis stabilization services may be 453.27 provided in the recipient's home, the home of a family member or 453.28 friend of the recipient, another community setting, or a 453.29 short-term supervised, licensed residential program. Mental 453.30 health crisis stabilization does not include partial 453.31 hospitalization or day treatment. 453.32 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 453.33 individual who: 453.34 (1) is age 18 or older; 453.35 (2) is screened as possibly experiencing a mental health 453.36 crisis or emergency where a mental health crisis assessment is 454.1 needed; and 454.2 (3) is assessed as experiencing a mental health crisis or 454.3 emergency, and mental health crisis intervention or crisis 454.4 intervention and stabilization services are determined to be 454.5 medically necessary. 454.6 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) A provider 454.7 entity is an entity that meets the standards listed in paragraph 454.8 (b) and: 454.9 (1) is a county board operated entity; or 454.10 (2) is a provider entity that is under contract with the 454.11 county board in the county where the potential crisis or 454.12 emergency is occurring. To provide services under this section, 454.13 the provider entity must directly provide the services; or if 454.14 services are subcontracted, the provider entity must maintain 454.15 responsibility for services and billing. 454.16 (b) The adult mental health crisis response services 454.17 provider entity must meet the following standards: 454.18 (1) has the capacity to recruit, hire, and manage and train 454.19 mental health professionals, practitioners, and rehabilitation 454.20 workers; 454.21 (2) has adequate administrative ability to ensure 454.22 availability of services; 454.23 (3) is able to ensure adequate preservice and in-service 454.24 training; 454.25 (4) is able to ensure that staff providing these services 454.26 are skilled in the delivery of mental health crisis response 454.27 services to recipients; 454.28 (5) is able to ensure that staff are capable of 454.29 implementing culturally specific treatment identified in the 454.30 individual treatment plan that is meaningful and appropriate as 454.31 determined by the recipient's culture, beliefs, values, and 454.32 language; 454.33 (6) is able to ensure enough flexibility to respond to the 454.34 changing intervention and care needs of a recipient as 454.35 identified by the recipient during the service partnership 454.36 between the recipient and providers; 455.1 (7) is able to ensure that mental health professionals and 455.2 mental health practitioners have the communication tools and 455.3 procedures to communicate and consult promptly about crisis 455.4 assessment and interventions as services occur; 455.5 (8) is able to coordinate these services with county 455.6 emergency services and mental health crisis services; 455.7 (9) is able to ensure that mental health crisis assessment 455.8 and mobile crisis intervention services are available 24 hours a 455.9 day, seven days a week; 455.10 (10) is able to ensure that services are coordinated with 455.11 other mental health service providers, county mental health 455.12 authorities, or federally recognized American Indian authorities 455.13 and others as necessary, with the consent of the adult. 455.14 Services must also be coordinated with the recipient's case 455.15 manager if the adult is receiving case management services; 455.16 (11) is able to ensure that crisis intervention services 455.17 are provided in a manner consistent with sections 245.461 to 455.18 245.486; 455.19 (12) is able to submit information as required by the 455.20 state; 455.21 (13) maintains staff training and personnel files; 455.22 (14) is able to establish and maintain a quality assurance 455.23 and evaluation plan to evaluate the outcomes of services and 455.24 recipient satisfaction; 455.25 (15) is able to keep records as required by applicable 455.26 laws; 455.27 (16) is able to comply with all applicable laws and 455.28 statutes; 455.29 (17) is an enrolled medical assistance provider; and 455.30 (18) develops and maintains written policies and procedures 455.31 regarding service provision and administration of the provider 455.32 entity, including safety of staff and recipients in high-risk 455.33 situations. 455.34 Subd. 5. [MOBILE CRISIS INTERVENTION STAFF 455.35 QUALIFICATIONS.] For provision of adult mental health mobile 455.36 crisis intervention services, a mobile crisis intervention team 456.1 is comprised of at least two mental health professionals as 456.2 defined in section 245.462, subdivision 18, clauses (1) to (5), 456.3 or a combination of at least one mental health professional and 456.4 one mental health practitioner as defined in section 245.462, 456.5 subdivision 17, with the required mental health crisis training 456.6 and under the clinical supervision of a mental health 456.7 professional on the team. The team must have at least two 456.8 people with at least one member providing on-site crisis 456.9 intervention services when needed. Team members must be 456.10 experienced in mental health assessment, crisis intervention 456.11 techniques, and clinical decision-making under emergency 456.12 conditions and have knowledge of local services and resources. 456.13 The team must recommend and coordinate the team's services with 456.14 appropriate local resources such as the county social services 456.15 agency, mental health services, and local law enforcement when 456.16 necessary. 456.17 Subd. 6. [INITIAL SCREENING, CRISIS ASSESSMENT, AND MOBILE 456.18 INTERVENTION TREATMENT PLANNING.] (a) Prior to initiating mobile 456.19 crisis intervention services, a screening of the potential 456.20 crisis situation must be conducted. The screening may use the 456.21 resources of crisis assistance and emergency services as defined 456.22 in sections 245.462, subdivision 6, and 245.469, subdivisions 1 456.23 and 2. The screening must gather information, determine whether 456.24 a crisis situation exists, identify parties involved, and 456.25 determine an appropriate response. 456.26 (b) If a crisis exists, a crisis assessment must be 456.27 completed. A crisis assessment evaluates any immediate needs 456.28 for which emergency services are needed and, as time permits, 456.29 the recipient's current life situation, sources of stress, 456.30 mental health problems and symptoms, strengths, cultural 456.31 considerations, support network, vulnerabilities, and current 456.32 functioning. 456.33 (c) If the crisis assessment determines mobile crisis 456.34 intervention services are needed, the intervention services must 456.35 be provided promptly. As opportunity presents during the 456.36 intervention, at least two members of the mobile crisis 457.1 intervention team must confer directly or by telephone about the 457.2 assessment, treatment plan, and actions taken and needed. At 457.3 least one of the team members must be on site providing crisis 457.4 intervention services. If providing on-site crisis intervention 457.5 services, a mental health practitioner must seek clinical 457.6 supervision as required in subdivision 9. 457.7 (d) The mobile crisis intervention team must develop an 457.8 initial, brief crisis treatment plan as soon as appropriate but 457.9 no later than 24 hours after the initial face-to-face 457.10 intervention. The plan must address the needs and problems 457.11 noted in the crisis assessment and include measurable short-term 457.12 goals, cultural considerations, and frequency and type of 457.13 services to be provided to achieve the goals and reduce or 457.14 eliminate the crisis. The treatment plan must be updated as 457.15 needed to reflect current goals and services. 457.16 (e) The team must document which short-term goals have been 457.17 met, and when no further crisis intervention services are 457.18 required. 457.19 (f) If the recipient's crisis is stabilized, but the 457.20 recipient needs a referral to other services, the team must 457.21 provide referrals to these services. If the recipient has a 457.22 case manager, planning for other services must be coordinated 457.23 with the case manager. 457.24 Subd. 7. [CRISIS STABILIZATION SERVICES.] (a) Crisis 457.25 stabilization services must be provided by qualified staff of a 457.26 crisis stabilization services provider entity and must meet the 457.27 following standards: 457.28 (1) a crisis stabilization treatment plan must be developed 457.29 which meets the criteria in subdivision 11; 457.30 (2) staff must be qualified as defined in subdivision 8; 457.31 and 457.32 (3) services must be delivered according to the treatment 457.33 plan and include face-to-face contact with the recipient by 457.34 qualified staff for further assessment, help with referrals, 457.35 updating of the crisis stabilization treatment plan, supportive 457.36 counseling, skills training, and collaboration with other 458.1 service providers in the community. 458.2 (b) If crisis stabilization services are provided in a 458.3 supervised, licensed residential setting, the recipient must be 458.4 contacted face-to-face daily by a qualified mental health 458.5 practitioner or mental health professional. The program must 458.6 have 24-hour-a-day residential staffing which may include staff 458.7 who do not meet the qualifications in subdivision 8. The 458.8 residential staff must have 24-hour-a-day immediate direct or 458.9 telephone access to a qualified mental health professional or 458.10 practitioner. 458.11 (c) If crisis stabilization services are provided in a 458.12 supervised, licensed residential setting that serves no more 458.13 than four adult residents, and no more than two are recipients 458.14 of crisis stabilization services, the residential staff must 458.15 include, for at least eight hours per day, at least one 458.16 individual who meets the qualifications in subdivision 8. 458.17 (d) If crisis stabilization services are provided in a 458.18 supervised, licensed residential setting that serves more than 458.19 four adult residents, and one or more are recipients of crisis 458.20 stabilization services, the residential staff must include, for 458.21 24 hours a day, at least one individual who meets the 458.22 qualifications in subdivision 8. During the first 48 hours that 458.23 a recipient is in the residential program, the residential 458.24 program must have at least two staff working 24 hours a day. 458.25 Staffing levels may be adjusted thereafter according to the 458.26 needs of the recipient as specified in the crisis stabilization 458.27 treatment plan. 458.28 Subd. 8. [ADULT CRISIS STABILIZATION STAFF 458.29 QUALIFICATIONS.] (a) Adult mental health crisis stabilization 458.30 services must be provided by qualified individual staff of a 458.31 qualified provider entity. Individual provider staff must have 458.32 the following qualifications: 458.33 (1) be a mental health professional as defined in section 458.34 245.462, subdivision 18, clauses (1) to (5); 458.35 (2) be a mental health practitioner as defined in section 458.36 245.462, subdivision 17. The mental health practitioner must 459.1 work under the clinical supervision of a mental health 459.2 professional; or 459.3 (3) be a mental health rehabilitation worker who meets the 459.4 criteria in section 256B.0623, subdivision 5, clause (3); works 459.5 under the direction of a mental health practitioner as defined 459.6 in section 245.462, subdivision 17, or under direction of a 459.7 mental health professional; and works under the clinical 459.8 supervision of a mental health professional. 459.9 (b) Mental health practitioners and mental health 459.10 rehabilitation workers must have completed at least 30 hours of 459.11 training in crisis intervention and stabilization during the 459.12 past two years. 459.13 Subd. 9. [SUPERVISION.] Mental health practitioners may 459.14 provide crisis assessment and mobile crisis intervention 459.15 services if the following clinical supervision requirements are 459.16 met: 459.17 (1) the mental health provider entity must accept full 459.18 responsibility for the services provided; 459.19 (2) the mental health professional of the provider entity, 459.20 who is an employee or under contract with the provider entity, 459.21 must be immediately available by phone or in person for clinical 459.22 supervision; 459.23 (3) the mental health professional is consulted, in person 459.24 or by phone, during the first three hours when a mental health 459.25 practitioner provides on-site service; 459.26 (4) the mental health professional must: 459.27 (i) review and approve of the tentative crisis assessment 459.28 and crisis treatment plan; 459.29 (ii) document the consultation; and 459.30 (iii) sign the crisis assessment and treatment plan within 459.31 the next business day; 459.32 (5) if the mobile crisis intervention services continue 459.33 into a second calendar day, a mental health professional must 459.34 contact the recipient face-to-face on the second day to provide 459.35 services and update the crisis treatment plan; and 459.36 (6) the on-site observation must be documented in the 460.1 recipient's record and signed by the mental health professional. 460.2 Subd. 10. [RECIPIENT FILE.] Providers of mobile crisis 460.3 intervention or crisis stabilization services must maintain a 460.4 file for each recipient containing the following information: 460.5 (1) individual crisis treatment plans signed by the 460.6 recipient, mental health professional, and mental health 460.7 practitioner who developed the crisis treatment plan, or if the 460.8 recipient refused to sign the plan, the date and reason stated 460.9 by the recipient as to why the recipient would not sign the 460.10 plan; 460.11 (2) signed release forms; 460.12 (3) recipient health information and current medications; 460.13 (4) emergency contacts for the recipient; 460.14 (5) case records which document the date of service, place 460.15 of service delivery, signature of the person providing the 460.16 service, and the nature, extent, and units of service. Direct 460.17 or telephone contact with the recipient's family or others 460.18 should be documented; 460.19 (6) required clinical supervision by mental health 460.20 professionals; 460.21 (7) summary of the recipient's case reviews by staff; and 460.22 (8) any written information by the recipient that the 460.23 recipient wants in the file. 460.24 Documentation in the file must comply with all requirements of 460.25 the commissioner. 460.26 Subd. 11. [TREATMENT PLAN.] The individual crisis 460.27 stabilization treatment plan must include, at a minimum: 460.28 (1) a list of problems identified in the assessment; 460.29 (2) a list of the recipient's strengths and resources; 460.30 (3) concrete, measurable short-term goals and tasks to be 460.31 achieved, including time frames for achievement; 460.32 (4) specific objectives directed toward the achievement of 460.33 each one of the goals; 460.34 (5) documentation of the participants involved in the 460.35 service planning. The recipient, if possible, must be a 460.36 participant. The recipient or the recipient's legal guardian 461.1 must sign the service plan or documentation must be provided why 461.2 this was not possible. A copy of the plan must be given to the 461.3 recipient and the recipient's legal guardian. The plan should 461.4 include services arranged, including specific providers where 461.5 applicable; 461.6 (6) planned frequency and type of services initiated; 461.7 (7) a crisis response action plan if a crisis should occur; 461.8 (8) clear progress notes on outcome of goals; 461.9 (9) a written plan must be completed within 24 hours of 461.10 beginning services with the recipient; and 461.11 (10) a treatment plan must be developed by a mental health 461.12 professional or mental health practitioner under the clinical 461.13 supervision of a mental health professional. The mental health 461.14 professional must approve and sign all treatment plans. 461.15 Subd. 12. [EXCLUDED SERVICES.] The following services are 461.16 excluded from reimbursement under this section: 461.17 (1) room and board services; 461.18 (2) services delivered to a recipient while admitted to an 461.19 inpatient hospital; 461.20 (3) recipient transportation costs may be covered under 461.21 other medical assistance provisions, but transportation services 461.22 are not an adult mental health crisis response service; 461.23 (4) services provided and billed by a provider who is not 461.24 enrolled under medical assistance to provide adult mental health 461.25 crisis response services; 461.26 (5) services performed by volunteers; 461.27 (6) direct billing of time spent "on call" when not 461.28 delivering services to a recipient; 461.29 (7) provider service time included in case management 461.30 reimbursement. When a provider is eligible to provide more than 461.31 one type of medical assistance service, the recipient must have 461.32 a choice of provider for each service, unless otherwise provided 461.33 for by law; 461.34 (8) outreach services to potential recipients; and 461.35 (9) a mental health service that is not medically necessary. 461.36 Sec. 41. Minnesota Statutes 2000, section 256B.0625, 462.1 subdivision 20, is amended to read: 462.2 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 462.3 extent authorized by rule of the state agency, medical 462.4 assistance covers case management services to persons with 462.5 serious and persistent mental illness and children with severe 462.6 emotional disturbance. Services provided under this section 462.7 must meet the relevant standards in sections 245.461 to 462.8 245.4888, the Comprehensive Adult and Children's Mental Health 462.9 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 462.10 9505.0322, excluding subpart 10. 462.11 (b) Entities meeting program standards set out in rules 462.12 governing family community support services as defined in 462.13 section 245.4871, subdivision 17, are eligible for medical 462.14 assistance reimbursement for case management services for 462.15 children with severe emotional disturbance when these services 462.16 meet the program standards in Minnesota Rules, parts 9520.0900 462.17 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 462.18 (c) Medical assistance and MinnesotaCare payment for mental 462.19 health case management shall be made on a monthly basis. In 462.20 order to receive payment for an eligible child, the provider 462.21 must document at least a face-to-face contact with the child, 462.22 the child's parents, or the child's legal representative. To 462.23 receive payment for an eligible adult, the provider must 462.24 document: 462.25 (1) at least a face-to-face contact with the adult or the 462.26 adult's legal representative; or 462.27 (2) at least a telephone contact with the adult or the 462.28 adult's legal representative and document a face-to-face contact 462.29 with the adult or the adult's legal representative within the 462.30 preceding two months. 462.31 (d) Payment for mental health case management provided by 462.32 county or state staff shall be based on the monthly rate 462.33 methodology under section 256B.094, subdivision 6, paragraph 462.34 (b), with separate rates calculated for child welfare and mental 462.35 health, and within mental health, separate rates for children 462.36 and adults. 463.1 (e) Payment for mental health case management provided by 463.2 Indian health services or by agencies operated by Indian tribes 463.3 may be made according to this section or other relevant 463.4 federally approved rate setting methodology. 463.5 (f) Payment for mental health case management provided by 463.6county-contractedvendors who contract with a county or Indian 463.7 tribe shall be based on a monthly rate negotiated by the host 463.8 county or tribe. The negotiated rate must not exceed the rate 463.9 charged by the vendor for the same service to other payers. If 463.10 the service is provided by a team of contracted vendors, the 463.11 county or tribe may negotiate a team rate with a vendor who is a 463.12 member of the team. The team shall determine how to distribute 463.13 the rate among its members. No reimbursement received by 463.14 contracted vendors shall be returned to the county or tribe, 463.15 except to reimburse the county or tribe for advance funding 463.16 provided by the county or tribe to the vendor. 463.17(f)(g) If the service is provided by a team which includes 463.18 contracted vendors, tribal staff, and county or state staff, the 463.19 costs for county or state staff participation in the team shall 463.20 be included in the rate for county-provided services. In this 463.21 case, the contracted vendor, the tribal agency, and the county 463.22 may each receive separate payment for services provided by each 463.23 entity in the same month. In order to prevent duplication of 463.24 services,the countyeach entity must document, in the 463.25 recipient's file, the need for team case management and a 463.26 description of the roles of the team members. 463.27(g)(h) The commissioner shall calculate the nonfederal 463.28 share of actual medical assistance and general assistance 463.29 medical care payments for each county, based on the higher of 463.30 calendar year 1995 or 1996, by service date, project that amount 463.31 forward to 1999, and transfer one-half of the result from 463.32 medical assistance and general assistance medical care to each 463.33 county's mental health grants under sections 245.4886 and 463.34 256E.12 for calendar year 1999. The annualized minimum amount 463.35 added to each county's mental health grant shall be $3,000 per 463.36 year for children and $5,000 per year for adults. The 464.1 commissioner may reduce the statewide growth factor in order to 464.2 fund these minimums. The annualized total amount transferred 464.3 shall become part of the base for future mental health grants 464.4 for each county. 464.5(h)(i) Any net increase in revenue to the county or tribe 464.6 as a result of the change in this section must be used to 464.7 provide expanded mental health services as defined in sections 464.8 245.461 to 245.4888, the Comprehensive Adult and Children's 464.9 Mental Health Acts, excluding inpatient and residential 464.10 treatment. For adults, increased revenue may also be used for 464.11 services and consumer supports which are part of adult mental 464.12 health projects approved under Laws 1997, chapter 203, article 464.13 7, section 25. For children, increased revenue may also be used 464.14 for respite care and nonresidential individualized 464.15 rehabilitation services as defined in section 245.492, 464.16 subdivisions 17 and 23. "Increased revenue" has the meaning 464.17 given in Minnesota Rules, part 9520.0903, subpart 3. 464.18(i)(j) Notwithstanding section 256B.19, subdivision 1, the 464.19 nonfederal share of costs for mental health case management 464.20 shall be provided by the recipient's county of responsibility, 464.21 as defined in sections 256G.01 to 256G.12, from sources other 464.22 than federal funds or funds used to match other federal 464.23 funds. If the service is provided by a tribal agency, the 464.24 nonfederal share, if any, shall be provided by the recipient's 464.25 tribe. 464.26(j)(k) The commissioner may suspend, reduce, or terminate 464.27 the reimbursement to a provider that does not meet the reporting 464.28 or other requirements of this section. The county of 464.29 responsibility, as defined in sections 256G.01 to 256G.12, or, 464.30 if applicable, the tribal agency, is responsible for any federal 464.31 disallowances. The county or tribe may share this 464.32 responsibility with its contracted vendors. 464.33(k)(l) The commissioner shall set aside a portion of the 464.34 federal funds earned under this section to repay the special 464.35 revenue maximization account under section 256.01, subdivision 464.36 2, clause (15). The repayment is limited to: 465.1 (1) the costs of developing and implementing this section; 465.2 and 465.3 (2) programming the information systems. 465.4(l)(m) Notwithstanding section 256.025, subdivision 2, 465.5 payments to counties and tribal agencies for case management 465.6 expenditures under this section shall only be made from federal 465.7 earnings from services provided under this section. Payments to 465.8contractedcounty-contracted vendors shall include both the 465.9 federal earnings and the county share. 465.10(m)(n) Notwithstanding section 256B.041, county payments 465.11 for the cost of mental health case management services provided 465.12 by county or state staff shall not be made to the state 465.13 treasurer. For the purposes of mental health case management 465.14 services provided by county or state staff under this section, 465.15 the centralized disbursement of payments to counties under 465.16 section 256B.041 consists only of federal earnings from services 465.17 provided under this section. 465.18(n)(o) Case management services under this subdivision do 465.19 not include therapy, treatment, legal, or outreach services. 465.20(o)(p) If the recipient is a resident of a nursing 465.21 facility, intermediate care facility, or hospital, and the 465.22 recipient's institutional care is paid by medical assistance, 465.23 payment for case management services under this subdivision is 465.24 limited to the last 30 days of the recipient's residency in that 465.25 facility and may not exceed more than two months in a calendar 465.26 year. 465.27(p)(q) Payment for case management services under this 465.28 subdivision shall not duplicate payments made under other 465.29 program authorities for the same purpose. 465.30(q)(r) By July 1, 2000, the commissioner shall evaluate 465.31 the effectiveness of the changes required by this section, 465.32 including changes in number of persons receiving mental health 465.33 case management, changes in hours of service per person, and 465.34 changes in caseload size. 465.35(r)(s) For each calendar year beginning with the calendar 465.36 year 2001, the annualized amount of state funds for each county 466.1 determined under paragraph(g)(h) shall be adjusted by the 466.2 county's percentage change in the average number of clients per 466.3 month who received case management under this section during the 466.4 fiscal year that ended six months prior to the calendar year in 466.5 question, in comparison to the prior fiscal year. 466.6(s)(t) For counties receiving the minimum allocation of 466.7 $3,000 or $5,000 described in paragraph(g)(h), the adjustment 466.8 in paragraph(r)(s) shall be determined so that the county 466.9 receives the higher of the following amounts: 466.10 (1) a continuation of the minimum allocation in paragraph 466.11(g)(h); or 466.12 (2) an amount based on that county's average number of 466.13 clients per month who received case management under this 466.14 section during the fiscal year that ended six months prior to 466.15 the calendar year in question,in comparison to the prior fiscal466.16year,times the average statewide grant per person per month for 466.17 counties not receiving the minimum allocation. 466.18(t)(u) The adjustments in paragraphs(r) and(s) and (t) 466.19 shall be calculated separately for children and adults. 466.20 Sec. 42. Minnesota Statutes 2000, section 256B.0625, is 466.21 amended by adding a subdivision to read: 466.22 Subd. 46. [MENTAL HEALTH PROVIDER TRAVEL TIME.] Medical 466.23 assistance covers provider travel time if a recipient's 466.24 individual treatment plan requires the provision of mental 466.25 health services outside of the provider's normal place of 466.26 business. This does not include any travel time which is 466.27 included in other billable services, and is only covered when 466.28 the mental health service being provided to a recipient is 466.29 covered under medical assistance. 466.30 Sec. 43. [256B.761] [REIMBURSEMENT FOR MENTAL HEALTH 466.31 SERVICES.] 466.32 Effective for services rendered on or after July 1, 2001, 466.33 payment for medication management provided to psychiatric 466.34 patients, outpatient mental health services, day treatment 466.35 services, home-based mental health services, and family 466.36 community support services shall be paid at the lower of (1) 467.1 submitted charges, or (2) 75.6 percent of the 50th percentile of 467.2 1999 charges. 467.3 Sec. 44. [256B.81] [MENTAL HEALTH PROVIDER APPEAL 467.4 PROCESS.] 467.5 If a county contract or certification is required to enroll 467.6 as an authorized provider of mental health services under 467.7 medical assistance, and if a county refuses to grant the 467.8 necessary contract or certification, the provider may appeal the 467.9 county decision to the commissioner. A recipient may initiate 467.10 an appeal on behalf of a provider who has been denied 467.11 certification. The commissioner shall determine whether the 467.12 provider meets applicable standards under state laws and rules 467.13 based on an independent review of the facts, including comments 467.14 from the county review. If the commissioner finds that the 467.15 provider meets the applicable standards, the commissioner shall 467.16 enroll the provider as an authorized provider. The commissioner 467.17 shall develop procedures for providers and recipients to appeal 467.18 a county decision to refuse to enroll a provider. After the 467.19 commissioner makes a decision regarding an appeal, the county, 467.20 provider, or recipient may request that the commissioner 467.21 reconsider the commissioner's initial decision. The 467.22 commissioner's reconsideration decision is final and not subject 467.23 to further appeal. 467.24 Sec. 45. [256B.82] [PREPAID PLANS AND MENTAL HEALTH 467.25 REHABILITATIVE SERVICES.] 467.26 Medical assistance and MinnesotaCare prepaid health plans 467.27 may include coverage for adult mental health rehabilitative 467.28 services under section 256B.0623 and adult mental health crisis 467.29 response services under section 256B.0624, beginning January 1, 467.30 2004. 467.31 By January 15, 2003, the commissioner shall report to the 467.32 legislature how these services should be included in prepaid 467.33 plans. The commissioner shall consult with mental health 467.34 advocates, health plans, and counties in developing this 467.35 report. The report recommendations must include a plan to 467.36 ensure coordination of these services between health plans and 468.1 counties, assure recipient access to essential community 468.2 providers, and monitor the health plans' delivery of services 468.3 through utilization review and quality standards. 468.4 Sec. 46. [256B.83] [MAINTENANCE OF EFFORT FOR CERTAIN 468.5 MENTAL HEALTH SERVICES.] 468.6 Any net increase in revenue to the county as a result of 468.7 the change in section 256B.0623 or 256B.0624 must be used to 468.8 provide expanded mental health services as defined in sections 468.9 245.461 to 245.486, the Comprehensive Adult Mental Health Act, 468.10 excluding inpatient and residential treatment. Increased 468.11 revenue may also be used for services and consumer supports, 468.12 which are part of adult mental health projects approved under 468.13 section 245.4661. "Increased revenue" has the meaning given in 468.14 Minnesota Rules, part 9520.0903, subpart 3. 468.15 Sec. 47. Minnesota Statutes 2000, section 260C.201, 468.16 subdivision 1, as amended by Laws 2001, chapter 178, article 1, 468.17 section 16, is amended to read: 468.18 Subdivision 1. [DISPOSITIONS.] (a) If the court finds that 468.19 the child is in need of protection or services or neglected and 468.20 in foster care, it shall enter an order making any of the 468.21 following dispositions of the case: 468.22 (1) place the child under the protective supervision of the 468.23 responsible social services agency or child-placing agency in 468.24 the home of a parent of the child under conditions prescribed by 468.25 the court directed to the correction of the child's need for 468.26 protection or services: 468.27 (i) the court may order the child into the home of a parent 468.28 who does not otherwise have legal custody of the child, however, 468.29 an order under this section does not confer legal custody on 468.30 that parent; 468.31 (ii) if the court orders the child into the home of a 468.32 father who is not adjudicated, he must cooperate with paternity 468.33 establishment proceedings regarding the child in the appropriate 468.34 jurisdiction as one of the conditions prescribed by the court 468.35 for the child to continue in his home; 468.36 (iii) the court may order the child into the home of a 469.1 noncustodial parent with conditions and may also order both the 469.2 noncustodial and the custodial parent to comply with the 469.3 requirements of a case plan under subdivision 2; or 469.4 (2) transfer legal custody to one of the following: 469.5 (i) a child-placing agency; or 469.6 (ii) the responsible social services agency. In placing a 469.7 child whose custody has been transferred under this paragraph, 469.8 the agencies shall make an individualized determination of how 469.9 the placement is in the child's best interests using the 469.10 consideration for relatives and the best interest factors in 469.11 section 260C.212, subdivision 2, paragraph (b); or 469.12 (3) if the child has been adjudicated as a child in need of 469.13 protection or services because the child is in need of special 469.14treatment andservices or carefor reasons of physical or mental469.15healthto treat or ameliorate a physical or mental disability, 469.16 the court may order the child's parent, guardian, or custodian 469.17 to provide it. The court may order the child's health plan 469.18 company to provide mental health services to the child. Section 469.19 62Q.535 applies to an order for mental health services directed 469.20 to the child's health plan company. If the health plan, parent, 469.21 guardian, or custodian fails or is unable to provide this 469.22 treatment or care, the court may order it provided. Absent 469.23 specific written findings by the court that the child's 469.24 disability is the result of abuse or neglect by the child's 469.25 parent or guardian, the court shall not transfer legal custody 469.26 of the child for the purpose of obtaining special treatment or 469.27 care solely because the parent is unable to provide the 469.28 treatment or care. If the court's order for mental health 469.29 treatment is based on a diagnosis made by a treatment 469.30 professional, the court may order that the diagnosing 469.31 professional not provide the treatment to the child if it finds 469.32 that such an order is in the child's best interests; or 469.33 (4) if the court believes that the child has sufficient 469.34 maturity and judgment and that it is in the best interests of 469.35 the child, the court may order a child 16 years old or older to 469.36 be allowed to live independently, either alone or with others as 470.1 approved by the court under supervision the court considers 470.2 appropriate, if the county board, after consultation with the 470.3 court, has specifically authorized this dispositional 470.4 alternative for a child. 470.5 (b) If the child was adjudicated in need of protection or 470.6 services because the child is a runaway or habitual truant, the 470.7 court may order any of the following dispositions in addition to 470.8 or as alternatives to the dispositions authorized under 470.9 paragraph (a): 470.10 (1) counsel the child or the child's parents, guardian, or 470.11 custodian; 470.12 (2) place the child under the supervision of a probation 470.13 officer or other suitable person in the child's own home under 470.14 conditions prescribed by the court, including reasonable rules 470.15 for the child's conduct and the conduct of the parents, 470.16 guardian, or custodian, designed for the physical, mental, and 470.17 moral well-being and behavior of the child; or with the consent 470.18 of the commissioner of corrections, place the child in a group 470.19 foster care facility which is under the commissioner's 470.20 management and supervision; 470.21 (3) subject to the court's supervision, transfer legal 470.22 custody of the child to one of the following: 470.23 (i) a reputable person of good moral character. No person 470.24 may receive custody of two or more unrelated children unless 470.25 licensed to operate a residential program under sections 245A.01 470.26 to 245A.16; or 470.27 (ii) a county probation officer for placement in a group 470.28 foster home established under the direction of the juvenile 470.29 court and licensed pursuant to section 241.021; 470.30 (4) require the child to pay a fine of up to $100. The 470.31 court shall order payment of the fine in a manner that will not 470.32 impose undue financial hardship upon the child; 470.33 (5) require the child to participate in a community service 470.34 project; 470.35 (6) order the child to undergo a chemical dependency 470.36 evaluation and, if warranted by the evaluation, order 471.1 participation by the child in a drug awareness program or an 471.2 inpatient or outpatient chemical dependency treatment program; 471.3 (7) if the court believes that it is in the best interests 471.4 of the child and of public safety that the child's driver's 471.5 license or instruction permit be canceled, the court may order 471.6 the commissioner of public safety to cancel the child's license 471.7 or permit for any period up to the child's 18th birthday. If 471.8 the child does not have a driver's license or permit, the court 471.9 may order a denial of driving privileges for any period up to 471.10 the child's 18th birthday. The court shall forward an order 471.11 issued under this clause to the commissioner, who shall cancel 471.12 the license or permit or deny driving privileges without a 471.13 hearing for the period specified by the court. At any time 471.14 before the expiration of the period of cancellation or denial, 471.15 the court may, for good cause, order the commissioner of public 471.16 safety to allow the child to apply for a license or permit, and 471.17 the commissioner shall so authorize; 471.18 (8) order that the child's parent or legal guardian deliver 471.19 the child to school at the beginning of each school day for a 471.20 period of time specified by the court; or 471.21 (9) require the child to perform any other activities or 471.22 participate in any other treatment programs deemed appropriate 471.23 by the court. 471.24 To the extent practicable, the court shall enter a 471.25 disposition order the same day it makes a finding that a child 471.26 is in need of protection or services or neglected and in foster 471.27 care, but in no event more than 15 days after the finding unless 471.28 the court finds that the best interests of the child will be 471.29 served by granting a delay. If the child was under eight years 471.30 of age at the time the petition was filed, the disposition order 471.31 must be entered within ten days of the finding and the court may 471.32 not grant a delay unless good cause is shown and the court finds 471.33 the best interests of the child will be served by the delay. 471.34 (c) If a child who is 14 years of age or older is 471.35 adjudicated in need of protection or services because the child 471.36 is a habitual truant and truancy procedures involving the child 472.1 were previously dealt with by a school attendance review board 472.2 or county attorney mediation program under section 260A.06 or 472.3 260A.07, the court shall order a cancellation or denial of 472.4 driving privileges under paragraph (b), clause (7), for any 472.5 period up to the child's 18th birthday. 472.6 (d) In the case of a child adjudicated in need of 472.7 protection or services because the child has committed domestic 472.8 abuse and been ordered excluded from the child's parent's home, 472.9 the court shall dismiss jurisdiction if the court, at any time, 472.10 finds the parent is able or willing to provide an alternative 472.11 safe living arrangement for the child, as defined in Laws 1997, 472.12 chapter 239, article 10, section 2. 472.13 (e) When a parent has complied with a case plan ordered 472.14 under subdivision 6 and the child is in the care of the parent, 472.15 the court may order the responsible social services agency to 472.16 monitor the parent's continued ability to maintain the child 472.17 safely in the home under such terms and conditions as the court 472.18 determines appropriate under the circumstances. 472.19 Sec. 48. [DEVELOPMENT OF PAYMENT SYSTEM FOR ADULT 472.20 RESIDENTIAL SERVICES GRANTS.] 472.21 The commissioner of human services shall review funding 472.22 methods for adult residential services grants under Minnesota 472.23 Rules, parts 9535.2000 to 9535.3000, and shall develop a payment 472.24 system that takes into account client difficulty of care as 472.25 manifested by client physical, mental, or behavioral 472.26 conditions. The payment system must provide reimbursement for 472.27 education, consultation, and support services provided to 472.28 families and other individuals as an extension of the treatment 472.29 process. The commissioner shall present recommendations and 472.30 draft legislation for an adult residential services payment 472.31 system to the legislature by January 15, 2002. The 472.32 recommendations must address whether additional funding for 472.33 adult residential services grants is necessary for the provision 472.34 of high quality services under a payment reimbursement system. 472.35 Sec. 49. [NOTICE REGARDING ESTABLISHMENT OF CONTINUING 472.36 CARE BENEFIT PROGRAM.] 473.1 When the continuing care benefit program for persons with 473.2 mental illness under Minnesota Statutes, section 256.9693 is 473.3 established, the commissioner of human services shall notify 473.4 counties, health plan companies with prepaid medical assistance 473.5 contracts, health care providers, and enrollees of the benefit 473.6 program through bulletins, workshops, and other meetings. 473.7 [EFFECTIVE DATE.] This section is effective July 1, 2002. 473.8 Sec. 50. [STUDY OF CHILDREN'S MENTAL HEALTH 473.9 COLLABORATIVES.] 473.10 The commissioner of human services shall conduct a study of 473.11 the role of the children's mental health and family services 473.12 collaboratives in the children's mental health system. This 473.13 study must be conducted in consultation with the commissioners 473.14 of health, corrections, and children, families, and learning, 473.15 providers of mental health services in schools, other providers 473.16 of mental health services, parents of children receiving mental 473.17 health services, local children's mental health collaboratives, 473.18 counties, and other interested persons. The study must include 473.19 an assessment and evaluation of the collaboratives. The 473.20 commissioner shall report findings and recommendations to the 473.21 legislature by January 15, 2003. 473.22 Sec. 51. [STUDY; LENGTH OF STAY FOR MEDICARE-ELIGIBLE 473.23 PERSONS.] 473.24 The commissioner of human services shall study and make 473.25 recommendations on how Medicare-eligible persons with mental 473.26 illness may obtain acute care hospital inpatient treatment for 473.27 mental illness for a length of stay beyond that allowed by the 473.28 diagnostic classifications for mental illness according to 473.29 Minnesota Statutes, section 256.969, subdivision 3a. The study 473.30 and recommendations shall be reported to the legislature by 473.31 January 15, 2002. 473.32 Sec. 52. [DATA REGARDING COUNTY COMMITMENT COSTS.] 473.33 Each county shall report data regarding all county costs 473.34 for civil commitments under Minnesota Statutes, section 253B.09, 473.35 beginning July 1, 2002, to the commissioner of human services. 473.36 This fiscal data must include but is not limited to court costs, 474.1 hold order costs under Minnesota Statutes, section 253B.05, the 474.2 county share of costs for placement in a regional treatment 474.3 center, costs for prepetition screening under Minnesota 474.4 Statutes, section 253B.07, case management costs, transportation 474.5 costs, and contract bed costs. The commissioner shall report 474.6 this information, including any increases or decreases in county 474.7 commitment costs that occur after the implementation of sections 474.8 in this article relating to civil commitment, to the legislature 474.9 by January 15, 2004. 474.10 ARTICLE 10 474.11 ASSISTANCE PROGRAMS 474.12 Section 1. Minnesota Statutes 2000, section 256.01, 474.13 subdivision 18, is amended to read: 474.14 Subd. 18. [IMMIGRATION STATUS VERIFICATIONS.] (a) 474.15 Notwithstanding any waiver of this requirement by the secretary 474.16 of the United States Department of Health and Human Services, 474.17 effective July 1, 2001, the commissioner shall utilize the 474.18 Systematic Alien Verification for Entitlements (SAVE) program to 474.19 conduct immigration status verifications: 474.20 (1) as required under United States Code, title 8, section 474.21 1642; 474.22 (2) for all applicants for food assistance benefits, 474.23 whether under the federal food stamp program, the MFIP or work 474.24 first program, or the Minnesota food assistance program; 474.25 (3) for all applicants for general assistance medical care, 474.26 except assistance for an emergency medical condition, for 474.27 immunization with respect to an immunizable disease, or for 474.28 testing and treatment of symptoms of a communicable disease; and 474.29 (4) for all applicants for general assistance, Minnesota 474.30 supplemental aid, MinnesotaCare, or group residential housing, 474.31 when the benefits provided by these programs would fall under 474.32 the definition of "federal public benefit" under United States 474.33 Code, title 8, section 1642, if federal funds were used to pay 474.34 for all or part of the benefits. 474.35The commissioner shall report to the Immigration and474.36Naturalization Service all undocumented persons who have been475.1identified through application verification procedures or by the475.2self-admission of an applicant for assistance. Reports made475.3under this subdivision must comply with the requirements of475.4section 411A of the Social Security Act, as amended, and United475.5States Code, title 8, section 1644.475.6 (b) The commissioner shall comply with the reporting 475.7 requirements under United States Code, title 42, section 611a, 475.8 and any federal regulation or guidance adopted under that law. 475.9 Sec. 2. Minnesota Statutes 2000, section 256.98, 475.10 subdivision 8, is amended to read: 475.11 Subd. 8. [DISQUALIFICATION FROM PROGRAM.] (a) Any person 475.12 found to be guilty of wrongfully obtaining assistance by a 475.13 federal or state court or by an administrative hearing 475.14 determination, or waiver thereof, through a disqualification 475.15 consent agreement, or as part of any approved diversion plan 475.16 under section 401.065, or any court-ordered stay which carries 475.17 with it any probationary or other conditions, in the Minnesota 475.18 familyassistanceinvestment program, the food stamp program, 475.19 the general assistance program, the group residential housing 475.20 program, or the Minnesota supplemental aid program shall be 475.21 disqualified from that program. In addition, any person 475.22 disqualified from the Minnesota family investment program shall 475.23 also be disqualified from the food stamp program. The needs of 475.24 that individual shall not be taken into consideration in 475.25 determining the grant level for that assistance unit: 475.26 (1) for one year after the first offense; 475.27 (2) for two years after the second offense; and 475.28 (3) permanently after the third or subsequent offense. 475.29 The period of program disqualification shall begin on the 475.30 date stipulated on the advance notice of disqualification 475.31 without possibility of postponement for administrative stay or 475.32 administrative hearing and shall continue through completion 475.33 unless and until the findings upon which the sanctions were 475.34 imposed are reversed by a court of competent jurisdiction. The 475.35 period for which sanctions are imposed is not subject to 475.36 review. The sanctions provided under this subdivision are in 476.1 addition to, and not in substitution for, any other sanctions 476.2 that may be provided for by law for the offense involved. A 476.3 disqualification established through hearing or waiver shall 476.4 result in the disqualification period beginning immediately 476.5 unless the person has become otherwise ineligible for 476.6 assistance. If the person is ineligible for assistance, the 476.7 disqualification period begins when the person again meets the 476.8 eligibility criteria of the program from which they were 476.9 disqualified and makes application for that program. 476.10 (b) A family receiving assistance through child care 476.11 assistance programs under chapter 119B with a family member who 476.12 is found to be guilty of wrongfully obtaining child care 476.13 assistance by a federal court, state court, or an administrative 476.14 hearing determination or waiver, through a disqualification 476.15 consent agreement, as part of an approved diversion plan under 476.16 section 401.065, or a court-ordered stay with probationary or 476.17 other conditions, is disqualified from child care assistance 476.18 programs. The disqualifications must be for periods of three 476.19 months, six months, and two years for the first, second, and 476.20 third offenses respectively. Subsequent violations must result 476.21 in permanent disqualification. During the disqualification 476.22 period, disqualification from any child care program must extend 476.23 to all child care programs and must be immediately applied. 476.24 Sec. 3. Minnesota Statutes 2000, section 256D.053, 476.25 subdivision 1, is amended to read: 476.26 Subdivision 1. [PROGRAM ESTABLISHED.] The Minnesota food 476.27 assistance program is established to provide food assistance to 476.28 legal noncitizens residing in this state who are ineligible to 476.29 participate in the federal Food Stamp Program solely due to the 476.30 provisions of section 402 or 403 of Public Law Number 104-193, 476.31 as authorized by Title VII of the 1997 Emergency Supplemental 476.32 Appropriations Act, Public Law Number 105-18, and as amended by 476.33 Public Law Number 105-185. 476.34 Beginning July 1,20022003, the Minnesota food assistance 476.35 program is limited to those noncitizens described in this 476.36 subdivision who are 50 years of age or older. 477.1 Sec. 4. Minnesota Statutes 2000, section 256D.425, 477.2 subdivision 1, is amended to read: 477.3 Subdivision 1. [PERSONS ENTITLED TO RECEIVE AID.] A person 477.4 who is aged, blind, or 18 years of age or older and disabled and 477.5 who is receiving supplemental security benefits under Title XVI 477.6 on the basis of age, blindness, or disability (or would be 477.7 eligible for such benefits except for excess income) is eligible 477.8 for a payment under the Minnesota supplemental aid program, if 477.9 the person's net income is less than the standards in section 477.10 256D.44. Persons who are not receiving supplemental security 477.11 income benefits under Title XVI of the Social Security Act or 477.12 disability insurance benefits under Title II of the Social 477.13 Security Act due to exhausting time limited benefits are not 477.14 eligible to receive benefits under the MSA program. Persons who 477.15 are not receiving social security or other maintenance benefits 477.16 for failure to meet or comply with the social security or other 477.17 maintenance program requirements are not eligible to receive 477.18 benefits under the MSA program. Persons who are found 477.19 ineligible for supplemental security income because of excess 477.20 income, but whose income is within the limits of the Minnesota 477.21 supplemental aid program, must have blindness or disability 477.22 determined by the state medical review team. 477.23 Sec. 5. [256J.021] [SEPARATE STATE PROGRAM FOR USE OF 477.24 STATE MONEY.] 477.25 Beginning October 1, 2001, and each year thereafter, the 477.26 commissioner of human services must treat financial assistance 477.27 expenditures made to or on behalf of any minor child under 477.28 section 256J.02, subdivision 2, clause (1), who is a resident of 477.29 this state under section 256J.12, and who is part of a 477.30 two-parent eligible household as expenditures under a separately 477.31 funded state program and report those expenditures to the 477.32 federal Department of Health and Human Services as separate 477.33 state program expenditures under Code of Federal Regulations, 477.34 title 45, section 263.5. 477.35 Sec. 6. Minnesota Statutes 2000, section 256J.08, 477.36 subdivision 55a, is amended to read: 478.1 Subd. 55a. [MFIP STANDARD OF NEED.] "MFIP standard of 478.2 need" means the appropriate standard used to determine MFIP 478.3 benefit payments for the MFIP unit and applies to: 478.4 (1) the transitional standard, sections 256J.08, 478.5 subdivision 85, and 256J.24, subdivision 5; and 478.6 (2) the shared household standard, section 256J.24, 478.7 subdivision 9; and478.8(3) the interstate transition standard, section 256J.43. 478.9 Sec. 7. Minnesota Statutes 2000, section 256J.08, is 478.10 amended by adding a subdivision to read: 478.11 Subd. 67a. [PERSON TRAINED IN DOMESTIC VIOLENCE.] "Person 478.12 trained in domestic violence" means an individual who works for 478.13 an organization that is designated by the Minnesota center for 478.14 crime victims services as providing services to victims of 478.15 domestic violence, or a county staff person who has received 478.16 similar specialized training, and includes any other person or 478.17 organization designated by a qualifying organization under this 478.18 section. 478.19 [EFFECTIVE DATE.] This section is effective October 1, 2001. 478.20 Sec. 8. Minnesota Statutes 2000, section 256J.09, 478.21 subdivision 1, is amended to read: 478.22 Subdivision 1. [WHERE TO APPLY.] To apply for assistance a 478.23 person mustapply for assistance atsubmit a signed application 478.24 to the county agency in the county where that person lives. 478.25 Sec. 9. Minnesota Statutes 2000, section 256J.09, 478.26 subdivision 2, is amended to read: 478.27 Subd. 2. [COUNTY AGENCY RESPONSIBILITY TO PROVIDE 478.28 INFORMATION.] When a person inquires about assistance, a county 478.29 agency mustinform a person who inquires about assistance about: 478.30 (1) explain the eligibility requirementsfor assistanceof, 478.31 and how to apply for, diversionary assistance, including478.32diversionary assistance andas provided in section 256J.47; 478.33 emergency assistance.as provided in section 256J.48; MFIP as 478.34 provided in section 256J.10; or any other assistance for which 478.35 the person may be eligible; and 478.36A county agency must(2) offer the person brochures 479.1 developed or approved by the commissioner that describe how to 479.2 apply for assistance. 479.3 Sec. 10. Minnesota Statutes 2000, section 256J.09, 479.4 subdivision 3, is amended to read: 479.5 Subd. 3. [SUBMITTING THE APPLICATION FORM.] (a) A county 479.6 agency must offer, in person or by mail, the application forms 479.7 prescribed by the commissioner as soon as a person makes a 479.8 written or oral inquiry. At that time, the county agency must: 479.9 (1) inform the person that assistance begins with the date 479.10 the signed application is received by the county agency or the 479.11 date all eligibility criteria are met, whichever is later. The479.12county agency must; 479.13 (2) inform theapplicantperson that any delay in 479.14 submitting the application will reduce the amount of assistance 479.15 paid for the month of application. A county agency must; 479.16 (3) inform a person that the person may submit the 479.17 application before an interviewappointment. To apply for479.18assistance, a person must submit a signed application to the479.19county agency.; 479.20 (4) explain the information that will be verified during 479.21 the application process by the county agency as provided in 479.22 section 256J.32; 479.23 (5) inform a person about the county agency's average 479.24 application processing time and explain how the application will 479.25 be processed under subdivision 5; 479.26 (6) explain how to contact the county agency if a person's 479.27 application information changes and how to withdraw the 479.28 application; 479.29 (7) inform a person that the next step in the application 479.30 process is an interview and what a person must do if the 479.31 application is approved including, but not limited to, attending 479.32 orientation under section 256J.45 and complying with employment 479.33 and training services requirements in sections 256J.52 to 479.34 256J.55; 479.35 (8) explain the child care and transportation services that 479.36 are available under paragraph (c) to enable caregivers to attend 480.1 the interview, screening, and orientation; and 480.2 (9) identify any language barriers and arrange for 480.3 translation assistance during appointments, including, but not 480.4 limited to, screening under subdivision 3a, orientation under 480.5 section 256J.45, and the initial assessment under section 480.6 256J.52. 480.7 (b) Upon receipt of a signed application, the county agency 480.8 must stamp the date of receipt on the face of the application. 480.9 The county agency must process the application within the time 480.10 period required under subdivision 5. An applicant may withdraw 480.11 the application at any time by giving written or oral notice to 480.12 the county agency. The county agency must issue a written 480.13 notice confirming the withdrawal. The notice must inform the 480.14 applicant of the county agency's understanding that the 480.15 applicant has withdrawn the application and no longer wants to 480.16 pursue it. When, within ten days of the date of the agency's 480.17 notice, an applicant informs a county agency, in writing, that 480.18 the applicant does not wish to withdraw the application, the 480.19 county agency must reinstate the application and finish 480.20 processing the application. 480.21 (c) Upon a participant's request, the county agency must 480.22 arrange for transportation and child care or reimburse the 480.23 participant for transportation and child care expenses necessary 480.24 to enable participants to attend the screening under subdivision 480.25 3a and orientation under section 256J.45. 480.26 Sec. 11. Minnesota Statutes 2000, section 256J.09, is 480.27 amended by adding a subdivision to read: 480.28 Subd. 3a. [SCREENING.] The county agency, or at county 480.29 option, the county's employment and training service provider as 480.30 defined in section 256J.49, must screen each applicant to 480.31 determine immediate needs and to determine if the applicant may 480.32 be eligible for: 480.33 (1) another program that is not partially funded through 480.34 the federal temporary assistance to needy families block grant 480.35 under Title I of Public Law Number 104-193, including the 480.36 expedited issuance of food stamps under section 256J.28, 481.1 subdivision 1. If the applicant may be eligible for another 481.2 program, a county caseworker must provide the appropriate 481.3 referral to the program; 481.4 (2) the diversionary assistance program under section 481.5 256J.47; or 481.6 (3) the emergency assistance program under section 256J.48. 481.7 Sec. 12. Minnesota Statutes 2000, section 256J.09, is 481.8 amended by adding a subdivision to read: 481.9 Subd. 3b. [INTERVIEW TO DETERMINE REFERRALS AND SERVICES.] 481.10 If the applicant is not diverted from applying for MFIP, and if 481.11 the applicant meets the MFIP eligibility requirements, then a 481.12 county agency must: 481.13 (1) identify an applicant who is under the age of 20 and 481.14 explain to the applicant the assessment procedures and 481.15 employment plan requirements for minor parents under section 481.16 256J.54; 481.17 (2) explain to the applicant the eligibility criteria for 481.18 an exemption under the family violence provisions in section 481.19 256J.52, subdivision 6, and explain what an applicant should do 481.20 to develop an alternative employment plan; 481.21 (3) determine if an applicant qualifies for an exemption 481.22 under section 256J.56 from employment and training services 481.23 requirements, explain how a person should report to the county 481.24 agency any status changes, and explain that an applicant who is 481.25 exempt may volunteer to participate in employment and training 481.26 services; 481.27 (4) for applicants who are not exempt from the requirement 481.28 to attend orientation, arrange for an orientation under section 481.29 256J.45 and an initial assessment under section 256J.52; 481.30 (5) inform an applicant who is not exempt from the 481.31 requirement to attend orientation that failure to attend the 481.32 orientation is considered an occurrence of noncompliance with 481.33 program requirements and will result in an imposition of a 481.34 sanction under section 256J.46; and 481.35 (6) explain how to contact the county agency if an 481.36 applicant has questions about compliance with program 482.1 requirements. 482.2 Sec. 13. Minnesota Statutes 2000, section 256J.21, 482.3 subdivision 2, is amended to read: 482.4 Subd. 2. [INCOME EXCLUSIONS.] (a) The following must be 482.5 excluded in determining a family's available income: 482.6 (1) payments for basic care, difficulty of care, and 482.7 clothing allowances received for providing family foster care to 482.8 children or adults under Minnesota Rules, parts 9545.0010 to 482.9 9545.0260 and 9555.5050 to 9555.6265, and payments received and 482.10 used for care and maintenance of a third-party beneficiary who 482.11 is not a household member; 482.12 (2) reimbursements for employment training received through 482.13 the Job Training Partnership Act, United States Code, title 29, 482.14 chapter 19, sections 1501 to 1792b; 482.15 (3) reimbursement for out-of-pocket expenses incurred while 482.16 performing volunteer services, jury duty, employment, or 482.17 informal carpooling arrangements directly related to employment; 482.18 (4) all educational assistance, except the county agency 482.19 must count graduate student teaching assistantships, 482.20 fellowships, and other similar paid work as earned income and, 482.21 after allowing deductions for any unmet and necessary 482.22 educational expenses, shall count scholarships or grants awarded 482.23 to graduate students that do not require teaching or research as 482.24 unearned income; 482.25 (5) loans, regardless of purpose, from public or private 482.26 lending institutions, governmental lending institutions, or 482.27 governmental agencies; 482.28 (6) loans from private individuals, regardless of purpose, 482.29 provided an applicant or participant documents that the lender 482.30 expects repayment; 482.31 (7)(i) state income tax refunds; and 482.32 (ii) federal income tax refunds; 482.33 (8)(i) federal earned income credits; 482.34 (ii) Minnesota working family credits; 482.35 (iii) state homeowners and renters credits under chapter 482.36 290A; and 483.1 (iv) federal or state tax rebates; 483.2 (9) funds received for reimbursement, replacement, or 483.3 rebate of personal or real property when these payments are made 483.4 by public agencies, awarded by a court, solicited through public 483.5 appeal, or made as a grant by a federal agency, state or local 483.6 government, or disaster assistance organizations, subsequent to 483.7 a presidential declaration of disaster; 483.8 (10) the portion of an insurance settlement that is used to 483.9 pay medical, funeral, and burial expenses, or to repair or 483.10 replace insured property; 483.11 (11) reimbursements for medical expenses that cannot be 483.12 paid by medical assistance; 483.13 (12) payments by a vocational rehabilitation program 483.14 administered by the state under chapter 268A, except those 483.15 payments that are for current living expenses; 483.16 (13) in-kind income, including any payments directly made 483.17 by a third party to a provider of goods and services; 483.18 (14) assistance payments to correct underpayments, but only 483.19 for the month in which the payment is received; 483.20 (15) emergency assistance payments; 483.21 (16) funeral and cemetery payments as provided by section 483.22 256.935; 483.23 (17) nonrecurring cash gifts of $30 or less, not exceeding 483.24 $30 per participant in a calendar month; 483.25 (18) any form of energy assistance payment made through 483.26 Public Law Number 97-35, Low-Income Home Energy Assistance Act 483.27 of 1981, payments made directly to energy providers by other 483.28 public and private agencies, and any form of credit or rebate 483.29 payment issued by energy providers; 483.30 (19) Supplemental Security Income (SSI), including 483.31 retroactive SSI payments and other income of an SSI recipient; 483.32 (20) Minnesota supplemental aid, including retroactive 483.33 payments; 483.34 (21) proceeds from the sale of real or personal property; 483.35 (22) adoption assistance payments under section 259.67; 483.36 (23) state-funded family subsidy program payments made 484.1 under section 252.32 to help families care for children with 484.2 mental retardation or related conditions, consumer support grant 484.3 funds under section 256.476, and resources and services for a 484.4 disabled household member under one of the home and 484.5 community-based waiver services programs under chapter 256B; 484.6 (24) interest payments and dividends from property that is 484.7 not excluded from and that does not exceed the asset limit; 484.8 (25) rent rebates; 484.9 (26) income earned by a minor caregiver, minor child 484.10 through age 6, or a minor child who is at least a half-time 484.11 student in an approved elementary or secondary education 484.12 program; 484.13 (27) income earned by a caregiver under age 20 who is at 484.14 least a half-time student in an approved elementary or secondary 484.15 education program; 484.16 (28) MFIP child care payments under section 119B.05; 484.17 (29) all other payments made through MFIP to support a 484.18 caregiver's pursuit of greater self-support; 484.19 (30) income a participant receives related to shared living 484.20 expenses; 484.21 (31) reverse mortgages; 484.22 (32) benefits provided by the Child Nutrition Act of 1966, 484.23 United States Code, title 42, chapter 13A, sections 1771 to 484.24 1790; 484.25 (33) benefits provided by the women, infants, and children 484.26 (WIC) nutrition program, United States Code, title 42, chapter 484.27 13A, section 1786; 484.28 (34) benefits from the National School Lunch Act, United 484.29 States Code, title 42, chapter 13, sections 1751 to 1769e; 484.30 (35) relocation assistance for displaced persons under the 484.31 Uniform Relocation Assistance and Real Property Acquisition 484.32 Policies Act of 1970, United States Code, title 42, chapter 61, 484.33 subchapter II, section 4636, or the National Housing Act, United 484.34 States Code, title 12, chapter 13, sections 1701 to 1750jj; 484.35 (36) benefits from the Trade Act of 1974, United States 484.36 Code, title 19, chapter 12, part 2, sections 2271 to 2322; 485.1 (37) war reparations payments to Japanese Americans and 485.2 Aleuts under United States Code, title 50, sections 1989 to 485.3 1989d; 485.4 (38) payments to veterans or their dependents as a result 485.5 of legal settlements regarding Agent Orange or other chemical 485.6 exposure under Public Law Number 101-239, section 10405, 485.7 paragraph (a)(2)(E); 485.8 (39) income that is otherwise specifically excluded from 485.9 MFIP consideration in federal law, state law, or federal 485.10 regulation; 485.11 (40) security and utility deposit refunds; 485.12 (41) American Indian tribal land settlements excluded under 485.13 Public Law Numbers 98-123, 98-124, and 99-377 to the Mississippi 485.14 Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs 485.15 reservations and payments to members of the White Earth Band, 485.16 under United States Code, title 25, chapter 9, section 331, and 485.17 chapter 16, section 1407; 485.18 (42) all income of the minor parent's parents and 485.19 stepparents when determining the grant for the minor parent in 485.20 households that include a minor parent living with parents or 485.21 stepparents on MFIP with other children; and 485.22 (43) income of the minor parent's parents and stepparents 485.23 equal to 200 percent of the federal poverty guideline for a 485.24 family size not including the minor parent and the minor 485.25 parent's child in households that include a minor parent living 485.26 with parents or stepparents not on MFIP when determining the 485.27 grant for the minor parent. The remainder of income is deemed 485.28 as specified in section 256J.37, subdivision 1b; 485.29 (44) payments made to children eligible for relative 485.30 custody assistance under section 257.85; 485.31 (45) vendor payments for goods and services made on behalf 485.32 of a client unless the client has the option of receiving the 485.33 payment in cash; and 485.34 (46) the principal portion of a contract for deed payment. 485.35 Sec. 14. Minnesota Statutes 2000, section 256J.24, 485.36 subdivision 2, is amended to read: 486.1 Subd. 2. [MANDATORY ASSISTANCE UNIT COMPOSITION.] Except 486.2 for minor caregivers and their children who must be in a 486.3 separate assistance unit from the other persons in the 486.4 household, when the following individuals live together, they 486.5 must be included in the assistance unit: 486.6 (1) a minor child, including a pregnant minor; 486.7 (2) the minor child's minor siblings, minor half-siblings, 486.8 and minor step-siblings; 486.9 (3) the minor child's natural parents, adoptive parents, 486.10 and stepparents; and 486.11 (4) the spouse of a pregnant woman. 486.12 A minor child must have a caregiver for the child to be 486.13 included in the assistance unit. 486.14 Sec. 15. Minnesota Statutes 2000, section 256J.24, 486.15 subdivision 9, is amended to read: 486.16 Subd. 9. [SHARED HOUSEHOLD STANDARD; MFIP.] (a) Except as 486.17 prohibited in paragraph (b), the county agency must use the 486.18 shared household standard when the household includes one or 486.19 more unrelated members, as that term is defined in section 486.20 256J.08, subdivision 86a. The county agency must use the shared 486.21 household standard, unless a member of the assistance unit is a 486.22 victim ofdomesticfamily violence and has anapproved safety486.23 alternative employment plan, regardless of the number of 486.24 unrelated members in the household. 486.25 (b) The county agency must not use the shared household 486.26 standard when all unrelated members are one of the following: 486.27 (1) a recipient of public assistance benefits, including 486.28 food stamps, Supplemental Security Income, adoption assistance, 486.29 relative custody assistance, or foster care payments; 486.30 (2) a roomer or boarder, or a person to whom the assistance 486.31 unit is paying room or board; 486.32 (3) a minor child under the age of 18; 486.33 (4) a minor caregiver living with the minor caregiver's 486.34 parents or in an approved supervised living arrangement; 486.35 (5) a caregiver who is not the parent of the minor child in 486.36 the assistance unit; or 487.1 (6) an individual who provides child care to a child in the 487.2 MFIP assistance unit. 487.3 (c) The shared household standard must be discontinued if 487.4 it is not approved by the United States Department of 487.5 Agriculture under the MFIP waiver. 487.6 Sec. 16. Minnesota Statutes 2000, section 256J.24, 487.7 subdivision 10, is amended to read: 487.8 Subd. 10. [MFIP EXIT LEVEL.](a) In state fiscal years487.92000 and 2001,The commissioner shall adjust the MFIP earned 487.10 income disregard to ensure that most participants do not lose 487.11 eligibility for MFIP until their income reaches at least 120 487.12 percent of the federal poverty guidelines in effect in October 487.13 of each fiscal year. The adjustment to the disregard shall be 487.14 based on a household size of three, and the resulting earned 487.15 income disregard percentage must be applied to all household 487.16 sizes. The adjustment under this subdivision must be 487.17 implemented at the same time as the October food stamp 487.18 cost-of-living adjustment is reflected in the food portion of 487.19 MFIP transitional standard as required under subdivision 5a. 487.20(b) In state fiscal year 2002 and thereafter, the earned487.21income disregard percentage must be the same as the percentage487.22implemented in October 2000.487.23 Sec. 17. Minnesota Statutes 2000, section 256J.26, 487.24 subdivision 1, is amended to read: 487.25 Subdivision 1. [PERSON CONVICTED OF DRUG OFFENSES.] (a) 487.26 Applicants or participants who have been convicted of a drug 487.27 offense committed after July 1, 1997, may, if otherwise 487.28 eligible, receive MFIP benefits subject to the following 487.29 conditions: 487.30 (1) Benefits for the entire assistance unit must be paid in 487.31 vendor form for shelter and utilities during any time the 487.32 applicant is part of the assistance unit. 487.33 (2) The convicted applicant or participant shall be subject 487.34 to random drug testing as a condition of continued eligibility 487.35 and following any positive test for an illegal controlled 487.36 substance is subject to the following sanctions: 488.1 (i) for failing a drug test the first time, the 488.2participant's grant shall be reduced by ten percent of the MFIP488.3standard of need, prior to making vendor payments for shelter488.4and utility costs; or488.5(ii) for failing a drug test two or more times, the488.6 residual amount of the participant's grant after making vendor 488.7 payments for shelter and utility costs, if any, must be reduced 488.8 by an amount equal to 30 percent of the MFIP standard of 488.9 need for an assistance unit of the same size. When a sanction 488.10 under this subdivision is in effect, the job counselor must 488.11 attempt to meet with the person face-to-face. During the 488.12 face-to-face meeting, the job counselor must explain the 488.13 consequences of a subsequent drug test failure and inform the 488.14 participant of the right to appeal the sanction under section 488.15 256J.40. If a face-to-face meeting is not possible, the county 488.16 agency must send the participant a notice of adverse action as 488.17 provided in section 256J.31, subdivisions 4 and 5, and must 488.18 include the information required in the face-to-face meeting; or 488.19 (ii) for failing a drug test two times, the participant is 488.20 permanently disqualified from receiving MFIP assistance, both 488.21 the cash and food portions. The assistance unit's MFIP grant 488.22 must be reduced by the amount which would have otherwise been 488.23 made available to the disqualified participant. 488.24 Disqualification under this item does not make a participant 488.25 ineligible for food stamps. Before a disqualification under 488.26 this provision is imposed, the job counselor must attempt to 488.27 meet with the participant face-to-face. During the face-to-face 488.28 meeting, the job counselor must identify other resources that 488.29 may be available to the participant to meet the needs of the 488.30 family and inform the participant of the right to appeal the 488.31 disqualification under section 256J.40. If a face-to-face 488.32 meeting is not possible, the county agency must send the 488.33 participant a notice of adverse action as provided in section 488.34 256J.31, subdivisions 4 and 5, and must include the information 488.35 required in the face-to-face meeting. 488.36 (3) A participant who failsan initiala drug test the 489.1 first time and is under a sanction due to other MFIP program 489.2 requirements is considered to have more than one occurrence of 489.3 noncompliance and is subject to the applicable level of sanction 489.4in clause (2)(ii)as specified under section 256J.46, 489.5 subdivision 1, paragraph (d). 489.6 (b) Applicants requesting only food stamps or participants 489.7 receiving only food stamps, who have been convicted of a drug 489.8 offense that occurred after July 1, 1997, may, if otherwise 489.9 eligible, receive food stamps if the convicted applicant or 489.10 participant is subject to random drug testing as a condition of 489.11 continued eligibility. Following a positive test for an illegal 489.12 controlled substance, the applicant is subject to the following 489.13 sanctions: 489.14 (1) for failing a drug test the first time,food stamps489.15shall be reduced by ten percent of the applicable food stamp489.16allotment; and489.17(2) for failing a drug test two or more times,food stamps 489.18 shall be reduced by an amount equal to 30 percent of the 489.19 applicable food stamp allotment. When a sanction under this 489.20 clause is in effect, a job counselor must attempt to meet with 489.21 the person face-to-face. During the face-to-face meeting, a job 489.22 counselor must explain the consequences of a subsequent drug 489.23 test failure and inform the participant of the right to appeal 489.24 the sanction under section 256J.40. If a face-to-face meeting 489.25 is not possible, a county agency must send the participant a 489.26 notice of adverse action as provided in section 256J.31, 489.27 subdivisions 4 and 5, and must include the information required 489.28 in the face-to-face meeting; and 489.29 (2) for failing a drug test two times, the participant is 489.30 permanently disqualified from receiving food stamps. Before a 489.31 disqualification under this provision is imposed, a job 489.32 counselor must attempt to meet with the participant 489.33 face-to-face. During the face-to-face meeting, the job 489.34 counselor must identify other resources that may be available to 489.35 the participant to meet the needs of the family and inform the 489.36 participant of the right to appeal the disqualification under 490.1 section 256J.40. If a face-to-face meeting is not possible, a 490.2 county agency must send the participant a notice of adverse 490.3 action as provided in section 256J.31, subdivisions 4 and 5, and 490.4 must include the information required in the face-to-face 490.5 meeting. 490.6 (c) For the purposes of this subdivision, "drug offense" 490.7 means an offense that occurred after July 1, 1997, of sections 490.8 152.021 to 152.025, 152.0261, or 152.096. Drug offense also 490.9 means a conviction in another jurisdiction of the possession, 490.10 use, or distribution of a controlled substance, or conspiracy to 490.11 commit any of these offenses, if the offense occurred after July 490.12 1, 1997, and the conviction is a felony offense in that 490.13 jurisdiction, or in the case of New Jersey, a high misdemeanor. 490.14 Sec. 18. Minnesota Statutes 2000, section 256J.31, 490.15 subdivision 4, is amended to read: 490.16 Subd. 4. [PARTICIPANT'S RIGHT TO NOTICE.] A county agency 490.17 must give a participant written notice of all adverse actions 490.18 affecting the participant including payment reductions, 490.19 suspensions, terminations, and use of protective, vendor, or 490.20 two-party payments. The notice of adverse action must be on a 490.21 form prescribed or approved by the commissioner, must be 490.22 understandable at a seventh grade reading level, and must be 490.23 mailed to the last known mailing address provided by the 490.24 participant. A notice written in English must include the 490.25 department of human services language block and must be sent to 490.26 every applicable participant. The county agency must state on 490.27 the notice of adverse action the action it intends to take, the 490.28 reasons for the action, the participant's right to appeal the 490.29 action, the conditions under which assistance can be continued 490.30 pending an appeal decision, and the related consequences of the 490.31 action. 490.32 Sec. 19. Minnesota Statutes 2000, section 256J.32, 490.33 subdivision 4, is amended to read: 490.34 Subd. 4. [FACTORS TO BE VERIFIED.] The county agency shall 490.35 verify the following at application: 490.36 (1) identity of adults; 491.1 (2) presence of the minor child in the home, if 491.2 questionable; 491.3 (3) relationship of a minor child to caregivers in the 491.4 assistance unit; 491.5 (4) age, if necessary to determine MFIP eligibility; 491.6 (5) immigration status; 491.7 (6) social security number according to the requirements of 491.8 section 256J.30, subdivision 12; 491.9 (7) income; 491.10 (8) self-employment expenses used as a deduction; 491.11 (9) source and purpose of deposits and withdrawals from 491.12 business accounts; 491.13 (10) spousal support and child support payments made to 491.14 persons outside the household; 491.15 (11) real property; 491.16 (12) vehicles; 491.17 (13) checking and savings accounts; 491.18 (14) savings certificates, savings bonds, stocks, and 491.19 individual retirement accounts; 491.20 (15) pregnancy, if related to eligibility; 491.21 (16) inconsistent information, if related to eligibility; 491.22 (17) medical insurance; 491.23 (18) burial accounts; 491.24 (19) school attendance, if related to eligibility; 491.25 (20) residence; 491.26 (21) a claim ofdomesticfamily violence if used as a basis 491.27 for adeferral or exemptionwaiver from the 60-month time limit 491.28 in section 256J.42orand regular employment and training 491.29 services requirements in section 256J.56; 491.30 (22) disability if used as an exemption from employment and 491.31 training services requirements under section 256J.56; and 491.32 (23) information needed to establish an exception under 491.33 section 256J.24, subdivision 9. 491.34 [EFFECTIVE DATE.] This section is effective October 1, 2001. 491.35 Sec. 20. Minnesota Statutes 2000, section 256J.32, 491.36 subdivision 7a, is amended to read: 492.1 Subd. 7a. [REQUIREMENT TO REPORT TO IMMIGRATION AND 492.2 NATURALIZATION SERVICES.]Notwithstanding subdivision 7,492.3effective July 1, 2001, the commissioner shall report to the492.4Immigration and Naturalization Services all undocumented persons492.5who have been identified through application verification492.6procedures or by the self-admission of an applicant for492.7assistance. Reports made under this subdivision must comply492.8with the requirements of section 411A of the Social Security492.9Act, as amended, and United States Code, title 8, section 1644.492.10 The commissioner shall comply with the reporting requirements 492.11 under United States Code, title 42, section 611a, and any 492.12 federal regulation or guidance adopted under that law. 492.13 Sec. 21. Minnesota Statutes 2000, section 256J.37, 492.14 subdivision 9, is amended to read: 492.15 Subd. 9. [UNEARNED INCOME.] (a) The county agency must 492.16 apply unearned income to the MFIP standard of need. When 492.17 determining the amount of unearned income, the county agency 492.18 must deduct the costs necessary to secure payments of unearned 492.19 income. These costs include legal fees, medical fees, and 492.20 mandatory deductions such as federal and state income taxes. 492.21 (b) Effective July 1,20012003, the county agency shall 492.22 count $100 of the value of public and assisted rental subsidies 492.23 provided through the Department of Housing and Urban Development 492.24 (HUD) as unearned income. The full amount of the subsidy must 492.25 be counted as unearned income when the subsidy is less than $100. 492.26 (c) The provisions of paragraph (b) shall not apply to MFIP 492.27 participants who are exempt from the employment and training 492.28 services component because they are: 492.29 (i) individuals who are age 60 or older; 492.30 (ii) individuals who are suffering from a professionally 492.31 certified permanent or temporary illness, injury, or incapacity 492.32 which is expected to continue for more than 30 days and which 492.33 prevents the person from obtaining or retaining employment; or 492.34 (iii) caregivers whose presence in the home is required 492.35 because of the professionally certified illness or incapacity of 492.36 another member in the assistance unit, a relative in the 493.1 household, or a foster child in the household. 493.2 (d) The provisions of paragraph (b) shall not apply to an 493.3 MFIP assistance unit where the parental caregiver receives 493.4 supplemental security income. 493.5 Sec. 22. Minnesota Statutes 2000, section 256J.39, 493.6 subdivision 2, is amended to read: 493.7 Subd. 2. [PROTECTIVE AND VENDOR PAYMENTS.] Alternatives to 493.8 paying assistance directly to a participant may be used when: 493.9 (1) a county agency determines that a vendor payment is the 493.10 most effective way to resolve an emergency situation pertaining 493.11 to basic needs; 493.12 (2) a caregiver makes a written request to the county 493.13 agency asking that part or all of the assistance payment be 493.14 issued by protective or vendor payments for shelter and utility 493.15 service only. The caregiver may withdraw this request in 493.16 writing at any time; 493.17 (3) the vendor payment is part of a sanction under section 493.18 256J.46; 493.19 (4) the vendor payment is required under section 256J.24, 493.20 subdivision 8, or 256J.26, or 256J.43; 493.21 (5) protective payments are required for minor parents 493.22 under section 256J.14; or 493.23 (6) a caregiver has exhibited a continuing pattern of 493.24 mismanaging funds as determined by the county agency. 493.25 The director of a county agency, or the director's 493.26 designee, must approve a proposal for protective or vendor 493.27 payment for money mismanagement when there is a pattern of 493.28 mismanagement under clause (6). During the time a protective or 493.29 vendor payment is being made, the county agency must provide 493.30 services designed to alleviate the causes of the mismanagement. 493.31 The continuing need for and method of payment must be 493.32 documented and reviewed every 12 months. The director of a 493.33 county agency or the director's designee must approve the 493.34 continuation of protective or vendor payments. When it appears 493.35 that the need for protective or vendor payments will continue or 493.36 is likely to continue beyond two years because the county 494.1 agency's efforts have not resulted in sufficiently improved use 494.2 of assistance on behalf of the minor child, judicial appointment 494.3 of a legal guardian or other legal representative must be sought 494.4 by the county agency. 494.5 Sec. 23. [256J.415] [NOTICE OF TIME LIMIT 12 MONTHS PRIOR 494.6 TO 60-MONTH TIME LIMIT EXPIRING.] 494.7 The county agency shall mail a notice to each assistance 494.8 unit when the assistance unit has 12 months of TANF assistance 494.9 remaining and each month thereafter until the 60-month limit has 494.10 expired. The notice must be developed by the commissioner of 494.11 human services and must contain information about the 60-month 494.12 limit, the number of months the participant has remaining, the 494.13 hardship extension policy, and any other information that the 494.14 commissioner deems pertinent to an assistance unit nearing the 494.15 60-month limit. 494.16 Sec. 24. Minnesota Statutes 2000, section 256J.42, 494.17 subdivision 1, is amended to read: 494.18 Subdivision 1. [TIME LIMIT.] (a) Exceptfor the exemptions494.19 as otherwise provided for in this section, an assistance unit in 494.20 which any adult caregiver has received 60 months of cash 494.21 assistance funded in whole or in part by the TANF block grant in 494.22 this or any other state or United States territory, or from a 494.23 tribal TANF program, MFIP, the AFDC program formerly codified in 494.24 sections 256.72 to 256.87, or the family general assistance 494.25 program formerly codified in sections 256D.01 to 256D.23, funded 494.26 in whole or in part by state appropriations, is ineligible to 494.27 receive MFIP. Any cash assistance funded with TANF dollars in 494.28 this or any other state or United States territory, or from a 494.29 tribal TANF program, or MFIP assistance funded in whole or in 494.30 part by state appropriations, that was received by the unit on 494.31 or after the date TANF was implemented, including any assistance 494.32 received in states or United States territories of prior 494.33 residence, counts toward the 60-month limitation. The 60-month 494.34 limit applies to a minorwho is the head of a household or who494.35is married to the head of a householdcaregiver except under 494.36 subdivision 5. The 60-month time period does not need to be 495.1 consecutive months for this provision to apply. 495.2 (b) The months before July 1998 in which individuals 495.3 received assistance as part of the field trials as an MFIP, 495.4 MFIP-R, or MFIP or MFIP-R comparison group family are not 495.5 included in the 60-month time limit. 495.6 Sec. 25. Minnesota Statutes 2000, section 256J.42, 495.7 subdivision 3, is amended to read: 495.8 Subd. 3. [ADULTS LIVINGON ANIN INDIAN 495.9RESERVATIONCOUNTRY.] In determining the number of months for 495.10 which an adult has received assistance under MFIP-S, the county 495.11 agency must disregard any month during which the adult livedon495.12anin Indianreservationcountry if during the month at least 50 495.13 percent of the adults livingon the reservationin Indian 495.14 country were not employed. 495.15 Sec. 26. Minnesota Statutes 2000, section 256J.42, 495.16 subdivision 4, is amended to read: 495.17 Subd. 4. [VICTIMS OFDOMESTICFAMILY VIOLENCE.] Any cash 495.18 assistance received by an assistance unit in a month when a 495.19 caregiveris complyingcomplied with a safety plan or after 495.20 October 1, 2001, complied or is complying with an alternative 495.21 employment plan underthe MFIP-S employment and training495.22componentsection 256J.49, subdivision 1a, does not count toward 495.23 the 60-month limitation on assistance. 495.24 Sec. 27. Minnesota Statutes 2000, section 256J.42, is 495.25 amended by adding a subdivision to read: 495.26 Subd. 6. [CASE REVIEW.] (a) Within 180 days, but not less 495.27 than 60 days, before the end of the participant's 60th month on 495.28 assistance, the county agency or job counselor must review the 495.29 participant's case to determine if the employment plan is still 495.30 appropriate or if the participant is exempt under section 495.31 256J.56 from the employment and training services component, and 495.32 attempt to meet with the participant face-to-face. 495.33 (b) During the face-to-face meeting, a county agency or the 495.34 job counselor must: 495.35 (1) inform the participant how many months of counted 495.36 assistance the participant has accrued and when the participant 496.1 is expected to reach the 60th month; 496.2 (2) explain the hardship extension criteria under section 496.3 256J.425 and what the participant should do if the participant 496.4 thinks a hardship extension applies; 496.5 (3) identify other resources that may be available to the 496.6 participant to meet the needs of the family; and 496.7 (4) inform the participant of the right to appeal the case 496.8 closure under section 256J.40. 496.9 (c) If a face-to-face meeting is not possible, the county 496.10 agency must send the participant a notice of adverse action as 496.11 provided in section 256J.31, subdivisions 4 and 5. 496.12 (d) Before a participant's case is closed under this 496.13 section, the county must ensure that: 496.14 (1) the case has been reviewed by the job counselor's 496.15 supervisor or the review team designated in the county's 496.16 approved local service unit plan to determine if the criteria 496.17 for a hardship extension, if requested, were applied 496.18 appropriately; and 496.19 (2) the county agency or the job counselor attempted to 496.20 meet with the participant face-to-face. 496.21 Sec. 28. [256J.425] [HARDSHIP EXTENSIONS.] 496.22 Subdivision 1. [ELIGIBILITY.] To be eligible for a 496.23 hardship extension, a participant in an assistance unit subject 496.24 to the time limit under section 256J.42, subdivision 1, in which 496.25 any participant has received 60 counted months of assistance, 496.26 must be in compliance in the month the participant is applying 496.27 for the extension. For purposes of determining eligibility for 496.28 a hardship extension, a participant is in compliance in any 496.29 month that the participant has not been sanctioned. 496.30 Subd. 1a. [REVIEW.] If a county grants a hardship 496.31 extension under this section, a county agency shall review the 496.32 case every six or 12 months, whichever is appropriate based on 496.33 the participant's circumstances and the extension category. 496.34 Subd. 2. [ILL OR INCAPACITATED.] (a) An assistance unit 496.35 subject to the time limit in section 256J.42, subdivision 1, in 496.36 which any participant has received 60 counted months of 497.1 assistance, is eligible to receive months of assistance under a 497.2 hardship extension if the participant belongs to any of the 497.3 following groups: 497.4 (1) participants who are suffering from a professionally 497.5 certified illness, injury, or incapacity which is expected to 497.6 continue for more than 30 days and which prevents the person 497.7 from obtaining or retaining employment and who are following the 497.8 treatment recommendations of the health care provider certifying 497.9 the illness, injury, or incapacity; 497.10 (2) participants whose presence in the home is required as 497.11 a caregiver because of a professionally certified illness or 497.12 incapacity of another member in the assistance unit, a relative 497.13 in the household, or a foster child in the household and the 497.14 illness or incapacity is expected to continue for more than 30 497.15 days; or 497.16 (3) caregivers with a child or an adult in the household 497.17 who meets the disability or medical criteria for home care 497.18 services under section 256B.0627, subdivision 1, paragraph (c), 497.19 or a home and community-based waiver services program under 497.20 chapter 256B, or meets the criteria for severe emotional 497.21 disturbance under section 245.4871, subdivision 6, or for 497.22 serious and persistent mental illness under section 245.462, 497.23 subdivision 20, paragraph (c). Caregivers in this category are 497.24 presumed to be prevented from obtaining or retaining employment. 497.25 (b) An assistance unit receiving assistance under a 497.26 hardship extension under this subdivision may continue to 497.27 receive assistance as long as the participant meets the criteria 497.28 in paragraph (a), clause (1), (2), or (3). 497.29 Subd. 3. [HARD-TO-EMPLOY PARTICIPANTS.] An assistance unit 497.30 subject to the time limit in section 256J.42, subdivision 1, in 497.31 which any participant has received 60 counted months of 497.32 assistance, is eligible to receive months of assistance under a 497.33 hardship extension if the participant belongs to any of the 497.34 following groups: 497.35 (1) a person who is diagnosed by a licensed physician, 497.36 psychological practitioner, or other qualified professional, as 498.1 mentally retarded or mentally ill, and that condition prevents 498.2 the person from obtaining or retaining unsubsidized employment; 498.3 (2) a person who: 498.4 (i) has been assessed by a vocational specialist or the 498.5 county agency to be unemployable for purposes of this 498.6 subdivision; or 498.7 (ii) has an IQ below 80 who has been assessed by a 498.8 vocational specialist or a county agency to be employable, but 498.9 not at a level that makes the participant eligible for an 498.10 extension under subdivision 4 or, in the case of a 498.11 non-English-speaking person for whom it is not possible to 498.12 provide a determination due to language barriers or absence of 498.13 culturally appropriate assessment tools, is determined by a 498.14 qualified professional to have an IQ below 80. A person is 498.15 considered employable if positions of employment in the local 498.16 labor market exist, regardless of the current availability of 498.17 openings for those positions, that the person is capable of 498.18 performing; or 498.19 (3) a person who is determined by the county agency to be 498.20 learning disabled or, in the case of a non-English-speaking 498.21 person for whom it is not possible to provide a medical 498.22 diagnosis due to language barriers or absence of culturally 498.23 appropriate assessment tools, is determined by a qualified 498.24 professional to have a learning disability. If a rehabilitation 498.25 plan for the person is developed or approved by the county 498.26 agency, the plan must be incorporated into the employment plan. 498.27 However, a rehabilitation plan does not replace the requirement 498.28 to develop and comply with an employment plan under section 498.29 256J.52. For purposes of this section, "learning disabled" 498.30 means the applicant or recipient has a disorder in one or more 498.31 of the psychological processes involved in perceiving, 498.32 understanding, or using concepts through verbal language or 498.33 nonverbal means. The disability must severely limit the 498.34 applicant or recipient in obtaining, performing, or maintaining 498.35 suitable employment. Learning disabled does not include 498.36 learning problems that are primarily the result of visual, 499.1 hearing, or motor handicaps; mental retardation; emotional 499.2 disturbance; or due to environmental, cultural, or economic 499.3 disadvantage. 499.4 Subd. 4. [EMPLOYED PARTICIPANTS.] (a) An assistance unit 499.5 subject to the time limit under section 256J.42, subdivision 1, 499.6 in which any participant has received 60 months of assistance, 499.7 is eligible to receive assistance under a hardship extension if 499.8 the participant belongs to: 499.9 (1) a one-parent assistance unit in which the participant 499.10 is participating in work activities for at least 30 hours per 499.11 week, of which an average of at least 25 hours per week every 499.12 month are spent participating in employment; or 499.13 (2) a two-parent assistance unit in which the participants 499.14 are participating in work activities for at least 55 hours per 499.15 week, of which an average of at least 45 hours per week every 499.16 month are spent participating in employment. 499.17 For purposes of this section, employment means: 499.18 (1) unsubsidized employment under section 256J.49, 499.19 subdivision 13, clause (1); 499.20 (2) subsidized employment under section 256J.49, 499.21 subdivision 13, clause (2); 499.22 (3) on-the-job training under section 256J.49, subdivision 499.23 13, clause (4); 499.24 (4) an apprenticeship under section 256J.49, subdivision 499.25 13, clause (19); 499.26 (5) supported work. For purposes of this section, 499.27 "supported work" means services supporting a participant on the 499.28 job which include, but are not limited to, supervision, job 499.29 coaching, and subsidized wages; 499.30 (6) a combination of (1) to (5); or 499.31 (7) child care under section 256J.49, subdivision 13, 499.32 clause (25), if it is in combination with paid employment. 499.33 (b) If a participant is complying with a child protection 499.34 plan under chapter 260C, the number of hours required under the 499.35 child protection plan count toward the number of hours required 499.36 under this subdivision. 500.1 (c) The county shall provide the opportunity for subsidized 500.2 employment to participants needing that type of employment 500.3 within available appropriations. 500.4 (d) To be eligible for a hardship extension for employed 500.5 participants under this subdivision, a participant in a 500.6 one-parent assistance unit or both parents in a two-parent 500.7 assistance unit must be in compliance for at least ten out of 500.8 the 12 months immediately preceding the participant's 61st month 500.9 on assistance. If only one parent in a two-parent assistance 500.10 unit fails to be in compliance ten out of the 12 months 500.11 immediately preceding the participant's 61st month, the county 500.12 shall give the assistance unit the option of disqualifying the 500.13 noncompliant parent. If the noncompliant participant is 500.14 disqualified, the assistance unit must be treated as a 500.15 one-parent assistance unit for the purposes of meeting the work 500.16 requirements under this subdivision and the assistance unit's 500.17 MFIP grant shall be calculated using the shared household 500.18 standard under section 256J.08, subdivision 82a. 500.19 (e) The employment plan developed under section 256J.52, 500.20 subdivision 5, for participants under this subdivision must 500.21 contain the number of hours specified in paragraph (a) related 500.22 to employment and work activities. The job counselor and the 500.23 participant must sign the employment plan to indicate agreement 500.24 between the job counselor and the participant on the contents of 500.25 the plan. 500.26 (f) Participants who fail to meet the requirements in 500.27 paragraph (a), without good cause under section 256J.57, shall 500.28 be sanctioned or permanently disqualified under subdivision 6. 500.29 Good cause may only be granted for that portion of the month for 500.30 which the good cause reason applies. Participants must meet all 500.31 remaining requirements in the approved employment plan or be 500.32 subject to sanction or permanent disqualification. 500.33 (g) If the noncompliance with an employment plan is due to 500.34 the involuntary loss of employment, the participant is exempt 500.35 from the hourly employment requirement under this subdivision 500.36 for one month. Participants must meet all remaining 501.1 requirements in the approved employment plan or be subject to 501.2 sanction or permanent disqualification. This exemption is 501.3 available to one-parent assistance units two times in a 12-month 501.4 period, and two-parent assistance units, two times per parent in 501.5 a 12-month period. 501.6 (h) This subdivision expires on June 30, 2004. 501.7 Subd. 5. [ACCRUAL OF CERTAIN EXEMPT MONTHS.] (a) A 501.8 participant who received TANF assistance that counted towards 501.9 the federal 60-month time limit while the participant was exempt 501.10 under section 256J.56, paragraph (a), clause (7), from 501.11 employment and training services requirements and who is no 501.12 longer eligible for assistance under a hardship extension under 501.13 subdivision 2, paragraph (a), clause (3), is eligible for 501.14 assistance under a hardship extension for a period of time equal 501.15 to the number of months that were counted toward the federal 501.16 60-month time limit while the participant was exempt under 501.17 section 256J.56, paragraph (a), clause (7), from the employment 501.18 and training services requirements. 501.19 (b) A participant who received TANF assistance that counted 501.20 towards the federal 60-month time limit while the participant 501.21 met the state time limit exemption criteria under section 501.22 256J.42, subdivision 4 or 5, is eligible for assistance under a 501.23 hardship extension for a period of time equal to the number of 501.24 months that were counted toward the federal 60-month time limit 501.25 while the participant met the state time limit exemption 501.26 criteria under section 256J.42, subdivision 5. 501.27 Subd. 6. [SANCTIONS FOR EXTENDED CASES.] (a) If one or 501.28 both participants in an assistance unit receiving assistance 501.29 under subdivision 3 or 4 are not in compliance with the 501.30 employment and training service requirements in sections 256J.52 501.31 to 256J.55, the sanctions under this subdivision apply. For a 501.32 first occurrence of noncompliance, an assistance unit must be 501.33 sanctioned under section 256J.46, subdivision 1, paragraph (d), 501.34 clause (1). For a second or third occurrence of noncompliance, 501.35 the assistance unit must be sanctioned under section 256J.46, 501.36 subdivision 1, paragraph (d), clause (2). For a fourth 502.1 occurrence of noncompliance, the assistance unit is disqualified 502.2 from MFIP. If a participant is determined to be out of 502.3 compliance, the participant may claim a good cause exception 502.4 under section 256J.57, however, the participant may not claim an 502.5 exemption under section 256J.56. 502.6 (b) If both participants in a two-parent assistance unit 502.7 are out of compliance at the same time, it is considered one 502.8 occurrence of noncompliance. 502.9 Subd. 7. [STATUS OF DISQUALIFIED PARTICIPANTS.] (a) An 502.10 assistance unit that is disqualified under subdivision 6, 502.11 paragraph (a), may be approved for MFIP if the participant 502.12 complies with MFIP program requirements and demonstrates 502.13 compliance for up to one month. No assistance shall be paid 502.14 during this period. 502.15 (b) An assistance unit that is disqualified under 502.16 subdivision 6, paragraph (a), and that reapplies under paragraph 502.17 (a) is subject to sanction under section 256J.46, subdivision 1, 502.18 paragraph (d), clause (1), for a first occurrence of 502.19 noncompliance. A subsequent occurrence of noncompliance results 502.20 in a permanent disqualification. 502.21 (c) If one participant in a two-parent assistance unit 502.22 receiving assistance under a hardship extension under 502.23 subdivision 3 or 4 is determined to be out of compliance with 502.24 the employment and training services requirements under sections 502.25 256J.52 to 256J.55, the county shall give the assistance unit 502.26 the option of disqualifying the noncompliant participant from 502.27 MFIP. In that case, the assistance unit shall be treated as a 502.28 one-parent assistance unit for the purposes of meeting the work 502.29 requirements under subdivision 4 and the assistance unit's MFIP 502.30 grant shall be calculated using the shared household standard 502.31 under section 256J.08, subdivision 82a. An applicant who is 502.32 disqualified from receiving assistance under this paragraph may 502.33 reapply under paragraph (a). If a participant is disqualified 502.34 from MFIP under this subdivision a second time, the participant 502.35 is permanently disqualified from MFIP. 502.36 (d) Prior to a disqualification under this subdivision, a 503.1 county agency must review the participant's case to determine if 503.2 the employment plan is still appropriate and attempt to meet 503.3 with the participant face-to-face. If a face-to-face meeting is 503.4 not conducted, the county agency must send the participant a 503.5 notice of adverse action as provided in section 256J.31. During 503.6 the face-to-face meeting, the county agency must: 503.7 (1) determine whether the continued noncompliance can be 503.8 explained and mitigated by providing a needed preemployment 503.9 activity, as defined in section 256J.49, subdivision 13, clause 503.10 (16), or services under a local intervention grant for 503.11 self-sufficiency under section 256J.625; 503.12 (2) determine whether the participant qualifies for a good 503.13 cause exception under section 256J.57; 503.14 (3) inform the participant of the participant's sanction 503.15 status and explain the consequences of continuing noncompliance; 503.16 (4) identify other resources that may be available to the 503.17 participant to meet the needs of the family; and 503.18 (5) inform the participant of the right to appeal under 503.19 section 256J.40. 503.20 Subd. 8. [COUNTY EXTENSION REQUEST.] A county may make a 503.21 request to the commissioner of human services, and the 503.22 commissioner may grant, an extension for a category of 503.23 participants that are not extended under section 256J.425, 503.24 provided the new category of participants is consistent with the 503.25 existing extension policy in which an extension is provided to 503.26 participants whose MFIP requirements conflict with other 503.27 statutory requirements or obligations. By January 15 of each 503.28 year, the commissioner must report to the chairs and ranking 503.29 minority members of the senate and house committees having 503.30 jurisdiction over health and human services the extensions that 503.31 were granted under this section during the previous calendar 503.32 year. The legislature must act in order for the extensions to 503.33 continue. If the legislature fails to act by the end of the 503.34 legislative session in which the extensions were reported, the 503.35 extensions granted under this section during the previous 503.36 calendar year expire on June 30 of that year. 504.1 Sec. 29. Minnesota Statutes 2000, section 256J.45, 504.2 subdivision 1, is amended to read: 504.3 Subdivision 1. [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 504.4 county agency must provide a face-to-face orientation to each 504.5 MFIP caregiverwho is not exempt under section 256J.56,504.6paragraph (a), clause (6) or (8), with a face-to-face504.7orientationunless the caregiver is: 504.8 (1) a single parent, or one parent in a two-parent family, 504.9 employed at least 35 hours per week; or 504.10 (2) a second parent in a two-parent family who is employed 504.11 for 20 or more hours per week provided the first parent is 504.12 employed at least 35 hours per week. 504.13 The county agency must inform caregivers who are not exempt 504.14 undersection 256J.56, paragraph (a), clause (6) or (8),clause 504.15 (1) or (2) that failure to attend the orientation is considered 504.16 an occurrence of noncompliance with program requirements, and 504.17 will result in the imposition of a sanction under section 504.18 256J.46. If the client complies with the orientation 504.19 requirement prior to the first day of the month in which the 504.20 grant reduction is proposed to occur, the orientation sanction 504.21 shall be lifted. 504.22 Sec. 30. Minnesota Statutes 2000, section 256J.45, 504.23 subdivision 2, is amended to read: 504.24 Subd. 2. [GENERAL INFORMATION.] TheMFIP-SMFIP 504.25 orientation must consist of a presentation that informs 504.26 caregivers of: 504.27 (1) the necessity to obtain immediate employment; 504.28 (2) the work incentives underMFIP-SMFIP, including the 504.29 availability of the federal earned income tax credit and the 504.30 Minnesota working family tax credit; 504.31 (3) the requirement to comply with the employment plan and 504.32 other requirements of the employment and training services 504.33 component ofMFIP-SMFIP, including a description of the range 504.34 of work and training activities that are allowable underMFIP-S504.35 MFIP to meet the individual needs of participants; 504.36 (4) the consequences for failing to comply with the 505.1 employment plan and other program requirements, and that the 505.2 county agency may not impose a sanction when failure to comply 505.3 is due to the unavailability of child care or other 505.4 circumstances where the participant has good cause under 505.5 subdivision 3; 505.6 (5) the rights, responsibilities, and obligations of 505.7 participants; 505.8 (6) the types and locations of child care services 505.9 available through the county agency; 505.10 (7) the availability and the benefits of the early 505.11 childhood health and developmental screening under sections 505.12 121A.16 to 121A.19; 123B.02, subdivision 16; and 123B.10; 505.13 (8) the caregiver's eligibility for transition year child 505.14 care assistance under section 119B.05; 505.15 (9) the caregiver's eligibility for extended medical 505.16 assistance when the caregiver loses eligibility forMFIP-SMFIP 505.17 due to increased earnings or increased child or spousal support; 505.18 (10) the caregiver's option to choose an employment and 505.19 training provider and information about each provider, including 505.20 but not limited to, services offered, program components, job 505.21 placement rates, job placement wages, and job retention rates; 505.22 (11) the caregiver's option to request approval of an 505.23 education and training plan according to section 256J.52;and505.24 (12) the work study programs available under the higher 505.25 education system; and 505.26 (13) effective October 1, 2001, information about the 505.27 60-month time limit exemption and waivers of regular employment 505.28 and training requirements for family violence victims and 505.29 referral information about shelters and programs for victims of 505.30 family violence. 505.31 Sec. 31. Minnesota Statutes 2000, section 256J.46, 505.32 subdivision 1, is amended to read: 505.33 Subdivision 1. [SANCTIONS FORPARTICIPANTS NOT COMPLYING 505.34 WITH PROGRAM REQUIREMENTS.] (a) A participant who fails without 505.35 good cause to comply with the requirements of this chapter, and 505.36 who is not subject to a sanction under subdivision 2, shall be 506.1 subject to a sanction as provided in this subdivision. Prior to 506.2 the imposition of a sanction, a county agency shall provide a 506.3 notice of intent to sanction under section 256J.57, subdivision 506.4 2, and, when applicable, a notice of adverse action as provided 506.5 in section 256J.31. 506.6 (b) A participant who fails to comply with an alternative 506.7 employment plan must have the plan reviewed by a person trained 506.8 in domestic violence and a job counselor or the county agency to 506.9 determine if components of the alternative employment plan are 506.10 still appropriate. If the activities are no longer appropriate, 506.11 the plan must be revised with a person trained in domestic 506.12 violence and approved by a job counselor or the county agency. 506.13 A participant who fails to comply with a plan that is determined 506.14 not to need revision will lose their exemption and be required 506.15 to comply with regular employment services activities. 506.16 (c) A sanction under this subdivision becomes effective the 506.17 month following the month in which a required notice is given. 506.18 A sanction must not be imposed when a participant comes into 506.19 compliance with the requirements for orientation under section 506.20 256J.45 or third-party liability for medical services under 506.21 section 256J.30, subdivision 10, prior to the effective date of 506.22 the sanction. A sanction must not be imposed when a participant 506.23 comes into compliance with the requirements for employment and 506.24 training services under sections 256J.49 to256J.72256J.55 ten 506.25 days prior to the effective date of the sanction. For purposes 506.26 of this subdivision, each month that a participant fails to 506.27 comply with a requirement of this chapter shall be considered a 506.28 separate occurrence of noncompliance. A participant who has had 506.29 one or more sanctions imposed must remain in compliance with the 506.30 provisions of this chapter for six months in order for a 506.31 subsequent occurrence of noncompliance to be considered a first 506.32 occurrence. 506.33(b)(d) Sanctions for noncompliance shall be imposed as 506.34 follows: 506.35 (1) For the first occurrence of noncompliance by a 506.36 participant ina single-parent household or by one participant507.1in a two-parent householdan assistance unit, the assistance 507.2 unit's grant shall be reduced by ten percent of the MFIP 507.3 standard of need for an assistance unit of the same size with 507.4 the residual grant paid to the participant. The reduction in 507.5 the grant amount must be in effect for a minimum of one month 507.6 and shall be removed in the month following the month that the 507.7 participant returns to compliance. 507.8 (2) For a second or subsequent occurrence of 507.9 noncompliance by a participant in an assistance unit, or 507.10 whenbotheach of the participants in a two-parenthousehold are507.11out of complianceassistance unit have a first occurrence of 507.12 noncompliance at the same time, the assistance unit's shelter 507.13 costs shall be vendor paid up to the amount of the cash portion 507.14 of the MFIP grant for which theparticipant'sassistance unit is 507.15 eligible. At county option, the assistance unit's utilities may 507.16 also be vendor paid up to the amount of the cash portion of the 507.17 MFIP grant remaining after vendor payment of the assistance 507.18 unit's shelter costs. The residual amount of the grant after 507.19 vendor payment, if any, must be reduced by an amount equal to 30 507.20 percent of the MFIP standard of need for an assistance unit of 507.21 the same size before the residual grant is paid to the 507.22 assistance unit. The reduction in the grant amount must be in 507.23 effect for a minimum of one month and shall be removed in the 507.24 month following the month thatathe participant in a one-parent 507.25householdassistance unit returns to compliance. In a 507.26 two-parenthouseholdassistance unit, the grant reduction must 507.27 be in effect for a minimum of one month and shall be removed in 507.28 the month following the month both participants return to 507.29 compliance. The vendor payment of shelter costs and, if 507.30 applicable, utilities shall be removed six months after the 507.31 month in which the participant or participants return to 507.32 compliance. If an assistance unit is sanctioned under this 507.33 clause, the participant's case file must be reviewed as required 507.34 under paragraph (e). 507.35(c) No later than during the second month that(e) When a 507.36 sanction under paragraph(b)(d), clause (2), is in effectdue508.1to noncompliance with employment services, the participant's508.2case file must be reviewed to determine if, the county agency 508.3 must review the participant's case to determine if the 508.4 employment plan is still appropriate and attempt to meet with 508.5 the participant face-to-face. The participant may bring an 508.6 advocate to the face-to-face meeting. If a face-to-face meeting 508.7 is not conducted, the county agency must send the participant a 508.8 written notice that includes the information required under 508.9 clause (1). 508.10 (1) During the face-to-face meeting, the county agency must: 508.11 (i) determine whether the continued noncompliance can be 508.12 explained and mitigated by providing a needed preemployment 508.13 activity, as defined in section 256J.49, subdivision 13, clause 508.14 (16), or services under a local intervention grant for 508.15 self-sufficiency under section 256J.625; 508.16 (ii) determine whether the participant qualifies for a good 508.17 cause exception under section 256J.57;or508.18 (iii) determine whether the participant qualifies for an 508.19 exemption under section 256J.56; 508.20 (iv) determine whether the participant qualifies for an 508.21 exemption from regular employment services requirements for 508.22 victims of family violence under section 256J.52, subdivision 6; 508.23 (v) inform the participant of the participant's sanction 508.24 status and explain the consequences of continuing noncompliance; 508.25 (vi) identify other resources that may be available to the 508.26 participant to meet the needs of the family; and 508.27 (vii) inform the participant of the right to appeal under 508.28 section 256J.40. 508.29 (2) If the lack of an identified activity can explain the 508.30 noncompliance, the county must work with the participant to 508.31 provide the identified activity, and the county must restore the 508.32 participant's grant amount to the full amount for which the 508.33 assistance unit is eligible. The grant must be restored 508.34 retroactively to the first day of the month in which the 508.35 participant was found to lack preemployment activities or to 508.36 qualify for an exemptionorunder section 256J.56, a good cause 509.1 exception under section 256J.57, or an exemption for victims of 509.2 family violence under section 256J.52, subdivision 6. 509.3 (3) If the participant is found to qualify for a good cause 509.4 exception or an exemption, the county must restore the 509.5 participant's grant to the full amount for which the assistance 509.6 unit is eligible. 509.7 [EFFECTIVE DATE.] The family violence provisions in this 509.8 section are effective October 1, 2001. 509.9 Sec. 32. Minnesota Statutes 2000, section 256J.46, 509.10 subdivision 2a, is amended to read: 509.11 Subd. 2a. [DUAL SANCTIONS.] (a) Notwithstanding the 509.12 provisions of subdivisions 1 and 2, for a participant subject to 509.13 a sanction for refusal to comply with child support requirements 509.14 under subdivision 2 and subject to a concurrent sanction for 509.15 refusal to cooperate with other program requirements under 509.16 subdivision 1, sanctions shall be imposed in the manner 509.17 prescribed in this subdivision. 509.18 A participant who has had one or more sanctions imposed 509.19 under this subdivision must remain in compliance with the 509.20 provisions of this chapter for six months in order for a 509.21 subsequent occurrence of noncompliance to be considered a first 509.22 occurrence. Any vendor payment of shelter costs or utilities 509.23 under this subdivision must remain in effect for six months 509.24 after the month in which the participant is no longer subject to 509.25 sanction under subdivision 1. 509.26 (b) If the participant was subject to sanction for: 509.27 (i) noncompliance under subdivision 1 before being subject 509.28 to sanction for noncooperation under subdivision 2; or 509.29 (ii) noncooperation under subdivision 2 before being 509.30 subject to sanction for noncompliance under subdivision 1;, the 509.31 participant is considered to have a second occurrence of 509.32 noncompliance and shall be sanctioned as provided in subdivision 509.33 1, paragraph(b)(d), clause (2), and the. Each subsequent 509.34 occurrence of noncompliance shall be considered one additional 509.35 occurrence and shall be subject to the applicable level of 509.36 sanction under subdivision 1, paragraph (d), or section 510.1 256J.462. The requirement that the county conduct a review as 510.2 specified in subdivision 1, paragraph(c)(e), remains in effect. 510.3 (c) A participant who first becomes subject to sanction 510.4 under both subdivisions 1 and 2 in the same month is subject to 510.5 sanction as follows: 510.6 (i) in the first month of noncompliance and noncooperation, 510.7 the participant's grant must be reduced by 25 percent of the 510.8 applicable MFIP standard of need, with any residual amount paid 510.9 to the participant; 510.10 (ii) in the second and subsequent months of noncompliance 510.11 and noncooperation, the participant shall besanctioned as510.12provided insubject to the applicable level of sanction under 510.13 subdivision 1, paragraph(b)(d),clause (2)or section 510.14 256J.462. 510.15 The requirement that the county conduct a review as 510.16 specified in subdivision 1, paragraph(c)(e), remains in effect. 510.17 (d) A participant remains subject to sanction under 510.18 subdivision 2 if the participant: 510.19 (i) returns to compliance and is no longer subject to 510.20 sanction under subdivision 1 or section 256J.462; or 510.21 (ii) has the sanction under subdivision 1, 510.22 paragraph(b)(d), or section 256J.462 removed upon completion 510.23 of the review under subdivision 1, paragraph(c)(e). 510.24 A participant remains subject to the applicable level of 510.25 sanction under subdivision 1, paragraph(b)(d), or section 510.26 256J.462 if the participant cooperates and is no longer subject 510.27 to sanction under subdivision 2. 510.28 Sec. 33. [256J.462] [SANCTIONS; COUNTY OPTIONS] 510.29 Subdivision 1. [COUNTY SANCTION POLICY PLAN.] In addition 510.30 to the sanctions under section 256J.46, a county agency may 510.31 annually modify sanctions for noncompliant MFIP participants by 510.32 implementing one of the sanction options under this section for 510.33 a sixth or subsequent occurrence of noncompliance. 510.34 Subd. 2. [PROCEDURE.] (a) If a county modifies sanctions 510.35 for noncompliant participants, a county agency must develop and 510.36 submit to the commissioner, by April 15, a proposed sanction 511.1 policy plan that describes the sanctions imposed for each 511.2 occurrence of noncompliance. A county agency must include the 511.3 sanction policy plan as part of its local service unit plan 511.4 under section 268.88. 511.5 (b) A county agency must send a written notice to MFIP 511.6 participants at least 60 days before a county implements a 511.7 modification of its sanction policy under this section. The 511.8 county must also send a notice of adverse action prior to 511.9 implementing a sanction under subdivision 3. 511.10 (c) For the purpose of applying sanctions under this 511.11 section, only occurrences of noncompliance that occur after the 511.12 effective date of the sanctions implemented under this section 511.13 shall be considered. If the participant is in 30 percent 511.14 sanction in the month the sanction takes effect, that month 511.15 counts as the first occurrence for purposes of applying the 511.16 sanctions under this section, but the sanction shall remain at 511.17 30 percent for that month. 511.18 (d) If an assistance unit that is in sanction status moves 511.19 to a county that has adopted more severe sanctions than the 511.20 assistance unit's previous county of residence, the participant 511.21 shall be subject to the level of sanction that was imposed in 511.22 the previous county of residence for the first six months of 511.23 residence in the new county or until the participant comes into 511.24 compliance, whichever occurs earlier. 511.25 (e) If both participants in a two-parent assistance unit 511.26 are out of compliance at the same time, it is considered one 511.27 occurrence of noncompliance. 511.28 Subd. 3. [SANCTION OPTIONS.] A county agency may modify 511.29 its sanction policy by implementing one of the following 511.30 sanctions for a sixth or subsequent occurrence of noncompliance: 511.31 (a) The county agency may vendor pay the assistance unit's 511.32 shelter or utility costs, or both costs, up to the amount of the 511.33 cash portion of the MFIP grant for which the assistance unit is 511.34 eligible. The residual amount of the grant after vendor 511.35 payment, if any, shall be reduced to zero. The sanction must be 511.36 in effect for a minimum of one month and shall be removed the 512.1 month following the month in which the participant returns to 512.2 compliance. In a two-parent assistance unit, the sanction must 512.3 be in effect for a minimum of one month and shall be removed the 512.4 month following the month in which both participants return to 512.5 compliance. The vendor payment of shelter or utility costs, or 512.6 both, shall be removed six months after the month in which the 512.7 participant returns to compliance. 512.8 (b) The county agency may disqualify an assistance unit 512.9 from receiving MFIP, both the cash and food portions. This 512.10 disqualification must be in effect for one full month. 512.11 Disqualification under this paragraph does not make a 512.12 participant automatically ineligible for food stamps. The 512.13 county shall determine eligibility for food stamps and assist 512.14 the participant in applying for food stamps, if eligible. 512.15 Subd. 4. [CASE REVIEW.] Before a sanction under this 512.16 section is imposed, a county agency shall conduct the case 512.17 review required under section 256J.46, subdivision 1, paragraph 512.18 (e). 512.19 Subd. 5. [ELIGIBILITY AFTER DISQUALIFICATION DUE TO 512.20 NONCOMPLIANCE.] In the sanction policy plan under subdivision 2, 512.21 a county may propose restrictions on assistance units that 512.22 reapply for MFIP after disqualification for noncompliance under 512.23 subdivision 3, paragraph (b). Such restrictions may not include 512.24 permanent disqualification for noncompliance. Any restrictions 512.25 must be limited to the first six months of MFIP eligibility 512.26 following reapplication, provided that the participant complies 512.27 with work requirements for the entire six months. Such 512.28 restrictions may include: 512.29 (1) requiring participants to comply with work requirements 512.30 for a period not to exceed one month before the assistance unit 512.31 could regain MFIP eligibility; 512.32 (2) requiring that reapplying assistance units remain in 512.33 ten percent sanction for six months; and 512.34 (3) changing the policy for subsequent sanctions for 512.35 noncompliance to shorten the time frame before disqualification. 512.36 Subd. 6. [SANCTION POLICY REVIEW.] The commissioner may 513.1 review a county's sanction policies and practices if the county 513.2 has a high or low sanction rate as compared to other counties or 513.3 a high sanction rate for certain hard-to-serve participants. 513.4 The commissioner shall require a county agency to complete 513.5 corrective actions to remedy identified agency errors or 513.6 misapplications of policy and may suspend a county's authority 513.7 to impose sanction options under this section until the 513.8 corrective actions are taken. 513.9 [EFFECTIVE DATE.] This section is effective March 1, 2002. 513.10 Sec. 34. Minnesota Statutes 2000, section 256J.48, is 513.11 amended by adding a subdivision to read: 513.12 Subd. 1a. [PROCESSING EMERGENCY APPLICATIONS.] Within 513.13 seven days of receiving the application, or sooner if the 513.14 immediacy and severity of the situation warrants it, families 513.15 must be notified in writing whether their application was 513.16 approved, denied, or pended. 513.17 Sec. 35. Minnesota Statutes 2000, section 256J.49, is 513.18 amended by adding a subdivision to read: 513.19 Subd. 1a. [ALTERNATIVE EMPLOYMENT PLAN.] "Alternative 513.20 employment plan" means a plan that is based on an individualized 513.21 assessment of need and is developed with a person trained in 513.22 domestic violence and approved by the county or a job 513.23 counselor. The plan may address safety, legal or emotional 513.24 issues, and other demands on the family as a result of the 513.25 family violence. The information in section 256J.515, clauses 513.26 (1) to (8), must be included as part of the development of the 513.27 alternative employment plan. The primary goal of an alternative 513.28 employment plan is to ensure the safety of the caregiver and 513.29 children. To the extent it is consistent with ensuring safety, 513.30 an alternative employment plan shall also include activities 513.31 that are designed to lead to self-sufficiency. An activity is 513.32 inconsistent with ensuring safety if, in the opinion of a person 513.33 trained in domestic violence, the activity would endanger the 513.34 safety of the participant or children. An alternative 513.35 employment plan may not automatically include a provision that 513.36 requires a participant to obtain an order for protection or to 514.1 attend counseling. 514.2 [EFFECTIVE DATE.] This section is effective October 1, 2001. 514.3 Sec. 36. Minnesota Statutes 2000, section 256J.49, 514.4 subdivision 2, is amended to read: 514.5 Subd. 2. [DOMESTICFAMILY VIOLENCE.] "DomesticFamily 514.6 violence" means: 514.7 (1) physical acts that result, or threaten to result in, 514.8 physical injury to an individual; 514.9 (2) sexual abuse; 514.10 (3) sexual activity involving a minor child; 514.11 (4) being forced as the caregiver of a minor child to 514.12 engage in nonconsensual sexual acts or activities; 514.13 (5) threats of, or attempts at, physical or sexual abuse; 514.14 (6) mental abuse; or 514.15 (7) neglect or deprivation of medical care. 514.16 Claims of family violence must be documented by the applicant or 514.17 participant providing a sworn statement, which is supported by 514.18 collateral documentation. Collateral documentation may consist 514.19 of any one of the following: 514.20 (1) police, government agency, or court records; 514.21 (2) a statement from a battered woman's shelter staff with 514.22 knowledge of circumstances or credible evidence that supports 514.23 the sworn statement; 514.24 (3) a statement from a sexual assault or domestic violence 514.25 advocate with knowledge of the circumstances or credible 514.26 evidence that supports a sworn statement; 514.27 (4) a statement from professionals from whom the applicant 514.28 or recipient has sought assistance for the abuse; or 514.29 (5) a sworn statement from any other individual with 514.30 knowledge of circumstances or credible evidence that supports 514.31 the sworn statement. 514.32 [EFFECTIVE DATE.] This section is effective October 1, 2001. 514.33 Sec. 37. Minnesota Statutes 2000, section 256J.49, 514.34 subdivision 13, is amended to read: 514.35 Subd. 13. [WORK ACTIVITY.] "Work activity" means any 514.36 activity in a participant's approved employment plan that is 515.1 tied to the participant's employment goal. For purposes of the 515.2 MFIP program, any activity that is included in a participant's 515.3 approved employment plan meets the definition of work activity 515.4 as counted under the federal participation standards. Work 515.5 activity includes, but is not limited to: 515.6 (1) unsubsidized employment; 515.7 (2) subsidized private sector or public sector employment, 515.8 including grant diversion as specified in section 256J.69; 515.9 (3) work experience, including CWEP as specified in section 515.10 256J.67, and including work associated with the refurbishing of 515.11 publicly assisted housing if sufficient private sector 515.12 employment is not available; 515.13 (4) on-the-job training as specified in section 256J.66; 515.14 (5) job search, either supervised or unsupervised; 515.15 (6) job readiness assistance; 515.16 (7) job clubs, including job search workshops; 515.17 (8) job placement; 515.18 (9) job development; 515.19 (10) job-related counseling; 515.20 (11) job coaching; 515.21 (12) job retention services; 515.22 (13) job-specific training or education; 515.23 (14) job skills training directly related to employment; 515.24 (15) the self-employment investment demonstration (SEID), 515.25 as specified in section 256J.65; 515.26 (16) preemployment activities, based on availability and 515.27 resources, such as volunteer work, literacy programs and related 515.28 activities, citizenship classes, English as a second language 515.29 (ESL) classes as limited by the provisions of section 256J.52, 515.30 subdivisions 3, paragraph (d), and 5, paragraph (c), or 515.31 participation in dislocated worker services, chemical dependency 515.32 treatment, mental health services, peer group networks, 515.33 displaced homemaker programs, strength-based resiliency 515.34 training, parenting education, or other programs designed to 515.35 help families reach their employment goals and enhance their 515.36 ability to care for their children; 516.1 (17) community service programs; 516.2 (18) vocational educational training or educational 516.3 programs that can reasonably be expected to lead to employment, 516.4 as limited by the provisions of section 256J.53; 516.5 (19) apprenticeships; 516.6 (20) satisfactory attendance in general educational 516.7 development diploma classes or an adult diploma program; 516.8 (21) satisfactory attendance at secondary school, if the 516.9 participant has not received a high school diploma; 516.10 (22) adult basic education classes; 516.11 (23) internships; 516.12 (24) bilingual employment and training services; 516.13 (25) providing child care services to a participant who is 516.14 working in a community service program; and 516.15 (26) activities included ina safetyan alternative 516.16 employment plan that is developed under section 256J.52, 516.17 subdivision 6. 516.18 [EFFECTIVE DATE.] This section is effective October 1, 2001. 516.19 Sec. 38. Minnesota Statutes 2000, section 256J.50, 516.20 subdivision 1, is amended to read: 516.21 Subdivision 1. [EMPLOYMENT AND TRAINING SERVICES COMPONENT 516.22 OF MFIP.] (a) By January 1, 1998, each county must develop and 516.23 implement an employment and training services component of MFIP 516.24 which is designed to put participants on the most direct path to 516.25 unsubsidized employment. Participation in these services is 516.26 mandatory for all MFIP caregivers, unless the caregiver is 516.27 exempt under section 256J.56. 516.28 (b) A county must provide employment and training services 516.29 under sections 256J.515 to 256J.74 within 30 days after the 516.30 caregiver's participation becomes mandatory under subdivision 516.31 5 or within 30 days of receipt of a request for services from a 516.32 caregiver who under section 256J.42 is no longer eligible to 516.33 receive MFIP but whose income is below 120 percent of the 516.34 federal poverty guidelines for a family of the same size. The 516.35 request must be made within 12 months of the date the 516.36 caregivers' MFIP case was closed. 517.1 Sec. 39. Minnesota Statutes 2000, section 256J.50, 517.2 subdivision 7, is amended to read: 517.3 Subd. 7. [LOCAL SERVICE UNIT PLAN.] (a) Each local or 517.4 county service unit shall prepare and submit a plan as specified 517.5 in section 268.88. 517.6 (b) The plan must include a description of how projects 517.7 funded under the local intervention grants for self-sufficiency 517.8 in section 256J.625, subdivisions 2 and 3, operate in the local 517.9 service unit, including: 517.10 (1) the target populations of hard-to-employ participants 517.11and, working participants in need of job retention and wage 517.12 advancement services, and caregivers who, within the last 12 517.13 months, have been determined under section 256J.42 to no longer 517.14 be eligible to receive MFIP and whose income is below 120 517.15 percent of the federal poverty guidelines for a family of the 517.16 same size, with a description of how individual participant 517.17 needs will be met; 517.18 (2) services that will be provided which may include paid 517.19 work experience, enhanced mental health services, outreach to 517.20 sanctioned families and to caregivers who, within the last 12 517.21 months, have been determined under section 256J.42 to no longer 517.22 be eligible to receive MFIP but whose income is below 120 517.23 percent of the federal poverty guidelines for a family of the 517.24 same size, child care for social services, child care transition 517.25 year set-aside, homeless and housing advocacy, and 517.26 transportation; 517.27 (3) projected expenditures by activity; 517.28 (4) anticipated program outcomes including the anticipated 517.29 impact the intervention efforts will have on performance 517.30 measures under section 256J.751 and on reducing the number of 517.31 MFIP participants expected to reach their 60-month time limit; 517.32 and 517.33 (5) a description of services that are provided or will be 517.34 provided to MFIP participants affected by chemical dependency, 517.35 mental health issues, learning disabilities, or family violence. 517.36 Each plan must demonstrate how the county or tribe is 518.1 working within its organization and with other organizations in 518.2 the community to serve hard-to-employ populations, including how 518.3 organizations in the community were engaged in planning for use 518.4 of these funds, services other entities will provide under the 518.5 plan, and whether multicounty or regional strategies are being 518.6 implemented as part of this plan. 518.7 (c) Activities and expenditures in the plan must enhance or 518.8 supplement MFIP activities without supplanting existing 518.9 activities and expenditures. However, this paragraph does not 518.10 require a county to maintain either: 518.11 (1) its current provision of child care assistance to MFIP 518.12 families through the expenditure of county resources under 518.13 chapter 256E for social services child care assistance if funds 518.14 are appropriated by another law for an MFIP social services 518.15 child care pool; 518.16 (2) its current provision of transition-year child care 518.17 assistance through the expenditure of county resources if funds 518.18 are appropriated by another law for this purpose; or 518.19 (3) its current provision of intensive ESL programs through 518.20 the expenditure of county resources if funds are appropriated by 518.21 another law for intensive ESL grants. 518.22 (d) The plan required under this subdivision must be 518.23 approved before the local or county service unit is eligible to 518.24 receive funds under section 256J.625, subdivisions 2 and 3. 518.25 Sec. 40. Minnesota Statutes 2000, section 256J.50, 518.26 subdivision 10, is amended to read: 518.27 Subd. 10. [REQUIRED NOTIFICATION TO VICTIMS OFDOMESTIC518.28 FAMILY VIOLENCE.] County agencies and their contractors must 518.29 provide universal notification to all applicants and recipients 518.30 ofMFIP-SMFIP that: 518.31 (1) referrals to counseling and supportive services are 518.32 available for victims ofdomesticfamily violence; 518.33 (2) nonpermanent resident battered individuals married to 518.34 United States citizens or permanent residents may be eligible to 518.35 petition for permanent residency under the federal Violence 518.36 Against Women Act, and that referrals to appropriate legal 519.1 services are available; 519.2 (3) victims ofdomesticfamily violence are exempt from the 519.3 60-month limit on assistance while the individual is complying 519.4 with an approved safety plan, as defined in section 256J.49,519.5subdivision 11or, after October 1, 2001, an alternative 519.6 employment plan, as defined in section 256J.49, subdivision 1a; 519.7 and 519.8 (4) victims ofdomesticfamily violence may choose tobe519.9exempt or deferred fromhave regular work requirementsfor up to519.1012 monthswaived while the individual is complying with 519.11 anapproved safetyalternative employment plan as defined in 519.12 section 256J.49, subdivision111a. 519.13 If an alternative plan is denied, the county or a job 519.14 counselor must provide reasons why the plan is not approved and 519.15 document how the denial of the plan does not interfere with the 519.16 safety of the participant or children. 519.17 Notification must be in writing and orally at the time of 519.18 application and recertification, when the individual is referred 519.19 to the title IV-D child support agency, and at the beginning of 519.20 any job training or work placement assistance program. 519.21 [EFFECTIVE DATE.] This section is effective October 1, 2001. 519.22 Sec. 41. Minnesota Statutes 2000, section 256J.50, is 519.23 amended by adding a subdivision to read: 519.24 Subd. 12. [ACCESS TO PERSONS TRAINED IN DOMESTIC 519.25 VIOLENCE.] In a county where there is no staff person who is 519.26 trained in domestic violence, as that term is defined in section 519.27 256J.08, subdivision 67a, the county must work with the nearest 519.28 organization that is designated as providing services to victims 519.29 of domestic violence to develop a process, which ensures that 519.30 domestic violence victims have access to a person trained in 519.31 domestic violence. 519.32 [EFFECTIVE DATE.] This section is effective October 1, 2001. 519.33 Sec. 42. Minnesota Statutes 2000, section 256J.515, is 519.34 amended to read: 519.35 256J.515 [OVERVIEW OF EMPLOYMENT AND TRAINING SERVICES.] 519.36 During the first meeting with participants, job counselors 520.1 must ensure that an overview of employment and training services 520.2 is provided that: 520.3 (1) stresses the necessity and opportunity of immediate 520.4 employment; 520.5 (2) outlines the job search resources offered; 520.6 (3) outlines education or training opportunities available; 520.7 (4) describes the range of work activities, including 520.8 activities under section 256J.49, subdivision 13, clause (18), 520.9 that are allowable under MFIP to meet the individual needs of 520.10 participants; 520.11 (5) explains the requirements to comply with an employment 520.12 plan; 520.13 (6) explains the consequences for failing to comply;and520.14 (7) explains the services that are available to support job 520.15 search and work and education; and 520.16 (8) provides referral information about shelters and 520.17 programs for victims of family violence, the time limit 520.18 exemption, and waivers of regular employment and training 520.19 requirements for family violence victims. 520.20 Failure to attend the overview of employment and training 520.21 services without good cause results in the imposition of a 520.22 sanction under section 256J.46. 520.23 Effective October 1, 2001, a participant who has an 520.24 alternative employment plan under section 256J.52, subdivision 520.25 6, as defined in section 256J.49, subdivision 1a, or who is in 520.26 the process of developing such a plan, is exempt from the 520.27 requirement to attend the overview. 520.28 Sec. 43. Minnesota Statutes 2000, section 256J.52, 520.29 subdivision 2, is amended to read: 520.30 Subd. 2. [INITIAL ASSESSMENT.] (a) The job counselor must, 520.31 with the cooperation of the participant, assess the 520.32 participant's ability to obtain and retain employment. This 520.33 initial assessment must include a review of the participant's 520.34 education level, prior employment or work experience, 520.35 transferable work skills, and existing job markets. 520.36 (b) In assessing the participant, the job counselor must 521.1 determine if the participant needs refresher courses for 521.2 professional certification or licensure, in which case, the job 521.3 search plan under subdivision 3 must include the courses 521.4 necessary to obtain the certification or licensure, in addition 521.5 to other work activities, provided the combination of the 521.6 courses and other work activities are at least for 40 hours per 521.7 week. 521.8 (c) If a participant can demonstrate to the satisfaction of 521.9 the county agency that lack of proficiency in English is a 521.10 barrier to obtaining suitable employment, the job counselor must 521.11 include participation in an intensive English as a second 521.12 language program if available or otherwise a regular English as 521.13 a second language program in the individual's employment plan 521.14 under subdivision 5. Lack of proficiency in English is not 521.15 necessarily a barrier to employment. 521.16 (d) The job counselor may approve an education or training 521.17 plan, and postpone the job search requirement, if the 521.18 participant has a proposal for an education program which: 521.19 (1) can be completed within1224 months; and 521.20 (2) meets the criteria of section 256J.53, subdivisions 1, 521.21 2, 3, and 5; and521.22(3) is likely, without additional training, to lead to521.23monthly employment earnings which, after subtraction of the521.24earnings disregard under section 256J.21, equal or exceed the521.25family wage level for the participant's assistance unit. 521.26 (e) A participant who, at the time of the initial 521.27 assessment, presents a plan that includes farming as a 521.28 self-employed work activity must have an employment plan 521.29 developed under subdivision 5 that includes the farming as an 521.30 approved work activity. 521.31 Sec. 44. Minnesota Statutes 2000, section 256J.52, 521.32 subdivision 6, is amended to read: 521.33 Subd. 6. [SAFETYALTERNATIVE EMPLOYMENT PLAN AND FAMILY 521.34 VIOLENCE WAIVER PROVISIONS.]Notwithstanding subdivisions 1 to521.355, a participant who is a victim of domestic violence and who521.36agrees to develop or has developed a safety plan meeting the522.1definition under section 256J.49, subdivision 11, is deferred522.2from the requirements of this section, sections 256J.54, and522.3256J.55 for a period of three months from the date the safety522.4plan is approved. A participant deferred under this subdivision522.5must submit a safety plan status report to the county agency on522.6a quarterly basis. Based on a review of the status report, the522.7county agency may approve or renew the participant's deferral522.8each quarter, provided the personal safety of the participant is522.9still at risk and the participant is complying with the plan. A522.10participant who is deferred under this subdivision may be522.11deferred for a total of 12 months under a safety plan, provided522.12the individual is complying with the terms of the plan.522.13 Participants who have a safety plan under section 256J.49, 522.14 subdivision 11, prior to October 1, 2001, will have that plan 522.15 converted to an alternative employment plan upon their plan 522.16 renewal date. An alternative employment plan must be reviewed 522.17 at the end of the first six months to determine if the 522.18 activities contained in the alternative employment plan are 522.19 still appropriate. It is the responsibility of the county or a 522.20 job counselor to contact the participant and notify the 522.21 participant that the plan is up for review, and document whether 522.22 the participant wishes to renew the plan. If the participant 522.23 does not wish to renew the plan, or if the participant fails to 522.24 respond after reasonable efforts to contact the participant are 522.25 made by the county or a job counselor, the participant must 522.26 participate in regular employment services activities. If the 522.27 participant requests renewal of the plan or if there is a 522.28 dispute over whether the plan is still appropriate, the 522.29 participant must receive the assistance of a person trained in 522.30 domestic violence. If the person trained in domestic violence 522.31 recommends that the activities are still appropriate, the county 522.32 or a job counselor must renew the alternative employment plan or 522.33 provide written reasons why the plan is not approved and 522.34 document how denial of the plan renewal does not interfere with 522.35 the safety of the participant or children. If the person 522.36 trained in domestic violence recommends that the activities are 523.1 no longer appropriate, the plan must be revised with the 523.2 assistance of a person trained in domestic violence. The county 523.3 or a job counselor must approve the revised plan or provide 523.4 written reasons why the plan is not approved and document how 523.5 denial of the plan renewal does not interfere with the safety of 523.6 the participant or children. After the first six months reviews 523.7 may take place quarterly. During the time a participant is 523.8 cooperating with the development or revision of an alternative 523.9 employment plan, the participant is not subject to a sanction 523.10 for noncompliance with regular employment services activities. 523.11 Sec. 45. Minnesota Statutes 2000, section 256J.53, 523.12 subdivision 1, is amended to read: 523.13 Subdivision 1. [LENGTH OF PROGRAM.] In order for a 523.14 post-secondary education or training program to be approved work 523.15 activity as defined in section 256J.49, subdivision 13, clause 523.16 (18), it must be a program lasting1224 months or less, and the 523.17 participant must meet the requirements of subdivisions 2 and 3. 523.18A program lasting up to 24 months may be approved on an523.19exception basis if the conditions specified in subdivisions 2 to523.204 are met. A participant may not be approved for more than a523.21total of 24 months of post-secondary education or training.523.22 Sec. 46. Minnesota Statutes 2000, section 256J.56, is 523.23 amended to read: 523.24 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 523.25 EXEMPTIONS.] 523.26 (a) An MFIPcaregiverparticipant is exempt from the 523.27 requirements of sections 256J.52 to 256J.55 if thecaregiver523.28 participant belongs to any of the following groups: 523.29 (1)individualsparticipants who are age 60 or older; 523.30 (2)individualsparticipants who are suffering from a 523.31 professionally certified permanent or temporary illness, injury, 523.32 or incapacity which is expected to continue for more than 30 523.33 days and which prevents the person from obtaining or retaining 523.34 employment. Persons in this category with a temporary illness, 523.35 injury, or incapacity must be reevaluated at least quarterly; 523.36 (3)caregiversparticipants whose presence in the home is 524.1 required as a caregiver because ofthea professionally 524.2 certified illness or incapacity of another member in the 524.3 assistance unit, a relative in the household, or a foster child 524.4 in the household and the illness or incapacity is expected to 524.5 continue for more than 30 days; 524.6 (4) women who are pregnant, if the pregnancy has resulted 524.7 in a professionally certified incapacity that prevents the woman 524.8 from obtaining or retaining employment; 524.9 (5) caregivers of a child under the age of one year who 524.10 personally provide full-time care for the child. This exemption 524.11 may be used for only 12 months in a lifetime. In two-parent 524.12 households, only one parent or other relative may qualify for 524.13 this exemption; 524.14 (6)individuals who are single parents, or one parent in a524.15two-parent family, employed at least 35 hours per week;524.16(7) individualsparticipants experiencing a personal or 524.17 family crisis that makes them incapable of participating in the 524.18 program, as determined by the county agency. If the participant 524.19 does not agree with the county agency's determination, the 524.20 participant may seek professional certification, as defined in 524.21 section 256J.08, that the participant is incapable of 524.22 participating in the program. 524.23 Persons in this exemption category must be reevaluated 524.24 every 60 days. A personal or family crisis related to family 524.25 violence, as determined by the county or a job counselor with 524.26 the assistance of a person trained in domestic violence, should 524.27 not result in an exemption, but should be addressed through the 524.28 development or revision of an alternative employment plan under 524.29 section 256J.52, subdivision 6; or 524.30(8) second parents in two-parent families employed for 20524.31or more hours per week, provided the first parent is employed at524.32least 35 hours per week; or524.33(9)(7) caregivers with a child or an adult in the 524.34 household who meets the disability or medical criteria for home 524.35 care services under section 256B.0627, subdivision 1, paragraph 524.36 (c), or a home and community-based waiver services program under 525.1 chapter 256B, or meets the criteria for severe emotional 525.2 disturbance under section 245.4871, subdivision 6, or for 525.3 serious and persistent mental illness under section 245.462, 525.4 subdivision 20, paragraph (c). Caregivers in this exemption 525.5 category are presumed to be prevented from obtaining or 525.6 retaining employment. 525.7 A caregiver who is exempt under clause (5) must enroll in 525.8 and attend an early childhood and family education class, a 525.9 parenting class, or some similar activity, if available, during 525.10 the period of time the caregiver is exempt under this section. 525.11 Notwithstanding section 256J.46, failure to attend the required 525.12 activity shall not result in the imposition of a sanction. 525.13 (b) The county agency must provide employment and training 525.14 services to MFIPcaregiversparticipants who are exempt under 525.15 this section, but who volunteer to participate. Exempt 525.16 volunteers may request approval for any work activity under 525.17 section 256J.49, subdivision 13. The hourly participation 525.18 requirements for nonexemptcaregiversparticipants under section 525.19 256J.50, subdivision 5, do not apply to exemptcaregivers525.20 participants who volunteer to participate. 525.21 Sec. 47. Minnesota Statutes 2000, section 256J.57, 525.22 subdivision 2, is amended to read: 525.23 Subd. 2. [NOTICE OF INTENT TO SANCTION.] (a) When a 525.24 participant fails without good cause to comply with the 525.25 requirements of sections 256J.52 to 256J.55, the job counselor 525.26 or the county agency must provide a notice of intent to sanction 525.27 to the participant specifying the program requirements that were 525.28 not complied with, informing the participant that the county 525.29 agency will impose the sanctions specified in section 256J.46, 525.30 and informing the participant of the opportunity to request a 525.31 conciliation conference as specified in paragraph (b). The 525.32 notice must also state that the participant's continuing 525.33 noncompliance with the specified requirements will result in 525.34 additional sanctions under section 256J.46, without the need for 525.35 additional notices or conciliation conferences under this 525.36 subdivision. The notice, written in English, must include the 526.1 department of human services language block, and must be sent to 526.2 every applicable participant. If the participant does not 526.3 request a conciliation conference within ten calendar days of 526.4 the mailing of the notice of intent to sanction, the job 526.5 counselor must notify the county agency that the assistance 526.6 payment should be reduced. The county must then send a notice 526.7 of adverse action to the participant informing the participant 526.8 of the sanction that will be imposed, the reasons for the 526.9 sanction, the effective date of the sanction, and the 526.10 participant's right to have a fair hearing under section 256J.40. 526.11 (b) The participant may request a conciliation conference 526.12 by sending a written request, by making a telephone request, or 526.13 by making an in-person request. The request must be received 526.14 within ten calendar days of the date the county agency mailed 526.15 the ten-day notice of intent to sanction. If a timely request 526.16 for a conciliation is received, the county agency's service 526.17 provider must conduct the conference within five days of the 526.18 request. The job counselor's supervisor, or a designee of the 526.19 supervisor, must review the outcome of the conciliation 526.20 conference. If the conciliation conference resolves the 526.21 noncompliance, the job counselor must promptly inform the county 526.22 agency and request withdrawal of the sanction notice. 526.23 (c) Upon receiving a sanction notice, the participant may 526.24 request a fair hearing under section 256J.40, without exercising 526.25 the option of a conciliation conference. In such cases, the 526.26 county agency shall not require the participant to engage in a 526.27 conciliation conference prior to the fair hearing. 526.28 (d) If the participant requests a fair hearing or a 526.29 conciliation conference, sanctions will not be imposed until 526.30 there is a determination of noncompliance. Sanctions must be 526.31 imposed as provided in section 256J.46. 526.32 Sec. 48. Minnesota Statutes 2000, section 256J.62, 526.33 subdivision 2a, is amended to read: 526.34 Subd. 2a. [CASELOAD-BASED FUNDS ALLOCATION.] Effective for 526.35 state fiscal year 2000, and for all subsequent years, money 526.36 shall be allocated to counties and eligible tribal providers 527.1 based on their average number of MFIP cases as a proportion of 527.2 the statewide total number of MFIP cases: 527.3 (1) the average number of cases must be based upon counts 527.4 of MFIP or tribal TANF cases as of March 31, June 30, September 527.5 30, and December 31 of the previous calendar year, less the 527.6 number of child only cases and cases where all the caregivers 527.7 are age 60 or over. Two-parent cases, with the exception of 527.8 those with a caregiver age 60 or over, will be multiplied by a 527.9 factor of two; 527.10 (2) the MFIP or tribal TANF case count for each eligible 527.11 tribal provider shall be based upon the number of MFIP or tribal 527.12 TANF cases who are enrolled in, or are eligible for enrollment 527.13 in the tribe; and the case must be an active MFIP case; and the 527.14 case members must reside within the tribal program's service 527.15 delivery area; and 527.16 (3) MFIP or tribal TANF cases counted for determining 527.17 allocations to tribal providers shall be removed from the case 527.18 counts of the respective counties where they reside to prevent 527.19 duplicate counts;. 527.20(4) prior to allocating funds to counties and tribal527.21providers, $1,000,000 shall be set aside to allow the527.22commissioner to use these set-aside funds to provide funding to527.23county or tribal providers who experience an unforeseen influx527.24of participants or other emergent situations beyond their527.25control; and527.26(5) the commissioner shall use a portion of the funds in527.27clause (4) to offset a reduction in funds allocated to any527.28county between state fiscal year 1999 and state fiscal year 2000527.29that results from the adjustment in clause (3). The funding527.30provided under this clause must reduce by half the reduction for527.31state fiscal year 2000 that any county would otherwise527.32experience in the absence of this clause.527.33Any funds specified in this clause that remain unspent by March527.3431 of each year shall be reallocated out to county and tribal527.35providers using the funding formula detailed in clauses (1) to527.36(5).528.1 Sec. 49. Minnesota Statutes 2000, section 256J.62, 528.2 subdivision 9, is amended to read: 528.3 Subd. 9. [CONTINUATION OF CERTAIN SERVICES.] At the 528.4 request of thecaregiverparticipant, the county may continue to 528.5 provide case management, counseling, or other support services 528.6 to a participantfollowing the participant's achievement of: 528.7 (a) who has achieved the employment goal,; or 528.8 (b) who under section 256J.42 is no longer eligible to 528.9 receive MFIP. 528.10 These services may be provided for up to 12 months 528.11 following termination of the participant's eligibility for MFIP. 528.12A county may expend funds for a specific employment and528.13training service for the duration of that service to a528.14participant if the funds are obligated or expended prior to the528.15participant losing MFIP eligibility.528.16 Sec. 50. Minnesota Statutes 2000, section 256J.625, 528.17 subdivision 1, is amended to read: 528.18 Subdivision 1. [ESTABLISHMENT; GUARANTEED MINIMUM 528.19 ALLOCATION.] (a) The commissioner shall make grants under this 528.20 subdivision to assist county and tribal TANF programs to more 528.21 effectively serve hard-to-employ MFIP participants and 528.22 participants who, within the last 12 months, have been 528.23 determined under section 256J.42 to no longer be eligible to 528.24 receive MFIP but whose income is below 120 percent of the 528.25 federal poverty guidelines for a family of the same size. Funds 528.26 appropriated for local intervention grants for self-sufficiency 528.27 must be allocated first in amounts equal to the guaranteed 528.28 minimum in paragraph (b), and second according to the provisions 528.29 of subdivision 2. Any remaining funds must be allocated 528.30 according to the formula in subdivision 3. Counties or tribes 528.31 must have an approved local service unit plan under section 528.32 256J.50, subdivision 7, paragraph (b), in order to receive and 528.33 expend funds under subdivisions 2 and 3. 528.34 (b) Each county or tribal program shall receive a 528.35 guaranteed minimum annual allocation of $25,000. 528.36 Sec. 51. Minnesota Statutes 2000, section 256J.625, 529.1 subdivision 2, is amended to read: 529.2 Subd. 2. [SET-ASIDE FUNDS.] (a) Of the funds appropriated 529.3 for grants under this section, after the allocation in 529.4 subdivision 1, paragraph (b), is made, 20 percent of the 529.5 remaining funds each year shall be retained by the commissioner 529.6 and awarded to counties or tribes whose approved plans 529.7 demonstrate additional need based on their identification of 529.8 hard-to-employ familiesand, working participants in need of job 529.9 retention and wage advancement services, and participants who 529.10 within the last 12 months, have been determined under section 529.11 256J.42 to no longer be eligible to receive MFIP but whose 529.12 income is below 120 percent of the federal poverty guidelines 529.13 for a family of same size, strong anticipated outcomes for 529.14 families and an effective plan for monitoring performance, or, 529.15 use of a multicounty, multi-entity or regional approach to serve 529.16 hard-to-employ familiesand, working participants in need of job 529.17 retention and wage advancement services, and participants who, 529.18 within the last 12 months, have been determined under section 529.19 256J.42 to no longer be eligible to receive MFIP but whose 529.20 income is below 120 percent of the federal poverty guidelines 529.21 for a family of the same size, who are identified as a target 529.22 population to be served in the plan submitted under section 529.23 256J.50, subdivision 7, paragraph (b). In distributing funds 529.24 under this paragraph, the commissioner must achieve a geographic 529.25 balance. The commissioner may award funds under this paragraph 529.26 to other public, private, or nonprofit entities to deliver 529.27 services in a county or region where the entity or entities 529.28 submit a plan that demonstrates a strong capability to fulfill 529.29 the terms of the plan and where the plan shows an innovative or 529.30 multi-entity approach. 529.31 (b) For fiscal year 2001 only, of the funds available under 529.32 this subdivision the commissioner must allocate funding in the 529.33 amounts specified in article 1, section 2, subdivision 7, for an 529.34 intensive intervention transitional employment training project 529.35 and for nontraditional career assistance and training programs. 529.36 These allocations must occur before any set-aside funds are 530.1 allocated under paragraph (a). 530.2 Sec. 52. Minnesota Statutes 2000, section 256J.625, 530.3 subdivision 4, is amended to read: 530.4 Subd. 4. [USE OF FUNDS.] (a) A county or tribal program 530.5 may use funds allocated under this subdivision to provide 530.6 services to MFIP participants who are hard-to-employ and their 530.7 families. Services provided must be intended to reduce the 530.8 number of MFIP participants who are expected to reach the 530.9 60-month time limit under section 256J.42. Counties, tribes, 530.10 and other entities receiving funds under subdivision 2 or 3 must 530.11 submit semiannual progress reports to the commissioner which 530.12 detail program outcomes. 530.13 (b) Funds allocated under this section may not be used to 530.14 provide benefits that are defined as "assistance" in Code of 530.15 Federal Regulations, title 45, section 260.31, to an assistance 530.16 unit that is only receiving the food portion of MFIP benefits or 530.17 under section 256J.42 is no longer eligible to receive MFIP. 530.18 (c) A county may use funds allocated under this section for 530.19 that part of the match for federal access to jobs transportation 530.20 funds that is TANF-eligible. A county may also use funds 530.21 allocated under this section to enhance transportation choices 530.22 for eligible recipients up to 150 percent of the federal poverty 530.23 guidelines. 530.24 Sec. 53. Minnesota Statutes 2000, section 256J.645, is 530.25 amended to read: 530.26 256J.645 [INDIAN TRIBEMFIP-SMFIP EMPLOYMENTAND TRAINING530.27 SERVICES.] 530.28 Subdivision 1. [AUTHORIZATION TO ENTER INTO AGREEMENTS.] 530.29 Effective July 1, 1997, the commissioner may enter into 530.30 agreements with federally recognized Indian tribes with a 530.31 reservation in the state to provideMFIP-SMFIP employmentand530.32trainingservices to members of the Indian tribe and to other 530.33 caregivers who are a part of the tribal member'sMFIP-SMFIP 530.34 assistance unit. For purposes of this section, "Indian tribe" 530.35 means a tribe, band, nation, or other federally recognized group 530.36 or community of Indians. The commissioner may also enter into 531.1 an agreement with a consortium of Indian tribes providing the 531.2 governing body of each Indian tribe in the consortium complies 531.3 with the provisions of this section. 531.4 Subd. 2. [TRIBAL REQUIREMENTS.] The Indian tribe must: 531.5 (1) agree to fulfill the responsibilities provided under 531.6 the employmentand trainingservices component ofMFIP-SMFIP 531.7 regarding operation ofMFIP-SMFIP employmentand training531.8 services, as designated by the commissioner; 531.9 (2) operate its employmentand trainingservices program 531.10 within a geographic service area not to exceed the counties 531.11 within which a border of the reservation falls; 531.12 (3) operate its program in conformity with section 13.46 531.13 and any applicable federal regulations in the use of data about 531.14MFIP-SMFIP recipients; 531.15 (4) coordinate operation of its program with the county 531.16 agency,Job Training PartnershipWorkforce Investment Act 531.17 programs, and other support services or employment-related 531.18 programs in the counties in which the tribal unit's program 531.19 operates; 531.20 (5) provide financial and program participant activity 531.21 recordkeeping and reporting in the manner and using the forms 531.22 and procedures specified by the commissioner and permit 531.23 inspection of its program and records by representatives of the 531.24 state; and 531.25 (6) have the Indian tribe's employmentand trainingservice 531.26 provider certified by the commissioner of economic security, or 531.27 approved by the county. 531.28 Subd. 3. [FUNDING.] If the commissioner and an Indian 531.29 tribe are parties to an agreement under this subdivision, the 531.30 agreementmayshall annually provide to the Indian tribe the 531.31 fundingamount in clause (1) or (2):allocated in section 531.32 256J.62, subdivisions 1 and 2a. 531.33(1) if the Indian tribe operated a tribal STRIDE program531.34during state fiscal year 1997, the amount to be provided is the531.35amount the Indian tribe received from the state for operation of531.36its tribal STRIDE program in state fiscal year 1997, except that532.1the amount provided for a fiscal year may increase or decrease532.2in the same proportion that the total amount of state and532.3federal funds available for MFIP-S employment and training532.4services increased or decreased that fiscal year; or532.5(2) if the Indian tribe did not operate a tribal STRIDE532.6program during state fiscal year 1997, the commissioner may532.7provide to the Indian tribe for the first year of operations the532.8amount determined by multiplying the state allocation for MFIP-S532.9employment and training services to each county agency in the532.10Indian tribe's service delivery area by the percentage of MFIP-S532.11recipients in that county who were members of the Indian tribe532.12during the previous state fiscal year. The resulting amount532.13shall also be the amount that the commissioner may provide to532.14the Indian tribe annually thereafter through an agreement under532.15this subdivision, except that the amount provided for a fiscal532.16year may increase or decrease in the same proportion that the532.17total amount of state and federal funds available for MFIP-S532.18employment and training services increased or decreased that532.19fiscal year.532.20 Subd. 4. [COUNTY AGENCY REQUIREMENT.] Indian tribal 532.21 members receivingMFIP-SMFIP benefits and residing in the 532.22 service area of an Indian tribe operating employmentand532.23trainingservices under an agreement with the commissioner must 532.24 be referred by county agencies in the service area to the Indian 532.25 tribe for employmentand trainingservices. 532.26 Sec. 54. Minnesota Statutes 2000, section 256J.751, is 532.27 amended to read: 532.28 256J.751 [COUNTY PERFORMANCE MANAGEMENT.] 532.29(a)Subdivision 1. [QUARTERLY COUNTY CASELOAD REPORT.] The 532.30 commissioner shall report quarterly toall countieseach county 532.31 on the county's performance on the following measures: 532.32 (1)percent of MFIP caseload working in paid employment;532.33(2) percentnumber ofMFIP caseloadcases receiving only 532.34 the food portion of assistance; 532.35 (2) number of child-only cases; 532.36 (3) number of minor caregivers; 533.1 (4) number of cases that are exempt from the 60-month time 533.2 limit by the exemption category under section 256J.42; 533.3 (5) number of participants who are exempt from employment 533.4 and training services requirements by the exemption category 533.5 under section 256J.56; 533.6 (6) number of assistance units receiving assistance under a 533.7 hardship extension under section 256J.425; 533.8 (7) number of participants and number of months spent in 533.9 each level of sanction under section 256J.46, subdivision 1; 533.10(3)(8) number of MFIP cases that have left assistance; 533.11(4)(9) federal participation requirements as specified in 533.12 title 1 of Public Law Number 104-193;and533.13(5)(10) median placement wage rate.; and 533.14(b)(11) of each county's total MFIP caseload less the 533.15 number of cases in clauses (1) to (6): 533.16 (i) number of one-parent cases; 533.17 (ii) number of two-parent cases; 533.18 (iii) percent of one-parent cases that are working more 533.19 than 20 hours per week; 533.20 (iv) percent of two-parent cases that are working more than 533.21 20 hours per week; and 533.22 (v) percent of cases that have received more than 36 months 533.23 of assistance. 533.24 Subd. 2. [QUARTERLY COMPARISON REPORT.] The commissioner 533.25 shall report quarterly to all counties on each county's 533.26 performance on the following measures: 533.27 (1) percent of MFIP caseload working in paid employment; 533.28 (2) percent of MFIP caseload receiving only the food 533.29 portion of assistance; 533.30 (3) number of MFIP cases that have left assistance; 533.31 (4) federal participation requirements as specified in 533.32 Title 1 of Public Law Number 104-193; 533.33 (5) median placement wage rate; and 533.34 (6) caseload by months of TANF assistance. 533.35 Subd. 3. [ANNUAL REPORT.] The commissioner must report to 533.36 all counties and to the legislature on each county's annual 534.1 performance on the measures required under subdivision 1 by 534.2 racial and ethnic group and, to the extent consistent with state 534.3 and federal law, must include each county's performance on: 534.4 (1) the number of out-of-wedlock births and births to teen 534.5 mothers; and 534.6 (2) number of cases by racial and ethnic group. 534.7 The report must be completed by January 1, 2002, and 534.8 January 1 of each year thereafter and must comply with sections 534.9 3.195 and 3.197. 534.10 Subd. 4. [DEVELOPMENT OF PERFORMANCE MEASURES.] By January 534.11 1, 2002, the commissioner shall, in consultation with counties, 534.12 develop measures for county performance in addition to those in 534.13paragraph (a)subdivision 1 and 2. In developing these 534.14 measures, the commissioner must consider: 534.15 (1) a measure for MFIP cases that leave assistance due to 534.16 employment; 534.17 (2) job retention after participants leave MFIP; and 534.18 (3) participant's earnings at a follow-up point after the 534.19 participant has left MFIP; and 534.20 (4) the appropriateness of services provided to minority 534.21 groups. 534.22(c)Subd. 5. [FAILURE TO MEET FEDERAL PERFORMANCE 534.23 STANDARDS.] (a) If sanctions occur for failure to meet the 534.24 performance standards specified in title 1 of Public Law Number 534.25 104-193 of the Personal Responsibility and Work Opportunity Act 534.26 of 1996, the state shall pay 88 percent of the sanction. The 534.27 remaining 12 percent of the sanction will be paid by the 534.28 counties. The county portion of the sanction will be 534.29 distributed across all counties in proportion to each county's 534.30 percentage of the MFIP average monthly caseload during the 534.31 period for which the sanction was applied. 534.32(d)(b) If a county fails to meet the performance standards 534.33 specified in title 1 of Public Law Number 104-193 of the 534.34 Personal Responsibility and Work Opportunity Act of 1996 for any 534.35 year, the commissioner shall work with counties to organize a 534.36 joint state-county technical assistance team to work with the 535.1 county. The commissioner shall coordinate any technical 535.2 assistance with other departments and agencies including the 535.3 departments of economic security and children, families, and 535.4 learning as necessary to achieve the purpose of this paragraph. 535.5 Sec. 55. Minnesota Statutes 2000, section 256K.25, 535.6 subdivision 1, is amended to read: 535.7 Subdivision 1. [ESTABLISHMENT AND PURPOSE.] (a) The 535.8 commissioner shall establish a supportive housing and managed 535.9 care pilot projectin two counties, one within the seven-county535.10metropolitan area and one outside of that area,to determine 535.11 whether the integrated delivery of employment services, 535.12 supportive services, housing, and health care into a single, 535.13 flexible program will: 535.14 (1) reduce public expenditures on homeless families with 535.15 minor children, homeless noncustodial parents, and other 535.16 homeless individuals; 535.17 (2) increase the employment rates of these persons; and 535.18 (3) provide a new alternative to providing services to this 535.19 hard-to-serve population. 535.20 (b) The commissioner shall create a program for counties 535.21 for the purpose of providing integrated intensive and 535.22 individualized case management services, employment services, 535.23 health care services, rent subsidies or other short- or 535.24 medium-term housing assistance, and other supportive services to 535.25 eligible families and individuals. Minimum project and 535.26 application requirements shall be developed by the commissioner 535.27 in cooperation with counties and their nonprofit partners with 535.28 the goal to provide the maximum flexibility in program design. 535.29 (c) Services available under this project must be 535.30 coordinated with available health care services for an eligible 535.31 project participant. 535.32 Sec. 56. Minnesota Statutes 2000, section 256K.25, 535.33 subdivision 3, is amended to read: 535.34 Subd. 3. [COUNTY ELIGIBILITY.] (a) A county may request 535.35 funding under this pilot project if the county: 535.36 (1) agrees to develop, in cooperation with nonprofit 536.1 partners, a supportive housing and managed care pilot project 536.2 that integrates the delivery of employment services, supportive 536.3 services, housing and health care for eligible families and 536.4 individuals, or agrees to contract with an existing integrated 536.5 program; 536.6 (2) for eligible participants who are also MFIP recipients, 536.7 agrees to develop, in cooperation with nonprofit partners, 536.8 procedures to ensure that the services provided under the pilot 536.9 project are closely coordinated with the services provided under 536.10 MFIP;and536.11 (3) develops a method for evaluating the quality of the 536.12 integrated services provided and the amount of any resulting 536.13 cost savings to the county and state.; and 536.14 (4) addresses in the pilot design the prevalence in the 536.15 homeless population served those individuals with mental 536.16 illness, a history of substance abuse, or HIV. 536.17 (b) Preference may be given to counties that cooperate with 536.18 other counties participating in the pilot project for purposes 536.19 of evaluation and counties that provide additional funding. 536.20 Sec. 57. Minnesota Statutes 2000, section 256K.25, 536.21 subdivision 4, is amended to read: 536.22 Subd. 4. [PARTICIPANT ELIGIBILITY.] (a) In order tobe536.23eligiblemeet initial eligibility criteria for the pilot 536.24 project, the county must determine that a participant is 536.25 homeless or is at risk of homelessness; has a mental illness, a536.26history of substance abuse, or HIV;and is a family that meets 536.27 the criteria in paragraph (b) or is an individual who meets the 536.28 criteria in paragraph (c). 536.29 (b) An eligible family must include a minor child or a 536.30 pregnant woman, and: 536.31 (1) be receiving or be eligible for MFIP assistance under 536.32 chapter 256J; or 536.33 (2) include an adult caregiver who is employed or is 536.34 receiving employment and training services, and have household 536.35 income below the MFIP exit level in section 256J.24, subdivision 536.36 10. 537.1 (c) An eligible individual must: 537.2 (1) meet the eligibility requirements of the group 537.3 residential housing program under section 256I.04, subdivision 537.4 1; or 537.5 (2) be a noncustodial parent who is employed or is 537.6 receiving employment and training services, and have household 537.7 income below the MFIP exit level in section 256J.24, subdivision 537.8 10. 537.9 (d) Counties participating in the pilot project may develop 537.10 and initiate disenrollment criteria, subject to approval by the 537.11 commissioner of human services. 537.12 Sec. 58. Minnesota Statutes 2000, section 256K.25, 537.13 subdivision 5, is amended to read: 537.14 Subd. 5. [FUNDING.] A county may request funding from the 537.15 commissioner for a specified number ofTANF-eligibleproject 537.16 participants. The commissioner shall review the request for 537.17 compliance with subdivisions 1 to 4 and may approve or 537.18 disapprove the request. If other funds are available, the 537.19 commissioner may allocate funding for project participants who 537.20 meet the eligibility requirements of subdivision 4, paragraph 537.21 (c). The commissioner may also redirect funds to the pilot 537.22 project. 537.23 Sec. 59. Minnesota Statutes 2000, section 256K.25, 537.24 subdivision 6, is amended to read: 537.25 Subd. 6. [REPORT.] Participating counties and the 537.26 commissioner shall collaborate to prepare and issue an annual 537.27 report, beginning December 1, 2001, to the chairs of the 537.28 appropriate legislative committees on the pilot project's use of 537.29 public resources, including other funds leveraged for this 537.30 initiative,and an assessment of the feasibility of financing 537.31 the pilot through other health and human services programs, the 537.32 employment and housing status of the families and individuals 537.33 served in the project, and the cost-effectiveness of the 537.34 project. The annual report must also evaluate the pilot project 537.35 with respect to the following project goals: that participants 537.36 will lead more productive, healthier, more stable and better 538.1 quality lives; that the teams created under the project to 538.2 deliver services for each project participant will be 538.3 accountable for ensuring that services are more appropriate, 538.4 cost-effective and well-coordinated; and that the system-wide 538.5 costs of serving this population, and the inappropriate use of 538.6 emergency, crisis-oriented or institutional services, will be 538.7 materially reduced. The commissioner shall provide data that 538.8 may be needed to evaluate the project to participating counties 538.9 that request the data. 538.10 Sec. 60. Minnesota Statutes 2000, section 261.062, is 538.11 amended to read: 538.12 261.062 [TAX FOR SUPPORT OF POOR.] 538.13 The county boardshallmay levy a tax annually sufficient 538.14 to defray the estimated expenses of supporting and relieving the 538.15 poor therein during the succeeding year, and to make up any 538.16 deficiency in the fund raised for that purpose during the 538.17 preceding year. 538.18 Sec. 61. Minnesota Statutes 2000, section 268.0122, 538.19 subdivision 2, is amended to read: 538.20 Subd. 2. [SPECIFIC POWERS.] The commissioner of economic 538.21 security shall: 538.22 (1) administer and supervise all forms of unemployment 538.23 benefits provided for under federal and state laws that are 538.24 vested in the commissioner, including make investigations and 538.25 audits, secure and transmit information, and make available 538.26 services and facilities as the commissioner considers necessary 538.27 or appropriate to facilitate the administration of any other 538.28 states, or the federal Economic Security Law, and accept and use 538.29 information, services, and facilities made available by other 538.30 states or the federal government; 538.31 (2) administer and supervise all employment and training 538.32 services assigned to the department under federal or state law; 538.33 (3) review and comment on local service unit plans and 538.34 community investment program plans and approve or disapprove the 538.35 plans; 538.36 (4) establish and maintain administrative units necessary 539.1 to perform administrative functions common to all divisions of 539.2 the department; 539.3 (5) supervise the county boards of commissioners, local 539.4 service units, and any other units of government designated in 539.5 federal or state law as responsible for employment and training 539.6 programs; 539.7 (6) establish administrative standards and payment 539.8 conditions for providers of employment and training services; 539.9 (7) act as the agent of, and cooperate with, the federal 539.10 government in matters of mutual concern, including the 539.11 administration of any federal funds granted to the state to aid 539.12 in the performance of functions of the commissioner; 539.13 (8) obtain reports from local service units and service 539.14 providers for the purpose of evaluating the performance of 539.15 employment and training services;and539.16 (9) review and comment on plans for Indian tribe employment 539.17 and training services and approve or disapprove the plans; and 539.18 (10) require all general employment and training programs 539.19 that receive state funds to make available information about 539.20 opportunities for women in nontraditional careers in the trades 539.21 and technical occupations. 539.22 Sec. 62. Laws 1997, chapter 203, article 9, section 21, as 539.23 amended by Laws 1998, chapter 407, article 6, section 111, and 539.24 Laws 2000, chapter 488, article 10, section 28, is amended to 539.25 read: 539.26 Sec. 21. [INELIGIBILITY FOR STATE FUNDED PROGRAMS.] 539.27 (a) Effective on the date specified, the following persons 539.28 will be ineligible for general assistance and general assistance 539.29 medical care under Minnesota Statutes, chapter 256D, group 539.30 residential housing under Minnesota Statutes, chapter 256I, and 539.31 MFIP assistance under Minnesota Statutes, chapter 256J, funded 539.32 with state money: 539.33 (1) Beginning July 1, 2002, persons who are terminated from 539.34 or denied Supplemental Security Income due to the 1996 changes 539.35 in the federal law making persons whose alcohol or drug 539.36 addiction is a material factor contributing to the person's 540.1 disability ineligible for Supplemental Security Income, and are 540.2 eligible for general assistance under Minnesota Statutes, 540.3 section 256D.05, subdivision 1, paragraph (a), clause (15), 540.4 general assistance medical care under Minnesota Statutes, 540.5 chapter 256D, or group residential housing under Minnesota 540.6 Statutes, chapter 256I; 540.7 (2) Beginning July 1, 2002, legal noncitizens who are 540.8 ineligible for Supplemental Security Income due to the 1996 540.9 changes in federal law making certain noncitizens ineligible for 540.10 these programs due to their noncitizen status; and 540.11 (3) Beginning July 1,20012003, legal noncitizens who are 540.12 eligible for MFIP assistance, either the cash assistance portion 540.13 or the food assistance portion, funded entirely with state money. 540.14 (b) State money that remains unspent due to changes in 540.15 federal law enacted after May 12, 1997, that reduce state 540.16 spending for legal noncitizens or for persons whose alcohol or 540.17 drug addiction is a material factor contributing to the person's 540.18 disability, or enacted after February 1, 1998, that reduce state 540.19 spending for food benefits for legal noncitizens shall not 540.20 cancel and shall be deposited in the TANF reserve account. 540.21 Sec. 63. [DOMESTIC VIOLENCE TRAINING FOR COUNTY AGENCIES.] 540.22 During fiscal year 2002, the commissioner of human services 540.23 will provide training for county agency staff to receive 540.24 specialized domestic violence training in order to carry out the 540.25 responsibilities in Minnesota Statutes, sections 256J.46, 540.26 subdivision 1a; 256J.49, subdivision 1a; 256J.52, subdivision 6; 540.27 and 256J.56, subdivision 6. This training must be similar to 540.28 the training provided to individuals who work for an 540.29 organization designated by the Minnesota center for crime 540.30 victims services as providing services to victims of domestic 540.31 violence. 540.32 Sec. 64. [REPORT ON ASSESSMENT OF COUNTY PERFORMANCE.] 540.33 By January 15, 2003, the commissioner, in consultation with 540.34 counties, must report to the chairs of the house and senate 540.35 committees having jurisdiction over human services, on a 540.36 proposal for assessing county performance using a methodology 541.1 that controls for demographic, economic, and other variables 541.2 that may impact county achievement of MFIP performance 541.3 outcomes. The proposal must recommend how state and federal 541.4 funds may be allocated to counties to encourage and reward high 541.5 performance. 541.6 Sec. 65. [EXTENSION RULEMAKING AUTHORITY.] 541.7 If rulemaking is required to implement section 28, the 541.8 commissioner of human services is authorized to adopt rules 541.9 under Minnesota Statutes, section 14.386. 541.10 Sec. 66. [INSTRUCTION TO REVISOR.] 541.11 In the next edition of Minnesota Statutes and Minnesota 541.12 Rules, the revisor shall change all references to Minnesota 541.13 Family Investment Program-Statewide (MFIP-S) to Minnesota Family 541.14 Investment Program (MFIP). 541.15 Sec. 67. [REPEALER.] 541.16 (a) Minnesota Statutes 2000, sections 256J.08, subdivision 541.17 50a; 256J.12, subdivision 3; 256J.43; and 256J.53, subdivision 541.18 4, are repealed. 541.19 (b) Minnesota Statutes 2000, section 256J.49, subdivision 541.20 11, is repealed October 1, 2001. 541.21 (c) Minnesota Statutes 2000, section 256D.066, is repealed. 541.22 (d) Minnesota Statutes 2000, section 256J.46, subdivision 541.23 1a, is repealed. 541.24 (e) Minnesota Statutes 2000, section 256J.44, is repealed. 541.25 ARTICLE 11 541.26 CHILD WELFARE AND FOSTER CARE 541.27 Section 1. Minnesota Statutes 2000, section 13.461, 541.28 subdivision 17, is amended to read: 541.29 Subd. 17. [VULNERABLE ADULTMALTREATMENT REVIEWPANEL541.30 PANELS.] Data of the vulnerable adult maltreatment review 541.31 panel or the child maltreatment review panel are classified 541.32 under section 256.021 or section 256.022. 541.33 [EFFECTIVE DATE.] This section is effective July 1, 2001. 541.34 Sec. 2. Minnesota Statutes 2000, section 245.814, 541.35 subdivision 1, is amended to read: 541.36 Subdivision 1. [INSURANCE FOR FOSTER HOME PROVIDERS.] The 542.1 commissioner of human services shall within the appropriation 542.2 provided purchase and provide insurance to individuals licensed 542.3 as foster home providers to cover their liability for: 542.4 (1) injuries or property damage caused or sustained by 542.5 persons in foster care in their home; and 542.6 (2) actions arising out of alienation of affections 542.7 sustained by the birth parents of a foster child or birth 542.8 parents or children of a foster adult. 542.9 For purposes of this subdivision, insurance for homes 542.10 licensed to provide adult foster care shall be limited to family 542.11 adult foster care homes as defined in section 144D.01, 542.12 subdivision 7. 542.13 Sec. 3. [256.022] [CHILD MALTREATMENT REVIEW PANEL.] 542.14 Subdivision 1. [CREATION.] The commissioner of human 542.15 services shall establish a review panel for purposes of 542.16 reviewing investigating agency determinations regarding 542.17 maltreatment of a child in a facility in response to requests 542.18 received under section 626.556, subdivision 10i, paragraph (b). 542.19 The review panel consists of the commissioners of health; human 542.20 services; children, families, and learning; and corrections; the 542.21 ombudsman for crime victims; and the ombudsman for mental health 542.22 and mental retardation; or their designees. 542.23 Subd. 2. [REVIEW PROCEDURE.] (a) The panel shall hold 542.24 quarterly meetings for purposes of conducting reviews under this 542.25 section. If an interested person acting on behalf of a child 542.26 requests a review under this section, the panel shall review the 542.27 request at its next quarterly meeting. If the next quarterly 542.28 meeting is within ten days of the panel's receipt of the request 542.29 for review, the review may be delayed until the next subsequent 542.30 meeting. The panel shall review the request and the final 542.31 determination regarding maltreatment made by the investigating 542.32 agency and may review any other data on the investigation 542.33 maintained by the agency that are pertinent and necessary to its 542.34 review of the determination. If more than one person requests a 542.35 review under this section with respect to the same 542.36 determination, the review panel shall combine the requests into 543.1 one review. Upon receipt of a request for a review, the panel 543.2 shall notify the alleged perpetrator of maltreatment that a 543.3 review has been requested and provide an approximate timeline 543.4 for conducting the review. 543.5 (b) Within 30 days of the review under this section, the 543.6 panel shall notify the investigating agency and the interested 543.7 person who requested the review as to whether the panel agrees 543.8 with the determination or whether the investigating agency must 543.9 reconsider the determination. If the panel determines that the 543.10 agency must reconsider the determination, the panel must make 543.11 specific investigative recommendations to the agency. Within 30 543.12 days the investigating agency shall conduct a review and report 543.13 back to the panel with its reconsidered determination and the 543.14 specific rationale for its determination. 543.15 Subd. 3. [REPORT.] By January 15 of each year, the panel 543.16 shall submit a report to the committees of the legislature with 543.17 jurisdiction over section 626.556 regarding the number of 543.18 requests for review it receives under this section, the number 543.19 of cases where the panel requires the investigating agency to 543.20 reconsider its final determination, the number of cases where 543.21 the final determination is changed, and any recommendations to 543.22 improve the review or investigative process. 543.23 Subd. 4. [DATA.] Data of the review panel created as part 543.24 of a review under this section are private data on individuals 543.25 as defined in section 13.02. 543.26 [EFFECTIVE DATE.] This section is effective July 1, 2001. 543.27 Sec. 4. Minnesota Statutes 2000, section 257.0725, is 543.28 amended to read: 543.29 257.0725 [ANNUAL REPORT.] 543.30 The commissioner of human services shall publish an annual 543.31 report on child maltreatment and on children in out-of-home 543.32 placement. The commissioner shall confer with counties, child 543.33 welfare organizations, child advocacy organizations, the courts, 543.34 and other groups on how to improve the content and utility of 543.35 the department's annual report. In regard to child 543.36 maltreatment, the report shall include the number and kinds of 544.1 maltreatment reports received and any other data that the 544.2 commissioner determines is appropriate to include in a report on 544.3 child maltreatment. In regard to children in out-of-home 544.4 placement, the report shall include, by county and statewide, 544.5 information on legal status, living arrangement, age, sex, race, 544.6 accumulated length of time in placement, reason for most recent 544.7 placement, race of family with whom placed, and other 544.8 information deemed appropriate on all children in out-of-home 544.9 placement. Out-of-home placement includes placement in any 544.10 facility by an authorized child-placing agency. 544.11 Sec. 5. Minnesota Statutes 2000, section 260C.301, 544.12 subdivision 3, as amended by Laws 2001, chapter 178, article 1, 544.13 section 34, is amended to read: 544.14 Subd. 3. [REQUIRED TERMINATION OF PARENTAL RIGHTS.] (a) 544.15 The county attorney shall file a termination of parental rights 544.16 petition within 30 days of the responsible social services 544.17 agency determining that a child has been subjected to egregious 544.18 harm as defined in section 260C.007, subdivision 26, is 544.19 determined to be the sibling of another child of the parent who 544.20 was subjected to egregious harm, or is an abandoned infant as 544.21 defined in subdivision 2, paragraph (a), clause (2), or the 544.22 parent has lost parental rights to another child through an 544.23 order involuntarily terminating the parent's rights, or another 544.24 child of the parent is the subject of an order involuntarily 544.25 transferring permanent legal and physical custody of the child 544.26 to a relative under section 260C.201, subdivision 11, paragraph 544.27 (e), clause (1), or a similar law of another jurisdiction. The 544.28 local social services agency shall concurrently identify, 544.29 recruit, process, and approve an adoptive family for the child. 544.30 If a termination of parental rights petition has been filed by 544.31 another party, the local social services agency shall be joined 544.32 as a party to the petition. If criminal charges have been filed 544.33 against a parent arising out of the conduct alleged to 544.34 constitute egregious harm, the county attorney shall determine 544.35 which matter should proceed to trial first, consistent with the 544.36 best interests of the child and subject to the defendant's right 545.1 to a speedy trial. 545.2 (b) This requirement does not apply if the county attorney 545.3 determines and files with the court: 545.4 (1) a petition for transfer of permanent legal and physical 545.5 custody to a relative under section 260C.201, subdivision 11, 545.6 including a determination that the transfer is in the best 545.7 interests of the child; or 545.8 (2) a petition alleging the child, and where appropriate, 545.9 the child's siblings, to be in need of protection or services 545.10 accompanied by a case plan prepared by the responsible social 545.11 services agency documenting a compelling reason why filing a 545.12 termination of parental rights petition would not be in the best 545.13 interests of the child. 545.14 Sec. 6. Minnesota Statutes 2000, section 626.556, 545.15 subdivision 10, as amended by Laws 2001, chapter 178, article 2, 545.16 section 11, is amended to read: 545.17 Subd. 10. [DUTIES OF LOCAL WELFARE AGENCY AND LOCAL LAW 545.18 ENFORCEMENT AGENCY UPON RECEIPT OF A REPORT.] (a) If the report 545.19 alleges neglect, physical abuse, or sexual abuse by a parent, 545.20 guardian, or individual functioning within the family unit as a 545.21 person responsible for the child's care, the local welfare 545.22 agency shall immediately conduct an assessment including 545.23 gathering information on the existence of substance abuse and 545.24 offer protective social services for purposes of preventing 545.25 further abuses, safeguarding and enhancing the welfare of the 545.26 abused or neglected minor, and preserving family life whenever 545.27 possible. If the report alleges a violation of a criminal 545.28 statute involving sexual abuse, physical abuse, or neglect or 545.29 endangerment, under section 609.378, the local law enforcement 545.30 agency and local welfare agency shall coordinate the planning 545.31 and execution of their respective investigation and assessment 545.32 efforts to avoid a duplication of fact-finding efforts and 545.33 multiple interviews. Each agency shall prepare a separate 545.34 report of the results of its investigation. In cases of alleged 545.35 child maltreatment resulting in death, the local agency may rely 545.36 on the fact-finding efforts of a law enforcement investigation 546.1 to make a determination of whether or not maltreatment 546.2 occurred. When necessary the local welfare agency shall seek 546.3 authority to remove the child from the custody of a parent, 546.4 guardian, or adult with whom the child is living. In performing 546.5 any of these duties, the local welfare agency shall maintain 546.6 appropriate records. 546.7 If the assessment indicates there is a potential for abuse 546.8 of alcohol or other drugs by the parent, guardian, or person 546.9 responsible for the child's care, the local welfare agency shall 546.10 conduct a chemical use assessment pursuant to Minnesota Rules, 546.11 part 9530.6615. The local welfare agency shall report the 546.12 determination of the chemical use assessment, and the 546.13 recommendations and referrals for alcohol and other drug 546.14 treatment services to the state authority on alcohol and drug 546.15 abuse. 546.16 (b) When a local agency receives a report or otherwise has 546.17 information indicating that a child who is a client, as defined 546.18 in section 245.91, has been the subject of physical abuse, 546.19 sexual abuse, or neglect at an agency, facility, or program as 546.20 defined in section 245.91, it shall, in addition to its other 546.21 duties under this section, immediately inform the ombudsman 546.22 established under sections 245.91 to 245.97. The commissioner 546.23 of children, families, and learning shall inform the ombudsman 546.24 established under sections 245.91 to 245.97 of reports regarding 546.25 a child defined as a client in section 245.91 that maltreatment 546.26 occurred at a school as defined in sections 120A.05, 546.27 subdivisions 9, 11, and 13, and 124D.10. 546.28 (c) Authority of the local welfare agency responsible for 546.29 assessing the child abuse or neglect report, the agency 546.30 responsible for assessing or investigating the report, and of 546.31 the local law enforcement agency for investigating the alleged 546.32 abuse or neglect includes, but is not limited to, authority to 546.33 interview, without parental consent, the alleged victim and any 546.34 other minors who currently reside with or who have resided with 546.35 the alleged offender. The interview may take place at school or 546.36 at any facility or other place where the alleged victim or other 547.1 minors might be found or the child may be transported to, and 547.2 the interview conducted at, a place appropriate for the 547.3 interview of a child designated by the local welfare agency or 547.4 law enforcement agency. The interview may take place outside 547.5 the presence of the alleged offender or parent, legal custodian, 547.6 guardian, or school official. Except as provided in this 547.7 paragraph, the parent, legal custodian, or guardian shall be 547.8 notified by the responsible local welfare or law enforcement 547.9 agency no later than the conclusion of the investigation or 547.10 assessment that this interview has occurred. Notwithstanding 547.11 rule 49.02 of the Minnesota rules of procedure for juvenile 547.12 courts, the juvenile court may, after hearing on an ex parte 547.13 motion by the local welfare agency, order that, where reasonable 547.14 cause exists, the agency withhold notification of this interview 547.15 from the parent, legal custodian, or guardian. If the interview 547.16 took place or is to take place on school property, the order 547.17 shall specify that school officials may not disclose to the 547.18 parent, legal custodian, or guardian the contents of the 547.19 notification of intent to interview the child on school 547.20 property, as provided under this paragraph, and any other 547.21 related information regarding the interview that may be a part 547.22 of the child's school record. A copy of the order shall be sent 547.23 by the local welfare or law enforcement agency to the 547.24 appropriate school official. 547.25 (d) When the local welfare, local law enforcement agency, 547.26 or the agency responsible for assessing or investigating a 547.27 report of maltreatment determines that an interview should take 547.28 place on school property, written notification of intent to 547.29 interview the child on school property must be received by 547.30 school officials prior to the interview. The notification shall 547.31 include the name of the child to be interviewed, the purpose of 547.32 the interview, and a reference to the statutory authority to 547.33 conduct an interview on school property. For interviews 547.34 conducted by the local welfare agency, the notification shall be 547.35 signed by the chair of the local social services agency or the 547.36 chair's designee. The notification shall be private data on 548.1 individuals subject to the provisions of this paragraph. School 548.2 officials may not disclose to the parent, legal custodian, or 548.3 guardian the contents of the notification or any other related 548.4 information regarding the interview until notified in writing by 548.5 the local welfare or law enforcement agency that the 548.6 investigation or assessment has been concluded, unless a school 548.7 employee or agent is alleged to have maltreated the child. 548.8 Until that time, the local welfare or law enforcement agency or 548.9 the agency responsible for assessing or investigating a report 548.10 of maltreatment shall be solely responsible for any disclosures 548.11 regarding the nature of the assessment or investigation. 548.12 Except where the alleged offender is believed to be a 548.13 school official or employee, the time and place, and manner of 548.14 the interview on school premises shall be within the discretion 548.15 of school officials, but the local welfare or law enforcement 548.16 agency shall have the exclusive authority to determine who may 548.17 attend the interview. The conditions as to time, place, and 548.18 manner of the interview set by the school officials shall be 548.19 reasonable and the interview shall be conducted not more than 24 548.20 hours after the receipt of the notification unless another time 548.21 is considered necessary by agreement between the school 548.22 officials and the local welfare or law enforcement agency. 548.23 Where the school fails to comply with the provisions of this 548.24 paragraph, the juvenile court may order the school to comply. 548.25 Every effort must be made to reduce the disruption of the 548.26 educational program of the child, other students, or school 548.27 staff when an interview is conducted on school premises. 548.28 (e) Where the alleged offender or a person responsible for 548.29 the care of the alleged victim or other minor prevents access to 548.30 the victim or other minor by the local welfare agency, the 548.31 juvenile court may order the parents, legal custodian, or 548.32 guardian to produce the alleged victim or other minor for 548.33 questioning by the local welfare agency or the local law 548.34 enforcement agency outside the presence of the alleged offender 548.35 or any person responsible for the child's care at reasonable 548.36 places and times as specified by court order. 549.1 (f) Before making an order under paragraph (e), the court 549.2 shall issue an order to show cause, either upon its own motion 549.3 or upon a verified petition, specifying the basis for the 549.4 requested interviews and fixing the time and place of the 549.5 hearing. The order to show cause shall be served personally and 549.6 shall be heard in the same manner as provided in other cases in 549.7 the juvenile court. The court shall consider the need for 549.8 appointment of a guardian ad litem to protect the best interests 549.9 of the child. If appointed, the guardian ad litem shall be 549.10 present at the hearing on the order to show cause. 549.11 (g) The commissioner of human services, the ombudsman for 549.12 mental health and mental retardation, the local welfare agencies 549.13 responsible for investigating reports, the commissioner of 549.14 children, families, and learning, and the local law enforcement 549.15 agencies have the right to enter facilities as defined in 549.16 subdivision 2 and to inspect and copy the facility's records, 549.17 including medical records, as part of the investigation. 549.18 Notwithstanding the provisions of chapter 13, they also have the 549.19 right to inform the facility under investigation that they are 549.20 conducting an investigation, to disclose to the facility the 549.21 names of the individuals under investigation for abusing or 549.22 neglecting a child, and to provide the facility with a copy of 549.23 the report and the investigative findings. 549.24 (h) The local welfare agency or the agency responsible for 549.25 assessing or investigating the report shall collect available 549.26 and relevant information to ascertain whether maltreatment 549.27 occurred and whether protective services are needed. 549.28 Information collected includes, when relevant, information with 549.29 regard to the person reporting the alleged maltreatment, 549.30 including the nature of the reporter's relationship to the child 549.31 and to the alleged offender, and the basis of the reporter's 549.32 knowledge for the report; the child allegedly being maltreated; 549.33 the alleged offender; the child's caretaker; and other 549.34 collateral sources having relevant information related to the 549.35 alleged maltreatment. The local welfare agency or the agency 549.36 responsible for assessing or investigating the report may make a 550.1 determination of no maltreatment early in an assessment, and 550.2 close the case and retain immunity, if the collected information 550.3 shows no basis for a full assessment or investigation. 550.4 Information relevant to the assessment or investigation 550.5 must be asked for, and may include: 550.6 (1) the child's sex and age, prior reports of maltreatment, 550.7 information relating to developmental functioning, credibility 550.8 of the child's statement, and whether the information provided 550.9 under this clause is consistent with other information collected 550.10 during the course of the assessment or investigation; 550.11 (2) the alleged offender's age, a record check for prior 550.12 reports of maltreatment, and criminal charges and convictions. 550.13 The local welfare agency or the agency responsible for assessing 550.14 or investigating the report must provide the alleged offender 550.15 with an opportunity to make a statement. The alleged offender 550.16 may submit supporting documentation relevant to the assessment 550.17 or investigation; 550.18 (3) collateral source information regarding the alleged 550.19 maltreatment and care of the child. Collateral information 550.20 includes, when relevant: (i) a medical examination of the 550.21 child; (ii) prior medical records relating to the alleged 550.22 maltreatment or the care of the child maintained by any 550.23 facility, clinic, or health care professional and an interview 550.24 with the treating professionals; and (iii) interviews with the 550.25 child's caretakers, including the child's parent, guardian, 550.26 foster parent, child care provider, teachers, counselors, family 550.27 members, relatives, and other persons who may have knowledge 550.28 regarding the alleged maltreatment and the care of the child; 550.29 and 550.30 (4) information on the existence of domestic abuse and 550.31 violence in the home of the child, and substance abuse. 550.32 Nothing in this paragraph precludes the local welfare 550.33 agency, the local law enforcement agency, or the agency 550.34 responsible for assessing or investigating the report from 550.35 collecting other relevant information necessary to conduct the 550.36 assessment or investigation. Notwithstanding section 13.384 or 551.1 144.335, the local welfare agency has access to medical data and 551.2 records for purposes of clause (3). Notwithstanding the data's 551.3 classification in the possession of any other agency, data 551.4 acquired by the local welfare agency or the agency responsible 551.5 for assessing or investigating the report during the course of 551.6 the assessment or investigation are private data on individuals 551.7 and must be maintained in accordance with subdivision 11. Data 551.8 of the commissioner of children, families, and learning 551.9 collected or maintained during and for the purpose of an 551.10 investigation of alleged maltreatment in a school are governed 551.11 by this section, notwithstanding the data's classification as 551.12 educational, licensing, or personnel data under chapter 13. 551.13 In conducting an assessment or investigation involving a 551.14 school facility as defined in subdivision 2, paragraph (f), the 551.15 commissioner of children, families, and learning shall collect 551.16 investigative reports and data that are relevant to a report of 551.17 maltreatment and are from local law enforcement and the school 551.18 facility. 551.19 (i) In the initial stages of an assessment or 551.20 investigation, the local welfare agency shall conduct a 551.21 face-to-face observation of the child reported to be maltreated 551.22 and a face-to-face interview of the alleged offender. The 551.23 interview with the alleged offender may be postponed if it would 551.24 jeopardize an active law enforcement investigation. 551.25 (j) The local welfare agency shall use a question and 551.26 answer interviewing format with questioning as nondirective as 551.27 possible to elicit spontaneous responses. The following 551.28 interviewing methods and procedures must be used whenever 551.29 possible when collecting information: 551.30 (1) audio recordings of all interviews with witnesses and 551.31 collateral sources; and 551.32 (2) in cases of alleged sexual abuse, audio-video 551.33 recordings of each interview with the alleged victim and child 551.34 witnesses. 551.35 (k) In conducting an assessment or investigation involving 551.36 a school facility as defined in subdivision 2, paragraph (f), 552.1 the commissioner of children, families, and learning shall 552.2 collect available and relevant information and use the 552.3 procedures in paragraphs (h), (i), and (j), provided that the 552.4 commissioner may also base the assessment or investigation on 552.5 investigative reports and data received from the school facility 552.6 and local law enforcement, to the extent those investigations 552.7 satisfy the requirements of paragraphs (h), (i), and (j). 552.8 Sec. 7. Minnesota Statutes 2000, section 626.556, 552.9 subdivision 10b, is amended to read: 552.10 Subd. 10b. [DUTIES OF COMMISSIONER; NEGLECT OR ABUSE IN 552.11 FACILITY.] (a) This section applies to the commissioners of 552.12 human services, health, and children, families, and learning. 552.13 The commissioner of the agency responsible for assessing or 552.14 investigating the report shall immediately investigate if the 552.15 report alleges that: 552.16 (1) a child who is in the care of a facility as defined in 552.17 subdivision 2 is neglected, physically abused,orsexually 552.18 abused, or is the victim of maltreatment in a facility by an 552.19 individual in that facility, or has been so neglected or abused, 552.20 or been the victim of maltreatment in a facility by an 552.21 individual in that facility within the three years preceding the 552.22 report; or 552.23 (2) a child was neglected, physically abused,orsexually 552.24 abused, or is the victim of maltreatment in a facility by an 552.25 individual in a facility defined in subdivision 2, while in the 552.26 care of that facility within the three years preceding the 552.27 report. 552.28 The commissioner of the agency responsible for assessing or 552.29 investigating the report shall arrange for the transmittal to 552.30 the commissioner of reports received by local agencies and may 552.31 delegate to a local welfare agency the duty to investigate 552.32 reports. In conducting an investigation under this section, the 552.33 commissioner has the powers and duties specified for local 552.34 welfare agencies under this section. The commissioner of the 552.35 agency responsible for assessing or investigating the report or 552.36 local welfare agency may interview any children who are or have 553.1 been in the care of a facility under investigation and their 553.2 parents, guardians, or legal custodians. 553.3 (b) Prior to any interview, the commissioner of the agency 553.4 responsible for assessing or investigating the report or local 553.5 welfare agency shall notify the parent, guardian, or legal 553.6 custodian of a child who will be interviewed in the manner 553.7 provided for in subdivision 10d, paragraph (a). If reasonable 553.8 efforts to reach the parent, guardian, or legal custodian of a 553.9 child in an out-of-home placement have failed, the child may be 553.10 interviewed if there is reason to believe the interview is 553.11 necessary to protect the child or other children in the 553.12 facility. The commissioner of the agency responsible for 553.13 assessing or investigating the report or local agency must 553.14 provide the information required in this subdivision to the 553.15 parent, guardian, or legal custodian of a child interviewed 553.16 without parental notification as soon as possible after the 553.17 interview. When the investigation is completed, any parent, 553.18 guardian, or legal custodian notified under this subdivision 553.19 shall receive the written memorandum provided for in subdivision 553.20 10d, paragraph (c). 553.21 (c) In conducting investigations under this subdivision the 553.22 commissioner or local welfare agency shall obtain access to 553.23 information consistent with subdivision 10, paragraphs (h), (i), 553.24 and (j). 553.25 (d) Except for foster care and family child care, the 553.26 commissioner has the primary responsibility for the 553.27 investigations and notifications required under subdivisions 10d 553.28 and 10f for reports that allege maltreatment related to the care 553.29 provided by or in facilities licensed by the commissioner. The 553.30 commissioner may request assistance from the local social 553.31 services agency. 553.32 [EFFECTIVE DATE.] This section is effective July 1, 2001. 553.33 Sec. 8. Minnesota Statutes 2000, section 626.556, 553.34 subdivision 10d, as amended by Laws 2001, chapter 178, article 553.35 2, section 13, is amended to read: 553.36 Subd. 10d. [NOTIFICATION OF NEGLECT OR ABUSE IN FACILITY.] 554.1 (a) When a report is received that alleges neglect, physical 554.2 abuse,orsexual abuse, or maltreatment of a child while in the 554.3 care of a licensed or unlicensed day care facility, residential 554.4 facility, agency, hospital, sanitarium, or other facility or 554.5 institution required to be licensed according to sections 144.50 554.6 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 245B, or a 554.7 school as defined in sections 120A.05, subdivisions 9, 11, and 554.8 13; and 124D.10; or a nonlicensed personal care provider 554.9 organization as defined in section 256B.04, subdivision 16, and 554.10 256B.0625, subdivision 19a, the commissioner of the agency 554.11 responsible for assessing or investigating the report or local 554.12 welfare agency investigating the report shall provide the 554.13 following information to the parent, guardian, or legal 554.14 custodian of a child alleged to have been neglected, physically 554.15 abused,orsexually abused, or the victim of maltreatment of a 554.16 child in the facility: the name of the facility; the fact that 554.17 a report alleging neglect, physical abuse,orsexual abuse, or 554.18 maltreatment of a child in the facility has been received; the 554.19 nature of the alleged neglect, physical abuse,orsexual abuse, 554.20 or maltreatment of a child in the facility; that the agency is 554.21 conducting an assessment or investigation; any protective or 554.22 corrective measures being taken pending the outcome of the 554.23 investigation; and that a written memorandum will be provided 554.24 when the investigation is completed. 554.25 (b) The commissioner of the agency responsible for 554.26 assessing or investigating the report or local welfare agency 554.27 may also provide the information in paragraph (a) to the parent, 554.28 guardian, or legal custodian of any other child in the facility 554.29 if the investigative agency knows or has reason to believe the 554.30 alleged neglect, physical abuse,orsexual abuse, or 554.31 maltreatment of a child in the facility has occurred. In 554.32 determining whether to exercise this authority, the commissioner 554.33 of the agency responsible for assessing or investigating the 554.34 report or local welfare agency shall consider the seriousness of 554.35 the alleged neglect, physical abuse,orsexual abuse, or 554.36 maltreatment of a child in the facility; the number of children 555.1 allegedly neglected, physically abused,orsexually abused, or 555.2 victims of maltreatment of a child in the facility; the number 555.3 of alleged perpetrators; and the length of the investigation. 555.4 The facility shall be notified whenever this discretion is 555.5 exercised. 555.6 (c) When the commissioner of the agency responsible for 555.7 assessing or investigating the report or local welfare agency 555.8 has completed its investigation, every parent, guardian, or 555.9 legal custodian previously notified of the investigation by the 555.10 commissioner or local welfare agency shall be provided with the 555.11 following information in a written memorandum: the name of the 555.12 facility investigated; the nature of the alleged neglect, 555.13 physical abuse,orsexual abuse, or maltreatment of a child in 555.14 the facility; the investigator's name; a summary of the 555.15 investigation findings; a statement whether maltreatment was 555.16 found; and the protective or corrective measures that are being 555.17 or will be taken. The memorandum shall be written in a manner 555.18 that protects the identity of the reporter and the child and 555.19 shall not contain the name, or to the extent possible, reveal 555.20 the identity of the alleged perpetrator or of those interviewed 555.21 during the investigation. If maltreatment is determined to 555.22 exist, the commissioner or local welfare agency shall also 555.23 provide the written memorandum to the parent, guardian, or legal 555.24 custodian of each child in the facilityif maltreatment is555.25determined to existwho had contact with the individual 555.26 responsible for the maltreatment. When the facility is the 555.27 responsible party for maltreatment, the commissioner or local 555.28 welfare agency shall also provide the written memorandum to the 555.29 parent, guardian, or legal custodian of each child who received 555.30 services in the population of the facility where the 555.31 maltreatment occurred. This notification must be provided to 555.32 the parent, guardian, or legal custodian of each child receiving 555.33 services from the time the maltreatment occurred until either 555.34 the individual responsible for maltreatment is no longer in 555.35 contact with a child or children in the facility or the 555.36 conclusion of the investigation. In the case of maltreatment 556.1 within a school facility, as defined in sections 120A.05, 556.2 subdivisions 9, 11, and 13, and 124D.10, the commissioner of 556.3 children, families, and learning need not provide notification 556.4 to parents, guardians, or legal custodians of each child in the 556.5 facility, but may provide notification to the parent, guardian, 556.6 or legal custodian of any student alleged to have been 556.7 maltreated or involved as a witness to alleged maltreatment. 556.8 Sec. 9. Minnesota Statutes 2000, section 626.556, 556.9 subdivision 10e, is amended to read: 556.10 Subd. 10e. [DETERMINATIONS.] Upon the conclusion of every 556.11 assessment or investigation it conducts, the local welfare 556.12 agency shall make two determinations: first, whether 556.13 maltreatment has occurred; and second, whether child protective 556.14 services are needed. When maltreatment is determined in an 556.15 investigation involving a facility, the investigating agency 556.16 shall also determine whether the facility or individual was 556.17 responsible for the maltreatment using the mitigating factors in 556.18 paragraph (d). Determinations under this subdivision must be 556.19 made based on a preponderance of the evidence. 556.20 (a) For the purposes of this subdivision, "maltreatment" 556.21 means any of the following acts or omissionscommitted by a556.22person responsible for the child's care: 556.23 (1) physical abuse as defined in subdivision 2, paragraph 556.24 (d); 556.25 (2) neglect as defined in subdivision 2, paragraph (c); 556.26 (3) sexual abuse as defined in subdivision 2, paragraph 556.27 (a);or556.28 (4) mental injury as defined in subdivision 2, paragraph 556.29 (k); or 556.30 (5) maltreatment of a child in a facility as defined in 556.31 subdivision 2, paragraph (f). 556.32 (b) For the purposes of this subdivision, a determination 556.33 that child protective services are needed means that the local 556.34 welfare agency has documented conditions during the assessment 556.35 or investigation sufficient to cause a child protection worker, 556.36 as defined in section 626.559, subdivision 1, to conclude that a 557.1 child is at significant risk of maltreatment if protective 557.2 intervention is not provided and that the individuals 557.3 responsible for the child's care have not taken or are not 557.4 likely to take actions to protect the child from maltreatment or 557.5 risk of maltreatment. 557.6 (c) This subdivision does not mean that maltreatment has 557.7 occurred solely because the child's parent, guardian, or other 557.8 person responsible for the child's care in good faith selects 557.9 and depends upon spiritual means or prayer for treatment or care 557.10 of disease or remedial care of the child, in lieu of medical 557.11 care. However, if lack of medical care may result in serious 557.12 danger to the child's health, the local welfare agency may 557.13 ensure that necessary medical services are provided to the child. 557.14 (d) When determining whether the facility or individual is 557.15 the responsible party for determined maltreatment in a facility, 557.16 the investigating agency shall consider at least the following 557.17 mitigating factors: 557.18 (1) whether the actions of the facility or the individual 557.19 caregivers were according to, and followed the terms of, an 557.20 erroneous physician order, prescription, individual care plan, 557.21 or directive; however, this is not a mitigating factor when the 557.22 facility or caregiver was responsible for the issuance of the 557.23 erroneous order, prescription, individual care plan, or 557.24 directive or knew or should have known of the errors and took no 557.25 reasonable measures to correct the defect before administering 557.26 care; 557.27 (2) comparative responsibility between the facility, other 557.28 caregivers, and requirements placed upon an employee, including 557.29 the facility's compliance with related regulatory standards and 557.30 the adequacy of facility policies and procedures, facility 557.31 training, an individual's participation in the training, the 557.32 caregiver's supervision, and facility staffing levels and the 557.33 scope of the individual employee's authority and discretion; and 557.34 (3) whether the facility or individual followed 557.35 professional standards in exercising professional judgment. 557.36 Individual counties may implement more detailed definitions 558.1 or criteria that indicate which allegations to investigate, as 558.2 long as a county's policies are consistent with the definitions 558.3 in the statutes and rules and are approved by the county board. 558.4 Each local welfare agency shall periodically inform mandated 558.5 reporters under subdivision 3 who work in the county of the 558.6 definitions of maltreatment in the statutes and rules and any 558.7 additional definitions or criteria that have been approved by 558.8 the county board. 558.9 [EFFECTIVE DATE.] This section is effective July 1, 2001. 558.10 Sec. 10. Minnesota Statutes 2000, section 626.556, 558.11 subdivision 10f, is amended to read: 558.12 Subd. 10f. [NOTICE OF DETERMINATIONS.] Within ten working 558.13 days of the conclusion of an assessment, the local welfare 558.14 agency or agency responsible for assessing or investigating the 558.15 report shall notify the parent or guardian of the child, the 558.16 person determined to be maltreating the child, and if 558.17 applicable, the director of the facility, of the determination 558.18 and a summary of the specific reasons for the determination. 558.19 The notice must also include a certification that the 558.20 information collection procedures under subdivision 10, 558.21 paragraphs (h), (i), and (j), were followed and a notice of the 558.22 right of a data subject to obtain access to other private data 558.23 on the subject collected, created, or maintained under this 558.24 section. In addition, the notice shall include the length of 558.25 time that the records will be kept under subdivision 11c. The 558.26 investigating agency shall notify the parent or guardian of the 558.27 child who is the subject of the report, and any person or 558.28 facility determined to have maltreated a child, of their 558.29 appeal or review rights under this section or section 256.022. 558.30 [EFFECTIVE DATE.] This section is effective July 1, 2001. 558.31 Sec. 11. Minnesota Statutes 2000, section 626.556, 558.32 subdivision 11, is amended to read: 558.33 Subd. 11. [RECORDS.] (a) Except as provided in paragraph 558.34 (b) or (c) and subdivisions 10b, 10d, 10g, and 11b, all records 558.35 concerning individuals maintained by a local welfare agency or 558.36 agency responsible for assessing or investigating the report 559.1 under this section, including any written reports filed under 559.2 subdivision 7, shall be private data on individuals, except 559.3 insofar as copies of reports are required by subdivision 7 to be 559.4 sent to the local police department or the county sheriff. 559.5 Reports maintained by any police department or the county 559.6 sheriff shall be private data on individuals except the reports 559.7 shall be made available to the investigating, petitioning, or 559.8 prosecuting authority, including county medical examiners or 559.9 county coroners. Section 13.82, subdivisions 7, 5a, and 5b, 559.10 apply to law enforcement data other than the reports. The local 559.11 social services agency or agency responsible for assessing or 559.12 investigating the report shall make available to the 559.13 investigating, petitioning, or prosecuting authority, including 559.14 county medical examiners or county coroners or their 559.15 professional delegates, any records which contain information 559.16 relating to a specific incident of neglect or abuse which is 559.17 under investigation, petition, or prosecution and information 559.18 relating to any prior incidents of neglect or abuse involving 559.19 any of the same persons. The records shall be collected and 559.20 maintained in accordance with the provisions of chapter 13. In 559.21 conducting investigations and assessments pursuant to this 559.22 section, the notice required by section 13.04, subdivision 2, 559.23 need not be provided to a minor under the age of ten who is the 559.24 alleged victim of abuse or neglect. An individual subject of a 559.25 record shall have access to the record in accordance with those 559.26 sections, except that the name of the reporter shall be 559.27 confidential while the report is under assessment or 559.28 investigation except as otherwise permitted by this 559.29 subdivision. Any person conducting an investigation or 559.30 assessment under this section who intentionally discloses the 559.31 identity of a reporter prior to the completion of the 559.32 investigation or assessment is guilty of a misdemeanor. After 559.33 the assessment or investigation is completed, the name of the 559.34 reporter shall be confidential. The subject of the report may 559.35 compel disclosure of the name of the reporter only with the 559.36 consent of the reporter or upon a written finding by the court 560.1 that the report was false and that there is evidence that the 560.2 report was made in bad faith. This subdivision does not alter 560.3 disclosure responsibilities or obligations under the rules of 560.4 criminal procedure. 560.5 (b) Upon request of the legislative auditor, data on 560.6 individuals maintained under this section must be released to 560.7 the legislative auditor in order for the auditor to fulfill the 560.8 auditor's duties under section 3.971. The auditor shall 560.9 maintain the data in accordance with chapter 13. 560.10 (c) The investigating agency shall exchange not public data 560.11 with the child maltreatment review panel under section 256.022 560.12 if the data are pertinent and necessary for a review requested 560.13 under section 256.022. Upon completion of the review, the not 560.14 public data received by the review panel must be returned to the 560.15 investigating agency. 560.16 [EFFECTIVE DATE.] This section is effective July 1, 2001. 560.17 Sec. 12. Minnesota Statutes 2000, section 626.556, 560.18 subdivision 12, is amended to read: 560.19 Subd. 12. [DUTIES OF FACILITY OPERATORS.] Any operator, 560.20 employee, or volunteer worker at any facility who intentionally 560.21 neglects, physically abuses, or sexually abuses any child in the 560.22 care of that facility may be charged with a violation of section 560.23 609.255, 609.377, or 609.378. Any operator of a facility who 560.24 knowingly permits conditions to exist which result in neglect, 560.25 physical abuse,orsexual abuse, or maltreatment of a child in a 560.26 facility while in the care of that facility may be charged with 560.27 a violation of section 609.378. The facility operator shall 560.28 inform all mandated reporters employed by or otherwise 560.29 associated with the facility of the duties required of mandated 560.30 reporters and shall inform all mandatory reporters of the 560.31 prohibition against retaliation for reports made in good faith 560.32 under this section. 560.33 Sec. 13. Minnesota Statutes 2000, section 626.559, 560.34 subdivision 2, is amended to read: 560.35 Subd. 2. [JOINT TRAINING.] The commissioners of human 560.36 services and public safety shall cooperate in the development of 561.1 a joint program for training child abuse services professionals 561.2 in the appropriate techniques for child abuse assessment and 561.3 investigation. The program shall include but need not be 561.4 limited to the following areas: 561.5 (1) the public policy goals of the state as set forth in 561.6 section 260C.001 and the role of the assessment or investigation 561.7 in meeting these goals; 561.8 (2) the special duties of child protection workers and law 561.9 enforcement officers under section 626.556; 561.10 (3) the appropriate methods for directing and managing 561.11 affiliated professionals who may be utilized in providing 561.12 protective services and strengthening family ties; 561.13 (4) the appropriate methods for interviewing alleged 561.14 victims of child abuse and other minors in the course of 561.15 performing an assessment or an investigation; 561.16 (5) the dynamics of child abuse and neglect within family 561.17 systems and the appropriate methods for interviewing parents in 561.18 the course of the assessment or investigation, including 561.19 training in recognizing cases in which one of the parents is a 561.20 victim of domestic abuse and in need of special legal or medical 561.21 services; 561.22 (6) the legal, evidentiary considerations that may be 561.23 relevant to the conduct of an assessment or an investigation; 561.24 (7) the circumstances under which it is appropriate to 561.25 remove the alleged abuser or the alleged victim from the home; 561.26 (8) the protective social services that are available to 561.27 protect alleged victims from further abuse, to prevent child 561.28 abuse and domestic abuse, and to preserve the family unit, and 561.29 training in the preparation of case plans to coordinate services 561.30 for the alleged child abuse victim with services for any parents 561.31 who are victims of domestic abuse;and561.32 (9) the methods by which child protection workers and law 561.33 enforcement workers cooperate in conducting assessments and 561.34 investigations in order to avoid duplication of efforts; and 561.35 (10) appropriate methods for interviewing alleged victims 561.36 of child abuse and conducting investigations in cases where the 562.1 alleged victim is developmentally, physically, or mentally 562.2 disabled. 562.3 Sec. 14. [CHILD WELFARE COST CONSOLIDATION REPORT.] 562.4 By January 15, 2002, the commissioner of human services 562.5 shall report to the chairs and ranking minority members of 562.6 appropriate legislative committees the feasibility and cost of 562.7 creating a single benefit package for all children removed from 562.8 the care of a parent or guardian pursuant to a court order under 562.9 Minnesota Statutes, chapter 260C, regardless of a particular 562.10 child's legal status. Legal status includes any placement away 562.11 from the parent or guardian, including foster or other 562.12 residential care, guardianship with the commissioner, adoption, 562.13 or legal custody with a relative except a birth or adoptive 562.14 parent. The report shall be prepared after consultation with 562.15 public and private child-placing agencies, foster and adoptive 562.16 parents, relatives who are legal custodians, judges, county 562.17 attorneys, attorneys for children and parents, guardians ad 562.18 litem, representatives of the councils on Asian-Pacific, African 562.19 American, American Indian, and Spanish-speaking Minnesotans, and 562.20 other appropriate child protection system stakeholders. The 562.21 benefit package addressed in the report shall include the cost 562.22 of room and board, additional monthly payments associated with 562.23 special efforts a caretaker must make or special skills or 562.24 training a caretaker must have in order to adequately address 562.25 the daily needs of the child, the availability of respite care, 562.26 and any other costs associated with safely maintaining a 562.27 particular child in a legally secure home and adequately 562.28 addressing any special needs the child may have. 562.29 Sec. 15. [STUDY OF OUTCOMES FOR CHILDREN IN THE CHILD 562.30 PROTECTION SYSTEM.] 562.31 (a) The commissioner of human services, in consultation 562.32 with local social services agencies, councils of color, 562.33 representatives of communities of color, child advocates, 562.34 representatives of courts, and other interested parties, shall 562.35 study why African American children in Minnesota are 562.36 disproportionately represented in child welfare out-of-home 563.1 placements. The commissioner also shall study each stage of the 563.2 proceedings concerning children in need of protection or 563.3 services, including the point at which children enter the child 563.4 welfare system, each decision-making point in the child welfare 563.5 system, and the outcomes for children in the child welfare 563.6 system, to determine why outcomes for children differ by race. 563.7 The commissioner shall use child welfare performance and outcome 563.8 indicators and data and other available data as part of this 563.9 study. The commissioner also shall study and determine if there 563.10 are decision-making points in the child protection system that 563.11 lead to different outcomes for children and how those 563.12 decision-making points affect outcomes for children. The 563.13 commissioner shall report and make legislative recommendations 563.14 on the following: 563.15 (1) amend the child protection statutes to reduce any 563.16 identified disparities in the child protection system relating 563.17 to outcomes for children of color, as compared to white 563.18 children; 563.19 (2) reduce any identified bias in the child protection 563.20 system; 563.21 (3) reduce the number and duration of out-of-home 563.22 placements for African American children; and 563.23 (4) improve the long-term outcomes for African American 563.24 children in out-of-home placements. 563.25 (b) The commissioner of human services shall submit the 563.26 report and recommended legislation to the chairs and ranking 563.27 minority members of the committees in the house of 563.28 representatives and senate with jurisdiction over child 563.29 protection and out-of-home placement issues by January 15, 2002. 563.30 ARTICLE 12 563.31 CHILD SUPPORT 563.32 Section 1. Minnesota Statutes 2000, section 13B.06, 563.33 subdivision 7, is amended to read: 563.34 Subd. 7. [FEES.] A financial institution may charge and 563.35 collect a fee from the public authority for providing account 563.36 information to the public authority. The commissioner may pay a 564.1 financial institution up to $150 each quarter if the 564.2 commissioner and the financial institution have entered into a 564.3 signed agreement that complies with federal law. The 564.4 commissioner shall develop procedures for the financial 564.5 institutions to charge and collect the fee. Payment of the fee 564.6 is limited by the amount of the appropriation for this purpose. 564.7 If the appropriation is insufficient, or if fund availability in 564.8 the fourth quarter would allow payments for actual costs in 564.9 excess of $150, the commissioner shall prorate the available 564.10 funds among the financial institutions that have submitted a 564.11 claim for the fee. No financial institution shall charge or 564.12 collect a fee that exceeds its actual costs of complying with 564.13 this section. The commissioner, together with an advisory group 564.14 consisting of representatives of the financial institutions in 564.15 the state, shalldetermine a fee structure that minimizes the564.16cost to the state and reasonably meets the needs of the564.17financial institutions, and shall report to the chairs of the564.18judiciary committees in the house of representatives and the564.19senate by February 1, 1998, a recommended fee structure for564.20inclusion in this sectionevaluate whether the fee paid to 564.21 financial institutions compensates them for their actual costs, 564.22 including start-up costs, of complying with this section and 564.23 shall submit a report to the legislature by July 1, 2002, with a 564.24 recommendation for retaining or modifying the fee. 564.25 Sec. 2. Minnesota Statutes 2000, section 256.741, 564.26 subdivision 1, is amended to read: 564.27 Subdivision 1. [PUBLIC ASSISTANCE.] (a) The term "direct 564.28 support" as used in this chapter and chapters 257, 518, and 518C 564.29 refers to an assigned support payment from an obligor which is 564.30 paid directly to a recipient of TANF or MFIP. 564.31 (b) The term "public assistance" as used in this chapter 564.32 and chapters 257, 518, and 518C, includes any form of assistance 564.33 provided under the AFDC program formerly codified in sections 564.34 256.72 to 256.87, MFIP and MFIP-R formerly codified under 564.35 chapter 256, MFIP under chapter 256J, work first program under 564.36 chapter 256K; child care assistance provided through the child 565.1 care fund under chapter 119B; any form of medical assistance 565.2 under chapter 256B; MinnesotaCare under chapter 256L; and foster 565.3 care as provided under title IV-E of the Social Security Act. 565.4(b)(c) The term "child support agency" as used in this 565.5 section refers to the public authority responsible for child 565.6 support enforcement. 565.7(c)(d) The term "public assistance agency" as used in this 565.8 section refers to a public authority providing public assistance 565.9 to an individual. 565.10 Sec. 3. Minnesota Statutes 2000, section 256.741, 565.11 subdivision 5, is amended to read: 565.12 Subd. 5. [COOPERATION WITH CHILD SUPPORT ENFORCEMENT.] 565.13 After notification from a public assistance agency that an 565.14 individual has applied for or is receiving any form of public 565.15 assistance, the child support agency shall determine whether the 565.16 party is cooperating with the agency in establishing paternity, 565.17 child support, modification of an existing child support order, 565.18 or enforcement of an existing child support order. The public 565.19 assistance agency shall notify each applicant or recipient in 565.20 writing of the right to claim a good cause exemption from 565.21 cooperating with the requirements in this section. A copy of 565.22 the notice must be furnished to the applicant or recipient, and 565.23 the applicant or recipient and a representative from the public 565.24 authority shall acknowledge receipt of the notice by signing and 565.25 dating a copy of the notice. The individual shall cooperate 565.26 with the child support agency by: 565.27 (1) providing all known information regarding the alleged 565.28 father or obligor, including name, address, social security 565.29 number, telephone number, place of employment or school, and the 565.30 names and addresses of any relatives; 565.31 (2) appearing at interviews, hearings and legal 565.32 proceedings; 565.33 (3) submitting to genetic tests including genetic testing 565.34 of the child, under a judicial or administrative order; and 565.35 (4) providing additional information known by the 565.36 individual as necessary for cooperating in good faith with the 566.1 child support agency. 566.2 The caregiver of a minor child must cooperate with the 566.3 efforts of the public authority to collect support according to 566.4 this subdivision. A caregiver mustforward tonotify the public 566.5 authority of all support the caregiver receives during the 566.6 period the assignment of support required under subdivision 2 is 566.7 in effect.Support received by a caregiver and not forwarded to566.8the public authority must be repaid to the child support566.9enforcement unit for any month following the date on which566.10initial eligibility is determinedDirect support retained by a 566.11 caregiver must be counted as unearned income when determining 566.12 the amount of the assistance payment,except as provided under566.13subdivision 8, paragraph (b), clause (4)and repaid to the child 566.14 support agency for any month when the direct support retained is 566.15 greater than the court-ordered child support and the assistance 566.16 payment and the obligor owes support arrears. 566.17 Sec. 4. Minnesota Statutes 2000, section 256.741, 566.18 subdivision 8, is amended to read: 566.19 Subd. 8. [REFUSAL TO COOPERATE WITH SUPPORT REQUIREMENTS.] 566.20 (a) Failure by a caregiver to satisfy any of the requirements of 566.21 subdivision 5 constitutes refusal to cooperate, and the 566.22 sanctions under paragraph (b) apply. The IV-D agency must 566.23 determine whether a caregiver has refused to cooperate according 566.24 to subdivision 5. 566.25 (b) Determination by the IV-D agency that a caregiver has 566.26 refused to cooperate has the following effects: 566.27 (1) a caregiver is subject to the applicable sanctions 566.28 under section 256J.46; 566.29 (2) a caregiver who is not a parent of a minor child in an 566.30 assistance unit may choose to remove the child from the 566.31 assistance unit unless the child is required to be in the 566.32 assistance unit; and 566.33 (3) a parental caregiver who refuses to cooperate is 566.34 ineligible for medical assistance; and566.35(4) direct support retained by a caregiver must be counted566.36as unearned income when determining the amount of the assistance567.1payment. 567.2 Sec. 5. Minnesota Statutes 2000, section 256.979, 567.3 subdivision 5, is amended to read: 567.4 Subd. 5. [PATERNITY ESTABLISHMENT AND CHILD SUPPORT ORDER 567.5 ESTABLISHMENT AND MODIFICATION BONUS INCENTIVES.] (a) A bonus 567.6 incentive program is created to increase the number of paternity 567.7 establishments and establishment and modifications of child 567.8 support orders done by county child support enforcement agencies. 567.9 (b) A bonus must be awarded to a county child support 567.10 agency for eachcasechild for which the agency completes a 567.11 paternity or child support order establishment or modification 567.12 through judicial or administrative processes. 567.13 (c) The rate of bonus incentive is $100 per child for each 567.14 paternity or child support order establishment and modification 567.15 set in a specific dollar amount. 567.16 (d) No bonus shall be paid for a modification that is a 567.17 result of a termination of child care costs according to section 567.18 518.551, subdivision 5, paragraph (b), or due solely to a 567.19 reduction of child care expenses. 567.20 Sec. 6. Minnesota Statutes 2000, section 256.979, 567.21 subdivision 6, is amended to read: 567.22 Subd. 6. [CLAIMS FOR BONUS INCENTIVE.] (a) The 567.23 commissioner of human services and the county agency shall 567.24 develop procedures for the claims process and criteria using 567.25 automated systems where possible. 567.26 (b) Only one county agency may receive a bonus per 567.27 paternity establishment or child support order establishment or 567.28 modification for eachcasechild. The county agency completing 567.29 the action or procedure needed to establish paternity or a child 567.30 support order or modify an order is the county agency entitled 567.31 to claim the bonus incentive. 567.32 (c) Disputed claims must be submitted to the commissioner 567.33 of human services and the commissioner's decision is final. 567.34(d) For purposes of this section, "case" means a family567.35unit for whom the county agency is providing child support567.36enforcement services.568.1 Sec. 7. Minnesota Statutes 2000, section 393.07, is 568.2 amended by adding a subdivision to read: 568.3 Subd. 9a. [ADMINISTRATIVE PENALTIES.] (a) The public 568.4 authority, as defined in section 518.54, may sanction an 568.5 employer or payor of funds $25 per day, up to $500 per incident, 568.6 for failing to comply with section 518.5513, subdivision 5, 568.7 paragraph (a), clauses (5) and (8), if: 568.8 (1) the public authority mails the employer or payor of 568.9 funds by certified mail a notice of an administrative sanction, 568.10 at the employer's or payor's of funds last known address, which 568.11 includes the date the sanction will take effect, the amount of 568.12 the sanction, the reason for imposing the sanction, and the 568.13 corrective action that must be taken to avoid the sanction; and 568.14 (2) the employer or payor of funds fails to correct the 568.15 violation before the effective date of the sanction. 568.16 (b) The public authority shall include with the sanction 568.17 notice an additional notice of the right to appeal the sanction 568.18 and the process for making the appeal. 568.19 (c) Unless an appeal is made, the administrative 568.20 determination of the sanction is final and binding. 568.21 Sec. 8. Minnesota Statutes 2000, section 518.5513, 568.22 subdivision 5, is amended to read: 568.23 Subd. 5. [ADMINISTRATIVE AUTHORITY.] (a) The public 568.24 authority may take the following actions relating to 568.25 establishment of paternity or to establishment, modification, or 568.26 enforcement of support orders, without the necessity of 568.27 obtaining an order from any judicial or administrative tribunal: 568.28 (1) recognize and enforce orders of child support agencies 568.29 of other states; 568.30 (2) upon request for genetic testing by a child, parent, or 568.31 any alleged parent, and using the procedure in paragraph (b), 568.32 order the child, parent, or alleged parent to submit to blood or 568.33 genetic testing for the purpose of establishing paternity; 568.34 (3) subpoena financial or other information needed to 568.35 establish, modify, or enforce a child support order andrequest568.36sanctionssanction a party for failure to respond to a subpoena; 569.1 (4) upon notice to the obligor, obligee, and the 569.2 appropriate court, direct the obligor or other payor to change 569.3 the payee to the central collections unit under sections 569.4 518.5851 to 518.5853; 569.5 (5) order income withholding of child support under section 569.6 518.6111 and sanction an employer or payor of funds pursuant to 569.7 section 393.07, subdivision 9a, for failing to comply with an 569.8 income withholding notice; 569.9 (6) secure assets to satisfy the debt or arrearage in cases 569.10 in which there is a support debt or arrearage by: 569.11 (i) intercepting or seizing periodic or lump sum payments 569.12 from state or local agencies, including unemployment benefits, 569.13 workers' compensation payments, judgments, settlements, 569.14 lotteries, and other lump sum payments; 569.15 (ii) attaching and seizing assets of the obligor held in 569.16 financial institutions or public or private retirement funds; 569.17 and 569.18 (iii) imposing liens in accordance with section 548.091 569.19 and, in appropriate cases, forcing the sale of property and the 569.20 distribution of proceeds; 569.21 (7) for the purpose of securing overdue support, increase 569.22 the amount of the monthly support payments by an additional 569.23 amount equal to 20 percent of the monthly support payment to 569.24 include amounts for debts or arrearages; and 569.25 (8) subpoena an employer or payor of funds to provide 569.26 promptly information on the employment, compensation, and 569.27 benefits of an individual employed by that employer as an 569.28 employee or contractor, andto request sanctionssanction an 569.29 employer or payor of funds pursuant to section 393.07, 569.30 subdivision 9a, for failure to respond to the subpoenaas569.31provided by law. 569.32 (b) A request for genetic testing by a child, parent, or 569.33 alleged parent must be supported by a sworn statement by the 569.34 person requesting genetic testing alleging paternity, which sets 569.35 forth facts establishing a reasonable possibility of the 569.36 requisite sexual contact between the parties, or denying 570.1 paternity, and setting forth facts establishing a reasonable 570.2 possibility of the nonexistence of sexual contact between the 570.3 alleged parties. The order for genetic tests may be served 570.4 anywhere within the state and served outside the state in the 570.5 same manner as prescribed by law for service of subpoenas issued 570.6 by the district court of this state. If the child, parent, or 570.7 alleged parent fails to comply with the genetic testing order, 570.8 the public authority may seek to enforce that order in district 570.9 court through a motion to compel testing. No results obtained 570.10 through genetic testing done in response to an order issued 570.11 under this section may be used in any criminal proceeding. 570.12 (c) Subpoenas may be served anywhere within the state and 570.13 served outside the state in the same manner as prescribed by law 570.14 for service of process of subpoenas issued by the district court 570.15 of this state. When a subpoena under this subdivision is served 570.16 on a third-party recordkeeper, written notice of the subpoena 570.17 shall be mailed to the person who is the subject of the 570.18 subpoenaed material at the person's last known address within 570.19 three days of the day the subpoena is served. This notice 570.20 provision does not apply if there is reasonable cause to believe 570.21 the giving of the notice may lead to interference with the 570.22 production of the subpoenaed documents. 570.23 (d) A person served with a subpoena may make a written 570.24 objection to the public authority or court before the time 570.25 specified in the subpoena for compliance. The public authority 570.26 or the court shall cancel or modify the subpoena, if 570.27 appropriate. The public authority shall pay the reasonable 570.28 costs of producing the documents, if requested. 570.29 (e) Subpoenas are enforceable in the same manner as 570.30 subpoenas of the district court. Upon motion of the county 570.31 attorney, the court may issue an order directing the production 570.32 of the records. Failure to comply with the court order may 570.33 subject the person who fails to comply to civil or criminal 570.34 contempt of court. 570.35 (f) The administrative actions under this subdivision are 570.36 subject to due process safeguards, including requirements for 571.1 notice, opportunity to contest the action, and opportunity to 571.2 appeal the order to the judge, judicial officer, or child 571.3 support magistrate. 571.4 Sec. 9. Minnesota Statutes 2000, section 518.575, 571.5 subdivision 1, is amended to read: 571.6 Subdivision 1. [MAKING NAMES PUBLIC.] At least once each 571.7 year, the commissioner of human services, in consultation with 571.8 the attorney general,shallmay publish a list of the names and 571.9 other identifying information of no more than 25 persons who (1) 571.10 are child support obligors, (2) are at least $10,000 in arrears, 571.11 (3) are not in compliance with a written payment agreement 571.12 regarding both current support and arrearages approved by the 571.13 court, a child support magistrate, or the public authority, (4) 571.14 cannot currently be located by the public authority for the 571.15 purposes of enforcing a support order, and (5) have not made a 571.16 support payment except tax intercept payments, in the preceding 571.17 12 months. 571.18 Identifying information may include the obligor's name, 571.19 last known address, amount owed, date of birth, photograph, the 571.20 number of children for whom support is owed, and any additional 571.21 information about the obligor that would assist in identifying 571.22 or locating the obligor. The commissioner and attorney general 571.23 may use posters, media presentations, electronic technology, and 571.24 other means that the commissioner and attorney general determine 571.25 are appropriate for dissemination of the information, including 571.26 publication on the Internet. The commissioner and attorney 571.27 general may make any or all of the identifying information 571.28 regarding these persons public. Information regarding an 571.29 obligor who meets the criteria in this subdivision will only be 571.30 made public subsequent to that person's selection by the 571.31 commissioner and attorney general. 571.32 Before making public the name of the obligor, the 571.33 department of human services shall send a notice to the 571.34 obligor's last known address which states the department's 571.35 intention to make public information on the obligor. The notice 571.36 must also provide an opportunity to have the obligor's name 572.1 removed from the list by paying the arrearage or by entering 572.2 into an agreement to pay the arrearage, or by providing 572.3 information to the public authority that there is good cause not 572.4 to make the information public. The notice must include the 572.5 final date when the payment or agreement can be accepted. 572.6 The department of human services shall obtain the written 572.7 consent of the obligee to make the name of the obligor public. 572.8 Sec. 10. Minnesota Statutes 2000, section 518.5851, is 572.9 amended by adding a subdivision to read: 572.10 Subd. 7. [UNCLAIMED SUPPORT FUNDS.] "Unclaimed support 572.11 funds" means any support payments collected by the public 572.12 authority from the obligor, which have not been disbursed to the 572.13 obligee or public authority. 572.14 Sec. 11. Minnesota Statutes 2000, section 518.5853, is 572.15 amended by adding a subdivision to read: 572.16 Subd. 12. [UNCLAIMED SUPPORT FUNDS.] (a) If support 572.17 payments have not been disbursed to an obligee because the 572.18 obligee is not located, the public authority shall continue 572.19 locate efforts for one year from the date the public authority 572.20 determines that the obligee is not located. 572.21 (b) If the public authority is unable to locate the obligee 572.22 after one year, the public authority shall mail a written notice 572.23 to the obligee at the obligee's last known address. The notice 572.24 shall give the obligee 60 days to contact the public authority. 572.25 If the obligee does not contact the public authority within 60 572.26 days from the date of notice, the public authority shall: 572.27 (1) close the nonpublic assistance portion of the case; 572.28 (2) disburse unclaimed support funds to pay public 572.29 assistance arrears. If public assistance arrears remain after 572.30 disbursing the unclaimed support funds, the public authority may 572.31 continue enforcement and collection of child support until all 572.32 public assistance arrears have been paid. If there are no 572.33 public assistance arrears, or unclaimed support funds remain 572.34 after paying public assistance arrears, remaining unclaimed 572.35 support funds shall be returned to the obligor; and 572.36 (3) mail, when all public assistance arrears have been paid 573.1 the public authority, to the obligor at the obligor's last known 573.2 address a written notice of termination of income withholding 573.3 and case closure due to the public authority's inability to 573.4 locate the obligee. The notice must indicate that the obligor's 573.5 support or maintenance obligation will remain in effect until 573.6 further order of the court and must inform the obligor that the 573.7 obligor can contact the public authority for assistance to 573.8 modify the order. A copy of the form prepared by the state 573.9 court administrator's office under section 518.64, subdivision 573.10 5, must be included with the notice. 573.11 (c) If the obligor is not located when attempting to return 573.12 unclaimed support funds, the public authority shall continue 573.13 locate efforts for one year from the date the public authority 573.14 determines that the obligor is not located. If the public 573.15 authority is unable to locate the obligor after one year, the 573.16 funds shall be treated as unclaimed property according to 573.17 federal law and chapter 345. 573.18 Sec. 12. Minnesota Statutes 2000, section 518.6111, 573.19 subdivision 5, is amended to read: 573.20 Subd. 5. [PAYOR OF FUNDS RESPONSIBILITIES.] (a) An order 573.21 for or notice of withholding is binding on a payor of funds upon 573.22 receipt. Withholding must begin no later than the first pay 573.23 period that occurs after 14 days following the date of receipt 573.24 of the order for or notice of withholding. In the case of a 573.25 financial institution, preauthorized transfers must occur in 573.26 accordance with a court-ordered payment schedule. 573.27 (b) A payor of funds shall withhold from the income payable 573.28 to the obligor the amount specified in the order or notice of 573.29 withholding and amounts specified under subdivisions 6 and 9 and 573.30 shall remit the amounts withheld to the public authority within 573.31 seven business days of the date the obligor is paid the 573.32 remainder of the income. The payor of funds shall include with 573.33 the remittance the social security number of the obligor, the 573.34 case type indicator as provided by the public authority and the 573.35 date the obligor is paid the remainder of the income. The 573.36 obligor is considered to have paid the amount withheld as of the 574.1 date the obligor received the remainder of the income. A payor 574.2 of funds may combine all amounts withheld from one pay period 574.3 into one payment to each public authority, but shall separately 574.4 identify each obligor making payment. 574.5 (c) A payor of funds shall not discharge, or refuse to 574.6 hire, or otherwise discipline an employee as a result of wage or 574.7 salary withholding authorized by this section. A payor of funds 574.8 shall be liable to the obligee for any amounts required to be 574.9 withheld. A payor of funds that fails to withhold or transfer 574.10 funds in accordance with this section is also liable to the 574.11 obligee for interest on the funds at the rate applicable to 574.12 judgments under section 549.09, computed from the date the funds 574.13 were required to be withheld or transferred. A payor of funds 574.14 is liable for reasonable attorney fees of the obligee or public 574.15 authority incurred in enforcing the liability under this 574.16 paragraph. A payor of funds that has failed to comply with the 574.17 requirements of this section is subject to contempt sanctions 574.18 under section 518.615. If the payor of funds is an employer or 574.19 independent contractor and violates this subdivision, a court 574.20 may award the obligor twice the wages lost as a result of this 574.21 violation. If a court finds a payor of funds violated this 574.22 subdivision, the court shall impose a civil fine of not less 574.23 than $500. The liabilities in this paragraph apply to 574.24 intentional noncompliance with this section. 574.25 (d) If a single employee is subject to multiple withholding 574.26 orders or multiple notices of withholding for the support of 574.27 more than one child, the payor of funds shall comply with all of 574.28 the orders or notices to the extent that the total amount 574.29 withheld from the obligor's income does not exceed the limits 574.30 imposed under the Consumer Credit Protection Act, United States 574.31 Code, title 15, section 1673(b), giving priority to amounts 574.32 designated in each order or notice as current support as follows: 574.33 (1) if the total of the amounts designated in the orders 574.34 for or notices of withholding as current support exceeds the 574.35 amount available for income withholding, the payor of funds 574.36 shall allocate to each order or notice an amount for current 575.1 support equal to the amount designated in that order or notice 575.2 as current support, divided by the total of the amounts 575.3 designated in the orders or notices as current support, 575.4 multiplied by the amount of the income available for income 575.5 withholding; and 575.6 (2) if the total of the amounts designated in the orders 575.7 for or notices of withholding as current support does not exceed 575.8 the amount available for income withholding, the payor of funds 575.9 shall pay the amounts designated as current support, and shall 575.10 allocate to each order or notice an amount for past due support, 575.11 equal to the amount designated in that order or notice as past 575.12 due support, divided by the total of the amounts designated in 575.13 the orders or notices as past due support, multiplied by the 575.14 amount of income remaining available for income withholding 575.15 after the payment of current support. 575.16 (e) When an order for or notice of withholding is in effect 575.17 and the obligor's employment is terminated, the obligor and the 575.18 payor of funds shall notify the public authority of the 575.19 termination within ten days of the termination date. The 575.20 termination notice shall include the obligor's home address and 575.21 the name and address of the obligor's new payor of funds, if 575.22 known. 575.23 (f) A payor of funds may deduct one dollar from the 575.24 obligor's remaining salary for each payment made pursuant to an 575.25 order for or notice of withholding under this section to cover 575.26 the expenses of withholding. 575.27 Sec. 13. Minnesota Statutes 2000, section 518.6195, is 575.28 amended to read: 575.29 518.6195 [COLLECTION; ARREARS ONLY.] 575.30 (a) Remedies available for the collection and enforcement 575.31 of support in this chapter and chapters 256, 257, and 518C also 575.32 apply to cases in which the child or children for whom support 575.33 is owed are emancipated and the obligor owes past support or has 575.34 an accumulated arrearage as of the date of the youngest child's 575.35 emancipation. Child support arrearages under this section 575.36 include arrearages for child support, medical support, child 576.1 care, pregnancy and birth expenses, and unreimbursed medical 576.2 expenses as defined in section 518.171. 576.3 (b) This section applies retroactively to any support 576.4 arrearage that accrued on or before the date of enactment and to 576.5 all arrearages accruing after the date of enactment. 576.6 (c) Past support or pregnancy and confinement expenses 576.7 ordered for which the obligor has specific court ordered terms 576.8 for repayment may not be enforced using drivers' and 576.9 occupational or professional license suspension, credit bureau 576.10 reporting, and additional income withholding under section 576.11 518.6111, subdivision 10, paragraph (a), unless the obligor 576.12 fails to comply with the terms of the court order for repayment. 576.13 (d) If an arrearage exists at the time a support order 576.14 would otherwise terminate and section 518.6111, subdivision 10, 576.15 paragraph (c), does not apply to this section, the arrearage 576.16 shall be repaid in an amount equal to the current support order 576.17 until all arrears have been paid in full, absent a court order 576.18 to the contrary. 576.19 (e) If an arrearage exists according to a support order 576.20 which fails to establish a monthly support obligation in a 576.21 specific dollar amount, the public authority, if it provides 576.22 child support services, or the obligee, may establish a payment 576.23 agreement which shall equal what the obligor would pay for 576.24 current support after application of section 518.551, plus an 576.25 additional 20 percent of the current support obligation, until 576.26 all arrears have been paid in full. If the obligor fails to 576.27 enter into or comply with a payment agreement, the public 576.28 authority, if it provides child support services, or the 576.29 obligee, may move the district court or child support 576.30 magistrate, if section 484.702 applies, for an order 576.31 establishing repayment terms. 576.32 Sec. 14. Minnesota Statutes 2000, section 518.64, 576.33 subdivision 2, as amended by Laws 2001, chapter 51, section 16, 576.34 is amended to read: 576.35 Subd. 2. [MODIFICATION.] (a) The terms of an order 576.36 respecting maintenance or support may be modified upon a showing 577.1 of one or more of the following: (1) substantially increased or 577.2 decreased earnings of a party; (2) substantially increased or 577.3 decreased need of a party or the child or children that are the 577.4 subject of these proceedings; (3) receipt of assistance under 577.5 the AFDC program formerly codified under sections 256.72 to 577.6 256.87 or 256B.01 to 256B.40, or chapter 256J or 256K; (4) a 577.7 change in the cost of living for either party as measured by the 577.8 federal bureau of statistics, any of which makes the terms 577.9 unreasonable and unfair; (5) extraordinary medical expenses of 577.10 the child not provided for under section 518.171; or (6) the 577.11 addition of work-related or education-related child care 577.12 expenses of the obligee or a substantial increase or decrease in 577.13 existing work-related or education-related child care expenses. 577.14 On a motion to modify support, the needs of any child the 577.15 obligor has after the entry of the support order that is the 577.16 subject of a modification motion shall be considered as provided 577.17 by section 518.551, subdivision 5f. 577.18 (b) It is presumed that there has been a substantial change 577.19 in circumstances under paragraph (a) and the terms of a current 577.20 support order shall be rebuttably presumed to be unreasonable 577.21 and unfair if: 577.22 (1) the application of the child support guidelines in 577.23 section 518.551, subdivision 5, to the current circumstances of 577.24 the parties results in a calculated court order that is at least 577.25 20 percent and at least $50 per month higher or lower than the 577.26 current support order; 577.27 (2) the medical support provisions of the order established 577.28 under section 518.171 are not enforceable by the public 577.29 authority or the obligee; 577.30 (3) health coverage ordered under section 518.171 is not 577.31 available to the child for whom the order is established by the 577.32 parent ordered to provide; or 577.33 (4) the existing support obligation is in the form of a 577.34 statement of percentage and not a specific dollar amount. 577.35 (c) On a motion for modification of maintenance, including 577.36 a motion for the extension of the duration of a maintenance 578.1 award, the court shall apply, in addition to all other relevant 578.2 factors, the factors for an award of maintenance under section 578.3 518.552 that exist at the time of the motion. On a motion for 578.4 modification of support, the court: 578.5 (1) shall apply section 518.551, subdivision 5, and shall 578.6 not consider the financial circumstances of each party's spouse, 578.7 if any; and 578.8 (2) shall not consider compensation received by a party for 578.9 employment in excess of a 40-hour work week, provided that the 578.10 party demonstrates, and the court finds, that: 578.11 (i) the excess employment began after entry of the existing 578.12 support order; 578.13 (ii) the excess employment is voluntary and not a condition 578.14 of employment; 578.15 (iii) the excess employment is in the nature of additional, 578.16 part-time employment, or overtime employment compensable by the 578.17 hour or fractions of an hour; 578.18 (iv) the party's compensation structure has not been 578.19 changed for the purpose of affecting a support or maintenance 578.20 obligation; 578.21 (v) in the case of an obligor, current child support 578.22 payments are at least equal to the guidelines amount based on 578.23 income not excluded under this clause; and 578.24 (vi) in the case of an obligor who is in arrears in child 578.25 support payments to the obligee, any net income from excess 578.26 employment must be used to pay the arrearages until the 578.27 arrearages are paid in full. 578.28 (d) A modification of support or maintenance, including 578.29 interest that accrued pursuant to section 548.091, may be made 578.30 retroactive only with respect to any period during which the 578.31 petitioning party has pending a motion for modification but only 578.32 from the date of service of notice of the motion on the 578.33 responding party and on the public authority if public 578.34 assistance is being furnished or the county attorney is the 578.35 attorney of record. However, modification may be applied to an 578.36 earlier period if the court makes express findings that: 579.1 (1) the party seeking modification was precluded from 579.2 serving a motion by reason of a significant physical or mental 579.3 disability, a material misrepresentation of another party, or 579.4 fraud upon the court and that the party seeking modification, 579.5 when no longer precluded, promptly served a motion; 579.6 (2) the party seeking modification was a recipient of 579.7 federal Supplemental Security Income (SSI), Title II Older 579.8 Americans, Survivor's Disability Insurance (OASDI), other 579.9 disability benefits, or public assistance based upon need during 579.10 the period for which retroactive modification is sought;or579.11 (3) the order for which the party seeks amendment was 579.12 entered by default, the party shows good cause for not 579.13 appearing, and the record contains no factual evidence, or 579.14 clearly erroneous evidence regarding the individual obligor's 579.15 ability to pay.; or 579.16 (4) the party seeking modification was institutionalized or 579.17 incarcerated for an offense other than nonsupport of a child 579.18 during the period for which retroactive modification is sought 579.19 and lacked the financial ability to pay the support ordered 579.20 during that time period. In determining whether to allow the 579.21 retroactive modification, the court shall consider whether and 579.22 when a request was made to the public authority for support 579.23 modification. 579.24 The court may provide that a reduction in the amount allocated 579.25 for child care expenses based on a substantial decrease in the 579.26 expenses is effective as of the date the expenses decreased. 579.27 (e) Except for an award of the right of occupancy of the 579.28 homestead, provided in section 518.63, all divisions of real and 579.29 personal property provided by section 518.58 shall be final, and 579.30 may be revoked or modified only where the court finds the 579.31 existence of conditions that justify reopening a judgment under 579.32 the laws of this state, including motions under section 518.145, 579.33 subdivision 2. The court may impose a lien or charge on the 579.34 divided property at any time while the property, or subsequently 579.35 acquired property, is owned by the parties or either of them, 579.36 for the payment of maintenance or support money, or may 580.1 sequester the property as is provided by section 518.24. 580.2 (f) The court need not hold an evidentiary hearing on a 580.3 motion for modification of maintenance or support. 580.4 (g) Section 518.14 shall govern the award of attorney fees 580.5 for motions brought under this subdivision. 580.6 Sec. 15. Minnesota Statutes 2000, section 518.641, 580.7 subdivision 1, is amended to read: 580.8 Subdivision 1. [REQUIREMENT.] (a) An orderfor580.9 establishing, modifying, or enforcing maintenance or child 580.10 support shall provide for a biennial adjustment in the amount to 580.11 be paid based on a change in the cost of living. An order that 580.12 provides for a cost-of-living adjustment shall specify the 580.13 cost-of-living index to be applied and the date on which the 580.14 cost-of-living adjustment shall become effective. The court may 580.15 use the consumer price index for all urban consumers, 580.16 Minneapolis-St. Paul (CPI-U), the consumer price index for wage 580.17 earners and clerical, Minneapolis-St. Paul (CPI-W), or another 580.18 cost-of-living index published by the department of labor which 580.19 it specifically finds is more appropriate. Cost-of-living 580.20 increases under this section shall be compounded. The court may 580.21 also increase the amount by more than the cost-of-living 580.22 adjustment by agreement of the parties or by making further 580.23 findings. 580.24 (b) The adjustment becomes effective on the first of May of 580.25 the year in which it is made, for cases in which payment is made 580.26 to the public authority. For cases in which payment is not made 580.27 to the public authority, application for an adjustment may be 580.28 made in any month but no application for an adjustment may be 580.29 made sooner than two years after the date of the dissolution 580.30 decree. A court may waive the requirement of the cost-of-living 580.31 clause if it expressly finds that the obligor's occupation or 580.32 income, or both, does not provide for cost-of-living adjustment 580.33 or that the order for maintenance or child support has a 580.34 provision such as a step increase that has the effect of a 580.35 cost-of-living clause. The court may waive a cost-of-living 580.36 adjustment in a maintenance order if the parties so agree in 581.1 writing. The commissioner of human services may promulgate 581.2 rules for child support adjustments under this section in 581.3 accordance with the rulemaking provisions of chapter 14. Notice 581.4 of this statute must comply with section 518.68, subdivision 2. 581.5 Sec. 16. Minnesota Statutes 2000, section 518.641, 581.6 subdivision 2, is amended to read: 581.7 Subd. 2. [CONDITIONSNOTICE.] No adjustment under this 581.8 section may be made unless the order provides for it anduntil581.9the following conditions are met:581.10(a) the obligee serves notice of the application for581.11adjustment by mail on the obligor at the obligor's last known581.12address at least 20 days before the effective date of the581.13adjustment;581.14(b) the notice to the obligor informs the obligor of the581.15date on which the adjustment in payments will become effective;581.16(c) after receipt of notice and before the effective day of581.17the adjustment, the obligor fails to request a hearing on the581.18issue of whether the adjustment should take effect, and ex581.19parte, to stay imposition of the adjustment pending outcome of581.20the hearing; or581.21(d) the public authoritythe public authority or the 581.22 obligee, if the obligee is requesting the cost-of-living 581.23 adjustment, sends notice ofits application forthe intended 581.24 adjustment to the obligor at the obligor's last known address at 581.25 least 20 days before the effective date of the adjustment, and. 581.26 The noticeinformsshall inform the obligor of the date on which 581.27 the adjustment will become effective and the procedures for 581.28 contesting the adjustmentaccording to section 484.702. 581.29 Sec. 17. Minnesota Statutes 2000, section 518.641, is 581.30 amended by adding a subdivision to read: 581.31 Subd. 2a. [PROCEDURES FOR CONTESTING ADJUSTMENT.] (a) To 581.32 contest cost-of-living adjustments initiated by the public 581.33 authority or an obligee who has applied for or is receiving 581.34 child support and maintenance collection services from the 581.35 public authority, other than income withholding only services, 581.36 the obligor, before the effective date of the adjustment, must: 582.1 (1) file a motion contesting the cost-of-living adjustment 582.2 with the court administrator; and 582.3 (2) serve the motion by first-class mail on the public 582.4 authority and the obligee. 582.5 The hearing shall take place in the expedited child support 582.6 process as governed by section 484.702. 582.7 (b) To contest cost-of-living adjustments initiated by an 582.8 obligee who is not receiving child support and maintenance 582.9 collection services from the public authority, or for an obligee 582.10 who receives income withholding only services from the public 582.11 authority, the obligor must, before the effective date of the 582.12 adjustment: 582.13 (1) file a motion contesting the cost-of-living adjustment 582.14 with the court administrator; and 582.15 (2) serve the motion by first-class mail on the obligee. 582.16 The hearing shall take place in district court. 582.17 (c) Upon receipt of a motion contesting the cost-of-living 582.18 adjustment, the cost-of-living adjustment shall be stayed 582.19 pending further order of the court. 582.20 (d) The court administrator shall make available pro se 582.21 motion forms for contesting a cost-of-living adjustment under 582.22 this subdivision. 582.23 Sec. 18. Minnesota Statutes 2000, section 518.641, 582.24 subdivision 3, is amended to read: 582.25 Subd. 3. [RESULT OF HEARING.] If, at a hearing pursuant to 582.26 this section, the obligor establishes an insufficient cost of 582.27 living or other increase in income that prevents fulfillment of 582.28 the adjusted maintenance or child support obligation, the 582.29 court or child support magistrate may direct that all or part of 582.30 the adjustment not take effect. If, at the hearing, the obligor 582.31 does not establish this insufficient increase in income, the 582.32 adjustment shall take effect as of the date it would have become 582.33 effective had no hearing been requested. 582.34 Sec. 19. Minnesota Statutes 2000, section 548.091, 582.35 subdivision 1a, is amended to read: 582.36 Subd. 1a. [CHILD SUPPORT JUDGMENT BY OPERATION OF LAW.] 583.1 (a) Any payment or installment of support required by a judgment 583.2 or decree of dissolution or legal separation, determination of 583.3 parentage, an order under chapter 518C, an order under section 583.4 256.87, or an order under section 260B.331 or 260C.331, that is 583.5 not paid or withheld from the obligor's income as required under 583.6 section 518.6111, or which is ordered as child support by 583.7 judgment, decree, or order by a court in any other state, is a 583.8 judgment by operation of law on and after the date it is due, is 583.9 entitled to full faith and credit in this state and any other 583.10 state, and shall be entered and docketed by the court 583.11 administrator on the filing of affidavits as provided in 583.12 subdivision 2a. Except as otherwise provided by paragraph (b), 583.13 interest accrues from the date the unpaid amount due is greater 583.14 than the current support due at the annual rate provided in 583.15 section 549.09, subdivision 1, plus two percent, not to exceed 583.16 an annual rate of 18 percent. A payment or installment of 583.17 support that becomes a judgment by operation of law between the 583.18 date on which a party served notice of a motion for modification 583.19 under section 518.64, subdivision 2, and the date of the court's 583.20 order on modification may be modified under that subdivision. 583.21 (b) Notwithstanding the provisions of section 549.09, upon 583.22 motion to the court and upon proof by the obligor of 36 583.23 consecutive months of complete and timely payments of both 583.24 current support and court-ordered paybacks of a child support 583.25 debt or arrearage, the court may order interest on the remaining 583.26 debt or arrearage to stop accruing. Timely payments are those 583.27 made in the month in which they are due. If, after that time, 583.28 the obligor fails to make complete and timely payments of both 583.29 current support and court-ordered paybacks of child support debt 583.30 or arrearage, the public authority or the obligee may move the 583.31 court for the reinstatement of interest as of the month in which 583.32 the obligor ceased making complete and timely payments. 583.33 The court shall provide copies of all orders issued under 583.34 this section to the public authority. The commissioner of human 583.35 services shall prepare and make available to the court and the 583.36 parties forms to be submitted by the parties in support of a 584.1 motion under this paragraph. 584.2 (c) Notwithstanding the provisions of section 549.09, upon 584.3 motion to the court, the court may order interest on a child 584.4 support debt to stop accruing where the court finds that the 584.5 obligor is: 584.6 (1) unable to pay support because of a significant physical 584.7 or mental disability;or584.8 (2) a recipient of Supplemental Security Income (SSI), 584.9 Title II Older Americans Survivor's Disability Insurance 584.10 (OASDI), other disability benefits, or public assistance based 584.11 upon need; or 584.12 (3) institutionalized or incarcerated for at least 30 days 584.13 for an offense other than nonsupport of the child or children 584.14 involved, and is otherwise financially unable to pay support. 584.15 Sec. 20. [REPEALER.] 584.16 Minnesota Statutes 2000, section 518.641, subdivisions 4 584.17 and 5, are repealed. 584.18 ARTICLE 13 584.19 MISCELLANEOUS 584.20 Section 1. Minnesota Statutes 2000, section 144.1491, 584.21 subdivision 1, is amended to read: 584.22 Subdivision 1. [PENALTIES FOR BREACH OF CONTRACT.] A 584.23 program participant who fails to complete two years of obligated 584.24 service shall repay the amount paid, as well as a financial 584.25 penalty based upon the length of the service obligation not 584.26 fulfilled. If the participant has served at least one year, the 584.27 financial penalty is the number of unserved months multiplied by 584.28 $1,000. If the participant has served less than one year, the 584.29 financial penalty is the total number of obligated months 584.30 multiplied by $1,000. The commissioner shall report to the 584.31 appropriate health-related licensing board a participant who 584.32 fails to complete the service obligation and fails to repay the 584.33 amount paid or fails to pay any financial penalty owed under 584.34 this subdivision. 584.35 Sec. 2. Minnesota Statutes 2000, section 148.212, is 584.36 amended to read: 585.1 148.212 [TEMPORARY PERMIT.] 585.2 Upon receipt of the applicable licensure or reregistration 585.3 fee and permit fee, and in accordance with rules of the board, 585.4 the board may issue a nonrenewable temporary permit to practice 585.5 professional or practical nursing to an applicant for licensure 585.6 or reregistration who is not the subject of a pending 585.7 investigation or disciplinary action, nor disqualified for any 585.8 other reason, under the following circumstances: 585.9 (a) The applicant for licensure by examination under 585.10 section 148.211, subdivision 1, has graduated from an approved 585.11 nursing program within the 60 days preceding board receipt of an 585.12 affidavit of graduation or transcript and has been authorized by 585.13 the board to write the licensure examination for the first time 585.14 in the United States. The permit holder must practice 585.15 professional or practical nursing under the direct supervision 585.16 of a registered nurse. The permit is valid from the date of 585.17 issue until the date the board takes action on the application 585.18 or for 60 days whichever occurs first. 585.19 (b) The applicant for licensure by endorsement under 585.20 section 148.211, subdivision 2, is currently licensed to 585.21 practice professional or practical nursing in another state, 585.22 territory, or Canadian province. The permit is valid from 585.23 submission of a proper request until the date of board action on 585.24 the application. 585.25 (c) The applicant for licensure by endorsement under 585.26 section 148.211, subdivision 2, or for reregistration under 585.27 section 148.231, subdivision 5, is currently registered in a 585.28 formal, structured refresher course or its equivalent for nurses 585.29 that includes clinical practice. 585.30 (d) The applicant for licensure by examination under 585.31 section 148.211, subdivision 1, has been issued a Commission on 585.32 Graduates of Foreign Nursing Schools certificate, has completed 585.33 all requirements for licensure except the examination, and has 585.34 been authorized by the board to write the licensure examination 585.35 for the first time in the United States. The permit holder must 585.36 practice professional nursing under the direct supervision of a 586.1 registered nurse. The permit is valid from the date of issue 586.2 until the date the board takes action on the application or for 586.3 60 days, whichever occurs first. 586.4 Sec. 3. Minnesota Statutes 2000, section 148.284, is 586.5 amended to read: 586.6 148.284 [CERTIFICATION OF ADVANCED PRACTICE REGISTERED 586.7 NURSES.] 586.8 (a) No person shall practice advanced practice registered 586.9 nursing or use any title, abbreviation, or other designation 586.10 tending to imply that the person is an advanced practice 586.11 registered nurse, clinical nurse specialist, nurse anesthetist, 586.12 nurse-midwife, or nurse practitioner unless the person is 586.13 certified for such advanced practice registered nursing by a 586.14 national nurse certification organization. 586.15 (b) Paragraph (a) does not apply to an advanced practice 586.16 registered nurse who is within six months after completion of an 586.17 advanced practice registered nurse course of study and is 586.18 awaiting certification, provided that the person has not 586.19 previously failed the certification examination. 586.20 (c) An advanced practice registered nurse who has completed 586.21 a formal course of study as an advanced practice registered 586.22 nurse and has been certified by a national nurse certification 586.23 organization prior to January 1, 1999, may continue to practice 586.24 in the field of nursing in which the advanced practice 586.25 registered nurse is practicing as of July 1, 1999, regardless of 586.26 the type of certification held if the advanced practice 586.27 registered nurse is not eligible for the proper certification. 586.28 Sec. 4. Minnesota Statutes 2000, section 148B.21, 586.29 subdivision 6a, is amended to read: 586.30 Subd. 6a. [BACKGROUND CHECKS.] The board shall request a 586.31 criminal history background check from the superintendent of the 586.32 bureau of criminal apprehension on all applicants for initial 586.33 licensure. An application for a license under this section must 586.34 be accompanied by an executed criminal history consent form and 586.35 the fee for conducting the criminal history background 586.36 check. The board shall deposit all fees paid by applicants for 587.1 criminal history background checks under this subdivision into 587.2 the miscellaneous special revenue fund. The fees collected 587.3 under this subdivision are appropriated to the board for the 587.4 purpose of reimbursing the bureau of criminal apprehension for 587.5 the cost of the background checks upon their completion. 587.6 Sec. 5. Minnesota Statutes 2000, section 148B.22, 587.7 subdivision 3, is amended to read: 587.8 Subd. 3. [BACKGROUND CHECKS.] The board shall request a 587.9 criminal history background check from the superintendent of the 587.10 bureau of criminal apprehension on all licensees under its 587.11 jurisdiction who did not complete a criminal history background 587.12 check as part of an application for initial licensure. This 587.13 background check is a one-time requirement. An application for 587.14 a license under this section must be accompanied by an executed 587.15 criminal history consent form and the fee for conducting the 587.16 criminal history background check. The board shall deposit all 587.17 fees paid by licensees for criminal history background checks 587.18 under this subdivision into the miscellaneous special revenue 587.19 fund. The fees collected under this subdivision are 587.20 appropriated to the board for the purpose of reimbursing the 587.21 bureau of criminal apprehension for the cost of the background 587.22 checks upon their completion. 587.23 Sec. 6. [214.105] [HEALTH-RELATED LICENSING BOARDS; 587.24 DEFAULT ON FEDERAL LOANS OR SERVICE OBLIGATIONS.] 587.25 A health-related licensing board may refuse to grant a 587.26 license or may impose disciplinary action against a person 587.27 regulated by the board if the person is intentionally in 587.28 nonpayment, default, or breach of a repayment or service 587.29 obligation under any federal educational loan, loan repayment, 587.30 or service conditional scholarship program. The board shall 587.31 consider the reasons for nonpayment, default, or breach of a 587.32 repayment or service obligation and may not impose disciplinary 587.33 action against a person in cases of total and permanent 587.34 disability or long-term temporary disability lasting more than a 587.35 year. 587.36 Sec. 7. Minnesota Statutes 2000, section 252A.02, is 588.1 amended by adding a subdivision to read: 588.2 Subd. 3a. [GUARDIANSHIP SERVICE PROVIDERS.] "Guardianship 588.3 service providers" are individuals or agencies that meet the 588.4 ethical conduct and best practice standards of the National 588.5 Guardianship Association, meet the criminal background check 588.6 requirements of section 245A.04, and do not provide any other 588.7 services to the individuals for whom guardianship services are 588.8 provided. 588.9 Sec. 8. Minnesota Statutes 2000, section 252A.02, 588.10 subdivision 12, is amended to read: 588.11 Subd. 12. [COMPREHENSIVE EVALUATION.] "Comprehensive 588.12 evaluation" shall consist of: 588.13 (1) a medical report on the health status and physical 588.14 condition of the proposed ward, prepared under the direction of 588.15 a licensed physician; 588.16 (2) a report on the proposed ward's intellectual capacity 588.17 and functional abilities, specifying the tests and other data 588.18 used in reaching its conclusions, prepared by a psychologist who 588.19 is qualified in the diagnosis of mental retardation; and 588.20 (3) a report from the case manager that includes: 588.21 (i) the most current assessment of individual service needs 588.22 as described in rules of the commissioner; 588.23 (ii) the most current individual service planas described588.24in rules of the commissionerunder section 256B.092, subdivision 588.25 1b; and 588.26 (iii) a description of contacts with and responses of near 588.27 relatives of the proposed ward notifying them that a nomination 588.28 for public guardianship has been made and advising them that 588.29 they may seek private guardianship. 588.30 Each report shall contain recommendations as to the amount 588.31 of assistance and supervision required by the proposed ward to 588.32 function as independently as possible in society. To be 588.33 considered part of the comprehensive evaluation, reports must be 588.34 completed no more than one year before filing the petition under 588.35 section 252A.05. 588.36 Sec. 9. Minnesota Statutes 2000, section 252A.02, 589.1 subdivision 13, is amended to read: 589.2 Subd. 13. [CASE MANAGER.] "Case manager" means the person 589.3 designatedby the county board under rules of the commissioner589.4to provide case management servicesunder section 256B.092. 589.5 Sec. 10. Minnesota Statutes 2000, section 252A.111, 589.6 subdivision 6, is amended to read: 589.7 Subd. 6. [SPECIAL DUTIES.] In exercising powers and duties 589.8 under this chapter, the commissioner shall: 589.9 (1) maintain close contact with the ward, visiting at least 589.10 twice a year; 589.11 (2)prohibit filming a ward in any way that would reveal589.12the identity of the ward unless the commissioner determines the589.13filming to be in the best interests of the ward. The589.14commissioner may give written consent for filming of the ward589.15after permitting and encouraging input by the nearest relative589.16 protect and exercise the legal rights of the ward; 589.17 (3) take actions and make decisions on behalf of the ward 589.18 that encourage and allow the maximum level of independent 589.19 functioning in a manner least restrictive of the ward's personal 589.20 freedom consistent with the need for supervision and protection; 589.21 and 589.22 (4) permit and encourage maximum self-reliance on the part 589.23 of the ward and permit and encourage input by the nearest 589.24 relative of the ward in planning and decision making on behalf 589.25 of the ward. 589.26 Sec. 11. Minnesota Statutes 2000, section 252A.16, 589.27 subdivision 1, is amended to read: 589.28 Subdivision 1. [REVIEW REQUIRED.] The commissioner 589.29 shallproviderequire an annual review of the physical, mental, 589.30 and social adjustment and progress of every ward and 589.31 conservatee. A copy of this review shall be kept on file at the 589.32 department of human services and may be inspected by the ward or 589.33 conservatee, the ward's or conservatee's parents, spouse, or 589.34 relatives and other persons who receive the permission of the 589.35 commissioner. The review shall contain information required 589.36 underrules of the commissionerMinnesota Rules, part 9525.3065, 590.1 subpart 1. 590.2 Sec. 12. Minnesota Statutes 2000, section 252A.19, 590.3 subdivision 2, is amended to read: 590.4 Subd. 2. [PETITION.] The commissioner, ward, or any 590.5 interested person may petition the appointing court or the court 590.6 to which venue has been transferred for an order to remove the 590.7 guardianship or to limit or expand the powers of the 590.8 conservatorship or to appoint a guardian or conservator under 590.9 sections 525.539 to 525.705 or to restore the ward or 590.10 conservatee to full legal capacity or to review de novo any 590.11 decision made by the public guardian or public conservator for 590.12 or on behalf of a ward or conservatee or for any other order as 590.13 the court may deem just and equitable. Section 525.61, 590.14 subdivision 3, does not apply to a petition to remove a public 590.15 guardian. 590.16 Sec. 13. Minnesota Statutes 2000, section 252A.20, 590.17 subdivision 1, is amended to read: 590.18 Subdivision 1. [WITNESS AND ATTORNEY FEES.] In each 590.19 proceeding under sections 252A.01 to 252A.21, the court shall 590.20 allow and order paid to each witness subpoenaed the fees and 590.21 mileage prescribed by law; to each physician, psychologist, or 590.22 social worker who assists in the preparation of the 590.23 comprehensive evaluation and who is not in the employ of the 590.24 local agency,or the state department of human services,or area590.25mental health-mental retardation board,a reasonable sum for 590.26 services and for travel; and to the ward's counsel, when 590.27 appointed by the court, a reasonable sum for travel and for each 590.28 day or portion of a day actually employed in court or actually 590.29 consumed in preparing for the hearing. Upon order the county 590.30 auditor shall issue a warrant on the county treasurer for 590.31 payment of the amount allowed. 590.32 Sec. 14. Minnesota Statutes 2000, section 256I.05, 590.33 subdivision 1d, is amended to read: 590.34 Subd. 1d. [SUPPLEMENTARY SERVICE RATES FOR CERTAIN 590.35 FACILITIES SERVING PERSONS WITH MENTAL ILLNESS OR CHEMICAL 590.36 DEPENDENCY.] Notwithstanding the provisions of subdivisions 1a 591.1 and 1cfor the fiscal year ending June 30, 1998, a county agency 591.2 may negotiate a supplementary service rate in addition to the 591.3 board and lodging rate for facilities licensed and registered by 591.4 the Minnesota department of health under section 157.17 prior to 591.5 December 31, 1996, if the facility meets the following criteria: 591.6 (1) at least 75 percent of the residents have a primary 591.7 diagnosis of mental illness, chemical dependency, or both, and 591.8 have related special needs; 591.9 (2) the facility provides 24-hour, on-site, year-round 591.10 supportive services by qualified staff capable of intervention 591.11 in a crisis of persons with late-state inebriety or mental 591.12 illness who are vulnerable to abuse or neglect; 591.13 (3) the services at the facility include, but are not 591.14 limited to: 591.15 (i) secure central storage of medication; 591.16 (ii) reminders and monitoring of medication for 591.17 self-administration; 591.18 (iii) support for developing an individual medical and 591.19 social service plan, updating the plan, and monitoring 591.20 compliance with the plan; and 591.21 (iv) assistance with setting up meetings, appointments, and 591.22 transportation to access medical, chemical health, and mental 591.23 health service providers; 591.24 (4) each resident has a documented need for at least one of 591.25 the services provided; 591.26 (5) each resident has been offered an opportunity to apply 591.27 for admission to a licensed residential treatment program for 591.28 mental illness, chemical dependency, or both, have refused that 591.29 offer, and the offer and their refusal has been documented to 591.30 writing; and 591.31 (6) the residents are not eligible for home and 591.32 community-based services waivers because of their unique need 591.33 for community support. 591.34The total supplementary service rate must not exceed $575.591.35 Until June 30, 2002, the supplementary service rate of 591.36 qualifying facilities under this subdivision may be increased by 592.1 up to 15 percent of the supplementary service rate in effect on 592.2 January 1, 2001, for the facility. Qualifying facilities with 592.3 no supplementary service rate may negotiate a supplementary 592.4 service rate not to exceed $300 per month. 592.5 Sec. 15. Minnesota Statutes 2000, section 256I.05, 592.6 subdivision 1e, is amended to read: 592.7 Subd. 1e. [SUPPLEMENTARY RATE FOR CERTAIN FACILITIES.] 592.8 Notwithstanding the provisions of subdivisions 1a and 1c, 592.9 beginning July 1,19992001, a county agency shall negotiate a 592.10 supplementary rate in addition to the rate specified in 592.11 subdivision 1, equal to2546 percent of the amount specified in 592.12 subdivision 1a, including any legislatively authorized 592.13 inflationary adjustments, for a group residential housing 592.14 provider that: 592.15 (1) is located in Hennepin county and has had a group 592.16 residential housing contract with the county since June 1996; 592.17 (2) operates in three separate locations a56-bed71-bed 592.18 facility,aand two 40-bedfacility, and a 30-bed facility592.19 facilities; and 592.20 (3) serves a chemically dependent clientele, providing 24 592.21 hours per day supervision and limiting a resident's maximum 592.22 length of stay to 13 months out of a consecutive 24-month period. 592.23 Sec. 16. Minnesota Statutes 2000, section 256I.05, is 592.24 amended by adding a subdivision to read: 592.25 Subd. 1f. [SUPPLEMENTARY SERVICE RATE INCREASES ON OR 592.26 AFTER JULY 1, 2001.] Until June 30, 2002, the supplementary 592.27 service rate for recipients of assistance under section 256I.04 592.28 who reside in a residence that is licensed by the commissioner 592.29 of health as a boarding care home but is not certified for 592.30 purposes of the medical assistance program may be increased by 592.31 up to 32 percent of the supplementary service rate in effect for 592.32 that facility on January 1, 2001. The new rate shall not exceed 592.33 the nonfederal share of the statewide weighted average monthly 592.34 medical assistance nursing facility payment rate for case mix A 592.35 in effect on January 1, 2001. 592.36 Sec. 17. [299A.76] [SUICIDE STATISTICS.] 593.1 (a) The commissioner of public safety shall not: 593.2 (1) include any statistics on committing suicide or 593.3 attempting suicide in any compilation of crime statistics 593.4 published by the commissioner; or 593.5 (2) label as a crime statistic, any data on committing 593.6 suicide or attempting suicide. 593.7 (b) This section does not apply to the crimes of aiding 593.8 suicide under section 609.215, subdivision 1, or aiding 593.9 attempted suicide under section 609.215, subdivision 2, or to 593.10 statistics on a suicide directly related to the commission of a 593.11 crime. 593.12 Sec. 18. Laws 1999, chapter 152, section 4, is amended to 593.13 read: 593.14 Sec. 4. [REPORT.] 593.15 The task force shall present a report recommending a new 593.16 payment rate structure to the legislature by January 15, 2000, 593.17 and shall make recommendations to the commissioner of human 593.18 services regarding the implementation of the pilot project for 593.19 the individualized payment rate structure, so the pilot project 593.20 can be implemented as required in section 25. The task force 593.21 expires onMarch 15, 2000December 30, 2003. 593.22 Sec. 19. Laws 1999, chapter 245, article 10, section 10, 593.23 as amended by Laws 2000, chapter 488, article 9, section 30, is 593.24 amended to read: 593.25 Sec. 10. [REPEALER.] 593.26(a) Minnesota Statutes 1998, section 256.973, is repealed593.27effective June 30, 2002.593.28(b)Laws 1997, chapter 225, article 6, section 8, is 593.29 repealed. 593.30 Sec. 20. Laws 2001, chapter 154, section 1, subdivision 1, 593.31 is amended to read: 593.32 Subdivision 1. [DEFINITIONS.] For the purposes of this 593.33 section, the following terms have the meanings given them in 593.34 this subdivision. 593.35 (a) "Genetic test" meansa test of a person's genes, gene593.36products, or chromosomes for abnormalities or deficiencies,594.1including carrier status, that are linked to physical or mental594.2disorders or impairments, or that indicate a susceptibility to594.3disease, impairment, or other disorders, whether physical or594.4mental, or that demonstrate genetic or chromosomal damage due to594.5environmental factors.the analysis of human DNA, RNA, 594.6 chromosomes, proteins, or certain metabolites in order to detect 594.7 disease-related genotypes or mutations. Tests for metabolites 594.8 fall within the definition of genetic test when an excess or 594.9 deficiency of the metabolites indicates the presence of a 594.10 mutation or mutations. Administration of metabolic tests by an 594.11 employer or employment agency that are not intended to reveal 594.12 the presence of a mutation does not violate this section, 594.13 regardless of the results of the tests. Test results revealing 594.14 a mutation are, however, subject to this section. 594.15 (b) "Employer" means any person having one or more 594.16 employees in Minnesota, and includes the state and any political 594.17 subdivisions of the state. 594.18 (c) "Employee" means a person who performs services for 594.19 hire in Minnesota for an employer, but does not include 594.20 independent contractors. 594.21 (d) "Protected genetic information" means: 594.22 (1) information about a person's genetic test; or 594.23 (2) information about a genetic test of a blood relative of 594.24 a person. 594.25 Sec. 21. Laws 2001, chapter 161, section 45, is amended to 594.26 read: 594.27 Sec. 45. Minnesota Statutes 2000, section 256.482, 594.28 subdivision 8, is amended to read: 594.29 Subd. 8. [SUNSET.] Notwithstanding section 15.059, 594.30 subdivision 5, the council on disability shall not sunset until 594.31 June 30, 2003. 594.32 [EFFECTIVE DATE.] This section is effective July 1, 2001. 594.33 Sec. 22. [FUNDING FOR DAY SERVICES PROGRAMS.] 594.34 Subdivision 1. [FEDERAL WAIVER REQUESTS.] The commissioner 594.35 of human services shall submit to the federal Health Care 594.36 Financing Administration by September 1, 2001, a request for a 595.1 home and community-based services waiver for day services, 595.2 including: community inclusion, supported employment, and day 595.3 training and habilitation services defined in Minnesota 595.4 Statutes, section 252.41, subdivision 3, clause (1), for persons 595.5 eligible for the waiver under Minnesota Statutes, section 595.6 256B.092. 595.7 Subd. 2. [COUNTY FUNDING OF NONFEDERAL SHARE.] On the 595.8 later of July 1, 2003, or July 1 of the second calendar year 595.9 after the date when the federal Health Care Financing 595.10 Administration grants the waiver request under subdivision 1, 595.11 the county must pay the nonfederal share of medical assistance 595.12 costs for day training for persons receiving services under the 595.13 day services waiver under subdivision 1. 595.14 Sec. 23. [DEAF/BLIND SERVICES STUDY.] 595.15 The department of human services shall convene and lead an 595.16 interagency workgroup for the purpose of studying and developing 595.17 recommendations regarding: 595.18 (1) how the state can most effectively and efficiently use 595.19 state appropriations and other resources to provide needed 595.20 services to deaf/blind children, adults, and their families; 595.21 (2) how state agencies can work together to enhance and 595.22 ensure that a seamless service delivery system exists across 595.23 agency lines for persons who are deaf/blind; and 595.24 (3) how other existing barriers to the effective and 595.25 efficient delivery of service for deaf/blind Minnesotans can be 595.26 removed. 595.27 The workgroup shall include representatives from the 595.28 departments of human services, economic security, children, 595.29 families, and learning; the state academy for the deaf; the 595.30 state academy for the blind; the Minnesota commission serving 595.31 deaf and hard-of-hearing; a consumer who is deaf/blind; a parent 595.32 of a deaf/blind child from the metro area and a parent of a 595.33 deaf/blind child from greater Minnesota; and anyone else that 595.34 the workgroup finds necessary to complete its work. 595.35 The departments of human services, economic security, and 595.36 children, families, and learning shall share equally in the 596.1 costs of the workgroup. 596.2 The workgroup shall report its findings and recommendations 596.3 to the legislature by February 1, 2002. 596.4 Sec. 24. [PUBLIC GUARDIANSHIP ALTERNATIVES.] 596.5 The commissioner of human services shall provide county 596.6 agencies with funds up to the amount appropriated for public 596.7 guardianship alternatives based on proposals by the counties to 596.8 establish private alternatives. 596.9 Sec. 25. [DAY TRAINING AND HABILITATION PAYMENT STRUCTURE 596.10 PILOT PROJECT.] 596.11 Subdivision 1. [INDIVIDUALIZED PAYMENT RATE 596.12 STRUCTURE.] Notwithstanding Minnesota Statutes, sections 596.13 252.451, subdivision 5; and 252.46; and Minnesota Rules, part 596.14 9525.1290, subpart 1, items A and B, the commissioner of human 596.15 services shall initiate a pilot project and phase-in for the 596.16 individualized payment rate structure described in this section 596.17 and section 26. The pilot project shall include actual 596.18 transfers of funds, not simulated transfers. The pilot project 596.19 may include all or some of the vendors in up to eight counties, 596.20 with no more than two counties from the seven-county 596.21 Minneapolis-St. Paul metropolitan area. Following initiation of 596.22 the pilot project, the commissioner shall phase in 596.23 implementation of the individualized payment rate structure to 596.24 the remaining counties and vendors according to the 596.25 implementation plan developed by the task force. The pilot and 596.26 phase-in shall not extend over more than 18 months. 596.27 Subd. 2. [SUNSET.] The pilot project shall sunset upon 596.28 implementation of a new statewide rate structure according to 596.29 the implementation plan developed by the task force described in 596.30 subdivision 3, in its report to the legislature. The rates of 596.31 vendors participating in the pilot project must be modified to 596.32 be consistent with the new statewide rate structure, as 596.33 implemented. 596.34 Subd. 3. [TASK FORCE RESPONSIBILITIES.] The day training 596.35 and habilitation task force established under Laws 1999, chapter 596.36 152, section 4, shall evaluate the pilot project authorized 597.1 under subdivision 1, and shall report to the legislature with an 597.2 implementation plan, which shall address how and when the pilot 597.3 project individualized payment rate structure will be 597.4 implemented statewide, shall ensure that vendors that wish to 597.5 maintain their current per diem rate may do so within the new 597.6 payment system, and shall identify criteria that would halt 597.7 statewide implementation if vendors or clients were adversely 597.8 affected by the new payment rate structure, and with 597.9 recommendations for any amendments that should be made before 597.10 statewide implementation. These recommendations shall be made 597.11 in a report to the chairs of the house health and human services 597.12 policy and finance committees and the senate health and family 597.13 security committee and finance division. 597.14 Subd. 4. [RATE SETTING.] (a) The rate structure under this 597.15 section is intended to allow a county to authorize an individual 597.16 rate for each client in the vendor's program based on the needs 597.17 and expected outcomes of the individual client. Rates shall be 597.18 based on an authorized package of services for each individual 597.19 over a typical time frame. Rates may be established across 597.20 multiple sites run by a single vendor. 597.21 (b) With county concurrence, a vendor shall establish up to 597.22 four levels of service, A through D, based on the intensity of 597.23 services provided to an individual client of day training and 597.24 habilitation services. Service level A shall be the highest 597.25 intensity of services, marked primarily, but not exclusively, by 597.26 a one-to-one client-to-staff ratio. Service level D shall be 597.27 the lowest intensity of services. The county shall document the 597.28 vendor's description of the type and amount of services 597.29 associated with each service level. 597.30 (c) For each vendor, a county board shall establish a 597.31 dollar value for one hour of service at each of the service 597.32 levels defined in paragraph (b). In establishing these values 597.33 for existing vendors transitioning from the payment rate 597.34 structure under Minnesota Statutes, section 252.46, subdivision 597.35 1, the county board shall follow the formula and guidelines 597.36 developed by the day training and habilitation task force under 598.1 paragraph (e). 598.2 (d) A vendor may elect to maintain a single transportation 598.3 rate or may elect to establish up to five types of 598.4 transportation services: public transportation, public special 598.5 transportation, nonambulatory transportation, out-of-service 598.6 area transportation, and ambulatory transportation. For vendors 598.7 that elect to establish multiple transportation services, the 598.8 county board shall establish a dollar value for a round trip on 598.9 each type of transportation service offered through the vendor. 598.10 With vendor concurrence, the county may also establish a uniform 598.11 one-way trip value for some or all of the transportation service 598.12 types. 598.13 (e) The county board shall ensure that the vendor 598.14 translates the vendor's existing program and transportation 598.15 rates to the rates and values in the pilot project by using the 598.16 conversion calculations for services and transportation approved 598.17 by the day training and habilitation task force established 598.18 under Laws 1999, chapter 152, and included in the task force's 598.19 recommendations to the legislature. The conversion calculation 598.20 may be amended by the task force with the approval of the 598.21 commissioner and any amendments shall become effective upon 598.22 notification to the pilot project counties from the 598.23 commissioner. The calculation shall take the total 598.24 reimbursement dollars available to the vendor and divide by the 598.25 units of service expected at each service level and of each 598.26 transportation type. In determining the total reimbursement 598.27 dollars available to a vendor, the vendor shall multiply the 598.28 vendor's current per diem rate for both services and 598.29 transportation, including any new rate increases, by the 598.30 vendor's actual utilization for the year prior to implementation 598.31 of the pilot project. Vendors shall be allowed to allocate 598.32 available reimbursement dollars between service and 598.33 transportation before the vendor's service level and 598.34 transportation values are calculated. After translating its 598.35 existing service and transportation rates to the service level 598.36 and transportation values under the pilot, the vendor shall 599.1 project its expected reimbursement income using the expected 599.2 service and transportation packages for its existing clients, 599.3 based on current service authorizations. If the projected 599.4 reimbursement income is less than the vendor would have received 599.5 under the payment structure of Minnesota Statutes, section 599.6 252.46, the vendor and the county, with the approval of the 599.7 commissioner, shall adjust the vendor's service level and 599.8 transportation values to eliminate the shortfall. The 599.9 commissioner shall report all adjustments to the day training 599.10 and habilitation task force for consideration of possible 599.11 modifications to the pilot project individualized payment rate 599.12 structure. 599.13 Subd. 5. [INDIVIDUAL RATE AUTHORIZATION.] (a) As part of 599.14 its annual authorization of services for each client under 599.15 Minnesota Statutes, section 252.44, paragraph (a), clause (1), 599.16 and Minnesota Rules, part 9525.0016, subpart 12, the county 599.17 shall authorize and document a service package and a 599.18 transportation package as follows: 599.19 (1) the service package shall include the amount and type 599.20 of services at each applicable service level to be provided to 599.21 the client over a package period. An individual client may 599.22 receive services at multiple service levels over the course of 599.23 the package period. The service package rate shall be the sum 599.24 of the amount of services at each level over the package period, 599.25 multiplied by the dollar value for each service level; 599.26 (2) the transportation package shall include the amount and 599.27 type of transportation services to be provided to the client 599.28 over the package period. The transportation package rate shall 599.29 be the sum of the amount of transportation services, multiplied 599.30 by the dollar value associated with the type of transportation 599.31 service authorized for the client; 599.32 (3) the package period shall be established by the county, 599.33 and may be one week, two weeks, or one month; and 599.34 (4) the individual rate authorization may be reviewed and 599.35 modified by the county at any time and must be reviewed and 599.36 reauthorized by the county at least annually. 600.1 (b) For vendors with rates established under this section, 600.2 a service day under Minnesota Statutes, sections 245B.06 and 600.3 252.44, includes any day in which a client receives any 600.4 reimbursable service from a vendor or attends employment 600.5 arranged by the vendor. 600.6 Subd. 6. [BILLING FOR SERVICES.] The vendor shall bill 600.7 for, and shall be reimbursed for, the service package rate and 600.8 transportation package rate for the package period as authorized 600.9 by the county for each client in the vendor's program. The 600.10 length of the package period shall not affect the timing or 600.11 frequency of vendors' submissions of claims for payment under 600.12 the Medicaid Management Information System II (MMIS) or its 600.13 successors. 600.14 Subd. 7. [NOTIFICATION OF CHANGE IN CLIENT NEEDS.] The 600.15 vendor shall notify an individual client's case manager if the 600.16 vendor has knowledge of a material change in the client's needs 600.17 that may indicate a need for a change in service authorization. 600.18 Factors that would require such notice include, but are not 600.19 limited to, significant changes in medical status, residential 600.20 placement, attendance patterns, behavioral needs, or skill 600.21 functioning. The vendor shall notify the case manager as soon 600.22 as possible but no later than 30 calendar days after becoming 600.23 aware of the change in needs. The service authorization for the 600.24 client shall not change until the county authorizes a new 600.25 service and transportation package for the client in accordance 600.26 with the provisions in Minnesota Statutes, section 256B.092. 600.27 Sec. 26. [COUNTY BOARD RESPONSIBILITIES.] 600.28 For each vendor with rates established under section 25, 600.29 the county board shall document the vendor's description of the 600.30 type and amount of services associated with each service level, 600.31 the vendor's service level values, the vendor's transportation 600.32 values, and the package period that will be used to determine 600.33 the rate for each individual client. The county shall establish 600.34 a package period of one week, two weeks, or one month. 600.35 Sec. 27. [STUDY OF DAY TRAINING AND HABILITATION VENDOR 600.36 RATES.] 601.1 The commissioner shall identify the vendors with the lowest 601.2 rates or underfunded programs in the state and make 601.3 recommendations to reconcile the discrepancies prior to the 601.4 implementation of the individualized payment rate structure 601.5 described in sections 25 and 26. 601.6 Sec. 28. [FEDERAL APPROVAL.] 601.7 The commissioner shall seek any amendments to the state 601.8 Medicaid plan and any waivers necessary to permit implementation 601.9 of section 25 within the timelines specified. 601.10 Sec. 29. [REPEALER.] 601.11 Minnesota Statutes 2000, section 252A.111, subdivision 3, 601.12 is repealed. 601.13 ARTICLE 14 601.14 DHS LICENSING AND 601.15 LICENSING BACKGROUND STUDIES 601.16 Section 1. Minnesota Statutes 2000, section 13.46, 601.17 subdivision 4, is amended to read: 601.18 Subd. 4. [LICENSING DATA.] (a) As used in this subdivision: 601.19 (1) "licensing data" means all data collected, maintained, 601.20 used, or disseminated by the welfare system pertaining to 601.21 persons licensed or registered or who apply for licensure or 601.22 registration or who formerly were licensed or registered under 601.23 the authority of the commissioner of human services; 601.24 (2) "client" means a person who is receiving services from 601.25 a licensee or from an applicant for licensure; and 601.26 (3) "personal and personal financial data" means social 601.27 security numbers, identity of and letters of reference, 601.28 insurance information, reports from the bureau of criminal 601.29 apprehension, health examination reports, and social/home 601.30 studies. 601.31 (b)(1) Except as provided in paragraph (c), the following 601.32 data on current and former licensees are public: name, address, 601.33 telephone number of licensees, date of receipt of a completed 601.34 application, dates of licensure, licensed capacity, type of 601.35 client preferred, variances granted, type of dwelling, name and 601.36 relationship of other family members, previous license history, 602.1 class of license, and the existence and status of complaints. 602.2 Whendisciplinary action has been taken against a licenseea 602.3 correction order or fine has been issued, a license is 602.4 suspended, immediately suspended, revoked, denied, or made 602.5 conditional, orthea complaint is resolved, the following data 602.6 on current and former licensees are public: the substance and 602.7 investigative findings of the complaint,the findings of the602.8investigation of the complaint,licensing violation, or 602.9 substantiated maltreatment; the record of informal resolution of 602.10 a licensing violation,; orders of hearing,; findings of 602.11 fact,; conclusions of law, and; specifications of the final 602.12disciplinary actioncorrection order, fine, suspension, 602.13 immediate suspension, revocation, denial, or conditional license 602.14 contained in the record ofdisciplinarylicensing action; and 602.15 the status of any appeal of these actions. When an individual 602.16 licensee is a substantiated perpetrator of maltreatment, and the 602.17 substantiated maltreatment is a reason for the licensing action, 602.18 the identity of the licensee as a perpetrator is public data. 602.19 For purposes of this clause, a person is a substantiated 602.20 perpetrator if the maltreatment determination has been upheld 602.21 under section 626.556, subdivision 10i, 626.557, subdivision 9d, 602.22 or 256.045, or an individual or facility has not timely 602.23 exercised appeal rights under these sections. 602.24 (2) For applicants who withdraw their application prior to 602.25 licensure or denial of a license, the following data are 602.26 public: the name of the applicant, the city and county in which 602.27 the applicant was seeking licensure, the dates of the 602.28 commissioner's receipt of the initial application and completed 602.29 application, the type of license sought, and the date of 602.30 withdrawal of the application. 602.31 (3) For applicants who are denied a license, the following 602.32 data are public: the name of the applicant, the city and county 602.33 in which the applicant was seeking licensure, the dates of the 602.34 commissioner's receipt of the initial application and completed 602.35 application, the type of license sought, the date of denial of 602.36 the application, the nature of the basis for the denial, and the 603.1 status of any appeal of the denial. 603.2 (4) The following data on persons subject to 603.3 disqualification under section 245A.04 in connection with a 603.4 license to provide family day care for children, child care 603.5 center services, foster care for children in the provider's 603.6 home, or foster care or day care services for adults in the 603.7 provider's home, are public: the nature of any disqualification 603.8 set aside under section 245A.04, subdivision 3b, and the reasons 603.9 for setting aside the disqualification; and the reasons for 603.10 granting any variance under section 245A.04, subdivision 9. 603.11 (5) When maltreatment is substantiated under section 603.12 626.556 or 626.557 and the victim and the substantiated 603.13 perpetrator are affiliated with a program licensed under chapter 603.14 245A, the commissioner of human services, local social services 603.15 agency, or county welfare agency may inform the license holder 603.16 where the maltreatment occurred of the identity of the 603.17 substantiated perpetrator and the victim. 603.18 (c) The following are private data on individuals under 603.19 section 13.02, subdivision 12, or nonpublic data under section 603.20 13.02, subdivision 9: personal and personal financial data on 603.21 family day care program and family foster care program 603.22 applicants and licensees and their family members who provide 603.23 services under the license. 603.24 (d) The following are private data on individuals: the 603.25 identity of persons who have made reports concerning licensees 603.26 or applicants that appear in inactive investigative data, and 603.27 the records of clients or employees of the licensee or applicant 603.28 for licensure whose records are received by the licensing agency 603.29 for purposes of review or in anticipation of a contested 603.30 matter. The names of reporters under sections 626.556 and 603.31 626.557 may be disclosed only as provided in section 626.556, 603.32 subdivision 11, or 626.557, subdivision 12b. 603.33 (e) Data classified as private, confidential, nonpublic, or 603.34 protected nonpublic under this subdivision become public data if 603.35 submitted to a court or administrative law judge as part of a 603.36 disciplinary proceeding in which there is a public hearing 604.1 concerningthe disciplinary actiona license which has been 604.2 suspended, immediately suspended, revoked, or denied. 604.3 (f) Data generated in the course of licensing 604.4 investigations that relate to an alleged violation of law are 604.5 investigative data under subdivision 3. 604.6 (g) Data that are not public data collected, maintained, 604.7 used, or disseminated under this subdivision that relate to or 604.8 are derived from a report as defined in section 626.556, 604.9 subdivision 2, or 626.5572, subdivision 18, are subject to the 604.10 destruction provisions ofsectionsections 626.556, subdivision 604.111111c, and 626.557, subdivision 12b. 604.12 (h) Upon request, not public data collected, maintained, 604.13 used, or disseminated under this subdivision that relate to or 604.14 are derived from a report of substantiated maltreatment as 604.15 defined in section 626.556 or 626.557 may be exchanged with the 604.16 department of health for purposes of completing background 604.17 studies pursuant to section 144.057. 604.18 (i) Data on individuals collected according to licensing 604.19 activities under chapter 245A, and data on individuals collected 604.20 by the commissioner of human services according to maltreatment 604.21 investigations under sections 626.556 and 626.557, may be shared 604.22 with the department of human rights, the department of health, 604.23 the department of corrections, the ombudsman for mental health 604.24 and retardation, and the individual's professional regulatory 604.25 board when there is reason to believe that laws or standards 604.26 under the jurisdiction of those agencies may have been violated. 604.27 (j) In addition to the notice of determinations required 604.28 under section 626.556, subdivision 10f, if the commissioner or 604.29 the local social services agency has determined that an 604.30 individual is a substantiated perpetrator of maltreatment of a 604.31 child based on sexual abuse, as defined in section 626.556, 604.32 subdivision 2, and the commissioner or local social services 604.33 agency knows that the individual is a person responsible for a 604.34 child's care in another facility, the commissioner or local 604.35 social services agency shall notify the head of that facility of 604.36 this determination. The notification must include an 605.1 explanation of the individual's available appeal rights and the 605.2 status of any appeal. If a notice is given under this 605.3 paragraph, the government entity making the notification shall 605.4 provide a copy of the notice to the individual who is the 605.5 subject of the notice. 605.6 Sec. 2. Minnesota Statutes 2000, section 144.057, is 605.7 amended to read: 605.8 144.057 [BACKGROUND STUDIES ON LICENSEES AND SUPPLEMENTAL 605.9 NURSING SERVICES AGENCY PERSONNEL.] 605.10 Subdivision 1. [BACKGROUND STUDIES REQUIRED.] The 605.11 commissioner of health shall contract with the commissioner of 605.12 human services to conduct background studies of: 605.13 (1) individuals providing services which have direct 605.14 contact, as defined under section 245A.04, subdivision 3, with 605.15 patients and residents in hospitals, boarding care homes, 605.16 outpatient surgical centers licensed under sections 144.50 to 605.17 144.58; nursing homes and home care agencies licensed under 605.18 chapter 144A; residential care homes licensed under chapter 605.19 144B, and board and lodging establishments that are registered 605.20 to provide supportive or health supervision services under 605.21 section 157.17;and605.22 (2) individuals specified in section 245A.04, subdivision 605.23 3, paragraph (c), who perform direct contact services in a 605.24 nursing home or a home care agency licensed under chapter 144A 605.25 or a boarding care home licensed under sections 144.50 to 605.26 144.58, and if the individual under study resides outside 605.27 Minnesota, the study must be at least as comprehensive as that 605.28 of a Minnesota resident and include a search of information from 605.29 the criminal justice data communications network in the state 605.30 where the subject of the study resides; 605.31 (3) beginning July 1, 1999, all other employees in nursing 605.32 homes licensed under chapter 144A, and boarding care homes 605.33 licensed under sections 144.50 to 144.58. A disqualification of 605.34 an individual in this section shall disqualify the individual 605.35 from positions allowing direct contact or access to patients or 605.36 residents receiving services. "Access" means physical access to 606.1 a client or the client's personal property without continuous, 606.2 direct supervision as defined in section 245A.04, subdivision 3, 606.3 paragraph (b), clause (2), when the employee's employment 606.4 responsibilities do not include providing direct contact 606.5 services; 606.6 (4) individuals employed by a supplemental nursing services 606.7 agency, as defined under section 144A.70, who are providing 606.8 services in health care facilities; and 606.9 (5) controlling persons of a supplemental nursing services 606.10 agency, as defined under section 144A.70. 606.11 If a facility or program is licensed by the department of 606.12 human services and subject to the background study provisions of 606.13 chapter 245A and is also licensed by the department of health, 606.14 the department of human services is solely responsible for the 606.15 background studies of individuals in the jointly licensed 606.16 programs. 606.17 Subd. 2. [RESPONSIBILITIES OF DEPARTMENT OF HUMAN 606.18 SERVICES.] The department of human services shall conduct the 606.19 background studies required by subdivision 1 in compliance with 606.20 the provisions of chapter 245Aand Minnesota Rules, parts606.219543.3000 to 9543.3090. For the purpose of this section, the 606.22 term "residential program" shall include all facilities 606.23 described in subdivision 1. The department of human services 606.24 shall provide necessary forms and instructions, shall conduct 606.25 the necessary background studies of individuals, and shall 606.26 provide notification of the results of the studies to the 606.27 facilities, supplemental nursing services agencies, individuals, 606.28 and the commissioner of health. Individuals shall be 606.29 disqualified under the provisions of chapter 245Aand Minnesota606.30Rules, parts 9543.3000 to 9543.3090. If an individual is 606.31 disqualified, the department of human services shall notify the 606.32 facility, the supplemental nursing services agency, and the 606.33 individual and shall inform the individual of the right to 606.34 request a reconsideration of the disqualification by submitting 606.35 the request to the department of health. 606.36 Subd. 3. [RECONSIDERATIONS.] The commissioner of health 607.1 shall review and decide reconsideration requests, including the 607.2 granting of variances, in accordance with the procedures and 607.3 criteria contained in chapter 245Aand Minnesota Rules, parts607.49543.3000 to 9543.3090. The commissioner's decision shall be 607.5 provided to the individual and to the department of human 607.6 services. The commissioner's decision to grant or deny a 607.7 reconsideration of disqualification is the final administrative 607.8 agency action, except for the provisions under section 245A.04, 607.9 subdivisions 3b, paragraphs (e) and (f); and 3c, paragraph (a). 607.10 [EFFECTIVE DATE.] This subdivision is effective January 1, 607.11 2002. 607.12 Subd. 4. [RESPONSIBILITIES OF FACILITIES AND AGENCIES.] 607.13 Facilities and agencies described in subdivision 1 shall be 607.14 responsible for cooperating with the departments in implementing 607.15 the provisions of this section. The responsibilities imposed on 607.16 applicants and licensees under chapter 245Aand Minnesota Rules,607.17parts 9543.3000 to 9543.3090,shall apply to these facilities 607.18 and supplemental nursing services agencies. The provision of 607.19 section 245A.04, subdivision 3, paragraph (e), shall apply to 607.20 applicants, licensees, registrants, or an individual's refusal 607.21 to cooperate with the completion of the background 607.22 studies. Supplemental nursing services agencies subject to the 607.23 registration requirements in section 144A.71 must maintain 607.24 records verifying compliance with the background study 607.25 requirements under this section. 607.26 Sec. 3. Minnesota Statutes 2000, section 214.104, is 607.27 amended to read: 607.28 214.104 [HEALTH-RELATED LICENSING BOARDS; DETERMINATIONS 607.29 REGARDINGDISQUALIFICATIONS FORMALTREATMENT.] 607.30 (a) A health-related licensing board shall make 607.31 determinations as to whetherlicenseesregulated persons who are 607.32 under the board's jurisdiction should bedisqualified under607.33section 245A.04, subdivision 3d, from positions allowing direct607.34contact with persons receiving servicesthe subject of 607.35 disciplinary or corrective action because of substantiated 607.36 maltreatment under section 626.556 or 626.557.A determination608.1under this section may be done as part of an investigation under608.2section 214.103.The board shall make a determinationwithin 90608.3days ofupon receipt, and after the review, of an investigation 608.4 memorandum or other notice of substantiated maltreatment under 608.5 section 626.556 or 626.557, or of a notice from the commissioner 608.6 of human services that a background study of alicensee608.7 regulated person shows substantiated maltreatment.The board608.8shall also make a determination under this section upon608.9consideration of the licensure of an individual who was subject608.10to disqualification before licensure because of substantiated608.11maltreatment.608.12(b) In making a determination under this section, the board608.13shall consider the nature and extent of any injury or harm608.14resulting from the conduct that would constitute grounds for608.15disqualification, the seriousness of the misconduct, the extent608.16that disqualification is necessary to protect persons receiving608.17services or the public, and other factors specified in section608.18245A.04, subdivision 3b, paragraph (b).608.19(c) The board shall determine the duration and extent of608.20the disqualification or may establish conditions under which the608.21licensee may hold a position allowing direct contact with608.22persons receiving services or in a licensed facility.608.23 (b) Upon completion of its review of a report of 608.24 substantiated maltreatment, the board shall notify the 608.25 commissioner of human servicesand the lead agency that608.26conducted an investigation under section 626.556 or 626.557, as608.27applicable,of its determination. The board shall notify the 608.28 commissioner of human services if, following a review of the 608.29 report of substantiated maltreatment, the board determines that 608.30 it does not have jurisdiction in the matter and the commissioner 608.31 shall make the appropriate disqualification decision regarding 608.32 the regulated person as otherwise provided in chapter 245A. The 608.33 board shall also notify the commissioner of health or the 608.34 commissioner of human services immediately upon receipt of 608.35 knowledge of a facility or program allowing a regulated person 608.36 to provide direct contact services at the facility or program 609.1 while not complying with requirements placed on the regulated 609.2 person. 609.3 (c) In addition to any other remedy provided by law, the 609.4 board may, through its designated board member, temporarily 609.5 suspend the license of a licensee; deny a credential to an 609.6 applicant; or require the regulated person to be continuously 609.7 supervised, if the board finds there is probable cause to 609.8 believe the regulated person referred to the board according to 609.9 paragraph (a) poses an immediate risk of harm to vulnerable 609.10 persons. The board shall consider all relevant information 609.11 available, which may include but is not limited to: 609.12 (1) the extent the action is needed to protect persons 609.13 receiving services or the public; 609.14 (2) the recency of the maltreatment; 609.15 (3) the number of incidents of maltreatment; 609.16 (4) the intrusiveness or violence of the maltreatment; and 609.17 (5) the vulnerability of the victim of maltreatment. 609.18 The action shall take effect upon written notice to the 609.19 regulated person, served by certified mail, specifying the 609.20 statute violated. The board shall notify the commissioner of 609.21 health or the commissioner of human services of the suspension 609.22 or denial of a credential. The action shall remain in effect 609.23 until the board issues a temporary stay or a final order in the 609.24 matter after a hearing or upon agreement between the board and 609.25 the regulated person. At the time the board issues the notice, 609.26 the regulated person shall inform the board of all settings in 609.27 which the regulated person is employed or practices. The board 609.28 shall inform all known employment and practice settings of the 609.29 board action and schedule a disciplinary hearing to be held 609.30 under chapter 14. The board shall provide the regulated person 609.31 with at least 30 days' notice of the hearing, unless the parties 609.32 agree to a hearing date that provides less than 30 days' notice, 609.33 and shall schedule the hearing to begin no later than 90 days 609.34 after issuance of the notice of hearing. 609.35 Sec. 4. Minnesota Statutes 2000, section 245A.02, 609.36 subdivision 1, is amended to read: 610.1 Subdivision 1. [SCOPE.] The terms used in this chapter and 610.2 chapter 245B have the meanings given them in this section. 610.3 Sec. 5. Minnesota Statutes 2000, section 245A.02, is 610.4 amended by adding a subdivision to read: 610.5 Subd. 3a. [CERTIFICATION.] "Certification" means the 610.6 commissioner's written authorization for a license holder 610.7 licensed by the commissioner of human services or the 610.8 commissioner of corrections to serve children in a residential 610.9 program and provide specialized services based on certification 610.10 standards in Minnesota Rules. The term "certification" and its 610.11 derivatives have the same meaning and may be substituted for the 610.12 term "licensure" and its derivatives in this chapter. 610.13 Sec. 6. Minnesota Statutes 2000, section 245A.02, 610.14 subdivision 9, is amended to read: 610.15 Subd. 9. [LICENSE HOLDER.] "License holder" means an 610.16 individual, corporation, partnership, voluntary association, or 610.17 other organization that is legally responsible for the operation 610.18 of the program, has been granted a license by the commissioner 610.19 under this chapter or chapter 245B and the rules of the 610.20 commissioner, and is a controlling individual. 610.21 Sec. 7. Minnesota Statutes 2000, section 245A.03, 610.22 subdivision 2, is amended to read: 610.23 Subd. 2. [EXCLUSION FROM LICENSURE.] This chapter does not 610.24 apply to: 610.25 (1) residential or nonresidential programs that are 610.26 provided to a person by an individual who is related unless the 610.27 residential program is a child foster care placement made by a 610.28 local social services agency or a licensed child-placing agency, 610.29 except as provided in subdivision 2a; 610.30 (2) nonresidential programs that are provided by an 610.31 unrelated individual to persons from a single related family; 610.32 (3) residential or nonresidential programs that are 610.33 provided to adults who do not abuse chemicals or who do not have 610.34 a chemical dependency, a mental illness, mental retardation or a 610.35 related condition, a functional impairment, or a physical 610.36 handicap; 611.1 (4) sheltered workshops or work activity programs that are 611.2 certified by the commissioner of economic security; 611.3 (5) programs for children enrolled in kindergarten to the 611.4 12th grade and prekindergarten special education in a school as 611.5 defined in section 120A.22, subdivision 4, and programs serving 611.6 children in combined special education and regular 611.7 prekindergarten programs that are operated or assisted by the 611.8 commissioner of children, families, and learning; 611.9 (6) nonresidential programs primarily for children that 611.10 provide care or supervision, without charge for ten or fewer 611.11 days a year, and for periods of less than three hours a day 611.12 while the child's parent or legal guardian is in the same 611.13 building as the nonresidential program or present within another 611.14 building that is directly contiguous to the building in which 611.15 the nonresidential program is located; 611.16 (7) nursing homes or hospitals licensed by the commissioner 611.17 of health except as specified under section 245A.02; 611.18 (8) board and lodge facilities licensed by the commissioner 611.19 of health that provide services for five or more persons whose 611.20 primary diagnosis is mental illness who have refused an 611.21 appropriate residential program offered by a county agency. 611.22 This exclusion expires on July 1, 1990; 611.23 (9) homes providing programs for persons placed there by a 611.24 licensed agency for legal adoption, unless the adoption is not 611.25 completed within two years; 611.26 (10) programs licensed by the commissioner of corrections; 611.27 (11) recreation programs for children or adults that 611.28 operate for fewer than 40 calendar days in a calendar year or 611.29 programs operated by a park and recreation board of a city of 611.30 the first class whose primary purpose is to provide social and 611.31 recreational activities to school age children, provided the 611.32 program is approved by the park and recreation board; 611.33 (12) programs operated by a school as defined in section 611.34 120A.22, subdivision 4, whose primary purpose is to provide 611.35 child care to school-age children, provided the program is 611.36 approved by the district's school board; 612.1 (13) Head Start nonresidential programs which operate for 612.2 less than 31 days in each calendar year; 612.3 (14) noncertified boarding care homes unless they provide 612.4 services for five or more persons whose primary diagnosis is 612.5 mental illness or mental retardation; 612.6 (15) nonresidential programs for nonhandicapped children 612.7 provided for a cumulative total of less than 30 days in any 612.8 12-month period; 612.9 (16) residential programs for persons with mental illness, 612.10 that are located in hospitals, until the commissioner adopts 612.11 appropriate rules; 612.12 (17) the religious instruction of school-age children; 612.13 Sabbath or Sunday schools; or the congregate care of children by 612.14 a church, congregation, or religious society during the period 612.15 used by the church, congregation, or religious society for its 612.16 regular worship; 612.17 (18) camps licensed by the commissioner of health under 612.18 Minnesota Rules, chapter 4630; 612.19 (19) mental health outpatient services for adults with 612.20 mental illness or children with emotional disturbance; 612.21 (20) residential programs serving school-age children whose 612.22 sole purpose is cultural or educational exchange, until the 612.23 commissioner adopts appropriate rules; 612.24 (21) unrelated individuals who provide out-of-home respite 612.25 care services to persons with mental retardation or related 612.26 conditions from a single related family for no more than 90 days 612.27 in a 12-month period and the respite care services are for the 612.28 temporary relief of the person's family or legal representative; 612.29 (22) respite care services provided as a home and 612.30 community-based service to a person with mental retardation or a 612.31 related condition, in the person's primary residence; 612.32 (23) community support services programs as defined in 612.33 section 245.462, subdivision 6, and family community support 612.34 services as defined in section 245.4871, subdivision 17; 612.35 (24) the placement of a child by a birth parent or legal 612.36 guardian in a preadoptive home for purposes of adoption as 613.1 authorized by section 259.47;or613.2 (25) settings registered under chapter 144D which provide 613.3 home care services licensed by the commissioner of health to 613.4 fewer than seven adults.; or 613.5 (26) consumer-directed community support service funded 613.6 under the Medicaid waiver for persons with mental retardation 613.7 and related conditions when the individual who provided the 613.8 service is: 613.9 (i) the same individual who is the direct payee of these 613.10 specific waiver funds or paid by a fiscal agent, fiscal 613.11 intermediary, or employer of record; and 613.12 (ii) not otherwise under the control of a residential or 613.13 nonresidential program that is required to be licensed under 613.14 this chapter when providing the service. 613.15 For purposes of clause (6), a building is directly 613.16 contiguous to a building in which a nonresidential program is 613.17 located if it shares a common wall with the building in which 613.18 the nonresidential program is located or is attached to that 613.19 building by skyway, tunnel, atrium, or common roof. 613.20 Sec. 8. Minnesota Statutes 2000, section 245A.03, 613.21 subdivision 2b, is amended to read: 613.22 Subd. 2b. [EXCEPTION.] The provision in subdivision 2, 613.23 clause (2), does not apply to: 613.24 (1) a child care provider who as an applicant for licensure 613.25 or as a license holder has received a license denial under 613.26 section 245A.05, afineconditional license under section 613.27 245A.06, or a sanction under section 245A.07 from the 613.28 commissioner that has not been reversed on appeal; or 613.29 (2) a child care provider, or a child care provider who has 613.30 a household member who, as a result of a licensing process, has 613.31 a disqualification under this chapter that has not been set 613.32 aside by the commissioner. 613.33 Sec. 9. Minnesota Statutes 2000, section 245A.03, is 613.34 amended by adding a subdivision to read: 613.35 Subd. 6. [RIGHT TO SEEK CERTIFICATION.] Nothing in this 613.36 section shall prohibit a residential program licensed by the 614.1 commissioner of corrections to serve children, that is excluded 614.2 from licensure under subdivision 2, clause (10), from seeking 614.3 certification from the commissioner of human services under this 614.4 chapter for program services for which certification standards 614.5 have been adopted. 614.6 Sec. 10. Minnesota Statutes 2000, section 245A.035, 614.7 subdivision 1, is amended to read: 614.8 Subdivision 1. [GRANT OF EMERGENCY LICENSE.] 614.9 Notwithstanding section 245A.03, subdivision 2a, a county agency 614.10 may place a child for foster care with a relative who is not 614.11 licensed to provide foster care, provided the requirements of 614.12 subdivision 2 are met. As used in this section, the term 614.13 "relative" has the meaning given it under section260.181,614.14subdivision 3260C.007, subdivision 14. 614.15 Sec. 11. Minnesota Statutes 2000, section 245A.04, 614.16 subdivision 3, is amended to read: 614.17 Subd. 3. [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 614.18 (a)Before the commissioner issues a license, the commissioner614.19shall conduct a study of the individuals specified in paragraph614.20(c), clauses (1) to (5), according to rules of the commissioner.614.21Beginning January 1, 1997, the commissioner shall also614.22conduct a study of employees providing direct contact services614.23for nonlicensed personal care provider organizationsIndividuals 614.24 and organizations that are required in statute to initiate 614.25 background studies under this section shall comply with the 614.26 following requirements: 614.27 (1) Applicants for licensure, license holders, and other 614.28 entities as provided in this section must submit completed 614.29 background study forms to the commissioner before individuals 614.30 specified in paragraph (c), clauses (1) to (4), (6), and (7), 614.31 begin positions allowing direct contact in any licensed program. 614.32 (2) Applicants and license holders under the jurisdiction 614.33 of other state agencies who are required in other statutory 614.34 sections to initiate background studies under this section must 614.35 submit completed background study forms to the commissioner 614.36 prior to the background study subject beginning in a position 615.1 allowing direct contact in the licensed program, or where 615.2 applicable, prior to being employed. 615.3 (3) Organizations required to initiate background studies 615.4 under section 256B.0627 for individuals described in paragraph 615.5 (c), clause (5), must submit a completed background study form 615.6 to the commissioner before those individuals begin a position 615.7 allowing direct contact with persons served by the organization. 615.8 The commissioner shall recover the cost of these background 615.9 studies through a fee of no more than $12 per study charged to 615.10 thepersonal care providerorganization responsible for 615.11 submitting the background study form. The fees collected under 615.12 this paragraph are appropriated to the commissioner for the 615.13 purpose of conducting background studies. 615.14Beginning August 1, 1997,Upon receipt of the background 615.15 study forms from the entities in clauses (1) to (3), the 615.16 commissioner shallconduct all background studies required under615.17this chapter for adult foster care providers who are licensed by615.18the commissioner of human services and registered under chapter615.19144D. The commissioner shall conduct these background studies615.20in accordance with this chapter. The commissioner shall615.21initiate a pilot project to conduct up to 5,000 background615.22studies under this chaptercomplete the background study as 615.23 specified under this section and provide notices required in 615.24 subdivision 3a. Unless otherwise specified, the subject of a 615.25 background study may have direct contact with persons served by 615.26 a program after the background study form is mailed or submitted 615.27 to the commissioner pending notification of the study results 615.28 under subdivision 3a. A county agency may accept a background 615.29 study completed by the commissioner under this section in place 615.30 of the background study required under section 245A.16, 615.31 subdivision 3, in programs with joint licensure as home and 615.32 community-based services and adult foster care for people with 615.33 developmental disabilities when the license holder does not 615.34 reside in the foster care residence and the subject of the study 615.35 has been continuously affiliated with the license holder since 615.36 the date of the commissioner's study. 616.1 (b)Beginning July 1, 1998, the commissioner shall conduct616.2a background study on individuals specified in paragraph (c),616.3clauses (1) to (5), who perform direct contact services in a616.4nursing home or a home care agency licensed under chapter 144A616.5or a boarding care home licensed under sections 144.50 to616.6144.58, when the subject of the study resides outside Minnesota;616.7the study must be at least as comprehensive as that of a616.8Minnesota resident and include a search of information from the616.9criminal justice data communications network in the state where616.10the subject of the study residesThe definitions in this 616.11 paragraph apply only to subdivisions 3 to 3e. 616.12 (1) "Background study" means the review of records 616.13 conducted by the commissioner to determine whether a subject is 616.14 disqualified from direct contact with persons served by a 616.15 program, and where specifically provided in statutes, whether a 616.16 subject is disqualified from having access to persons served by 616.17 a program. 616.18 (2) "Continuous, direct supervision" means an individual is 616.19 within sight or hearing of the supervising person to the extent 616.20 that supervising person is capable at all times of intervening 616.21 to protect the health and safety of the persons served by the 616.22 program. 616.23 (3) "Contractor" means any person, regardless of employer, 616.24 who is providing program services for hire under the control of 616.25 the provider. 616.26 (4) "Direct contact" means providing face-to-face care, 616.27 training, supervision, counseling, consultation, or medication 616.28 assistance to persons served by the program. 616.29 (5) "Reasonable cause" means information or circumstances 616.30 exist which provide the commissioner with articulable suspicion 616.31 that further pertinent information may exist concerning a 616.32 subject. The commissioner has reasonable cause when, but not 616.33 limited to, the commissioner has received a report from the 616.34 subject, the license holder, or a third party indicating that 616.35 the subject has a history that would disqualify the person or 616.36 that may pose a risk to the health or safety of persons 617.1 receiving services. 617.2 (6) "Subject of a background study" means an individual on 617.3 whom a background study is required or completed. 617.4 (c) The applicant, license holder,theregistrant under 617.5 section 144A.71, subdivision 1, bureau of criminal apprehension, 617.6thecommissioner of health, and county agencies, after written 617.7 notice to the individual who is the subject of the study, shall 617.8 help with the study by giving the commissioner criminal 617.9 conviction data and reports about the maltreatment of adults 617.10 substantiated under section 626.557 and the maltreatment of 617.11 minors in licensed programs substantiated under section 617.12 626.556. The individuals to be studied shall include: 617.13 (1) the applicant; 617.14 (2) personsover theageof13 and over living in the 617.15 household where the licensed program will be provided; 617.16 (3) current employees or contractors of the applicant who 617.17 will have direct contact with persons served by the facility, 617.18 agency, or program; 617.19 (4) volunteers or student volunteers who have direct 617.20 contact with persons served by the program to provide program 617.21 services, if the contact is not directly supervised by the 617.22 individuals listed in clause (1) or (3);and617.23 (5) any personwho, as an individual or as a member of an617.24organization, exclusively offers, provides, or arranges for617.25personal care assistant services under the medical assistance617.26program as authorized under sections 256B.04, subdivision 16,617.27and 256B.0625, subdivision 19a.required under section 256B.0627 617.28 to have a background study completed under this section; 617.29 (6) persons age 10 to 12 living in the household where the 617.30 licensed services will be provided when the commissioner has 617.31 reasonable cause; and 617.32 (7) persons who, without providing direct contact services 617.33 at a licensed program, may have unsupervised access to children 617.34 or vulnerable adults receiving services from the program 617.35 licensed to provide family child care for children, foster care 617.36 for children in the provider's own home, or foster care or day 618.1 care services for adults in the provider's own home when the 618.2 commissioner has reasonable cause. 618.3 (d) According to paragraph (c), clauses (2) and (6), the 618.4 commissioner shall review records from the juvenile courts. For 618.5 persons under paragraph (c), clauses (1), (3), (4), (5), and 618.6 (7), who are ages 13 to 17, the commissioner shall review 618.7 records from the juvenile courts when the commissioner has 618.8 reasonable cause. The juvenile courts shallalsohelp with the 618.9 study by giving the commissioner existing juvenile court records 618.10 on individuals described inclauseparagraph (c), clauses (2), 618.11 (6), and (7), relating to delinquency proceedings held within 618.12 either the five years immediately preceding theapplication618.13 background study or the five years immediately preceding the 618.14 individual's 18th birthday, whichever time period is longer. 618.15 The commissioner shall destroy juvenile records obtained 618.16 pursuant to this subdivision when the subject of the records 618.17 reaches age 23. 618.18 (e) Beginning August 1, 2001, the commissioner shall 618.19 conduct all background studies required under this chapter and 618.20 initiated by supplemental nursing services agencies registered 618.21 under section 144A.71, subdivision 1. Studies for the agencies 618.22 must be initiated annually by each agency. The commissioner 618.23 shall conduct the background studies according to this chapter. 618.24 The commissioner shall recover the cost of the background 618.25 studies through a fee of no more than $8 per study, charged to 618.26 the supplemental nursing services agency. The fees collected 618.27 under this paragraph are appropriated to the commissioner for 618.28 the purpose of conducting background studies. 618.29 (f) For purposes of this sectionand Minnesota Rules, part618.309543.3070, a finding that a delinquency petition is proven in 618.31 juvenile court shall be considered a conviction in state 618.32 district court. 618.33For purposes of this subdivision, "direct contact" means618.34providing face-to-face care, training, supervision, counseling,618.35consultation, or medication assistance to persons served by a618.36program. For purposes of this subdivision, "directly supervised"619.1means an individual listed in clause (1), (3), or (5) is within619.2sight or hearing of a volunteer to the extent that the619.3individual listed in clause (1), (3), or (5) is capable at all619.4times of intervening to protect the health and safety of the619.5persons served by the program who have direct contact with the619.6volunteer.619.7 (g) A study of an individual in paragraph (c), clauses (1) 619.8 to(5)(7), shall be conducted at least upon application for 619.9 initial license for all license types or registration under 619.10 section 144A.71, subdivision 1, and at reapplication for a 619.11 license or registration for family child care, child foster 619.12 care, and adult foster care. The commissioner is not required 619.13 to conduct a study of an individual at the time of reapplication 619.14 for a license or if the individual has been continuously 619.15 affiliated with a foster care provider licensed by the 619.16 commissioner of human services and registered under chapter 619.17 144D, other than a family day care or foster care license, if: 619.18 (i) a study of the individual was conducted either at the time 619.19 of initial licensure or when the individual became affiliated 619.20 with the license holder; (ii) the individual has been 619.21 continuously affiliated with the license holder since the last 619.22 study was conducted; and (iii) the procedure described in 619.23 paragraph(d)(j) has been implemented and was in effect 619.24 continuously since the last study was conducted. For the 619.25 purposes of this section, a physician licensed under chapter 147 619.26 is considered to be continuously affiliated upon the license 619.27 holder's receipt from the commissioner of health or human 619.28 services of the physician's background study results. For 619.29 individuals who are required to have background studies 619.30 underclauses (1) to (5)paragraph (c) and who have been 619.31 continuously affiliated with a foster care provider that is 619.32 licensed in more than one county, criminal conviction data may 619.33 be shared among those counties in which the foster care programs 619.34 are licensed. A county agency's receipt of criminal conviction 619.35 data from another county agency shall meet the criminal data 619.36 background study requirements of this section. 620.1 (h) The commissioner may also conduct studies on 620.2 individuals specified in paragraph (c), clauses (3) and (4), 620.3 when the studies are initiated by: 620.4 (i) personnel pool agencies; 620.5 (ii) temporary personnel agencies; 620.6 (iii) educational programs that train persons by providing 620.7 direct contact services in licensed programs; and 620.8 (iv) professional services agencies that are not licensed 620.9 and which contract with licensed programs to provide direct 620.10 contact services or individuals who provide direct contact 620.11 services. 620.12 (i) Studies on individuals in paragraph (h), items (i) to 620.13 (iv), must be initiated annually by these agencies, programs, 620.14 and individuals. Exceptfor personal care provider620.15organizationsas provided in paragraph (a), clause (3), no 620.16 applicant, license holder, or individual who is the subject of 620.17 the study shall pay any fees required to conduct the study. 620.18 (1) At the option of the licensed facility, rather than 620.19 initiating another background study on an individual required to 620.20 be studied who has indicated to the licensed facility that a 620.21 background study by the commissioner was previously completed, 620.22 the facility may make a request to the commissioner for 620.23 documentation of the individual's background study status, 620.24 provided that: 620.25 (i) the facility makes this request using a form provided 620.26 by the commissioner; 620.27 (ii) in making the request the facility informs the 620.28 commissioner that either: 620.29 (A) the individual has been continuously affiliated with a 620.30 licensed facility since the individual's previous background 620.31 study was completed, or since October 1, 1995, whichever is 620.32 shorter; or 620.33 (B) the individual is affiliated only with a personnel pool 620.34 agency, a temporary personnel agency, an educational program 620.35 that trains persons by providing direct contact services in 620.36 licensed programs, or a professional services agency that is not 621.1 licensed and which contracts with licensed programs to provide 621.2 direct contact services or individuals who provide direct 621.3 contact services; and 621.4 (iii) the facility provides notices to the individual as 621.5 required in paragraphs (a) to(d)(j), and that the facility is 621.6 requesting written notification of the individual's background 621.7 study status from the commissioner. 621.8 (2) The commissioner shall respond to each request under 621.9 paragraph (1) with a written or electronic notice to the 621.10 facility and the study subject. If the commissioner determines 621.11 that a background study is necessary, the study shall be 621.12 completed without further request from a licensed agency or 621.13 notifications to the study subject. 621.14 (3) When a background study is being initiated by a 621.15 licensed facility or a foster care provider that is also 621.16 registered under chapter 144D, a study subject affiliated with 621.17 multiple licensed facilities may attach to the background study 621.18 form a cover letter indicating the additional facilities' names, 621.19 addresses, and background study identification numbers. When 621.20 the commissioner receives such notices, each facility identified 621.21 by the background study subject shall be notified of the study 621.22 results. The background study notice sent to the subsequent 621.23 agencies shall satisfy those facilities' responsibilities for 621.24 initiating a background study on that individual. 621.25(d)(j) If an individual who is affiliated with a program 621.26 or facility regulated by the department of human services or 621.27 department of health or who is affiliated witha nonlicensed621.28personal care provider organizationany type of home care agency 621.29 or provider of personal care assistance services, is convicted 621.30 of a crime constituting a disqualification under subdivision 3d, 621.31 the probation officer or corrections agent shall notify the 621.32 commissioner of the conviction. For the purpose of this 621.33 paragraph, "conviction" has the meaning given it in section 621.34 609.02, subdivision 5. The commissioner, in consultation with 621.35 the commissioner of corrections, shall develop forms and 621.36 information necessary to implement this paragraph and shall 622.1 provide the forms and information to the commissioner of 622.2 corrections for distribution to local probation officers and 622.3 corrections agents. The commissioner shall inform individuals 622.4 subject to a background study that criminal convictions for 622.5 disqualifying crimes will be reported to the commissioner by the 622.6 corrections system. A probation officer, corrections agent, or 622.7 corrections agency is not civilly or criminally liable for 622.8 disclosing or failing to disclose the information required by 622.9 this paragraph. Upon receipt of disqualifying information, the 622.10 commissioner shall provide the notifications required in 622.11 subdivision 3a, as appropriate to agencies on record as having 622.12 initiated a background study or making a request for 622.13 documentation of the background study status of the individual. 622.14 This paragraph does not apply to family day care and child 622.15 foster care programs. 622.16(e)(k) The individual who is the subject of the study must 622.17 provide the applicant or license holder with sufficient 622.18 information to ensure an accurate study including the 622.19 individual's first, middle, and last name and all other names by 622.20 which the individual has been known; home address, city, county, 622.21 and state of residence for the past five years; zip code; sex; 622.22 date of birth; and driver's license number or state 622.23 identification number. The applicant or license holder shall 622.24 provide this information about an individual in paragraph (c), 622.25 clauses (1) to(5)(7), on forms prescribed by the commissioner. 622.26 By January 1, 2000, for background studies conducted by the 622.27 department of human services, the commissioner shall implement a 622.28 system for the electronic transmission of: (1) background study 622.29 information to the commissioner; and (2) background study 622.30 results to the license holder. The commissioner may request 622.31 additional information of the individual, which shall be 622.32 optional for the individual to provide, such as the individual's 622.33 social security number or race. 622.34(f) Except for child foster care, adult foster care, and622.35family day care homes(l) For programs directly licensed by the 622.36 commissioner, a study must include information related to names 623.1 of substantiated perpetrators of maltreatment of vulnerable 623.2 adults that has been received by the commissioner as required 623.3 under section 626.557, subdivision 9c, paragraph (i), and the 623.4 commissioner's records relating to the maltreatment of minors in 623.5 licensed programs, information from juvenile courts as required 623.6 in paragraph (c) for persons listed in paragraph (c), 623.7clauseclauses (2), (6), and (7), and information from the 623.8 bureau of criminal apprehension. For child foster care, adult 623.9 foster care, and family day care homes, the study must include 623.10 information from the county agency's record of substantiated 623.11 maltreatment of adults, and the maltreatment of minors, 623.12 information from juvenile courts as required in paragraph (c) 623.13 for persons listed in paragraph (c),clauseclauses (2), (6), 623.14 and (7), and information from the bureau of criminal 623.15 apprehension. The commissioner may also review arrest and 623.16 investigative information from the bureau of criminal 623.17 apprehension, the commissioner of health, a county attorney, 623.18 county sheriff, county agency, local chief of police, other 623.19 states, the courts, or the Federal Bureau of Investigation if 623.20 the commissioner has reasonable cause to believe the information 623.21 is pertinent to the disqualification of an individual listed in 623.22 paragraph (c), clauses (1) to(5)(7). The commissioner is not 623.23 required to conduct more than one review of a subject's records 623.24 from the Federal Bureau of Investigation if a review of the 623.25 subject's criminal history with the Federal Bureau of 623.26 Investigation has already been completed by the commissioner and 623.27 there has been no break in the subject's affiliation with the 623.28 license holder who initiated the backgroundstudiesstudy. 623.29 (m) When the commissioner has reasonable cause to believe 623.30 that further pertinent information may exist on the subject, the 623.31 subject shall provide a set of classifiable fingerprints 623.32 obtained from an authorized law enforcement agency. For 623.33 purposes of requiring fingerprints, the commissioner shall be 623.34 considered to have reasonable cause under, but not limited to, 623.35 the following circumstances: 623.36 (1) information from the bureau of criminal apprehension 624.1 indicates that the subject is a multistate offender; 624.2 (2) information from the bureau of criminal apprehension 624.3 indicates that multistate offender status is undetermined; or 624.4 (3) the commissioner has received a report from the subject 624.5 or a third party indicating that the subject has a criminal 624.6 history in a jurisdiction other than Minnesota. 624.7(g)(n) The failure or refusal of anapplicant's or license624.8holder's failure or refusalapplicant, license holder, or 624.9 registrant under section 144A.71, subdivision 1, to cooperate 624.10 with the commissioner is reasonable cause to disqualify a 624.11 subject, deny a license application or immediately suspend, 624.12 suspend, or revoke a license or registration. Failure or 624.13 refusal of an individual to cooperate with the study is just 624.14 cause for denying or terminating employment of the individual if 624.15 the individual's failure or refusal to cooperate could cause the 624.16 applicant's application to be denied or the license holder's 624.17 license to be immediately suspended, suspended, or revoked. 624.18(h)(o) The commissioner shall not consider an application 624.19 to be complete until all of the information required to be 624.20 provided under this subdivision has been received. 624.21(i)(p) No person in paragraph (c),clauseclauses (1),624.22(2), (3), (4), or (5)to (7), who is disqualified as a result of 624.23 this section may be retained by the agency in a position 624.24 involving direct contact with persons served by the program.or 624.25 in a position allowing access to persons served by the program 624.26 as provided for in statutes, unless the commissioner has 624.27 provided written notice to the agency stating that: 624.28 (1) the individual may remain in direct contact during the 624.29 period in which the individual may request reconsideration as 624.30 provided in subdivision 3a, paragraph (b), clause (2) or (3); 624.31 (2) the individual's disqualification has been set aside 624.32 for that agency as provided in subdivision 3b, paragraph (b); or 624.33 (3) the license holder has been granted a variance for the 624.34 disqualified individual under subdivision 3e. 624.35(j)(q) Termination of persons in paragraph (c),clause624.36 clauses (1), (2), (3), (4), or (5)to (7), made in good faith 625.1 reliance on a notice of disqualification provided by the 625.2 commissioner shall not subject the applicant or license holder 625.3 to civil liability. 625.4(k)(r) The commissioner may establish records to fulfill 625.5 the requirements of this section. 625.6(l)(s) The commissioner may not disqualify an individual 625.7 subject to a study under this section because that person has, 625.8 or has had, a mental illness as defined in section 245.462, 625.9 subdivision 20. 625.10(m)(t) An individual subject to disqualification under 625.11 this subdivision has the applicable rights in subdivision 3a, 625.12 3b, or 3c. 625.13(n)(u) For the purposes of background studies completed by 625.14 tribal organizations performing licensing activities otherwise 625.15 required of the commissioner under this chapter, after obtaining 625.16 consent from the background study subject, tribal licensing 625.17 agencies shall have access to criminal history data in the same 625.18 manner as county licensing agencies and private licensing 625.19 agencies under this chapter. 625.20 Sec. 12. Minnesota Statutes 2000, section 245A.04, 625.21 subdivision 3a, is amended to read: 625.22 Subd. 3a. [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 625.23 STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) Within 15 625.24 working days, the commissioner shall notify the applicantor, 625.25 license holder, or registrant under section 144A.71, subdivision 625.26 1, and the individual who is the subject of the study, in 625.27 writing or by electronic transmission, of the results of the 625.28 study or that more time is needed to complete the study. When 625.29 the study is completed, a notice that the study was undertaken 625.30 and completed shall be maintained in the personnel files of the 625.31 program. For studies on individuals pertaining to a license to 625.32 provide family day care or group family day care, foster care 625.33 for children in the provider's own home, or foster care or day 625.34 care services for adults in the provider's own home, the 625.35 commissioner is not required to provide a separate notice of the 625.36 background study results to the individual who is the subject of 626.1 the study unless the study results in a disqualification of the 626.2 individual. 626.3 The commissioner shall notify the individual studied if the 626.4 information in the study indicates the individual is 626.5 disqualified from direct contact with persons served by the 626.6 program. The commissioner shall disclose the information 626.7 causing disqualification and instructions on how to request a 626.8 reconsideration of the disqualification to the individual 626.9 studied. An applicant or license holder who is not the subject 626.10 of the study shall be informed that the commissioner has found 626.11 information that disqualifies the subject from direct contact 626.12 with persons served by the program. However, only the 626.13 individual studied must be informed of the information contained 626.14 in the subject's background study unless theonlybasis for the 626.15 disqualification is failure to cooperate, substantiated 626.16 maltreatment under section 626.556 or 626.557, the Data 626.17 Practices Act provides for release of the information, or the 626.18 individual studied authorizes the release of the 626.19 information. When a disqualification is based on the subject's 626.20 failure to cooperate with the background study or substantiated 626.21 maltreatment under section 626.556 or 626.557, the agency that 626.22 initiated the study shall be informed by the commissioner of the 626.23 reason for the disqualification. 626.24 (b) Except as provided in subdivision 3d, paragraph (b), if 626.25 the commissioner determines that the individual studied has a 626.26 disqualifying characteristic, the commissioner shall review the 626.27 information immediately available and make a determination as to 626.28 the subject's immediate risk of harm to persons served by the 626.29 program where the individual studied will have direct contact. 626.30 The commissioner shall consider all relevant information 626.31 available, including the following factors in determining the 626.32 immediate risk of harm: the recency of the disqualifying 626.33 characteristic; the recency of discharge from probation for the 626.34 crimes; the number of disqualifying characteristics; the 626.35 intrusiveness or violence of the disqualifying characteristic; 626.36 the vulnerability of the victim involved in the disqualifying 627.1 characteristic; and the similarity of the victim to the persons 627.2 served by the program where the individual studied will have 627.3 direct contact. The commissioner may determine that the 627.4 evaluation of the information immediately available gives the 627.5 commissioner reason to believe one of the following: 627.6 (1) The individual poses an imminent risk of harm to 627.7 persons served by the program where the individual studied will 627.8 have direct contact. If the commissioner determines that an 627.9 individual studied poses an imminent risk of harm to persons 627.10 served by the program where the individual studied will have 627.11 direct contact, the individual and the license holder must be 627.12 sent a notice of disqualification. The commissioner shall order 627.13 the license holder to immediately remove the individual studied 627.14 from direct contact. The notice to the individual studied must 627.15 include an explanation of the basis of this determination. 627.16 (2) The individual poses a risk of harm requiring 627.17 continuous, direct supervision while providing direct contact 627.18 services during the period in which the subject may request a 627.19 reconsideration. If the commissioner determines that an 627.20 individual studied poses a risk of harm that requires 627.21 continuous, direct supervision, the individual and the license 627.22 holder must be sent a notice of disqualification. The 627.23 commissioner shall order the license holder to immediately 627.24 remove the individual studied from direct contact services or 627.25 assure that the individual studied is within sight or hearing of 627.26 another staff person when providing direct contact services 627.27 during the period in which the individual may request a 627.28 reconsideration of the disqualification. If the individual 627.29 studied does not submit a timely request for reconsideration, or 627.30 the individual submits a timely request for reconsideration, but 627.31 the disqualification is not set aside for that license holder, 627.32 the license holder will be notified of the disqualification and 627.33 ordered to immediately remove the individual from any position 627.34 allowing direct contact with persons receiving services from the 627.35 license holder. 627.36 (3) The individual does not pose an imminent risk of harm 628.1 or a risk of harm requiring continuous, direct supervision while 628.2 providing direct contact services during the period in which the 628.3 subject may request a reconsideration. If the commissioner 628.4 determines that an individual studied does not pose a risk of 628.5 harm that requires continuous, direct supervision, only the 628.6 individual must be sent a notice of disqualification. The 628.7 license holder must be sent a notice that more time is needed to 628.8 complete the individual's background study. If the individual 628.9 studied submits a timely request for reconsideration, and if the 628.10 disqualification is set aside for that license holder, the 628.11 license holder will receive the same notification received by 628.12 license holders in cases where the individual studied has no 628.13 disqualifying characteristic. If the individual studied does 628.14 not submit a timely request for reconsideration, or the 628.15 individual submits a timely request for reconsideration, but the 628.16 disqualification is not set aside for that license holder, the 628.17 license holder will be notified of the disqualification and 628.18 ordered to immediately remove the individual from any position 628.19 allowing direct contact with persons receiving services from the 628.20 license holder. 628.21 (c) County licensing agencies performing duties under this 628.22 subdivision may develop an alternative system for determining 628.23 the subject's immediate risk of harm to persons served by the 628.24 program, providing the notices under paragraph (b), and 628.25 documenting the action taken by the county licensing agency. 628.26 Each county licensing agency's implementation of the alternative 628.27 system is subject to approval by the commissioner. 628.28 Notwithstanding this alternative system, county licensing 628.29 agencies shall complete the requirements of paragraph (a). 628.30 Sec. 13. Minnesota Statutes 2000, section 245A.04, 628.31 subdivision 3b, is amended to read: 628.32 Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a) The 628.33 individual who is the subject of the disqualification may 628.34 request a reconsideration of the disqualification. 628.35 The individual must submit the request for reconsideration 628.36 to the commissioner in writing. A request for reconsideration 629.1 for an individual who has been sent a notice of disqualification 629.2 under subdivision 3a, paragraph (b), clause (1) or (2), must be 629.3 submitted within 30 calendar days of the disqualified 629.4 individual's receipt of the notice of disqualification. Upon 629.5 showing that the information in clause (1) or (2) cannot be 629.6 obtained within 30 days, the disqualified individual may request 629.7 additional time, not to exceed 30 days, to obtain that 629.8 information. A request for reconsideration for an individual 629.9 who has been sent a notice of disqualification under subdivision 629.10 3a, paragraph (b), clause (3), must be submitted within 15 629.11 calendar days of the disqualified individual's receipt of the 629.12 notice of disqualification. An individual who was determined to 629.13 have maltreated a child under section 626.556 or a vulnerable 629.14 adult under section 626.557, and who was disqualified under this 629.15 section on the basis of serious or recurring maltreatment, may 629.16 request reconsideration of both the maltreatment and the 629.17 disqualification determinations. The request for 629.18 reconsideration of the maltreatment determination and the 629.19 disqualification must be submitted within 30 calendar days of 629.20 the individual's receipt of the notice of disqualification. 629.21 Removal of a disqualified individual from direct contact shall 629.22 be ordered if the individual does not request reconsideration 629.23 within the prescribed time, and for an individual who submits a 629.24 timely request for reconsideration, if the disqualification is 629.25 not set aside. The individual must present information showing 629.26 that: 629.27 (1) the information the commissioner relied upon is 629.28 incorrect or inaccurate. If the basis of a reconsideration 629.29 request is that a maltreatment determination or disposition 629.30 under section 626.556 or 626.557 is incorrect, and the 629.31 commissioner has issued a final order in an appeal of that 629.32 determination or disposition under section 256.045 or 245A.08, 629.33 subdivision 5, the commissioner's order is conclusive on the 629.34 issue of maltreatment. If the individual did not request 629.35 reconsideration of the maltreatment determination, the 629.36 maltreatment determination is deemed conclusive; or 630.1 (2) the subject of the study does not pose a risk of harm 630.2 to any person served by the applicantor, license holder, or 630.3 registrant under section 144A.71, subdivision 1. 630.4 (b) The commissioner shall rescind the disqualification if 630.5 the commissioner finds that the information relied on to 630.6 disqualify the subject is incorrect. The commissioner may set 630.7 aside the disqualification under this section if the 630.8 commissioner finds that theinformation the commissioner relied630.9upon is incorrect or theindividual does not pose a risk of harm 630.10 to any person served by the applicantor, license holder, or 630.11 registrant under section 144A.71, subdivision 1. In determining 630.12 that an individual does not pose a risk of harm, the 630.13 commissioner shall consider the nature, severity, and 630.14 consequences of the event or events that lead to 630.15 disqualification, whether there is more than one disqualifying 630.16 event, the age and vulnerability of the victim at the time of 630.17 the event, the harm suffered by the victim, the similarity 630.18 between the victim and persons served by the program, the time 630.19 elapsed without a repeat of the same or similar event, 630.20 documentation of successful completion by the individual studied 630.21 of training or rehabilitation pertinent to the event, and any 630.22 other information relevant to reconsideration. In reviewing a 630.23 disqualification under this section, the commissioner shall give 630.24 preeminent weight to the safety of each person to be served by 630.25 the license holderor, applicant, or registrant under section 630.26 144A.71, subdivision 1, over the interests of the license holder 630.27or, applicant, or registrant under section 144A.71, subdivision 630.28 1. 630.29 (c) Unless the information the commissioner relied on in 630.30 disqualifying an individual is incorrect, the commissioner may 630.31 not set aside the disqualification of an individual in 630.32 connection with a license to provide family day care for 630.33 children, foster care for children in the provider's own home, 630.34 or foster care or day care services for adults in the provider's 630.35 own home if: 630.36 (1) less than ten years have passed since the discharge of 631.1 the sentence imposed for the offense; and the individual has 631.2 been convicted of a violation of any offense listed in sections 631.3 609.20 (manslaughter in the first degree), 609.205 (manslaughter 631.4 in the second degree), criminal vehicular homicide under 609.21 631.5 (criminal vehicular homicide and injury), 609.215 (aiding 631.6 suicide or aiding attempted suicide), felony violations under 631.7 609.221 to 609.2231 (assault in the first, second, third, or 631.8 fourth degree), 609.713 (terroristic threats), 609.235 (use of 631.9 drugs to injure or to facilitate crime), 609.24 (simple 631.10 robbery), 609.245 (aggravated robbery), 609.25 (kidnapping), 631.11 609.255 (false imprisonment), 609.561 or 609.562 (arson in the 631.12 first or second degree), 609.71 (riot), burglary in the first or 631.13 second degree under 609.582 (burglary), 609.66 (dangerous 631.14 weapon), 609.665 (spring guns), 609.67 (machine guns and 631.15 short-barreled shotguns), 609.749 (harassment; stalking), 631.16 152.021 or 152.022 (controlled substance crime in the first or 631.17 second degree), 152.023, subdivision 1, clause (3) or (4), or 631.18 subdivision 2, clause (4) (controlled substance crime in the 631.19 third degree), 152.024, subdivision 1, clause (2), (3), or (4) 631.20 (controlled substance crime in the fourth degree), 609.224, 631.21 subdivision 2, paragraph (c) (fifth-degree assault by a 631.22 caregiver against a vulnerable adult), 609.228 (great bodily 631.23 harm caused by distribution of drugs), 609.23 (mistreatment of 631.24 persons confined), 609.231 (mistreatment of residents or 631.25 patients), 609.2325 (criminal abuse of a vulnerable adult), 631.26 609.233 (criminal neglect of a vulnerable adult), 609.2335 631.27 (financial exploitation of a vulnerable adult), 609.234 (failure 631.28 to report), 609.265 (abduction), 609.2664 to 609.2665 631.29 (manslaughter of an unborn child in the first or second degree), 631.30 609.267 to 609.2672 (assault of an unborn child in the first, 631.31 second, or third degree), 609.268 (injury or death of an unborn 631.32 child in the commission of a crime), 617.293 (disseminating or 631.33 displaying harmful material to minors), a felony level 631.34 conviction involving alcohol or drug use, a gross misdemeanor 631.35 offense under 609.324, subdivision 1 (other prohibited acts), a 631.36 gross misdemeanor offense under 609.378 (neglect or endangerment 632.1 of a child), a gross misdemeanor offense under 609.377 632.2 (malicious punishment of a child), 609.72, subdivision 3 632.3 (disorderly conduct against a vulnerable adult); or an attempt 632.4 or conspiracy to commit any of these offenses, as each of these 632.5 offenses is defined in Minnesota Statutes; or an offense in any 632.6 other state, the elements of which are substantially similar to 632.7 the elements of any of the foregoing offenses; 632.8 (2) regardless of how much time has passed since the 632.9 involuntary termination of parental rights under section 632.10 260C.301 or the discharge of the sentence imposed for the 632.11 offense, the individual was convicted of a violation of any 632.12 offense listed in sections 609.185 to 609.195 (murder in the 632.13 first, second, or third degree), 609.2661 to 609.2663 (murder of 632.14 an unborn child in the first, second, or third degree), a felony 632.15 offense under 609.377 (malicious punishment of a child), a 632.16 felony offense under 609.324, subdivision 1 (other prohibited 632.17 acts), a felony offense under 609.378 (neglect or endangerment 632.18 of a child), 609.322 (solicitation, inducement, and promotion of 632.19 prostitution), 609.342 to 609.345 (criminal sexual conduct in 632.20 the first, second, third, or fourth degree), 609.352 632.21 (solicitation of children to engage in sexual conduct), 617.246 632.22 (use of minors in a sexual performance), 617.247 (possession of 632.23 pictorial representations of a minor), 609.365 (incest), a 632.24 felony offense under sections 609.2242 and 609.2243 (domestic 632.25 assault), a felony offense of spousal abuse, a felony offense of 632.26 child abuse or neglect, a felony offense of a crime against 632.27 children, or an attempt or conspiracy to commit any of these 632.28 offenses as defined in Minnesota Statutes, or an offense in any 632.29 other state, the elements of which are substantially similar to 632.30 any of the foregoing offenses; 632.31 (3) within the seven years preceding the study, the 632.32 individual committed an act that constitutes maltreatment of a 632.33 child under section 626.556, subdivision 10e, and that resulted 632.34 in substantial bodily harm as defined in section 609.02, 632.35 subdivision 7a, or substantial mental or emotional harm as 632.36 supported by competent psychological or psychiatric evidence; or 633.1 (4) within the seven years preceding the study, the 633.2 individual was determined under section 626.557 to be the 633.3 perpetrator of a substantiated incident of maltreatment of a 633.4 vulnerable adult that resulted in substantial bodily harm as 633.5 defined in section 609.02, subdivision 7a, or substantial mental 633.6 or emotional harm as supported by competent psychological or 633.7 psychiatric evidence. 633.8 In the case of any ground for disqualification under 633.9 clauses (1) to (4), if the act was committed by an individual 633.10 other than the applicantor, license holder, or registrant under 633.11 section 144A.71, subdivision 1, residing in the applicant's or 633.12 license holder's home, or the home of a registrant under section 633.13 144A.71, subdivision 1, the applicantor, license holder, or 633.14 registrant under section 144A.71, subdivision 1, may seek 633.15 reconsideration when the individual who committed the act no 633.16 longer resides in the home. 633.17 The disqualification periods provided under clauses (1), 633.18 (3), and (4) are the minimum applicable disqualification 633.19 periods. The commissioner may determine that an individual 633.20 should continue to be disqualified from licensure or 633.21 registration under section 144A.71, subdivision 1, because the 633.22 license holderor, applicant, or registrant under section 633.23 144A.71, subdivision 1, poses a risk of harm to a person served 633.24 by that individual after the minimum disqualification period has 633.25 passed. 633.26 (d) The commissioner shall respond in writing or by 633.27 electronic transmission to all reconsideration requests for 633.28 which the basis for the request is that the information relied 633.29 upon by the commissioner to disqualify is incorrect or 633.30 inaccurate within 30 working days of receipt of a request and 633.31 all relevant information. If the basis for the request is that 633.32 the individual does not pose a risk of harm, the commissioner 633.33 shall respond to the request within 15 working days after 633.34 receiving the request for reconsideration and all relevant 633.35 information. If the request is based on both the correctness or 633.36 accuracy of the information relied on to disqualify the 634.1 individual and the risk of harm, the commissioner shall respond 634.2 to the request within 45 working days after receiving the 634.3 request for reconsideration and all relevant information. If 634.4 the disqualification is set aside, the commissioner shall notify 634.5 the applicant or license holder in writing or by electronic 634.6 transmission of the decision. 634.7 (e) Except as provided in subdivision 3c,the634.8commissioner's decision to disqualify an individual, including634.9the decision to grant or deny a rescission or set aside a634.10disqualification under this section, is the final administrative634.11agency action and shall not be subject to further review in a634.12contested case under chapter 14 involving a negative licensing634.13appeal taken in response to the disqualification or involving an634.14accuracy and completeness appeal under section 13.04.if a 634.15 disqualification is not set aside or is not rescinded, an 634.16 individual who was disqualified on the basis of a preponderance 634.17 of evidence that the individual committed an act or acts that 634.18 meet the definition of any of the crimes lists in subdivision 634.19 3d, paragraph (a), clauses (1) to (4); or for failure to make 634.20 required reports under section 626.556, subdivision 3, or 634.21 626.557, subdivision 3, pursuant to subdivision 3d, paragraph 634.22 (a), clause (4), may request a fair hearing under section 634.23 256.045. Except as provided under subdivision 3c, the 634.24 commissioner's final order for an individual under this 634.25 paragraph is conclusive on the issue of maltreatment and 634.26 disqualification, including for purposes of subsequent studies 634.27 conducted under subdivision 3, and is the only administrative 634.28 appeal of the final agency determination, specifically, 634.29 including a challenge to the accuracy and completeness of data 634.30 under section 13.04. 634.31 (f) Except as provided under subdivision 3c, if an 634.32 individual was disqualified on the basis of a determination of 634.33 maltreatment under section 626.556 or 626.557, which was serious 634.34 or recurring, and the individual has requested reconsideration 634.35 of the maltreatment determination under section 626.556, 634.36 subdivision 10i, or 626.557, subdivision 9d, and also requested 635.1 reconsideration of the disqualification under this subdivision, 635.2 reconsideration of the maltreatment determination and 635.3 reconsideration of the disqualification shall be consolidated 635.4 into a single reconsideration. For maltreatment and 635.5 disqualification determinations made by county agencies, the 635.6 consolidated reconsideration shall be conducted by the county 635.7 agency. Except as provided under subdivision 3c, if an 635.8 individual who was disqualified on the basis of serious or 635.9 recurring maltreatment requests a fair hearing on the 635.10 maltreatment determination under section 626.556, subdivision 635.11 10i, or 626.557, subdivision 9d, the scope of the fair hearing 635.12 under section 256.045 shall include the maltreatment 635.13 determination and the disqualification. Except as provided 635.14 under subdivision 3c, the commissioner's final order for an 635.15 individual under this paragraph is conclusive on the issue of 635.16 maltreatment and disqualification, including for purposes of 635.17 subsequent studies conducted under subdivision 3, and is the 635.18 only administrative appeal of the final agency determination, 635.19 specifically, including a challenge to the accuracy and 635.20 completeness of data under section 13.04. 635.21 Sec. 14. Minnesota Statutes 2000, section 245A.04, 635.22 subdivision 3c, is amended to read: 635.23 Subd. 3c. [CONTESTED CASE.] (a) Notwithstanding 635.24 subdivision 3b, paragraphs (e) and (f), if a disqualification is 635.25 not set aside, a person who is an employee of an employer, as 635.26 defined in section 179A.03, subdivision 15, may request a 635.27 contested case hearing under chapter 14. If the 635.28 disqualification which was not set aside or was not rescinded 635.29 was based on a maltreatment determination, the scope of the 635.30 contested case hearing shall include the maltreatment 635.31 determination and the disqualification. In such cases, a fair 635.32 hearing shall not be conducted under section 256.045. Rules 635.33 adopted under this chapter may not preclude an employee in a 635.34 contested case hearing for disqualification from submitting 635.35 evidence concerning information gathered under subdivision 3, 635.36 paragraph (e). 636.1 (b) If a disqualification for which reconsideration was 636.2 requested and which was not set aside or was not rescinded under 636.3 subdivision 3b is the basis for a denial of a license under 636.4 section 245A.05 or a licensing sanction under section 245A.07, 636.5 the license holder has the right to a contested case hearing 636.6 under chapter 14 and Minnesota Rules, parts 1400.8510 to 636.7 1400.8612 and successor rules. The appeal must be submitted in 636.8 accordance with section 245A.05 or 245A.07, subdivision 3. As 636.9 provided for under section 245A.08, subdivision 2a, the scope of 636.10 the consolidated contested case hearing shall include the 636.11 disqualification and the licensing sanction or denial of a 636.12 license. If the disqualification was based on a determination 636.13 of substantiated serious or recurring maltreatment under section 636.14 626.556 or 626.557, the appeal must be submitted in accordance 636.15 with sections 245A.07, subdivision 3, and 626.556, subdivision 636.16 10i, or 626.557, subdivision 9d. As provided for under section 636.17 245A.08, subdivision 2a, the scope of the contested case hearing 636.18 shall include the maltreatment determination, the 636.19 disqualification, and the licensing sanction or denial of a 636.20 license. In such cases, a fair hearing shall not be conducted 636.21 under section 256.045. 636.22 (c) If a maltreatment determination or disqualification, 636.23 which was not set aside or was not rescinded under subdivision 636.24 3b, is the basis for a denial of a license under section 245A.05 636.25 or a licensing sanction under section 245A.07, and the 636.26 disqualified subject is an individual other than the license 636.27 holder and upon whom a background study must be conducted under 636.28 subdivision 3, the hearing of all parties may be consolidated 636.29 into a single contested case hearing upon consent of all parties 636.30 and the administrative law judge. 636.31 (d) The commissioner's final order under section 245A.08, 636.32 subdivision 5, is conclusive on the issue of maltreatment and 636.33 disqualification, including for purposes of subsequent 636.34 background studies. The contested case hearing under this 636.35 subdivision is the only administrative appeal of the final 636.36 agency determination, specifically, including a challenge to the 637.1 accuracy and completeness of data under section 13.04. 637.2 [EFFECTIVE DATE.] This section is effective January 1, 2002. 637.3 Sec. 15. Minnesota Statutes 2000, section 245A.04, 637.4 subdivision 3d, is amended to read: 637.5 Subd. 3d. [DISQUALIFICATION.](a) Except as provided in637.6paragraph (b),Upon receipt of information showing, or when a 637.7 background study completed under subdivision 3 shows any of the 637.8 following: a conviction of one or more crimes listed in clauses 637.9 (1) to (4); the individual has admitted to or a preponderance of 637.10 the evidence indicates the individual has committed an act or 637.11 acts that meet the definition of any of the crimes listed in 637.12 clauses (1) to (4); or an investigation results in an 637.13 administrative determination listed under clause (4), the 637.14 individual shall be disqualified from any position allowing 637.15 direct contact with persons receiving services from the license 637.16 holder, entity identified in subdivision 3, paragraph (a), or 637.17 registrant under section 144A.71, subdivision 1, and for 637.18 individuals studied under section 245A.04, subdivision 3, 637.19 paragraph (c), clauses (2), (6), and (7), the individual shall 637.20 also be disqualified from access to a person receiving services 637.21 from the license holder: 637.22 (1) regardless of how much time has passed since the 637.23 involuntary termination of parental rights under section 637.24 260C.301 or the discharge of the sentence imposed for the 637.25 offense, and unless otherwise specified, regardless of the level 637.26 of the conviction, the individual was convicted of any of the 637.27 following offenses: sections 609.185 (murder in the first 637.28 degree); 609.19 (murder in the second degree); 609.195 (murder 637.29 in the third degree); 609.2661 (murder of an unborn child in the 637.30 first degree); 609.2662 (murder of an unborn child in the second 637.31 degree); 609.2663 (murder of an unborn child in the third 637.32 degree); 609.322 (solicitation, inducement, and promotion of 637.33 prostitution); 609.342 (criminal sexual conduct in the first 637.34 degree); 609.343 (criminal sexual conduct in the second degree); 637.35 609.344 (criminal sexual conduct in the third degree); 609.345 637.36 (criminal sexual conduct in the fourth degree); 609.352 638.1 (solicitation of children to engage in sexual conduct); 609.365 638.2 (incest); felony offense under 609.377 (malicious punishment of 638.3 a child); a felony offense under 609.378 (neglect or 638.4 endangerment of a child); a felony offense under 609.324, 638.5 subdivision 1 (other prohibited acts); 617.246 (use of minors in 638.6 sexual performance prohibited); 617.247 (possession of pictorial 638.7 representations of minors); a felony offense under sections 638.8 609.2242 and 609.2243 (domestic assault), a felony offense of 638.9 spousal abuse, a felony offense of child abuse or neglect, a 638.10 felony offense of a crime against children; or attempt or 638.11 conspiracy to commit any of these offenses as defined in 638.12 Minnesota Statutes, or an offense in any other state or country, 638.13 where the elements are substantially similar to any of the 638.14 offenses listed in this clause; 638.15 (2) if less than 15 years have passed since the discharge 638.16 of the sentence imposed for the offense; and the individual has 638.17 received a felony conviction for a violation of any of these 638.18 offenses: sections 609.20 (manslaughter in the first degree); 638.19 609.205 (manslaughter in the second degree); 609.21 (criminal 638.20 vehicular homicide and injury); 609.215 (suicide); 609.221 to 638.21 609.2231 (assault in the first, second, third, or fourth 638.22 degree); repeat offenses under 609.224 (assault in the fifth 638.23 degree); repeat offenses under 609.3451 (criminal sexual conduct 638.24 in the fifth degree); 609.713 (terroristic threats); 609.235 638.25 (use of drugs to injure or facilitate crime); 609.24 (simple 638.26 robbery); 609.245 (aggravated robbery); 609.25 (kidnapping); 638.27 609.255 (false imprisonment); 609.561 (arson in the first 638.28 degree); 609.562 (arson in the second degree); 609.563 (arson in 638.29 the third degree); repeat offenses under 617.23 (indecent 638.30 exposure; penalties); repeat offenses under 617.241 (obscene 638.31 materials and performances; distribution and exhibition 638.32 prohibited; penalty); 609.71 (riot); 609.66 (dangerous weapons); 638.33 609.67 (machine guns and short-barreled shotguns); 609.749 638.34 (harassment; stalking; penalties); 609.228 (great bodily harm 638.35 caused by distribution of drugs); 609.2325 (criminal abuse of a 638.36 vulnerable adult); 609.2664 (manslaughter of an unborn child in 639.1 the first degree); 609.2665 (manslaughter of an unborn child in 639.2 the second degree); 609.267 (assault of an unborn child in the 639.3 first degree); 609.2671 (assault of an unborn child in the 639.4 second degree); 609.268 (injury or death of an unborn child in 639.5 the commission of a crime); 609.52 (theft); 609.2335 (financial 639.6 exploitation of a vulnerable adult); 609.521 (possession of 639.7 shoplifting gear); 609.582 (burglary); 609.625 (aggravated 639.8 forgery); 609.63 (forgery); 609.631 (check forgery; offering a 639.9 forged check); 609.635 (obtaining signature by false pretense); 639.10 609.27 (coercion); 609.275 (attempt to coerce); 609.687 639.11 (adulteration); 260C.301 (grounds for termination of parental 639.12 rights);andchapter 152 (drugs; controlled substance); and a 639.13 felony level conviction involving alcohol or drug use. An 639.14 attempt or conspiracy to commit any of these offenses, as each 639.15 of these offenses is defined in Minnesota Statutes; or an 639.16 offense in any other state or country, the elements of which are 639.17 substantially similar to the elements of the offenses in this 639.18 clause. If the individual studied is convicted of one of the 639.19 felonies listed in this clause, but the sentence is a gross 639.20 misdemeanor or misdemeanor disposition, the lookback period for 639.21 the conviction is the period applicable to the disposition, that 639.22 is the period for gross misdemeanors or misdemeanors; 639.23 (3) if less than ten years have passed since the discharge 639.24 of the sentence imposed for the offense; and the individual has 639.25 received a gross misdemeanor conviction for a violation of any 639.26 of the following offenses: sections 609.224 (assault in the 639.27 fifth degree); 609.2242 and 609.2243 (domestic assault); 639.28 violation of an order for protection under 518B.01, subdivision 639.29 14; 609.3451 (criminal sexual conduct in the fifth degree); 639.30 repeat offenses under 609.746 (interference with privacy); 639.31 repeat offenses under 617.23 (indecent exposure); 617.241 639.32 (obscene materials and performances); 617.243 (indecent 639.33 literature, distribution); 617.293 (harmful materials; 639.34 dissemination and display to minors prohibited); 609.71 (riot); 639.35 609.66 (dangerous weapons); 609.749 (harassment; stalking; 639.36 penalties); 609.224, subdivision 2, paragraph (c) (assault in 640.1 the fifth degree by a caregiver against a vulnerable adult); 640.2 609.23 (mistreatment of persons confined); 609.231 (mistreatment 640.3 of residents or patients); 609.2325 (criminal abuse of a 640.4 vulnerable adult); 609.233 (criminal neglect of a vulnerable 640.5 adult); 609.2335 (financial exploitation of a vulnerable adult); 640.6 609.234 (failure to report maltreatment of a vulnerable adult); 640.7 609.72, subdivision 3 (disorderly conduct against a vulnerable 640.8 adult); 609.265 (abduction); 609.378 (neglect or endangerment of 640.9 a child); 609.377 (malicious punishment of a child); 609.324, 640.10 subdivision 1a (other prohibited acts; minor engaged in 640.11 prostitution); 609.33 (disorderly house); 609.52 (theft); 640.12 609.582 (burglary); 609.631 (check forgery; offering a forged 640.13 check); 609.275 (attempt to coerce); or an attempt or conspiracy 640.14 to commit any of these offenses, as each of these offenses is 640.15 defined in Minnesota Statutes; or an offense in any other state 640.16 or country, the elements of which are substantially similar to 640.17 the elements of any of the offenses listed in this clause. If 640.18 the defendant is convicted of one of the gross misdemeanors 640.19 listed in this clause, but the sentence is a misdemeanor 640.20 disposition, the lookback period for the conviction is the 640.21 period applicable to misdemeanors; or 640.22 (4) if less than seven years have passed since the 640.23 discharge of the sentence imposed for the offense; and the 640.24 individual has received a misdemeanor conviction for a violation 640.25 of any of the following offenses: sections 609.224 (assault in 640.26 the fifth degree); 609.2242 (domestic assault); violation of an 640.27 order for protection under 518B.01 (Domestic Abuse Act); 640.28 violation of an order for protection under 609.3232 (protective 640.29 order authorized; procedures; penalties); 609.746 (interference 640.30 with privacy); 609.79 (obscene or harassing phone calls); 640.31 609.795 (letter, telegram, or package; opening; harassment); 640.32 617.23 (indecent exposure; penalties); 609.2672 (assault of an 640.33 unborn child in the third degree); 617.293 (harmful materials; 640.34 dissemination and display to minors prohibited); 609.66 640.35 (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 640.36 exploitation of a vulnerable adult); 609.234 (failure to report 641.1 maltreatment of a vulnerable adult); 609.52 (theft); 609.27 641.2 (coercion); or an attempt or conspiracy to commit any of these 641.3 offenses, as each of these offenses is defined in Minnesota 641.4 Statutes; or an offense in any other state or country, the 641.5 elements of which are substantially similar to the elements of 641.6 any of the offenses listed in this clause; a determination or 641.7 disposition of failure to make required reports under section 641.8 626.556, subdivision 3, or 626.557, subdivision 3, for incidents 641.9 in which: (i) the final disposition under section 626.556 or 641.10 626.557 was substantiated maltreatment, and (ii) the 641.11 maltreatment was recurring or serious; or a determination or 641.12 disposition of substantiated serious or recurring maltreatment 641.13 of a minor under section 626.556 or of a vulnerable adult under 641.14 section 626.557 for which there is a preponderance of evidence 641.15 that the maltreatment occurred, and that the subject was 641.16 responsible for the maltreatment. 641.17 For the purposes of this section, "serious maltreatment" 641.18 means sexual abuse; maltreatment resulting in death; or 641.19 maltreatment resulting in serious injury which reasonably 641.20 requires the care of a physician whether or not the care of a 641.21 physician was sought; or abuse resulting in serious injury. For 641.22 purposes of this section, "abuse resulting in serious injury" 641.23 means: bruises, bites, skin laceration or tissue damage; 641.24 fractures; dislocations; evidence of internal injuries; head 641.25 injuries with loss of consciousness; extensive second-degree or 641.26 third-degree burns and other burns for which complications are 641.27 present; extensive second-degree or third-degree frostbite, and 641.28 others for which complications are present; irreversible 641.29 mobility or avulsion of teeth; injuries to the eyeball; 641.30 ingestion of foreign substances and objects that are harmful; 641.31 near drowning; and heat exhaustion or sunstroke. For purposes 641.32 of this section, "care of a physician" is treatment received or 641.33 ordered by a physician, but does not include diagnostic testing, 641.34 assessment, or observation. For the purposes of this section, 641.35 "recurring maltreatment" means more than one incident of 641.36 maltreatment for which there is a preponderance of evidence that 642.1 the maltreatment occurred, and that the subject was responsible 642.2 for the maltreatment. For purposes of this section, "access" 642.3 means physical access to an individual receiving services or the 642.4 individual's personal property without continuous, direct 642.5 supervision as defined in section 245A.04, subdivision 3. 642.6 (b)IfExcept for background studies related to child 642.7 foster care, adult foster care, or family child care licensure, 642.8 when the subject of a background study islicensedregulated by 642.9 a health-related licensing board as defined in chapter 214, and 642.10 the regulated person has been determined to have been 642.11 responsible for substantiated maltreatment under section 626.556 642.12 or 626.557, instead of the commissioner making a decision 642.13 regarding disqualification, the board shall makethea 642.14 determinationregarding a disqualification under this642.15subdivision based on a finding of substantiated maltreatment642.16under section 626.556 or 626.557. The commissioner shall notify642.17the health-related licensing board if a background study shows642.18that a licensee would be disqualified because of substantiated642.19maltreatment and the board shall make a determination under642.20section 214.104.whether to impose disciplinary or corrective 642.21 action under chapter 214. 642.22 (1) The commissioner shall notify the health-related 642.23 licensing board: 642.24 (i) upon completion of a background study that produces a 642.25 record showing that the individual was determined to have been 642.26 responsible for substantiated maltreatment; 642.27 (ii) upon the commissioner's completion of an investigation 642.28 that determined the individual was responsible for substantiated 642.29 maltreatment; or 642.30 (iii) upon receipt from another agency of a finding of 642.31 substantiated maltreatment for which the individual was 642.32 responsible. 642.33 (2) The commissioner's notice shall indicate whether the 642.34 individual would have been disqualified by the commissioner for 642.35 the substantiated maltreatment if the individual were not 642.36 regulated by the board. The commissioner shall concurrently 643.1 send this notice to the individual. 643.2 (3) Notwithstanding the exclusion from this subdivision for 643.3 individuals who provide child foster care, adult foster care, or 643.4 family child care, when the commissioner or a local agency has 643.5 reason to believe that the direct contact services provided by 643.6 the individual may fall within the jurisdiction of a 643.7 health-related licensing board, a referral shall be made to the 643.8 board as provided in this section. 643.9 (4) If, upon review of the information provided by the 643.10 commissioner, a health-related licensing board informs the 643.11 commissioner that the board does not have jurisdiction to take 643.12 disciplinary or corrective action, the commissioner shall make 643.13 the appropriate disqualification decision regarding the 643.14 individual as otherwise provided in this chapter. 643.15 (5) The commissioner has the authority to monitor the 643.16 facility's compliance with any requirements that the 643.17 health-related licensing board places on regulated persons 643.18 practicing in a facility either during the period pending a 643.19 final decision on a disciplinary or corrective action or as a 643.20 result of a disciplinary or corrective action. The commissioner 643.21 has the authority to order the immediate removal of a regulated 643.22 person from direct contact or access when a board issues an 643.23 order of temporary suspension based on a determination that the 643.24 regulated person poses an immediate risk of harm to persons 643.25 receiving services in a licensed facility. 643.26 (6) A facility that allows a regulated person to provide 643.27 direct contact services while not complying with the 643.28 requirements imposed by the health-related licensing board is 643.29 subject to action by the commissioner as specified under 643.30 sections 245A.06 and 245A.07. 643.31 (7) The commissioner shall notify a health-related 643.32 licensing board immediately upon receipt of knowledge of 643.33 noncompliance with requirements placed on a facility or upon a 643.34 person regulated by the board. 643.35 Sec. 16. Minnesota Statutes 2000, section 245A.04, is 643.36 amended by adding a subdivision to read: 644.1 Subd. 3e. [VARIANCE FOR A DISQUALIFIED PERSON.] (a) When a 644.2 background study subject's disqualification has not been set 644.3 aside by the commissioner, and there are conditions under which 644.4 the disqualified individual may provide direct contact services 644.5 or have access to people receiving services that minimize the 644.6 risk of harm to people receiving services, the commissioner may 644.7 grant a time limited variance to a license holder that states 644.8 the reason for the disqualification, the services that may be 644.9 provided by the disqualified individual, and the conditions with 644.10 which the license holder or applicant must comply for the 644.11 variance to be effective. 644.12 (b) Except for programs licensed to provide family day care 644.13 for children, foster care for children in the provider's own 644.14 home, or foster care or day care services for adults in the 644.15 provider's own home, the commissioner may not grant a variance 644.16 for a disqualified person unless the applicant or license holder 644.17 has requested the variance and the disqualified individual has 644.18 provided written consent for the commissioner to disclose to the 644.19 applicant or license holder the reason for the disqualification. 644.20 (c) When a license holder permits a disqualified individual 644.21 to provide any services for which the subject is disqualified 644.22 without complying with the conditions of the variance, 644.23 termination of the variance is immediate and the license holder 644.24 may be subject to fines or sanctions under sections 245A.06 and 644.25 245A.07. 644.26 (d) The commissioner may terminate a variance for a 644.27 disqualified person at any time for cause. 644.28 (e) The commissioner's decision to grant or deny a variance 644.29 request is final and not subject to appeal under the provisions 644.30 of chapter 14. 644.31 Sec. 17. Minnesota Statutes 2000, section 245A.04, 644.32 subdivision 6, is amended to read: 644.33 Subd. 6. [COMMISSIONER'S EVALUATION.] Beforegranting644.34 issuing, denying, suspending, revoking, or making conditional a 644.35 license, the commissioner shall evaluate information gathered 644.36 under this section. The commissioner's evaluation shall 645.1 consider facts, conditions, or circumstances concerning the 645.2 program's operation, the well-being of persons served by the 645.3 program, available consumer evaluations of the program, and 645.4 information about the qualifications of the personnel employed 645.5 by the applicant or license holder. 645.6 The commissioner shall evaluate the results of the study 645.7 required in subdivision 3 and determine whether a risk of harm 645.8 to the persons served by the program exists. In conducting this 645.9 evaluation, the commissioner shall apply the disqualification 645.10 standards set forth in rules adopted under this chapter. 645.11 Sec. 18. Minnesota Statutes 2000, section 245A.04, 645.12 subdivision 11, is amended to read: 645.13 Subd. 11. [EDUCATION PROGRAM; ADDITIONAL REQUIREMENT.] (a) 645.14 The education program offered in a residential or nonresidential 645.15 program, except for child care, foster care, or services for 645.16 adults, must be approved by the commissioner of children, 645.17 families, and learning before the commissioner of human services 645.18 may grant a license to the program. 645.19 (b) A residential program licensed under Minnesota Rules, 645.20 parts 9545.0905 to 9545.1125 or 9545.1400 to 9545.1480, may 645.21 serve persons through the age of 19 when: 645.22 (1) the admission is necessary for a person to complete a 645.23 secondary school program or its equivalent, or it is necessary 645.24 to facilitate a transition period after completing the secondary 645.25 school program or its equivalent for up to four months in order 645.26 for the resident to obtain other living arrangements; 645.27 (2) the facility develops policies, procedures, and plans 645.28 required under section 245A.65; 645.29 (3) the facility documents an assessment of the 18- or 645.30 19-year-old person's risk of victimizing children residing in 645.31 the facility, and develops necessary risk reduction measures, 645.32 including sleeping arrangements, to minimize any risk of harm to 645.33 children; and 645.34 (4) notwithstanding the license holder's target population 645.35 age range, whenever persons age 18 or 19 years old are receiving 645.36 residential services, the age difference among residents may not 646.1 exceed five years. 646.2 (c) Nothing in this paragraph precludes the license holder 646.3 from seeking other variances under section 245A.04, subdivision 646.4 9. 646.5 Sec. 19. Minnesota Statutes 2000, section 245A.05, is 646.6 amended to read: 646.7 245A.05 [DENIAL OF APPLICATION.] 646.8 The commissioner may deny a license if an applicant fails 646.9 to comply with applicable laws or rules, or knowingly withholds 646.10 relevant information from or gives false or misleading 646.11 information to the commissioner in connection with an 646.12 application for a license or during an investigation. An 646.13 applicant whose application has been denied by the commissioner 646.14 must be given notice of the denial. Notice must be given by 646.15 certified mail. The notice must state the reasons the 646.16 application was denied and must inform the applicant of the 646.17 right to a contested case hearing under chapter 14 and Minnesota 646.18 Rules, parts 1400.8510 to 1400.8612 and successor rules. The 646.19 applicant may appeal the denial by notifying the commissioner in 646.20 writing by certified mail within 20 calendar days after 646.21 receiving notice that the application was denied. Section 646.22 245A.08 applies to hearings held to appeal the commissioner's 646.23 denial of an application. 646.24 [EFFECTIVE DATE.] This section is effective January 1, 2002. 646.25 Sec. 20. Minnesota Statutes 2000, section 245A.06, is 646.26 amended to read: 646.27 245A.06 [CORRECTION ORDER ANDFINESCONDITIONAL LICENSE.] 646.28 Subdivision 1. [CONTENTS OF CORRECTION ORDERSOR FINESAND 646.29 CONDITIONAL LICENSES.] (a) If the commissioner finds that the 646.30 applicant or license holder has failed to comply with an 646.31 applicable law or rule and this failure does not imminently 646.32 endanger the health, safety, or rights of the persons served by 646.33 the program, the commissioner may issue a correction order and 646.34 an order of conditional license toor impose a fine onthe 646.35 applicant or license holder. When issuing a conditional 646.36 license, the commissioner shall consider the nature, chronicity, 647.1 or severity of the violation of law or rule and the effect of 647.2 the violation on the health, safety, or rights of persons served 647.3 by the program. The correction order orfineconditional 647.4 license must state: 647.5 (1) the conditions that constitute a violation of the law 647.6 or rule; 647.7 (2) the specific law or rule violated; 647.8 (3) the time allowed to correct each violation; and 647.9 (4) if afine is imposed, the amount of the finelicense is 647.10 made conditional, the length and terms of the conditional 647.11 license. 647.12 (b) Nothing in this section prohibits the commissioner from 647.13 proposing a sanction as specified in section 245A.07, prior to 647.14 issuing a correction order orfineconditional license. 647.15 Subd. 2. [RECONSIDERATION OF CORRECTION ORDERS.] If the 647.16 applicant or license holder believes that the contents of the 647.17 commissioner's correction order are in error, the applicant or 647.18 license holder may ask the department of human services to 647.19 reconsider the parts of the correction order that are alleged to 647.20 be in error. The request for reconsideration must be in writing 647.21 and received by the commissioner within 20 calendar days after 647.22 receipt of the correction order by the applicant or license 647.23 holder, and: 647.24 (1) specify the parts of the correction order that are 647.25 alleged to be in error; 647.26 (2) explain why they are in error; and 647.27 (3) include documentation to support the allegation of 647.28 error. 647.29 A request for reconsideration does not stay any provisions 647.30 or requirements of the correction order. The commissioner's 647.31 disposition of a request for reconsideration is final and not 647.32 subject to appeal under chapter 14. 647.33 Subd. 3. [FAILURE TO COMPLY.] If the commissioner finds 647.34 that the applicant or license holder has not corrected the 647.35 violations specified in the correction order or conditional 647.36 license, the commissioner may impose a fine and order other 648.1 licensing sanctions pursuant to section 245A.07.If a fine was648.2imposed and the violation was not corrected, the commissioner648.3may impose an additional fine. This section does not prohibit648.4the commissioner from seeking a court order, denying an648.5application, or suspending, revoking, or making conditional the648.6license in addition to imposing a fine.648.7 Subd. 4. [NOTICE OFFINECONDITIONAL LICENSE; 648.8 RECONSIDERATION OFFINECONDITIONAL LICENSE.]A license holder648.9who is ordered to pay a fineIf a license is made conditional, 648.10 the license holder must be notified of the order by certified 648.11 mail. The notice must be mailed to the address shown on the 648.12 application or the last known address of the license holder. 648.13 The notice must state the reasons thefineconditional license 648.14 was ordered and must inform the license holder of the 648.15responsibility for payment of fines in subdivision 7 and the648.16 right to request reconsideration of thefineconditional license 648.17 by the commissioner. The license holder may request 648.18 reconsideration of the orderto forfeit a fineof conditional 648.19 license by notifying the commissioner by certified mailwithin648.2020 calendar days after receiving the order. The request must be 648.21 in writing and must be received by the commissioner within ten 648.22 calendar days after the license holder received the order. The 648.23 license holder may submit with the request for reconsideration 648.24 written argument or evidence in support of the request for 648.25 reconsideration. A timely request for reconsideration shall 648.26 stayforfeiture of the fineimposition of the terms of the 648.27 conditional license until the commissioner issues a decision on 648.28 the request for reconsideration.The request for648.29reconsideration must be in writing and:648.30(1) specify the parts of the violation that are alleged to648.31be in error;648.32(2) explain why they are in error;648.33(3) include documentation to support the allegation of648.34error; and648.35(4) any other information relevant to the fine or the648.36amount of the fine.649.1 The commissioner's disposition of a request for 649.2 reconsideration is final and not subject to appeal under chapter 649.3 14. 649.4Subd. 5. [FORFEITURE OF FINES.] The license holder shall649.5pay the fines assessed on or before the payment date specified649.6in the commissioner's order. If the license holder fails to649.7fully comply with the order, the commissioner shall issue a649.8second fine or suspend the license until the license holder649.9complies. If the license holder receives state funds, the649.10state, county, or municipal agencies or departments responsible649.11for administering the funds shall withhold payments and recover649.12any payments made while the license is suspended for failure to649.13pay a fine.649.14Subd. 5a. [ACCRUAL OF FINES.] A license holder shall649.15promptly notify the commissioner of human services, in writing,649.16when a violation specified in an order to forfeit is corrected.649.17If upon reinspection the commissioner determines that a649.18violation has not been corrected as indicated by the order to649.19forfeit, the commissioner may issue a second fine. The649.20commissioner shall notify the license holder by certified mail649.21that a second fine has been assessed. The license holder may649.22request reconsideration of the second fine under the provisions649.23of subdivision 4.649.24Subd. 6. [AMOUNT OF FINES.] Fines shall be assessed as649.25follows:649.26(1) the license holder shall forfeit $1,000 for each649.27occurrence of violation of law or rule prohibiting the649.28maltreatment of children or the maltreatment of vulnerable649.29adults, including but not limited to corporal punishment,649.30illegal or unauthorized use of physical, mechanical, or chemical649.31restraints, and illegal or unauthorized use of aversive or649.32deprivation procedures;649.33(2) the license holder shall forfeit $200 for each649.34occurrence of a violation of law or rule governing matters of649.35health, safety, or supervision, including but not limited to the649.36provision of adequate staff to child or adult ratios; and650.1(3) the license holder shall forfeit $100 for each650.2occurrence of a violation of law or rule other than those650.3included in clauses (1) and (2).650.4For the purposes of this section, "occurrence" means each650.5violation identified in the commissioner's forfeiture order.650.6Subd. 7. [RESPONSIBILITY FOR PAYMENT OF FINES.] When a650.7fine has been assessed, the license holder may not avoid payment650.8by closing, selling, or otherwise transferring the licensed650.9program to a third party. In such an event, the license holder650.10will be personally liable for payment. In the case of a650.11corporation, each controlling individual is personally and650.12jointly liable for payment.650.13Fines for child care centers must be assessed according to650.14this section.650.15 Sec. 21. Minnesota Statutes 2000, section 245A.07, is 650.16 amended to read: 650.17 245A.07 [SANCTIONS.] 650.18 Subdivision 1. [SANCTIONS AVAILABLE.] In addition to 650.19ordering forfeiture of finesmaking a license conditional under 650.20 section 245A.06, the commissioner may propose to suspend,or 650.21 revoke, or make conditionalthe license, impose a fine, or 650.22 secure an injunction against the continuing operation of the 650.23 program of a license holder who does not comply with applicable 650.24 law or rule. When applying sanctions authorized under this 650.25 section, the commissioner shall consider the nature, chronicity, 650.26 or severity of the violation of law or rule and the effect of 650.27 the violation on the health, safety, or rights of persons served 650.28 by the program. 650.29 Subd. 2. [IMMEDIATE SUSPENSION IN CASES OF IMMINENT DANGER650.30TO HEALTH, SAFETY, OR RIGHTSTEMPORARY IMMEDIATE SUSPENSION.] If 650.31 the license holder's actions or failure to comply with 650.32 applicable law or rulehas placedposes an imminent risk of harm 650.33 to the health, safety, or rights of persons served by the 650.34 programin imminent danger, the commissioner shall act 650.35 immediately to temporarily suspend the license. No state funds 650.36 shall be made available or be expended by any agency or 651.1 department of state, county, or municipal government for use by 651.2 a license holder regulated under this chapter while a license is 651.3 under immediate suspension. A notice stating the reasons for 651.4 the immediate suspension and informing the license holder of the 651.5 right toa contested casean expedited hearing under chapter 651.6 14 and Minnesota Rules, parts 1400.8510 to 1400.8612 and 651.7 successor rules, must be delivered by personal service to the 651.8 address shown on the application or the last known address of 651.9 the license holder. The license holder may appeal an order 651.10 immediately suspending a license. The appeal of an order 651.11 immediately suspending a license must be made in writing by 651.12 certified mail and must be received by the commissioner within 651.13 five calendar days after the license holder receives notice that 651.14 the license has been immediately suspended. A license holder 651.15 and any controlling individual shall discontinue operation of 651.16 the program upon receipt of the commissioner's order to 651.17 immediately suspend the license. 651.18 Subd. 2a. [IMMEDIATE SUSPENSION EXPEDITED HEARING.] (a) 651.19 Within five working days of receipt of the license holder's 651.20 timely appeal, the commissioner shall request assignment of an 651.21 administrative law judge. The request must include a proposed 651.22 date, time, and place of a hearing. A hearing must be conducted 651.23 by an administrative law judge within 30 calendar days of the 651.24 request for assignment, unless an extension is requested by 651.25 either party and granted by the administrative law judge for 651.26 good cause. The commissioner shall issue a notice of hearing by 651.27 certified mail at least ten working days before the hearing. 651.28 The scope of the hearing shall be limited solely to the issue of 651.29 whether the temporary immediate suspension should remain in 651.30 effect pending the commissioner's final order under section 651.31 245A.08, regarding a licensing sanction issued under subdivision 651.32 3 following the immediate suspension. The burden of proof in 651.33 expedited hearings under this subdivision shall be limited to 651.34 the commissioner's demonstration that reasonable cause exists to 651.35 believe that the license holder's actions or failure to comply 651.36 with applicable law or rule poses an imminent risk of harm to 652.1 the health, safety, or rights of persons served by the program. 652.2 (b) The administrative law judge shall issue findings of 652.3 fact, conclusions, and a recommendation within ten working days 652.4 from the date of hearing. The commissioner's final order shall 652.5 be issued within ten working days from receipt of the 652.6 recommendation of the administrative law judge. Within 90 652.7 calendar days after a final order affirming an immediate 652.8 suspension, the commissioner shall make a determination 652.9 regarding whether a final licensing sanction shall be issued 652.10 under subdivision 3. The license holder shall continue to be 652.11 prohibited from operation of the program during this 90-day 652.12 period. 652.13 Subd. 3. [LICENSE SUSPENSION, REVOCATION,DENIALOR 652.14CONDITIONAL LICENSEFINE.] The commissioner may suspend,or 652.15 revoke, make conditional, or denya license, or impose a fine if 652.16an applicant ora license holder fails to comply fully with 652.17 applicable laws or rules, or knowingly withholds relevant 652.18 information from or gives false or misleading information to the 652.19 commissioner in connection with an application for a license or 652.20 during an investigation. A license holder who has had a license 652.21 suspended, revoked, ormade conditionalhas been ordered to pay 652.22 a fine must be given notice of the action by certified mail. 652.23 The notice must be mailed to the address shown on the 652.24 application or the last known address of the license holder. 652.25 The notice must state the reasons the license was suspended, 652.26 revoked, ormade conditionala fine was ordered. 652.27 (a) If the license was suspended or revoked, the notice 652.28 must inform the license holder of the right to a contested case 652.29 hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to 652.30 1400.8612 and successor rules. The license holder may appeal an 652.31 order suspending or revoking a license. The appeal of an order 652.32 suspending or revoking a license must be made in writing by 652.33 certified mail and must be received by the commissioner within 652.34 ten calendar days after the license holder receives notice that 652.35 the license has been suspended or revoked. 652.36 (b)If the license was made conditional, the notice must653.1inform the license holder of the right to request a653.2reconsideration by the commissioner. The request for653.3reconsideration must be made in writing by certified mail and653.4must be received by the commissioner within ten calendar days653.5after the license holder receives notice that the license has653.6been made conditional. The license holder may submit with the653.7request for reconsideration written argument or evidence in653.8support of the request for reconsideration. The commissioner's653.9disposition of a request for reconsideration is final and is not653.10subject to appeal under chapter 14.(1) If the license holder 653.11 was ordered to pay a fine, the notice must inform the license 653.12 holder of the responsibility for payment of fines and the right 653.13 to a contested case hearing under chapter 14 and Minnesota 653.14 Rules, parts 1400.8510 to 1400.8612 and successor rules. The 653.15 appeal of an order to pay a fine must be made in writing by 653.16 certified mail and must be received by the commissioner within 653.17 ten calendar days after the license holder receives notice that 653.18 the fine has been ordered. 653.19 (2) The license holder shall pay the fines assessed on or 653.20 before the payment date specified. If the license holder fails 653.21 to fully comply with the order, the commissioner may issue a 653.22 second fine or suspend the license until the license holder 653.23 complies. If the license holder receives state funds, the 653.24 state, county, or municipal agencies or departments responsible 653.25 for administering the funds shall withhold payments and recover 653.26 any payments made while the license is suspended for failure to 653.27 pay a fine. A timely appeal shall stay payment of the fine 653.28 until the commissioner issues a final order. 653.29 (3) A license holder shall promptly notify the commissioner 653.30 of human services, in writing, when a violation specified in the 653.31 order to forfeit a fine is corrected. If upon reinspection the 653.32 commissioner determines that a violation has not been corrected 653.33 as indicated by the order to forfeit a fine, the commissioner 653.34 may issue a second fine. The commissioner shall notify the 653.35 license holder by certified mail that a second fine has been 653.36 assessed. The license holder may appeal the second fine as 654.1 provided under this subdivision. 654.2 (4) Fines shall be assessed as follows: the license holder 654.3 shall forfeit $1,000 for each determination of maltreatment of a 654.4 child under section 626.556 or the maltreatment of a vulnerable 654.5 adult under section 626.557; the license holder shall forfeit 654.6 $200 for each occurrence of a violation of law or rule governing 654.7 matters of health, safety, or supervision, including but not 654.8 limited to the provision of adequate staff-to-child or adult 654.9 ratios, and failure to submit a background study; and the 654.10 license holder shall forfeit $100 for each occurrence of a 654.11 violation of law or rule other than those subject to a $1,000 or 654.12 $200 fine above. For purposes of this section, "occurrence" 654.13 means each violation identified in the commissioner's fine order. 654.14 (5) When a fine has been assessed, the license holder may 654.15 not avoid payment by closing, selling, or otherwise transferring 654.16 the licensed program to a third party. In such an event, the 654.17 license holder will be personally liable for payment. In the 654.18 case of a corporation, each controlling individual is personally 654.19 and jointly liable for payment. 654.20 Subd. 4. [ADOPTION AGENCY VIOLATIONS.] If a license holder 654.21 licensed to place children for adoption fails to provide 654.22 services as described in the disclosure form required by section 654.23 259.37, subdivision 2, the sanctions under this section may be 654.24 imposed. 654.25 [EFFECTIVE DATE.] This section is effective January 1, 2002. 654.26 Sec. 22. Minnesota Statutes 2000, section 245A.08, is 654.27 amended to read: 654.28 245A.08 [HEARINGS.] 654.29 Subdivision 1. [RECEIPT OF APPEAL; CONDUCT OF HEARING.] 654.30 Upon receiving a timely appeal or petition pursuant to 654.31 section 245A.04, subdivision 3c, 245A.05, or 245A.07, 654.32 subdivision 3, the commissioner shall issue a notice of and 654.33 order for hearing to the appellant under chapter 14 and 654.34 Minnesota Rules, parts 1400.8510 to 1400.8612 and successor 654.35 rules. 654.36 Subd. 2. [CONDUCT OF HEARINGS.] At any hearing provided 655.1 for by section 245A.04, subdivision 3c, 245A.05, or 245A.07, 655.2 subdivision 3, the appellant may be represented by counsel and 655.3 has the right to call, examine, and cross-examine witnesses. 655.4 The administrative law judge may require the presence of 655.5 witnesses and evidence by subpoena on behalf of any party. 655.6 Subd. 2a. [CONSOLIDATED CONTESTED CASE HEARINGS FOR 655.7 SANCTIONS BASED ON MALTREATMENT DETERMINATIONS AND 655.8 DISQUALIFICATIONS.] (a) When a denial of a license under section 655.9 245A.05 or a licensing sanction under section 245A.07, 655.10 subdivision 3, is based on a disqualification for which 655.11 reconsideration was requested and which was not set aside or was 655.12 not rescinded under section 245A.04, subdivision 3b, the scope 655.13 of the contested case hearing shall include the disqualification 655.14 and the licensing sanction or denial of a license. When the 655.15 licensing sanction or denial of a license is based on a 655.16 determination of maltreatment under section 626.556 or 626.557, 655.17 or a disqualification for serious or recurring maltreatment 655.18 which was not set aside or was not rescinded, the scope of the 655.19 contested case hearing shall include the maltreatment 655.20 determination, disqualification, and the licensing sanction or 655.21 denial of a license. In such cases, a fair hearing under 655.22 section 256.045 shall not be conducted as provided for in 655.23 sections 626.556, subdivision 10i, and 626.557, subdivision 9d. 655.24 (b) In consolidated contested case hearings regarding 655.25 sanctions issued in family child care, child foster care, and 655.26 adult foster care, the county attorney shall defend the 655.27 commissioner's orders in accordance with section 245A.16, 655.28 subdivision 4. 655.29 (c) The commissioner's final order under subdivision 5 is 655.30 the final agency action on the issue of maltreatment and 655.31 disqualification, including for purposes of subsequent 655.32 background studies under section 245A.04, subdivision 3, and is 655.33 the only administrative appeal of the final agency 655.34 determination, specifically, including a challenge to the 655.35 accuracy and completeness of data under section 13.04. 655.36 (d) When consolidated hearings under this subdivision 656.1 involve a licensing sanction based on a previous maltreatment 656.2 determination for which the commissioner has issued a final 656.3 order in an appeal of that determination under section 256.045, 656.4 or the individual failed to exercise the right to appeal the 656.5 previous maltreatment determination under section 626.556, 656.6 subdivision 10i, or 626.557, subdivision 9d, the commissioner's 656.7 order is conclusive on the issue of maltreatment. In such 656.8 cases, the scope of the administrative law judge's review shall 656.9 be limited to the disqualification and the licensing sanction or 656.10 denial of a license. In the case of a denial of a license or a 656.11 licensing sanction issued to a facility based on a maltreatment 656.12 determination regarding an individual who is not the license 656.13 holder or a household member, the scope of the administrative 656.14 law judge's review includes the maltreatment determination. 656.15 (e) If a maltreatment determination or disqualification, 656.16 which was not set aside or was not rescinded under section 656.17 245A.04, subdivision 3b, is the basis for a denial of a license 656.18 under section 245A.05 or a licensing sanction under section 656.19 245A.07, and the disqualified subject is an individual other 656.20 than the license holder and upon whom a background study must be 656.21 conducted under section 245A.04, subdivision 3, the hearings of 656.22 all parties may be consolidated into a single contested case 656.23 hearing upon consent of all parties and the administrative law 656.24 judge. 656.25 Subd. 3. [BURDEN OF PROOF.] (a) At a hearing regarding 656.26suspension, immediate suspension, or revocation of a license for656.27family day care or foster carea licensing sanction under 656.28 section 245A.07, including consolidated hearings under 656.29 subdivision 2a, the commissioner may demonstrate reasonable 656.30 cause for action taken by submitting statements, reports, or 656.31 affidavits to substantiate the allegations that the license 656.32 holder failed to comply fully with applicable law or rule. If 656.33 the commissioner demonstrates that reasonable cause existed, the 656.34 burden of proofin hearings involving suspension, immediate656.35suspension, or revocation of a family day care or foster care656.36licenseshifts to the license holder to demonstrate by a 657.1 preponderance of the evidence that the license holder was in 657.2 full compliance with those laws or rules that the commissioner 657.3 alleges the license holder violated, at the time that the 657.4 commissioner alleges the violations of law or rules occurred. 657.5 (b) At a hearing on denial of an application, the applicant 657.6 bears the burden of proof to demonstrate by a preponderance of 657.7 the evidence that the appellant has complied fully withsections657.8245A.01 to 245A.15this chapter and other applicable law or rule 657.9 and that the application should be approved and a license 657.10 granted. 657.11(c) At all other hearings under this section, the657.12commissioner bears the burden of proof to demonstrate, by a657.13preponderance of the evidence, that the violations of law or657.14rule alleged by the commissioner occurred.657.15 Subd. 4. [RECOMMENDATION OF ADMINISTRATIVE LAW JUDGE.] The 657.16 administrative law judge shall recommend whether or not the 657.17 commissioner's order should be affirmed. The recommendations 657.18 must be consistent with this chapter and the rules of the 657.19 commissioner. The recommendations must be in writing and 657.20 accompanied by findings of fact and conclusions and must be 657.21 mailed to the parties by certified mail to their last known 657.22 addresses as shown on the license or application. 657.23 Subd. 5. [NOTICE OF THE COMMISSIONER'S FINAL ORDER.] After 657.24 considering the findings of fact, conclusions, and 657.25 recommendations of the administrative law judge, the 657.26 commissioner shall issue a final order. The commissioner shall 657.27 consider, but shall not be bound by, the recommendations of the 657.28 administrative law judge. The appellant must be notified of the 657.29 commissioner's final order as required by chapter 14 and 657.30 Minnesota Rules, parts 1400.8510 to 1400.8612 and successor 657.31 rules. The notice must also contain information about the 657.32 appellant's rights under chapter 14 and Minnesota Rules, parts 657.33 1400.8510 to 1400.8612 and successor rules. The institution of 657.34 proceedings for judicial review of the commissioner's final 657.35 order shall not stay the enforcement of the final order except 657.36 as provided in section 14.65. A license holder and each 658.1 controlling individual of a license holder whose license has 658.2 been revoked because of noncompliance with applicable law or 658.3 rule must not be granted a license for five years following the 658.4 revocation. An applicant whose application was denied must not 658.5 be granted a license for two years following a denial, unless 658.6 the applicant's subsequent application contains new information 658.7 which constitutes a substantial change in the conditions that 658.8 caused the previous denial. 658.9 [EFFECTIVE DATE.] This section is effective January 1, 2002. 658.10 Sec. 23. [245A.144] [REDUCTION OF RISK OF SUDDEN INFANT 658.11 DEATH SYNDROME IN CHILD CARE PROGRAMS.] 658.12 License holders must ensure that before staff persons, 658.13 caregivers, and helpers assist in the care of infants, they 658.14 receive training on reducing the risk of sudden infant death 658.15 syndrome. The training on reducing the risk of sudden infant 658.16 death syndrome may be provided as orientation training under 658.17 Minnesota Rules, part 9503.0035, subpart 1, as initial training 658.18 under Minnesota Rules, part 9502.0385, subpart 2, as in-service 658.19 training under Minnesota Rules, part 9503.0035, subpart 4, or as 658.20 ongoing training under Minnesota Rules, part 9502.0385, subpart 658.21 3. Training required under this section must be completed at 658.22 least once every five years. 658.23 Sec. 24. Minnesota Statutes 2000, section 245A.16, 658.24 subdivision 1, is amended to read: 658.25 Subdivision 1. [DELEGATION OF AUTHORITY TO AGENCIES.] (a) 658.26 County agencies and private agencies that have been designated 658.27 or licensed by the commissioner to perform licensing functions 658.28 and activities under section 245A.04, to recommend denial of 658.29 applicants under section 245A.05, to issue correction orders, to 658.30 issue variances, and recommendfinesa conditional license under 658.31 section 245A.06, or to recommend suspending,or revoking, and658.32making licenses probationarya license or issuing a fine under 658.33 section 245A.07, shall comply with rules and directives of the 658.34 commissioner governing those functions and with this 658.35 section. The following variances are excluded from the 658.36 delegation of variance authority and may be issued only by the 659.1 commissioner: 659.2 (1) dual licensure of family child care and child foster 659.3 care, dual licensure of child and adult foster care, and adult 659.4 foster care and family child care; 659.5 (2) adult foster care maximum capacity; 659.6 (3) adult foster care minimum age requirement; 659.7 (4) child foster care maximum age requirement; 659.8 (5) variances regarding disqualified individuals; and 659.9 (6) the required presence of a caregiver in the adult 659.10 foster care residence during normal sleeping hours. 659.11 (b) For family day care programs, the commissioner may 659.12 authorize licensing reviews every two years after a licensee has 659.13 had at least one annual review. 659.14 Sec. 25. Minnesota Statutes 2000, section 245B.08, 659.15 subdivision 3, is amended to read: 659.16 Subd. 3. [SANCTIONS AVAILABLE.] Nothing in this 659.17 subdivision shall be construed to limit the commissioner's 659.18 authority to suspend,or revoke, or make conditionala license 659.19 or issue a fine at any timea licenseunder section 245A.07; 659.20 make correction orders andrequire finesmake a license 659.21 conditional for failure to comply with applicable laws or rules 659.22 under section 245A.06; or deny an application for license under 659.23 section 245A.05. 659.24 Sec. 26. Minnesota Statutes 2000, section 256.045, 659.25 subdivision 3, is amended to read: 659.26 Subd. 3. [STATE AGENCY HEARINGS.] (a) State agency 659.27 hearings are available for the following: (1) any person 659.28 applying for, receiving or having received public assistance, 659.29 medical care, or a program of social services granted by the 659.30 state agency or a county agency or the federal Food Stamp Act 659.31 whose application for assistance is denied, not acted upon with 659.32 reasonable promptness, or whose assistance is suspended, 659.33 reduced, terminated, or claimed to have been incorrectly paid; 659.34 (2) any patient or relative aggrieved by an order of the 659.35 commissioner under section 252.27; (3) a party aggrieved by a 659.36 ruling of a prepaid health plan; (4) except as provided under 660.1 chapter 245A, any individual or facility determined by a lead 660.2 agency to have maltreated a vulnerable adult under section 660.3 626.557 after they have exercised their right to administrative 660.4 reconsideration under section 626.557; (5) any person whose 660.5 claim for foster care payment according to a placement of the 660.6 child resulting from a child protection assessment under section 660.7 626.556 is denied or not acted upon with reasonable promptness, 660.8 regardless of funding source; (6) any person to whom a right of 660.9 appeal according to this section is given by other provision of 660.10 law; (7) an applicant aggrieved by an adverse decision to an 660.11 application for a hardship waiver under section 660.12 256B.15;or(8) except as provided under chapter 245A, an 660.13 individual or facility determined to have maltreated a minor 660.14 under section 626.556, after the individual or facility has 660.15 exercised the right to administrative reconsideration under 660.16 section 626.556; or (9) except as provided under chapter 245A, 660.17 an individual disqualified under section 245A.04, subdivision 660.18 3d, on the basis of serious or recurring maltreatment; a 660.19 preponderance of the evidence that the individual has committed 660.20 an act or acts that meet the definition of any of the crimes 660.21 listed in section 245A.04, subdivision 3d, paragraph (a), 660.22 clauses (1) to (4); or for failing to make reports required 660.23 under section 626.556, subdivision 3, or 626.557, subdivision 660.24 3. Hearings regarding a maltreatment determination under clause 660.25 (4) or (8) and a disqualification under this clause in which the 660.26 basis for a disqualification is serious or recurring 660.27 maltreatment, which has not been set aside or rescinded under 660.28 section 245A.04, subdivision 3b, shall be consolidated into a 660.29 single fair hearing. In such cases, the scope of review by the 660.30 human services referee shall include both the maltreatment 660.31 determination and the disqualification. The failure to exercise 660.32 the right to an administrative reconsideration shall not be a 660.33 bar to a hearing under this section if federal law provides an 660.34 individual the right to a hearing to dispute a finding of 660.35 maltreatment. Individuals and organizations specified in this 660.36 section may contest the specified action, decision, or final 661.1 disposition before the state agency by submitting a written 661.2 request for a hearing to the state agency within 30 days after 661.3 receiving written notice of the action, decision, or final 661.4 disposition, or within 90 days of such written notice if the 661.5 applicant, recipient, patient, or relative shows good cause why 661.6 the request was not submitted within the 30-day time limit. 661.7 The hearing for an individual or facility under clause 661.8 (4)or, (8), or (9) is the only administrative appeal to the 661.9 final agency determination specifically, including a challenge 661.10 to the accuracy and completeness of data under section 13.04. 661.11 Hearings requested under clause (4) apply only to incidents of 661.12 maltreatment that occur on or after October 1, 1995. Hearings 661.13 requested by nursing assistants in nursing homes alleged to have 661.14 maltreated a resident prior to October 1, 1995, shall be held as 661.15 a contested case proceeding under the provisions of chapter 14. 661.16 Hearings requested under clause (8) apply only to incidents of 661.17 maltreatment that occur on or after July 1, 1997. A hearing for 661.18 an individual or facility under clause (8) is only available 661.19 when there is no juvenile court or adult criminal action 661.20 pending. If such action is filed in either court while an 661.21 administrative review is pending, the administrative review must 661.22 be suspended until the judicial actions are completed. If the 661.23 juvenile court action or criminal charge is dismissed or the 661.24 criminal action overturned, the matter may be considered in an 661.25 administrative hearing. 661.26 For purposes of this section, bargaining unit grievance 661.27 procedures are not an administrative appeal. 661.28 The scope of hearings involving claims to foster care 661.29 payments under clause (5) shall be limited to the issue of 661.30 whether the county is legally responsible for a child's 661.31 placement under court order or voluntary placement agreement 661.32 and, if so, the correct amount of foster care payment to be made 661.33 on the child's behalf and shall not include review of the 661.34 propriety of the county's child protection determination or 661.35 child placement decision. 661.36 (b) A vendor of medical care as defined in section 256B.02, 662.1 subdivision 7, or a vendor under contract with a county agency 662.2 to provide social services under section 256E.08, subdivision 4, 662.3 is not a party and may not request a hearing under this section, 662.4 except if assisting a recipient as provided in subdivision 4. 662.5 (c) An applicant or recipient is not entitled to receive 662.6 social services beyond the services included in the amended 662.7 community social services plan developed under section 256E.081, 662.8 subdivision 3, if the county agency has met the requirements in 662.9 section 256E.081. 662.10 (d) The commissioner may summarily affirm the county or 662.11 state agency's proposed action without a hearing when the sole 662.12 issue is an automatic change due to a change in state or federal 662.13 law. 662.14 Sec. 27. Minnesota Statutes 2000, section 256.045, 662.15 subdivision 3b, is amended to read: 662.16 Subd. 3b. [STANDARD OF EVIDENCE FOR MALTREATMENT AND 662.17 DISQUALIFICATION HEARINGS.] The state human services referee 662.18 shall determine that maltreatment has occurred if a 662.19 preponderance of evidence exists to support the final 662.20 disposition under sections 626.556 and 626.557. For purposes of 662.21 hearings regarding disqualification, the state human services 662.22 referee shall affirm the proposed disqualification in an appeal 662.23 under subdivision 3, paragraph (a), clause (9), if a 662.24 preponderance of the evidence shows the individual has: 662.25 (1) committed maltreatment under section 626.556 or 662.26 626.557, which is serious or recurring; 662.27 (2) committed an act or acts meeting the definition of any 662.28 of the crimes listed in section 245A.04, subdivision 3d, 662.29 paragraph (a), clauses (1) to (4); or 662.30 (3) failed to make required reports under section 626.556 662.31 or 626.557, for incidents in which: 662.32 (i) the final disposition under section 626.556 or 626.557 662.33 was substantiated maltreatment; and 662.34 (ii) the maltreatment was recurring or serious; or 662.35 substantiated serious or recurring maltreatment of a minor under 662.36 section 626.556 or of a vulnerable adult under section 626.557 663.1 for which there is a preponderance of evidence that the 663.2 maltreatment occurred, and that the subject was responsible for 663.3 the maltreatment. If the disqualification is affirmed, the 663.4 state human services referee shall determine whether the 663.5 individual poses a risk of harm in accordance with the 663.6 requirements of section 245A.04, subdivision 3b. 663.7 The state human services referee shall recommend an order 663.8 to the commissioner of health or human services, as applicable, 663.9 who shall issue a final order. The commissioner shall affirm, 663.10 reverse, or modify the final disposition. Any order of the 663.11 commissioner issued in accordance with this subdivision is 663.12 conclusive upon the parties unless appeal is taken in the manner 663.13 provided in subdivision 7. Except as provided under section 663.14 245A.04, subdivisions 3b, paragraphs (e) and (f), and 3c, in any 663.15 licensing appeal under chapter 245A and sections 144.50 to 663.16 144.58 and 144A.02 to 144A.46, the commissioner's determination 663.17 as to maltreatment is conclusive. 663.18 Sec. 28. Minnesota Statutes 2000, section 256.045, 663.19 subdivision 4, is amended to read: 663.20 Subd. 4. [CONDUCT OF HEARINGS.] (a) All hearings held 663.21 pursuant to subdivision 3, 3a, 3b, or 4a shall be conducted 663.22 according to the provisions of the federal Social Security Act 663.23 and the regulations implemented in accordance with that act to 663.24 enable this state to qualify for federal grants-in-aid, and 663.25 according to the rules and written policies of the commissioner 663.26 of human services. County agencies shall install equipment 663.27 necessary to conduct telephone hearings. A state human services 663.28 referee may schedule a telephone conference hearing when the 663.29 distance or time required to travel to the county agency offices 663.30 will cause a delay in the issuance of an order, or to promote 663.31 efficiency, or at the mutual request of the parties. Hearings 663.32 may be conducted by telephone conferences unless the applicant, 663.33 recipient, former recipient, person, or facility contesting 663.34 maltreatment objects. The hearing shall not be held earlier 663.35 than five days after filing of the required notice with the 663.36 county or state agency. The state human services referee shall 664.1 notify all interested persons of the time, date, and location of 664.2 the hearing at least five days before the date of the hearing. 664.3 Interested persons may be represented by legal counsel or other 664.4 representative of their choice, including a provider of therapy 664.5 services, at the hearing and may appear personally, testify and 664.6 offer evidence, and examine and cross-examine witnesses. The 664.7 applicant, recipient, former recipient, person, or facility 664.8 contesting maltreatment shall have the opportunity to examine 664.9 the contents of the case file and all documents and records to 664.10 be used by the county or state agency at the hearing at a 664.11 reasonable time before the date of the hearing and during the 664.12 hearing. In hearings under subdivision 3, paragraph (a), 664.13 clauses (4)and, (8), and (9), either party may subpoena the 664.14 private data relating to the investigation prepared by the 664.15 agency under section 626.556 or 626.557 that is not otherwise 664.16 accessible under section 13.04, provided the identity of the 664.17 reporter may not be disclosed. 664.18 (b) The private data obtained by subpoena in a hearing 664.19 under subdivision 3, paragraph (a), clause (4)or, (8), or (9), 664.20 must be subject to a protective order which prohibits its 664.21 disclosure for any other purpose outside the hearing provided 664.22 for in this section without prior order of the district court. 664.23 Disclosure without court order is punishable by a sentence of 664.24 not more than 90 days imprisonment or a fine of not more than 664.25 $700, or both. These restrictions on the use of private data do 664.26 not prohibit access to the data under section 13.03, subdivision 664.27 6. Except for appeals under subdivision 3, paragraph (a), 664.28 clauses (4), (5),and(8), and (9), upon request, the county 664.29 agency shall provide reimbursement for transportation, child 664.30 care, photocopying, medical assessment, witness fee, and other 664.31 necessary and reasonable costs incurred by the applicant, 664.32 recipient, or former recipient in connection with the appeal. 664.33 All evidence, except that privileged by law, commonly accepted 664.34 by reasonable people in the conduct of their affairs as having 664.35 probative value with respect to the issues shall be submitted at 664.36 the hearing and such hearing shall not be "a contested case" 665.1 within the meaning of section 14.02, subdivision 3. The agency 665.2 must present its evidence prior to or at the hearing, and may 665.3 not submit evidence after the hearing except by agreement of the 665.4 parties at the hearing, provided the petitioner has the 665.5 opportunity to respond. 665.6 Sec. 29. Minnesota Statutes 2000, section 626.556, 665.7 subdivision 10i, as amended by Laws 2001, chapter 178, article 665.8 2, section 15, is amended to read: 665.9 Subd. 10i. [ADMINISTRATIVE RECONSIDERATION OF FINAL 665.10 DETERMINATION OF MALTREATMENT AND DISQUALIFICATION BASED ON 665.11 SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 665.12 provided under paragraph (e), an individual or facility that the 665.13 commissioner of human services, a local social service agency, 665.14 or the commissioner of children, families, and learning 665.15 determines has maltreated a child,or the child's designeean 665.16 interested person acting on behalf of the child, regardless of 665.17 the determination, who contests the investigating agency's final 665.18 determination regarding maltreatment, may request the 665.19 investigating agency to reconsider its final determination 665.20 regarding maltreatment. The request for reconsideration must be 665.21 submitted in writing to the investigating agency within 15 665.22 calendar days after receipt of notice of the final determination 665.23 regarding maltreatment or, if the request is made by an 665.24 interested person who is not entitled to notice, within 15 days 665.25 after receipt of the notice by the parent or guardian of the 665.26 child. Effective January 1, 2002, an individual who was 665.27 determined to have maltreated a child under this section and who 665.28 was disqualified on the basis of serious or recurring 665.29 maltreatment under section 245A.04, subdivision 3d, may request 665.30 reconsideration of the maltreatment determination and the 665.31 disqualification. The request for reconsideration of the 665.32 maltreatment determination and the disqualification must be 665.33 submitted within 30 calendar days of the individual's receipt of 665.34 the notice of disqualification under section 245A.04, 665.35 subdivision 3a. 665.36 (b) Except as provided under paragraphs (e) and (f), if the 666.1 investigating agency denies the request or fails to act upon the 666.2 request within 15 calendar days after receiving the request for 666.3 reconsideration, the person or facility entitled to a fair 666.4 hearing under section 256.045 may submit to the commissioner of 666.5 human services or the commissioner of children, families, and 666.6 learning a written request for a hearing under that section. 666.7 Section 256.045 also governs hearings requested to contest a 666.8 final determination of the commissioner of children, families, 666.9 and learning. For reports involving maltreatment of a child in 666.10 a facility, an interested person acting on behalf of the child 666.11 may request a review by the child maltreatment review panel 666.12 under section 256.022 if the investigating agency denies the 666.13 request or fails to act upon the request or if the interested 666.14 person contests a reconsidered determination. The investigating 666.15 agency shall notify persons who request reconsideration of their 666.16 rights under this paragraph. The request must be submitted in 666.17 writing to the review panel and a copy sent to the investigating 666.18 agency within 30 calendar days of receipt of notice of a denial 666.19 of a request for reconsideration or of a reconsidered 666.20 determination. The request must specifically identify the 666.21 aspects of the agency determination with which the person is 666.22 dissatisfied. 666.23 (c) If, as a result ofthea reconsideration or review, the 666.24 investigating agency changes the final determination of 666.25 maltreatment, that agency shall notify the parties specified in 666.26 subdivisions 10b, 10d, and 10f. 666.27 (d) Except as provided under paragraph (f), if an 666.28 individual or facility contests the investigating agency's final 666.29 determination regarding maltreatment by requesting a fair 666.30 hearing under section 256.045, the commissioner of human 666.31 services shall assure that the hearing is conducted and a 666.32 decision is reached within 90 days of receipt of the request for 666.33 a hearing. The time for action on the decision may be extended 666.34 for as many days as the hearing is postponed or the record is 666.35 held open for the benefit of either party. 666.36 (e) Effective January 1, 2002, if an individual was 667.1 disqualified under section 245A.04, subdivision 3d, on the basis 667.2 of a determination of maltreatment, which was serious or 667.3 recurring, and the individual has requested reconsideration of 667.4 the maltreatment determination under paragraph (a) and requested 667.5 reconsideration of the disqualification under section 245A.04, 667.6 subdivision 3b, reconsideration of the maltreatment 667.7 determination and reconsideration of the disqualification shall 667.8 be consolidated into a single reconsideration. If an individual 667.9 disqualified on the basis of a determination of maltreatment, 667.10 which was serious or recurring requests a fair hearing under 667.11 paragraph (b), the scope of the fair hearing shall include the 667.12 maltreatment determination and the disqualification. 667.13 (f) Effective January 1, 2002, if a maltreatment 667.14 determination or a disqualification based on serious or 667.15 recurring maltreatment is the basis for a denial of a license 667.16 under section 245A.05 or a licensing sanction under section 667.17 245A.07, the license holder has the right to a contested case 667.18 hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to 667.19 1400.8612 and successor rules. As provided for under section 667.20 245A.08, subdivision 2a, the scope of the contested case hearing 667.21 shall include the maltreatment determination, disqualification, 667.22 and licensing sanction or denial of a license. In such cases, a 667.23 fair hearing regarding the maltreatment determination shall not 667.24 be conducted under paragraph (b). If the disqualified subject 667.25 is an individual other than the license holder and upon whom a 667.26 background study must be conducted under section 245A.04, 667.27 subdivision 3, the hearings of all parties may be consolidated 667.28 into a single contested case hearing upon consent of all parties 667.29 and the administrative law judge. 667.30 (g) For purposes of this subdivision, "interested person 667.31 acting on behalf of the child" means a parent or legal guardian; 667.32 stepparent; grandparent; guardian ad litem; adult stepbrother, 667.33 stepsister, or sibling; or adult aunt or uncle; unless the 667.34 person has been determined to be the perpetrator of the 667.35 maltreatment. 667.36 Sec. 30. Minnesota Statutes 2000, section 626.557, 668.1 subdivision 3, is amended to read: 668.2 Subd. 3. [TIMING OF REPORT.] (a) A mandated reporter who 668.3 has reason to believe that a vulnerable adult is being or has 668.4 been maltreated, or who has knowledge that a vulnerable adult 668.5 has sustained a physical injury which is not reasonably 668.6 explained shall immediately report the information to the common 668.7 entry point. If an individual is a vulnerable adult solely 668.8 because the individual is admitted to a facility, a mandated 668.9 reporter is not required to report suspected maltreatment of the 668.10 individual that occurred prior to admission, unless: 668.11 (1) the individual was admitted to the facility from 668.12 another facility and the reporter has reason to believe the 668.13 vulnerable adult was maltreated in the previous facility; or 668.14 (2) the reporter knows or has reason to believe that the 668.15 individual is a vulnerable adult as defined in section 626.5572, 668.16 subdivision 21, clause (4). 668.17 (b) A person not required to report under the provisions of 668.18 this section may voluntarily report as described above. 668.19 (c) Nothing in this section requires a report of known or 668.20 suspected maltreatment, if the reporter knows or has reason to 668.21 know that a report has been made to the common entry point. 668.22 (d) Nothing in this section shall preclude a reporter from 668.23 also reporting to a law enforcement agency. 668.24 (e) A mandated reporter who knows or has reason to believe 668.25 that an error under section 626.5572, subdivision 17, paragraph 668.26 (c), clause (5), occurred must make a report under this 668.27 subdivision. If the reporter or a facility, at any time 668.28 believes that an investigation by a lead agency will determine 668.29 or should determine that the reported error was not neglect 668.30 according to the criteria under section 626.5572, subdivision 668.31 17, paragraph (c), clause (5), the reporter or facility may 668.32 provide to the common entry point or directly to the lead agency 668.33 information explaining how the event meets the criteria under 668.34 section 626.5572, subdivision 17, paragraph (c), clause (5). 668.35 The lead agency shall consider this information when making an 668.36 initial disposition of the report under subdivision 9c. 669.1 [EFFECTIVE DATE.] This section is effective August 1, 2001. 669.2 Sec. 31. Minnesota Statutes 2000, section 626.557, 669.3 subdivision 9d, is amended to read: 669.4 Subd. 9d. [ADMINISTRATIVE RECONSIDERATION OF FINAL 669.5 DISPOSITION OF MALTREATMENT AND DISQUALIFICATION BASED ON 669.6 SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 669.7 provided under paragraph (e), any individual or facility which a 669.8 lead agency determines has maltreated a vulnerable adult, or the 669.9 vulnerable adult or an interested person acting on behalf of the 669.10 vulnerable adult, regardless of the lead agency's determination, 669.11 who contests the lead agency's final disposition of an 669.12 allegation of maltreatment, may request the lead agency to 669.13 reconsider its final disposition. The request for 669.14 reconsideration must be submitted in writing to the lead agency 669.15 within 15 calendar days after receipt of notice of final 669.16 disposition or, if the request is made by an interested person 669.17 who is not entitled to notice, within 15 days after receipt of 669.18 the notice by the vulnerable adult or the vulnerable adult's 669.19 legal guardian. An individual who was determined to have 669.20 maltreated a vulnerable adult under this section and who was 669.21 disqualified on the basis of serious or recurring maltreatment 669.22 under section 245A.04, subdivision 3d, may request 669.23 reconsideration of the maltreatment determination and the 669.24 disqualification. The request for reconsideration of the 669.25 maltreatment determination and the disqualification must be 669.26 submitted within 30 calendar days of the individual's receipt of 669.27 the notice of disqualification under section 245A.04, 669.28 subdivision 3a. 669.29 (b) Except as provided under paragraphs (e) and (f), if the 669.30 lead agency denies the request or fails to act upon the request 669.31 within 15 calendar days after receiving the request for 669.32 reconsideration, the person or facility entitled to a fair 669.33 hearing under section 256.045, may submit to the commissioner of 669.34 human services a written request for a hearing under that 669.35 statute. The vulnerable adult, or an interested person acting 669.36 on behalf of the vulnerable adult, may request a review by the 670.1 vulnerable adult maltreatment review panel under section 256.021 670.2 if the lead agency denies the request or fails to act upon the 670.3 request, or if the vulnerable adult or interested person 670.4 contests a reconsidered disposition. The lead agency shall 670.5 notify persons who request reconsideration of their rights under 670.6 this paragraph. The request must be submitted in writing to the 670.7 review panel and a copy sent to the lead agency within 30 670.8 calendar days of receipt of notice of a denial of a request for 670.9 reconsideration or of a reconsidered disposition. The request 670.10 must specifically identify the aspects of the agency 670.11 determination with which the person is dissatisfied. 670.12 (c) If, as a result of a reconsideration or review, the 670.13 lead agency changes the final disposition, it shall notify the 670.14 parties specified in subdivision 9c, paragraph (d). 670.15 (d) For purposes of this subdivision, "interested person 670.16 acting on behalf of the vulnerable adult" means a person 670.17 designated in writing by the vulnerable adult to act on behalf 670.18 of the vulnerable adult, or a legal guardian or conservator or 670.19 other legal representative, a proxy or health care agent 670.20 appointed under chapter 145B or 145C, or an individual who is 670.21 related to the vulnerable adult, as defined in section 245A.02, 670.22 subdivision 13. 670.23 (e) If an individual was disqualified under section 670.24 245A.04, subdivision 3d, on the basis of a determination of 670.25 maltreatment, which was serious or recurring, and the individual 670.26 has requested reconsideration of the maltreatment determination 670.27 under paragraph (a) and reconsideration of the disqualification 670.28 under section 245A.04, subdivision 3b, reconsideration of the 670.29 maltreatment determination and requested reconsideration of the 670.30 disqualification shall be consolidated into a single 670.31 reconsideration. If an individual who was disqualified on the 670.32 basis of serious or recurring maltreatment requests a fair 670.33 hearing under paragraph (b), the scope of the fair hearing shall 670.34 include the maltreatment determination and the disqualification. 670.35 (f) If a maltreatment determination or a disqualification 670.36 based on serious or recurring maltreatment is the basis for a 671.1 denial of a license under section 245A.05 or a licensing 671.2 sanction under section 245A.07, the license holder has the right 671.3 to a contested case hearing under chapter 14 and Minnesota 671.4 Rules, parts 1400.8510 to 1400.8612 and successor rules. As 671.5 provided for under section 245A.08, the scope of the contested 671.6 case hearing shall include the maltreatment determination, 671.7 disqualification, and licensing sanction or denial of a 671.8 license. In such cases, a fair hearing shall not be conducted 671.9 under paragraph (b). If the disqualified subject is an 671.10 individual other than the license holder and upon whom a 671.11 background study must be conducted under section 245A.04, 671.12 subdivision 3, the hearings of all parties may be consolidated 671.13 into a single contested case hearing upon consent of all parties 671.14 and the administrative law judge. 671.15 (g) Until August 1, 2002, an individual or facility that 671.16 was determined by the commissioner of human services or the 671.17 commissioner of health to be responsible for neglect under 671.18 section 626.5572, subdivision 17, after October 1, 1995, and 671.19 before August 1, 2001, that believes that the finding of neglect 671.20 does not meet an amended definition of neglect may request a 671.21 reconsideration of the determination of neglect. The 671.22 commissioner of human services or the commissioner of health 671.23 shall mail a notice to the last known address of individuals who 671.24 are eligible to seek this reconsideration. The request for 671.25 reconsideration must state how the established findings no 671.26 longer meet the elements of the definition of neglect. The 671.27 commissioner shall review the request for reconsideration and 671.28 make a determination within 15 calendar days. The 671.29 commissioner's decision on this reconsideration is the final 671.30 agency action. 671.31 (1) For purposes of compliance with the data destruction 671.32 schedule under subdivision 12b, paragraph (d), when a finding of 671.33 substantiated maltreatment has been changed as a result of a 671.34 reconsideration under this paragraph, the date of the original 671.35 finding of a substantiated maltreatment must be used to 671.36 calculate the destruction date. 672.1 (2) For purposes of any background studies under section 672.2 245A.04, when a determination of substantiated maltreatment has 672.3 been changed as a result of a reconsideration under this 672.4 paragraph, any prior disqualification of the individual under 672.5 section 245A.04 that was based on this determination of 672.6 maltreatment shall be rescinded, and for future background 672.7 studies under section 245A.04 the commissioner must not use the 672.8 previous determination of substantiated maltreatment as a basis 672.9 for disqualification or as a basis for referring the 672.10 individual's maltreatment history to a health-related licensing 672.11 board under section 245A.04, subdivision 3d, paragraph (b). 672.12 [EFFECTIVE DATE.] Paragraph (g) of this section is 672.13 effective the day following final enactment. Paragraphs (a), 672.14 (b), (e), and (f) are effective January 1, 2002. 672.15 Sec. 32. Minnesota Statutes 2000, section 626.5572, 672.16 subdivision 17, is amended to read: 672.17 Subd. 17. [NEGLECT.] "Neglect" means: 672.18 (a) The failure or omission by a caregiver to supply a 672.19 vulnerable adult with care or services, including but not 672.20 limited to, food, clothing, shelter, health care, or supervision 672.21 which is: 672.22 (1) reasonable and necessary to obtain or maintain the 672.23 vulnerable adult's physical or mental health or safety, 672.24 considering the physical and mental capacity or dysfunction of 672.25 the vulnerable adult; and 672.26 (2) which is not the result of an accident or therapeutic 672.27 conduct. 672.28 (b) The absence or likelihood of absence of care or 672.29 services, including but not limited to, food, clothing, shelter, 672.30 health care, or supervision necessary to maintain the physical 672.31 and mental health of the vulnerable adult which a reasonable 672.32 person would deem essential to obtain or maintain the vulnerable 672.33 adult's health, safety, or comfort considering the physical or 672.34 mental capacity or dysfunction of the vulnerable adult. 672.35 (c) For purposes of this section, a vulnerable adult is not 672.36 neglected for the sole reason that: 673.1 (1) the vulnerable adult or a person with authority to make 673.2 health care decisions for the vulnerable adult under sections 673.3 144.651, 144A.44, chapter 145B, 145C, or 252A, or section 673.4 253B.03, or 525.539 to 525.6199, refuses consent or withdraws 673.5 consent, consistent with that authority and within the boundary 673.6 of reasonable medical practice, to any therapeutic conduct, 673.7 including any care, service, or procedure to diagnose, maintain, 673.8 or treat the physical or mental condition of the vulnerable 673.9 adult, or, where permitted under law, to provide nutrition and 673.10 hydration parenterally or through intubation; this paragraph 673.11 does not enlarge or diminish rights otherwise held under law by: 673.12 (i) a vulnerable adult or a person acting on behalf of a 673.13 vulnerable adult, including an involved family member, to 673.14 consent to or refuse consent for therapeutic conduct; or 673.15 (ii) a caregiver to offer or provide or refuse to offer or 673.16 provide therapeutic conduct; or 673.17 (2) the vulnerable adult, a person with authority to make 673.18 health care decisions for the vulnerable adult, or a caregiver 673.19 in good faith selects and depends upon spiritual means or prayer 673.20 for treatment or care of disease or remedial care of the 673.21 vulnerable adult in lieu of medical care, provided that this is 673.22 consistent with the prior practice or belief of the vulnerable 673.23 adult or with the expressed intentions of the vulnerable adult; 673.24 (3) the vulnerable adult, who is not impaired in judgment 673.25 or capacity by mental or emotional dysfunction or undue 673.26 influence, engages in sexual contact with: 673.27 (i) a person including a facility staff person when a 673.28 consensual sexual personal relationship existed prior to the 673.29 caregiving relationship; or 673.30 (ii) a personal care attendant, regardless of whether the 673.31 consensual sexual personal relationship existed prior to the 673.32 caregiving relationship; or 673.33 (4) an individual makes an error in the provision of 673.34 therapeutic conduct to a vulnerable adult which: (i)does not 673.35 result in injury or harm which reasonably requires medical or 673.36 mental health care; or, if it reasonably requires care,674.1 (5) an individual makes an error in the provision of 674.2 therapeutic conduct to a vulnerable adult that results in injury 674.3 or harm, which reasonably requires the care of a physician; and: 674.4 (i) the necessary care issought andprovided in a timely 674.5 fashion as dictated by the condition of the vulnerable adult; 674.6and the injury or harm that required care does not result in674.7substantial acute, or chronic injury or illness, or permanent674.8disability above and beyond the vulnerable adult's preexisting674.9condition; 674.10 (ii) is after receiving care, the health status of the 674.11 vulnerable adult can be reasonably expected, as determined by 674.12 the attending physician, to be restored to the vulnerable 674.13 adult's preexisting condition; 674.14 (iii) the error is not part of a pattern of errors by the 674.15 individual; 674.16 (iv) if in a facility, the error is immediately reported as 674.17 required under section 626.557, and recorded internallyby the674.18employee or person providing servicesin the facilityin order674.19to evaluate and identify corrective action; 674.20 (v) if in a facility, the facility identifies and takes 674.21 corrective action and implements measures designed to reduce the 674.22 risk of further occurrence of this error and similar errors; and 674.23(iii) is(vi) if in a facility, the actions required under 674.24 items (iv) and (v) are sufficiently documented for review and 674.25 evaluation by the facility and any applicable licensing, 674.26 certification, and ombudsman agency; and674.27(iv) is not part of a pattern of errors by the individual. 674.28 (d) Nothing in this definition requires a caregiver, if 674.29 regulated, to provide services in excess of those required by 674.30 the caregiver's license, certification, registration, or other 674.31 regulation. 674.32 (e) If the findings of an investigation by a lead agency 674.33 result in a determination of substantiated maltreatment for the 674.34 sole reason that the actions required of a facility under 674.35 paragraph (c), clause (5), item (iv), (v), or (vi), were not 674.36 taken, then the facility is subject to a correction order. An 675.1 individual will not be found to have neglected or maltreated the 675.2 vulnerable adult based solely on the facility's not having taken 675.3 the actions required under paragraph (c), clause (5), item (iv), 675.4 (v), or (vi). This must not alter the lead agency's 675.5 determination of mitigating factors under section 626.557, 675.6 subdivision 9c, paragraph (c). 675.7 Sec. 33. [FEDERAL LAW CHANGE REQUEST OR WAIVER.] 675.8 The commissioner of health or human services, whichever is 675.9 appropriate, shall pursue changes to federal law necessary to 675.10 allow greater discretion on disciplinary activities of 675.11 unlicensed health care workers, and apply for necessary federal 675.12 waivers or approval that would allow for a set-aside process 675.13 related to disqualifications for nurse aides in nursing homes by 675.14 July 1, 2002. 675.15 Sec. 34. [WAIVER FROM FEDERAL RULES AND REGULATIONS.] 675.16 By January 2002, the commissioner of health shall work with 675.17 providers to examine federal rules and regulations prohibiting 675.18 neglect, abuse, and financial exploitation of residents in 675.19 licensed nursing facilities and shall apply for federal waivers 675.20 to: 675.21 (1) allow the use of Minnesota Statutes, section 626.5572, 675.22 to control the identification and prevention of maltreatment of 675.23 residents in licensed nursing facilities, rather than the 675.24 definitions under federal rules and regulations; and 675.25 (2) allow the use of Minnesota Statutes, sections 214.104, 675.26 245A.04, and 626.557 to control the disqualification or 675.27 discipline of any persons providing services to residents in 675.28 licensed nursing facilities, rather than the nurse aide registry 675.29 or other exclusionary provisions of federal rules and 675.30 regulations. 675.31 [EFFECTIVE DATE.] This section is effective July 1, 2001. 675.32 Sec. 35. [INSTRUCTION TO REVISOR.] 675.33 (a) The revisor of statutes shall replace any references to 675.34 "sections 245A.01 to 245A.16" in chapter 245A with "this 675.35 chapter." 675.36 (b) The revisor of statutes shall replace references in 676.1 Minnesota Rules and Minnesota Statutes to "parts 9543.3000 to 676.2 9543.3090" with "section 245A.04." 676.3 (c) The revisor of statutes shall replace references in 676.4 Minnesota Rules and Minnesota Statutes to "part 9543.3070" with 676.5 "section 245A.04, subdivision 3d." 676.6 (d) The revisor of statutes shall replace references in 676.7 Minnesota Rules and Minnesota Statutes to "part 9543.3080" with 676.8 "section 245A.04, subdivision 3b." 676.9 Sec. 36. [REPEALER.] 676.10 Minnesota Rules, parts 9543.3000; 9543.3010; 9543.3020; 676.11 9543.3030; 9543.3040; 9543.3050; 9543.3060; 9543.3080; and 676.12 9543.3090, are repealed. 676.13 ARTICLE 15 676.14 VITAL STATISTICS 676.15 Section 1. Minnesota Statutes 2000, section 144.212, 676.16 subdivision 2a, is amended to read: 676.17 Subd. 2a. [DELAYED REGISTRATION.] "Delayed registration" 676.18 means registration of acertificaterecord of birth or death 676.19 filed one or more years after the dateestablished by law for676.20filing a certificateof birth or death. 676.21 Sec. 2. Minnesota Statutes 2000, section 144.212, 676.22 subdivision 3, is amended to read: 676.23 Subd. 3. [FILE.] "File" means to present a vital record or 676.24 report for registration to the office of the state registrar and 676.25 to have the vital record or report accepted for registration by 676.26 the office of the state registrar. 676.27 Sec. 3. Minnesota Statutes 2000, section 144.212, 676.28 subdivision 5, is amended to read: 676.29 Subd. 5. [REGISTRATION.] "Registration" means the 676.30acceptance of a vital record for filing by a registrar of vital676.31statisticsprocess by which vital records are completed, filed, 676.32 and incorporated into the official records of the office of the 676.33 state registrar. 676.34 Sec. 4. Minnesota Statutes 2000, section 144.212, 676.35 subdivision 7, is amended to read: 676.36 Subd. 7. [SYSTEM OF VITAL STATISTICS.] "System of vital 677.1 statistics" includes the registration, collection, preservation, 677.2 amendment, and certification of vital records, the collection of 677.3 other reports required by sections 144.211 to 144.227, and 677.4 related activities including the tabulation, analysisand, 677.5 publication, and dissemination of vital statistics. 677.6 Sec. 5. Minnesota Statutes 2000, section 144.212, 677.7 subdivision 8, is amended to read: 677.8 Subd. 8. [VITAL RECORD.] "Vital record" meanscertificates677.9or reportsa record or report of birth, death, marriage, 677.10 dissolution and annulment, and data related thereto. The birth 677.11 record is not a medical record of the mother or the child. 677.12 Sec. 6. Minnesota Statutes 2000, section 144.212, 677.13 subdivision 9, is amended to read: 677.14 Subd. 9. [VITAL STATISTICS.] "Vital statistics" means the 677.15 data derived fromcertificates andrecords and reports of birth, 677.16 death, fetal death, induced abortion, marriage, dissolution and 677.17 annulment, and related reports. 677.18 Sec. 7. Minnesota Statutes 2000, section 144.212, 677.19 subdivision 11, is amended to read: 677.20 Subd. 11. [CONSENT TO DISCLOSURE.] "Consent to disclosure" 677.21 means an affidavit filed with the state registrar which sets 677.22 forth the following information: 677.23(a)(1) the current name and address of the affiant; 677.24(b)(2) any previous name by which the affiant was known; 677.25(c)(3) the original and adopted names, if known, of the 677.26 adopted child whose original birthcertificaterecord is to be 677.27 disclosed; 677.28(d)(4) the place and date of birth of the adopted child; 677.29(e)(5) the biological relationship of the affiant to the 677.30 adopted child; and 677.31(f)(6) the affiant's consent to disclosure of information 677.32 from the originalunalteredbirthcertificaterecord of the 677.33 adopted child. 677.34 Sec. 8. Minnesota Statutes 2000, section 144.214, 677.35 subdivision 1, is amended to read: 677.36 Subdivision 1. [DISTRICTS.]Each countyThe counties of 678.1 the state, and the city of St. Paul,shall constitute the8887 678.2 registration districts of the state.TheA local registrar in 678.3 each county shall bethe court administrator of district court678.4in that countydesignated by the county board of commissioners. 678.5 The local registrar in any city which maintains local 678.6 registration of vital statistics shall be the agent of a board 678.7 of health as authorized under section 145A.04. In addition, the 678.8 state registrar may establish registration districts on United 678.9 States government reservations,and may appoint a local 678.10 registrar for each registration district so established. 678.11 Sec. 9. Minnesota Statutes 2000, section 144.214, 678.12 subdivision 3, is amended to read: 678.13 Subd. 3. [DUTIES.]The local registrar shall examine each678.14certificate of birth and death received pursuant to the rules of678.15the commissioner. If the certificate is complete it shall be678.16registered.The local registrar shall enforce the provisions of 678.17 sections 144.211 to 144.227 and the rules promulgated thereunder 678.18 within the registration district,and shall promptly report 678.19 violations of the laws or rules to the state registrar. 678.20 Sec. 10. Minnesota Statutes 2000, section 144.214, 678.21 subdivision 4, is amended to read: 678.22 Subd. 4. [DESIGNATED MORTICIANS.] The state registrar may 678.23 designate licensed morticians to receive records of death for 678.24 filingcertificates of death, to issue burial permits, and to 678.25 issue permits for the transportation of dead bodies or dead 678.26 fetuses within a designated territory. The designated 678.27 morticians shall perform duties as prescribed by rule of the 678.28 commissioner. 678.29 Sec. 11. Minnesota Statutes 2000, section 144.215, 678.30 subdivision 1, is amended to read: 678.31 Subdivision 1. [WHEN AND WHERE TO FILE.] Acertificate678.32 record of birth for each live birth which occurs in this state 678.33 shall be filed with the state registraror the local registrar678.34of the district in which the birth occurred,within five days 678.35 after the birth. 678.36 Sec. 12. Minnesota Statutes 2000, section 144.215, 679.1 subdivision 3, is amended to read: 679.2 Subd. 3. [FATHER'S NAME; CHILD'S NAME.] In any case in 679.3 which paternity of a child is determined by a court of competent 679.4 jurisdiction, a declaration of parentage is executed under 679.5 section 257.34, or a recognition of parentage is executed under 679.6 section 257.75, the name of the father shall be entered on the 679.7 birthcertificaterecord. If the order of the court declares 679.8 the name of the child, it shall also be entered on the birth 679.9certificaterecord. If the order of the court does not declare 679.10 the name of the child, or there is no court order, then upon the 679.11 request of both parents in writing, the surname of the child 679.12 shall bethat of the fatherdefined by both parents. 679.13 Sec. 13. Minnesota Statutes 2000, section 144.215, 679.14 subdivision 4, is amended to read: 679.15 Subd. 4. [SOCIAL SECURITY NUMBER REGISTRATION.] (a) 679.16 Parents of a child born within this state shall givetheirthe 679.17 parents' social security numbers to the office ofvital679.18statisticsthe state registrar at the time of filing the birth 679.19certificaterecord, but the numbers shall not appear on the 679.20 certificate. 679.21 (b) The social security numbers are classified as private 679.22 data, as defined in section 13.02, subdivision 12, on 679.23 individuals, but the office ofvital statisticsthe state 679.24 registrar shall providethea social security number to the 679.25 public authority responsible for child support services upon 679.26 request by the public authority for use in the establishment of 679.27 parentage and the enforcement of child support obligations. 679.28 Sec. 14. Minnesota Statutes 2000, section 144.215, 679.29 subdivision 6, is amended to read: 679.30 Subd. 6. [BIRTHS OCCURRING OUTSIDE AN INSTITUTION.] When a 679.31 birth occurs outside of an institution as defined in subdivision 679.32 5, thecertificaterecord of birth shall beprepared andfiled 679.33 by one of the following persons, in the indicated order of 679.34 preference: 679.35 (1) the physician present at the time of the birth or 679.36 immediately thereafter; 680.1 (2) in the absence of a physician, a person, other than the 680.2 mother, present at the time of the birth or immediately 680.3 thereafter; 680.4 (3) the fatheror motherof the child;or680.5 (4) the mother of the child; or 680.6 (5) in the absence of the father and if the mother is 680.7 unable, the person with primary responsibility for the premises 680.8 where the child was born. 680.9 Sec. 15. Minnesota Statutes 2000, section 144.215, 680.10 subdivision 7, is amended to read: 680.11 Subd. 7. [EVIDENCE REQUIRED TO REGISTER A NONINSTITUTION 680.12 BIRTH WITHIN THE FIRST YEAR OF BIRTH.] When a birth occurs in 680.13 this state outside of an institution, as defined in subdivision 680.14 5, and the birthcertificaterecord is filed before the first 680.15 birthday, evidence in support of the facts of birth shall be 680.16 requiredwhen neither the state nor local registrar has personal680.17knowledge regarding the facts of birth. Evidence shall be 680.18 presented by the individual responsible for filing 680.19 thecertificatevital record under subdivision 6. Evidence 680.20 shall consist of proof that the child was born alive, proof of 680.21 pregnancy,orand evidence of the mother's presence in this 680.22 state on the date of the birth. If the evidence is not 680.23 acceptable, the state registrar shall advise the applicant of 680.24 the reason for not filing a birthcertificaterecord and shall 680.25 further advise the applicant of the right of appeal to a court 680.26 of competent jurisdiction. 680.27 Sec. 16. Minnesota Statutes 2000, section 144.217, is 680.28 amended to read: 680.29 144.217 [DELAYEDCERTIFICATESRECORDS OF BIRTH.] 680.30 Subdivision 1. [EVIDENCE REQUIRED FOR FILING.] Before a 680.31 delayedcertificaterecord of birth is registered, the person 680.32 presenting the delayedcertificatevital record for registration 680.33 shall offer evidence of the facts contained in thecertificate680.34 vital record, as required by the rules of the commissioner. In 680.35 the absence of the evidence required, the delayedcertificate680.36 vital record shall not be registered. No delayed record of 681.1 birth shall be registered for a deceased person. 681.2 Subd. 2. [COURT PETITION.] If a delayedcertificaterecord 681.3 of birth is rejected under subdivision 1, a person may petition 681.4 the appropriate court for an order establishing a record of the 681.5 date and place of the birth and the parentage of the person 681.6 whose birth is to be registered. The petition shall state: 681.7(a)(1) that the person for whom a delayed 681.8certificaterecord of birth is sought was born in this state; 681.9(b)(2) that nocertificaterecord of birth can be found in 681.10 the office of the stateor localregistrar; 681.11(c)(3) that diligent efforts by the petitioner have failed 681.12 to obtain the evidence required in subdivision 1; 681.13(d)(4) that the state registrar has refused to register a 681.14 delayedcertificaterecord of birth; and 681.15(e)(5) other information as may be required by the court. 681.16 Subd. 3. [COURT ORDER.] The court shall fix a time and 681.17 place for a hearing on the petition and shall give the state 681.18 registrar ten days' notice of the hearing. The state registrar 681.19 may appear and testify in the proceeding. If the court is 681.20 satisfied from the evidence received at the hearing of the truth 681.21 of the statements in the petition, the court shall order the 681.22 registration of the delayedcertificatevital record. 681.23Subd. 4. [FILING THE ORDER.] A certified copy of the order681.24shall be filed with the state registrar, who shall forward a681.25copy to the local registrar in the district of birth. Certified681.26copies of the order shall be evidence of the truth of their681.27contents and be admissible as birth certificates.681.28 Sec. 17. Minnesota Statutes 2000, section 144.218, is 681.29 amended to read: 681.30 144.218 [REPLACEMENTCERTIFICATES OFBIRTH RECORDS.] 681.31 Subdivision 1. [ADOPTION.] Upon receipt of a certified 681.32 copy of an order, decree, or certificate of adoption, the state 681.33 registrar shall register a replacementcertificatevital record 681.34 in the new name of the adopted person. The originalcertificate681.35 record of birthand the certified copy areis confidential 681.36 pursuant to section 13.02, subdivision 3, and shall not be 682.1 disclosed except pursuant to court order or section144.1761682.2 144.2252.A certified copy of the original birth certificate682.3from which the registration number has been deleted and which682.4has been marked "Not for Official Use," orThe information 682.5 contained on the original birthcertificate, except for the682.6registration number,record, except for the registration number, 682.7 shall be provided on request to a parent who is named on the 682.8 original birthcertificaterecord. Upon the receipt of a 682.9 certified copy of a court order of annulment of adoption the 682.10 state registrar shall restore the originalcertificatevital 682.11 record to its original place in the file. 682.12 Subd. 2. [ADOPTION OF FOREIGN PERSONS.] In proceedings for 682.13 the adoption of a person who was born in a foreign country, the 682.14 court, upon evidence presented by the commissioner of human 682.15 services from information secured at the port of entry,or upon 682.16 evidence from other reliable sources, may make findings of fact 682.17 as to the date and place of birth and parentage. Upon receipt 682.18 of certified copies of the court findings and the order or 682.19 decree of adoption, a certificate of adoption, or a certified 682.20 copy of a decree issued under section 259.60, the state 682.21 registrar shall register a birthcertificaterecord in the new 682.22 name of the adopted person. The certified copies of the court 682.23 findings and the order,or decree of adoption, certificate of 682.24 adoption, or decree issued under section 259.60 are 682.25 confidential, pursuant to section 13.02, subdivision 3, and 682.26 shall not be disclosed except pursuant to court order or section 682.27144.1761144.2252. The birthcertificaterecord shall state the 682.28 place of birth as specifically as possible,and that 682.29 thecertificatevital record is not evidence of United States 682.30 citizenship. 682.31 Subd. 3. [SUBSEQUENT MARRIAGE OF BIRTH PARENTS.] If, in 682.32 cases in which acertificaterecord of birth has been registered 682.33 pursuant to section 144.215 and the birth parents of the child 682.34 marry after the birth of the child, a replacementcertificate682.35 record of birth shall be registered upon presentation of a 682.36 certified copy of the marriage certificate of the birth parents, 683.1 and either a recognition of parentage or court adjudication of 683.2 paternity. Theinformation presented and theoriginal 683.3certificaterecord of birthareis confidential, pursuant to 683.4 section 13.02, subdivision 3, and shall not be disclosed except 683.5 pursuant to court order. 683.6 Subd. 4. [INCOMPLETE, INCORRECT, AND MODIFIEDCERTIFICATES683.7 VITAL RECORDS.] If a court finds that a birthcertificaterecord 683.8 is incomplete, inaccurate, or false,or if it is being issued 683.9 pursuant to section 259.10, subdivision 2,itthe court may 683.10 order the registration of a replacementcertificatevital 683.11 record, and, if necessary, set forth the correct information in 683.12 the order. Upon receipt of the order, thestateregistrar shall 683.13 register a replacementcertificatevital record containing the 683.14 findings of the court, and. The priorcertificatevital record 683.15 shall be confidential pursuant to section 13.02, subdivision 3, 683.16 and shall not be disclosed except pursuant to court order. 683.17 Subd. 5. [REPLACEMENT OF VITAL RECORDS.] Upon the order of 683.18 a court of this state, upon the request of a court of another 683.19 state, upon the filing of a declaration of parentage under 683.20 section 257.34, or upon the filing of a recognition of parentage 683.21 with a registrar, a replacement birth record must be registered 683.22 consistent with the findings of the court, the declaration of 683.23 parentage, or the recognition of parentage. 683.24 Sec. 18. Minnesota Statutes 2000, section 144.221, 683.25 subdivision 1, is amended to read: 683.26 Subdivision 1. [WHEN AND WHERE TO FILE.] A death 683.27certificaterecord for each death which occurs in the state 683.28 shall be filed with the state registrar or local registrarof683.29the district in which the death occurredor with a mortician 683.30appointeddesignated pursuant to section 144.214, subdivision 4, 683.31 within five days after death and prior to final disposition. 683.32 Sec. 19. Minnesota Statutes 2000, section 144.221, 683.33 subdivision 3, is amended to read: 683.34 Subd. 3. [WHEN NO BODY IS FOUND.] When circumstances 683.35 suggest that a death has occurred although a dead body cannot be 683.36 produced to confirm the fact of death, a deathcertificate684.1 record shall not be registered until a court has adjudicated the 684.2 fact of death.A certified copy of the court finding shall be684.3attached to the death certificate when it is registered.684.4 Sec. 20. Minnesota Statutes 2000, section 144.222, 684.5 subdivision 2, is amended to read: 684.6 Subd. 2. [SUDDEN INFANT DEATH.] Each infant death which is 684.7 diagnosed as sudden infant death syndrome shall be 684.8 reportedpromptlywithin five days to the state registrar. 684.9 Sec. 21. Minnesota Statutes 2000, section 144.223, is 684.10 amended to read: 684.11 144.223 [REPORT OF MARRIAGE.] 684.12 Data relating to certificates of marriage registered shall 684.13 be reported to the state registrar by the localregistrars684.14 registrar or designee of the county board in each of the 87 684.15 registration districts pursuant to the rules of the 684.16 commissioner. The information in clause (1) necessary to 684.17 compile the report shall be furnished by the applicant prior to 684.18 the issuance of the marriage license. The report shall contain 684.19 the followinginformation: 684.20A.(1) personal information on bride and groom: 684.211.(i) name; 684.222.(ii) residence; 684.233.(iii) date and place of birth; 684.244.(iv) race; 684.255.(v) if previously married, how terminated; and 684.266.(vi) signature of applicantand, date signed, and social 684.27 security number.; and 684.28B.(2) information concerning the marriage: 684.291.(i) date of marriage; 684.302.(ii) place of marriage; and 684.313.(iii) civil or religious ceremony. 684.32 Sec. 22. Minnesota Statutes 2000, section 144.225, 684.33 subdivision 1, is amended to read: 684.34 Subdivision 1. [PUBLIC INFORMATION; ACCESS TO VITAL 684.35 RECORDS.] Except as otherwise provided for in this section and 684.36 section144.1761144.2252, information contained in vital 685.1 records shall be public information. Physical access to vital 685.2 records shall be subject to the supervision and regulation of 685.3 state and local registrars and their employees pursuant to rules 685.4 promulgated by the commissioner in order to protect vital 685.5 records from loss, mutilation or destruction and to prevent 685.6 improper disclosure of vital records which are confidential or 685.7 private data on individuals, as defined in section 13.02, 685.8 subdivisions 3 and 12. 685.9 Sec. 23. Minnesota Statutes 2000, section 144.225, 685.10 subdivision 2, is amended to read: 685.11 Subd. 2. [DATA ABOUT BIRTHS.] (a) Except as otherwise 685.12 provided in this subdivision, data pertaining to the birth of a 685.13 child to a woman who was not married to the child's father when 685.14 the child was conceived nor when the child was born, including 685.15 the originalcertificaterecord of birth and the certified 685.16copyvital record, are confidential data. At the time of the 685.17 birth of a child to a woman who was not married to the child's 685.18 father when the child was conceived nor when the child was born, 685.19 the mother may designateon the birth registration form whether685.20 demographic data pertaining to the birthwill beas public 685.21data. Notwithstanding the designation of the data as 685.22 confidential, it may be disclosed: 685.23 (1) to a parent or guardian of the child; 685.24 (2) to the child when the child is1816 years of age or 685.25 older; 685.26 (3) under paragraph (b) or (e); or 685.27 (4) pursuant to a court order. For purposes of this 685.28 section, a subpoena does not constitute a court order. 685.29 (b) Unless the child is adopted, data pertaining to the 685.30 birth of a child that are not accessible to the public become 685.31 public data if 100 years have elapsed since the birth of the 685.32 child who is the subject of the data, or as provided under 685.33 section 13.10, whichever occurs first. 685.34 (c) If a child is adopted, data pertaining to the child's 685.35 birth are governed by the provisions relating to adoption 685.36 records, including sections 13.10, subdivision 5;144.1761;686.1 144.218, subdivision 1; 144.2252; and 259.89.The birth and686.2death records of the commissioner of health shall be open to686.3inspection by the commissioner of human services and it shall686.4not be necessary for the commissioner of human services to686.5obtain an order of the court in order to inspect records or to686.6secure certified copies of them.686.7 (d) The name and address of a mother under paragraph (a) 686.8 and the child's date of birth may be disclosed to the county 686.9 social services or public health member of a family services 686.10 collaborative for purposes of providing services under section 686.11 124D.23. 686.12 (e) The commissioner of human services shall have access to 686.13 birth records for: 686.14 (1) the purposes of administering medical assistance, 686.15 general assistance medical care, and the MinnesotaCare program; 686.16 (2) child support enforcement purposes; and 686.17 (3) other public health purposes as determined by the 686.18 commissioner of health. 686.19 Sec. 24. Minnesota Statutes 2000, section 144.225, 686.20 subdivision 2a, is amended to read: 686.21 Subd. 2a. [HEALTH DATA ASSOCIATED WITH BIRTH 686.22 REGISTRATION.] Information from which an identification of risk 686.23 for disease, disability, or developmental delay in a mother or 686.24 child can be made, that is collected in conjunction with birth 686.25 registration or fetal death reporting, is private data as 686.26 defined in section 13.02, subdivision 12. The commissioner may 686.27 disclose to a local board of health, as defined in section 686.28 145A.02, subdivision 2, health data associated with birth 686.29 registration which identifies a mother or child at high risk for 686.30 serious disease, disability, or developmental delay in order to 686.31 assure access to appropriate health, social, or educational 686.32 services. Notwithstanding the designation of the private data, 686.33 the commissioner of human services shall have access to health 686.34 data associated with birth registration for: 686.35 (1) purposes of administering medical assistance, general 686.36 assistance medical care, and the MinnesotaCare program; and 687.1 (2) for other public health purposes as determined by the 687.2 commissioner of health. 687.3 Sec. 25. Minnesota Statutes 2000, section 144.225, 687.4 subdivision 3, is amended to read: 687.5 Subd. 3. [LAWS AND RULES FOR PREPARINGCERTIFICATESVITAL 687.6 RECORDS.] No person shall prepare or issue anycertificatevital 687.7 record which purports to be an original, certified copy, or copy 687.8 of a vital record except as authorized in sections 144.211 to 687.9 144.227 or the rules of the commissioner. 687.10 Sec. 26. Minnesota Statutes 2000, section 144.225, 687.11 subdivision 7, as amended by Laws 2001, chapter 15, section 1, 687.12 is amended to read: 687.13 Subd. 7. [CERTIFIEDCOPY OFBIRTH OR DEATH 687.14CERTIFICATERECORD.] (a) The state or local registrar shall 687.15 issue a certifiedcopy of abirth or deathcertificaterecord or 687.16 a statement of no vital record found to an individual upon the 687.17 individual's proper completion of an attestation provided by the 687.18 commissioner: 687.19 (1) to a person who has a tangible interest in the 687.20 requestedcertificatevital record. A person who has a tangible 687.21 interest is: 687.22 (i) the subject of thecertificatevital record; 687.23 (ii) a child of the subject; 687.24 (iii) the spouse of the subject; 687.25 (iv) a parent of the subject; 687.26 (v) the grandparent or grandchild of the subject; 687.27 (vi) the party responsible for filing thecertificatevital 687.28 record; 687.29 (vii) the legal custodian or guardian or conservator of the 687.30 subject; 687.31 (viii) a personal representative, by sworn affidavit of the 687.32 fact that the certified copy is required for administration of 687.33 the estate; 687.34 (ix) a successor of the subject, as defined in section 687.35 524.1-201, if the subject is deceased, by sworn affidavit of the 687.36 fact that the certified copy is required for administration of 688.1 the estate; 688.2 (x) if the requested certificate is a death certificate, a 688.3 trustee of a trust by sworn affidavit of the fact that the 688.4 certified copy is needed for the proper administration of the 688.5 trust;or688.6 (xi) a person or entity who demonstrates that a 688.7 certifiedcopy of the certificatevital record is necessary for 688.8 the determination or protection of a personal or property right, 688.9 pursuant to rules adopted by the commissioner; or 688.10 (xii) adoption agencies in order to complete confidential 688.11 postadoption searches as required by section 259.83; 688.12 (2) to any local, state, or federal governmental agency 688.13 upon request if the certifiedcertificatevital record is 688.14 necessary for the governmental agency to perform its authorized 688.15 duties. An authorized governmental agency includes the 688.16 department of human services, the department of revenue, and the 688.17 United States Immigration and Naturalization Service; 688.18 (3) to an attorney upon evidence of the attorney's license; 688.19 (4) pursuant to a court order issued by a court of 688.20 competent jurisdiction. For purposes of this section, a 688.21 subpoena does not constitute a court order; or 688.22 (5) to a representative authorized by a person under 688.23 clauses (1) to (4). 688.24 (b) The state or local registrar shall also issue a 688.25 certified death record to an individual described in paragraph 688.26 (a), clause (1), items (ii) to (vii), if, on behalf of the 688.27 individual, a mortician designated to receive death certificates 688.28 under section 144.214, subdivision 4, furnishes the registrar 688.29 with a properly completed attestation in the form provided by 688.30 the commissioner within 180 days of the time of death of the 688.31 subject of the death record. This paragraph is not subject to 688.32 the requirements specified in Minnesota Rules, part 4601.2600, 688.33 subpart 5, item B. 688.34 Sec. 27. [144.2252] [ACCESS TO ORIGINAL BIRTH RECORD AFTER 688.35 ADOPTION.] 688.36 (a) Whenever an adopted person requests the state registrar 689.1 to disclose the information on the adopted person's original 689.2 birth record, the state registrar shall act according to section 689.3 259.89. 689.4 (b) The state registrar shall provide a transcript of an 689.5 adopted person's original birth record to an authorized 689.6 representative of a federally recognized American Indian tribe 689.7 for the sole purpose of determining the adopted person's 689.8 eligibility for enrollment or membership. Information contained 689.9 in the birth record may not be used to provide the adopted 689.10 person information about the person's birth parents, except as 689.11 provided in this section or section 259.83. 689.12 Sec. 28. Minnesota Statutes 2000, section 144.226, 689.13 subdivision 1, is amended to read: 689.14 Subdivision 1. [WHICH SERVICES ARE FOR FEE.] The fees for 689.15 the following services shall be the following or an amount 689.16 prescribed by rule of the commissioner: 689.17 (a) The fee for the issuance of a certifiedcopy or689.18certification of avital record,or a certification that the 689.19 vital record cannot be found is $8. No fee shall be charged for 689.20 a certified birth or death record that is reissued within one 689.21 year of the original issue, if an amendment is made to the vital 689.22 record and if the previously issued vital record is surrendered. 689.23 (b) The fee for the replacement of a birth record for all 689.24 events, exceptadoptionwhen filing a recognition of parentage 689.25 pursuant to section 257.73, subdivision 1, is $20. 689.26 (c) The fee for the filing of a delayed registration of 689.27 birth or death is $20. 689.28 (d) The fee for the amendment of any vital record when 689.29 requested more thanone year45 days after the filing of the 689.30 vital record is $20. No fee shall be charged for an amendment 689.31 requested withinone year45 days after the filing of the 689.32certificatevital record. 689.33 (e) The fee for the verification of information from vital 689.34 records is $8 when the applicant furnishes the specific 689.35 information to locate the vital record. When the applicant does 689.36 not furnish specific information, the fee is $20 per hour for 690.1 staff time expended. Specific informationshall include690.2 includes the correct date of the event and the correct name of 690.3 the registrant. Fees charged shall approximate the costs 690.4 incurred in searching and copying the vital records. The fee 690.5 shall be payable at the time of application. 690.6 (f) The fee for issuance of acertified or noncertified690.7 copy of any document on file pertaining to a vital record ora690.8certificationstatement thatthe recorda related document 690.9 cannot be found is $8. 690.10 Sec. 29. Minnesota Statutes 2000, section 144.226, 690.11 subdivision 3, is amended to read: 690.12 Subd. 3. [BIRTHCERTIFICATE COPYRECORD SURCHARGE.] In 690.13 addition to any fee prescribed under subdivision 1, there shall 690.14 be a nonrefundable surcharge of $3 for each certifiedcopy of a690.15 birthcertificate,record and for a certification that the vital 690.16 record cannot be found. The local or state registrar shall 690.17 forward this amount to the commissioner of finance for deposit 690.18 into the account for the children's trust fund for the 690.19 prevention of child abuse established under section 119A.12. 690.20 This surcharge shall not be charged under those circumstances in 690.21 which no fee for a certifiedcopy of abirthcertificaterecord 690.22 is permitted under subdivision 1, paragraph (a). Upon 690.23 certification by the commissioner of finance that the assets in 690.24 that fund exceed $20,000,000, this surcharge shall be 690.25 discontinued. 690.26 Sec. 30. Minnesota Statutes 2000, section 144.227, is 690.27 amended to read: 690.28 144.227 [PENALTIES.] 690.29 Subdivision 1. [FALSE STATEMENTS.]WhoeverA person who 690.30 intentionally makesanya false statement in a certificate, 690.31 vital record, or report required to be filed under sections 690.32 144.211 to 144.214 or 144.216 to 144.227, or in an application 690.33 for an amendment thereof, or in an application for a 690.34 certifiedcopy of avital record,or who supplies false 690.35 information intending that the information be used in the 690.36 preparation ofanya report, vital record, certificate, or 691.1 amendment thereof, is guilty of a misdemeanor. 691.2 Subd. 2. [FRAUD.]AnyA person who, without lawful 691.3 authority and with the intent to deceive, willfully and 691.4 knowingly makes, counterfeits, alters, obtains, possesses, uses, 691.5 or sellsanya certificate, vital record, or report required to 691.6 be filed under sections 144.211 to 144.227,or a certifiedcopy691.7of acertificate, vital record, or report, is guilty of a gross 691.8 misdemeanor. 691.9 Subd. 3. [BIRTH REGISTRATION.]WhoeverA person who 691.10 intentionally makes a false statement in a registration required 691.11 under section 144.215 or in an application for an amendment to 691.12 such a registration,or who intentionally supplies false 691.13 information intending that the information be used in the 691.14 preparation of a registration under section 144.215 is guilty of 691.15 a gross misdemeanor. This offense shall be prosecuted by the 691.16 county attorney. 691.17 Sec. 31. Minnesota Statutes 2000, section 260C.317, 691.18 subdivision 4, is amended to read: 691.19 Subd. 4. [RIGHTS OF TERMINATED PARENT.] Upon entry of an 691.20 order terminating the parental rights of any person who is 691.21 identified as a parent on the original birth certificate of the 691.22 child as to whom the parental rights are terminated, the court 691.23 shall cause written notice to be made to that person setting 691.24 forth: 691.25(a)(1) the right of the person to file at any time with 691.26 the state registrar of vital statistics a consent to disclosure, 691.27 as defined in section 144.212, subdivision 11; 691.28(b)(2) the right of the person to file at any time with 691.29 the state registrar of vital statistics an affidavit stating 691.30 that the information on the original birth certificate shall not 691.31 be disclosed as provided in section144.1761144.2252; and 691.32(c)(3) the effect of a failure to file either a consent to 691.33 disclosure, as defined in section 144.212, subdivision 11, or an 691.34 affidavit stating that the information on the original birth 691.35 certificate shall not be disclosed. 691.36 Sec. 32. [REVISOR'S INSTRUCTION.] 692.1 (a) The revisor of statutes shall change the terms 692.2 "certificate of birth," "birth certificate," or similar terms to 692.3 "record of birth," "birth record," or similar terms wherever 692.4 they appear in Minnesota Statutes and Minnesota Rules. 692.5 (b) The revisor of statutes shall change the terms 692.6 "certificate of death," "death certificate," or similar terms to 692.7 "record of death," "death record," or similar terms wherever 692.8 they appear in Minnesota Statutes and Minnesota Rules. 692.9 (c) The revisor of statutes shall change the term "office 692.10 of vital statistics" to "office of the state registrar" wherever 692.11 it appears in Minnesota Statutes and Minnesota Rules. 692.12 Sec. 33. [REPEALER.] 692.13 Minnesota Statutes 2000, sections 144.1761; 144.217, 692.14 subdivision 4; and 144.219, are repealed. 692.15 ARTICLE 16 692.16 PATIENT PROTECTION 692.17 Section 1. Minnesota Statutes 2000, section 45.027, 692.18 subdivision 6, is amended to read: 692.19 Subd. 6. [VIOLATIONS AND PENALTIES.] The commissioner may 692.20 impose a civil penalty not to exceed $10,000 per violation upon 692.21 a person who violates any law, rule, or order related to the 692.22 duties and responsibilities entrusted to the commissioner unless 692.23 a different penalty is specified. If a civil penalty is imposed 692.24 on a health carrier as defined in section 62A.011, the 692.25 commissioner must divide 50 percent of the amount among any 692.26 policy holders or certificate holders affected by the violation, 692.27 unless the commissioner certifies in writing that the division 692.28 and distribution to enrollees would be too administratively 692.29 complex or that the number of enrollees affected by the penalty 692.30 would result in a distribution of less than $50 per enrollee. 692.31 Sec. 2. [62D.109] [SERVICES ASSOCIATED WITH CLINICAL 692.32 TRIALS.] 692.33 A health maintenance organization must inform an enrollee 692.34 who is a participant in a clinical trial upon inquiry by the 692.35 enrollee that coverage shall be provided as required under the 692.36 enrollee's health maintenance contract or under state or federal 693.1 rule or statute. 693.2 Sec. 3. Minnesota Statutes 2000, section 62D.17, 693.3 subdivision 1, is amended to read: 693.4 Subdivision 1. [ADMINISTRATIVE PENALTY.] The commissioner 693.5 of health may, for any violation of statute or rule applicable 693.6 to a health maintenance organization, or in lieu of suspension 693.7 or revocation of a certificate of authority under section 693.8 62D.15, levy an administrative penalty in an amount up to 693.9 $25,000 for each violation. In the case of contracts or 693.10 agreements made pursuant to section 62D.05, subdivisions 2 to 4, 693.11 each contract or agreement entered into or implemented in a 693.12 manner which violates sections 62D.01 to 62D.30 shall be 693.13 considered a separate violation. In determining the level of an 693.14 administrative penalty, the commissioner shall consider the 693.15 following factors: 693.16 (1) the number of enrollees affected by the violation; 693.17 (2) the effect of the violation on enrollees' health and 693.18 access to health services; 693.19 (3) if only one enrollee is affected, the effect of the 693.20 violation on that enrollee's health; 693.21 (4) whether the violation is an isolated incident or part 693.22 of a pattern of violations; and 693.23 (5) the economic benefits derived by the health maintenance 693.24 organization or a participating provider by virtue of the 693.25 violation. 693.26 Reasonable notice in writing to the health maintenance 693.27 organization shall be given of the intent to levy the penalty 693.28 and the reasons therefor, and the health maintenance 693.29 organization may have 15 days within which to file a written 693.30 request for an administrative hearing and review of the 693.31 commissioner of health's determination. Such administrative 693.32 hearing shall be subject to judicial review pursuant to chapter 693.33 14. If an administrative penalty is levied, the commissioner 693.34 must divide 50 percent of the amount among any enrollees 693.35 affected by the violation, unless the commissioner certifies in 693.36 writing that the division and distribution to enrollees would be 694.1 too administratively complex or that the number of enrollees 694.2 affected by the penalty would result in a distribution of less 694.3 than $50 per enrollee. 694.4 Sec. 4. Minnesota Statutes 2000, section 62J.38, is 694.5 amended to read: 694.6 62J.38 [COST CONTAINMENT DATA FROM GROUP PURCHASERS.] 694.7 (a) The commissioner shall require group purchasers to 694.8 submit detailed data on total health care spending for each 694.9 calendar year. Group purchasers shall submit data for the 1993 694.10 calendar year by April 1, 1994, and each April 1 thereafter 694.11 shall submit data for the preceding calendar year. 694.12 (b) The commissioner shall require each group purchaser to 694.13 submit data on revenue, expenses, and member months, as 694.14 applicable. Revenue data must distinguish between premium 694.15 revenue and revenue from other sources and must also include 694.16 information on the amount of revenue in reserves and changes in 694.17 reserves. Expenditure data, including raw data from claims, may694.18 must distinguish between costs incurred for patient care and 694.19 administrative costs. Patient care and administrative costs 694.20 must include only expenses incurred on behalf of health plan 694.21 members and must not include the cost of providing health care 694.22 services for nonmembers at facilities owned by the group 694.23 purchaser or affiliate. Expenditure data must be provided 694.24 separately for the following categoriesorand for other 694.25 categories required by the commissioner: physician services, 694.26 dental services, other professional services, inpatient hospital 694.27 services, outpatient hospital services, emergency, pharmacy 694.28 services and other nondurable medical goods, mental health, and 694.29 chemical dependency services, other expenditures, subscriber 694.30 liability, and administrative costs. Administrative costs must 694.31 include costs for marketing; advertising; overhead; salaries and 694.32 benefits of central office staff who do not provide direct 694.33 patient care; underwriting; lobbying; claims processing; 694.34 provider contracting and credentialing; detection and prevention 694.35 of payment for fraudulent or unjustified requests for 694.36 reimbursement or services; clinical quality assurance and other 695.1 types of medical care quality improvement efforts; concurrent or 695.2 prospective utilization review as defined in section 62M.02; 695.3 costs incurred to acquire a hospital, clinic, or health care 695.4 facility, or the assets thereof; capital costs incurred on 695.5 behalf of a hospital or clinic; lease payments; or any other 695.6 costs incurred pursuant to a partnership, joint venture, 695.7 integration, or affiliation agreement with a hospital, clinic, 695.8 or other health care provider. Capital costs and costs incurred 695.9 must be recorded according to standard accounting principles. 695.10 The reports of this data must also separately identify expenses 695.11 for local, state, and federal taxes, fees, and assessments. The 695.12 commissioner may require each group purchaser to submit any 695.13 other data, including data in unaggregated form, for the 695.14 purposes of developing spending estimates, setting spending 695.15 limits, and monitoring actual spending and costs. In addition 695.16 to reporting administrative costs incurred to acquire a 695.17 hospital, clinic, or health care facility, or the assets 695.18 thereof; or any other costs incurred pursuant to a partnership, 695.19 joint venture, integration, or affiliation agreement with a 695.20 hospital, clinic, or other health care provider; reports 695.21 submitted under this section also must include the payments made 695.22 during the calendar year for these purposes. The commissioner 695.23 shall make public, by group purchaser data collected under this 695.24 paragraph in accordance with section 62J.321, subdivision 5. 695.25 Workers' compensation insurance plans and automobile insurance 695.26 plans are exempt from complying with this paragraph as it 695.27 relates to the submission of administrative costs. 695.28 (c) The commissioner may collect information on: 695.29 (1) premiums, benefit levels, managed care procedures, and 695.30 other features of health plan companies; 695.31 (2) prices, provider experience, and other information for 695.32 services less commonly covered by insurance or for which 695.33 patients commonly face significant out-of-pocket expenses; and 695.34 (3) information on health care services not provided 695.35 through health plan companies, including information on prices, 695.36 costs, expenditures, and utilization. 696.1 (d) All group purchasers shall provide the required data 696.2 using a uniform format and uniform definitions, as prescribed by 696.3 the commissioner. 696.4 Sec. 5. Minnesota Statutes 2000, section 62M.02, 696.5 subdivision 21, is amended to read: 696.6 Subd. 21. [UTILIZATION REVIEW ORGANIZATION.] "Utilization 696.7 review organization" means an entity including but not limited 696.8 to an insurance company licensed under chapter 60A to offer, 696.9 sell, or issue a policy of accident and sickness insurance as 696.10 defined in section 62A.01; a health service plan licensed under 696.11 chapter 62C; a health maintenance organization licensed under 696.12 chapter 62D; a community integrated service network licensed 696.13 under chapter 62N; an accountable provider network operating 696.14 under chapter 62T; a fraternal benefit society operating under 696.15 chapter 64B; a joint self-insurance employee health plan 696.16 operating under chapter 62H; a multiple employer welfare 696.17 arrangement, as defined in section 3 of the Employee Retirement 696.18 Income Security Act of 1974 (ERISA), United States Code, title 696.19 29, section 1103, as amended; a third party administrator 696.20 licensed under section 60A.23, subdivision 8, which conducts 696.21 utilization review and determines certification of an admission, 696.22 extension of stay, or other health care services for a Minnesota 696.23 resident; or any entity performing utilization review that is 696.24 affiliated with, under contract with, or conducting utilization 696.25 review on behalf of, a business entity in this state. 696.26 Utilization review organization does not include a clinic or 696.27 health care system acting pursuant to a written delegation 696.28 agreement with an otherwise regulated utilization review 696.29 organization that contracts with the clinic or health care 696.30 system. The regulated utilization review organization is 696.31 accountable for the delegated utilization review activities of 696.32 the clinic or health care system. 696.33 Sec. 6. [62Q.121] [LICENSURE OF MEDICAL DIRECTORS.] 696.34 (a) No health plan company may employ a person as a medical 696.35 director unless the person is licensed as a physician in this 696.36 state. This section does not apply to a health plan company 697.1 that is assessed less than three percent of the total amount 697.2 assessed by the Minnesota comprehensive health association. 697.3 (b) For purposes of this section, "medical director" means 697.4 a physician employed by a health plan company who has direct 697.5 decision-making authority, based upon medical training and 697.6 knowledge, regarding the health plan company's medical 697.7 protocols, medical policies, or coverage of treatment of a 697.8 particular enrollee, regardless of the physician's title. 697.9 (c) This section applies only to medical directors who make 697.10 recommendations or decisions that involve or affect enrollees 697.11 who live in this state. 697.12 (d) Each health plan company that is subject to this 697.13 section shall provide the commissioner with the names and 697.14 licensure information of its medical directors and shall provide 697.15 updates no later than 30 days after any changes. 697.16 Sec. 7. Minnesota Statutes 2000, section 62Q.56, is 697.17 amended to read: 697.18 62Q.56 [CONTINUITY OF CARE.] 697.19 Subdivision 1. [CHANGE IN HEALTH CARE PROVIDER; GENERAL 697.20 NOTIFICATION.] (a) If enrollees are required to access services 697.21 through selected primary care providers for coverage, the health 697.22 plan company shall prepare a written plan that provides for 697.23 continuity of care in the event of contract termination between 697.24 the health plan company and any of the contracted primary care 697.25 providers, specialists, or general hospital providers. The 697.26 written plan must explain: 697.27 (1) how the health plan company will inform affected 697.28 enrollees, insureds, or beneficiariesabout termination at least 697.29 30 days before the termination is effective, if the health plan 697.30 company or health care network cooperative has received at least 697.31 120 days' prior notice; 697.32 (2) how the health plan company will inform the affected 697.33 enrollees about what other participating providers are available 697.34 to assume care and how it will facilitate an orderly transfer of 697.35 its enrollees from the terminating provider to the new provider 697.36 to maintain continuity of care; 698.1 (3) the procedures by which enrollees will be transferred 698.2 to other participating providers, when special medical needs, 698.3 special risks, or other special circumstances, such as cultural 698.4 or language barriers, require them to have a longer transition 698.5 period or be transferred to nonparticipating providers; 698.6 (4) who will identify enrollees with special medical needs 698.7 or at special risk and what criteria will be used for this 698.8 determination; and 698.9 (5) how continuity of care will be provided for enrollees 698.10 identified as having special needs or at special risk, and 698.11 whether the health plan company has assigned this responsibility 698.12 to its contracted primary care providers. 698.13 (b)If the contract termination was not for cause,698.14enrollees can request a referral to the terminating provider for698.15up to 120 days if they have special medical needs or have other698.16special circumstances, such as cultural or language barriers.698.17The health plan company can require medical records and other698.18supporting documentation in support of the requested referral.698.19Each request for referral to a terminating provider shall be698.20considered by the health plan company on a case-by-case698.21basis.For purposes of this section, contract termination 698.22 includes nonrenewal. 698.23(c) If the contract termination was for cause, enrollees698.24must be notified of the change and transferred to participating698.25providers in a timely manner so that health care services remain698.26available and accessible to the affected enrollees. The health698.27plan company is not required to refer an enrollee back to the698.28terminating provider if the termination was for cause.698.29 Subd. 1a. [CHANGE IN HEALTH CARE PROVIDER; TERMINATION NOT 698.30 FOR CAUSE.] (a) If the contract termination was not for cause 698.31 and the contract was terminated by the health plan company, the 698.32 health plan company must provide the terminated provider and all 698.33 enrollees being treated by that provider with notification of 698.34 the enrollees' rights to continuity of care with the terminated 698.35 provider. 698.36 (b) The health plan company must provide, upon request, 699.1 authorization to receive services that are otherwise covered 699.2 under the terms of the health plan through the enrollee's 699.3 current provider: 699.4 (1) for up to 120 days if the enrollee is engaged in a 699.5 current course of treatment for one or more of the following 699.6 conditions: 699.7 (i) an acute condition; 699.8 (ii) a life-threatening mental or physical illness; 699.9 (iii) pregnancy beyond the first trimester of pregnancy; 699.10 (iv) a physical or mental disability defined as an 699.11 inability to engage in one or more major life activities, 699.12 provided that the disability has lasted or can be expected to 699.13 last for at least one year, or can be expected to result in 699.14 death; or 699.15 (v) a disabling or chronic condition that is in an acute 699.16 phase; or 699.17 (2) for the rest of the enrollee's life if a physician 699.18 certifies that the enrollee has an expected lifetime of 180 days 699.19 or less. 699.20 For all requests for authorization to receive services under 699.21 this paragraph, the health plan company must grant the request 699.22 unless the enrollee does not meet the criteria provided in this 699.23 paragraph. 699.24 (c) The health plan company shall prepare a written plan 699.25 that provides a process for coverage determinations regarding 699.26 continuity of care of up to 120 days for enrollees who request 699.27 continuity of care with their former provider, if the enrollee: 699.28 (1) is receiving culturally appropriate services and the 699.29 health plan company does not have a provider in its preferred 699.30 provider network with special expertise in the delivery of those 699.31 culturally appropriate services within the time and distance 699.32 requirements of section 62D.124, subdivision 1; or 699.33 (2) does not speak English and the health plan company does 699.34 not have a provider in its preferred provider network who can 699.35 communicate with the enrollee, either directly or through an 699.36 interpreter, within the time and distance requirements of 700.1 section 62D.124, subdivision 1. 700.2 The written plan must explain the criteria that will be used to 700.3 determine whether a need for continuity of care exists and how 700.4 it will be provided. 700.5 Subd. 1b. [CHANGE IN HEALTH CARE PROVIDER; TERMINATION FOR 700.6 CAUSE.] If the contract termination was for cause, enrollees 700.7 must be notified of the change and transferred to participating 700.8 providers in a timely manner so that health care services remain 700.9 available and accessible to the affected enrollees. The health 700.10 plan company is not required to refer an enrollee back to the 700.11 terminating provider if the termination was for cause. 700.12 Subd. 2. [CHANGE IN HEALTH PLANS.] (a)The health plan700.13company shall prepare a written plan that provides a process for700.14coverage determinations for continuity of care for new enrollees700.15with special needs, special risks, or other special700.16circumstances, such as cultural or language barriers, who700.17request continuity of care with their former provider for up to700.18120 days. The written plan must explain the criteria that will700.19be used for determining special needs cases, and how continuity700.20of care will be provided.If an enrollee is subject to a change 700.21 in health plans, the enrollee's new health plan company must 700.22 provide, upon request, authorization to receive services that 700.23 are otherwise covered under the terms of the new health plan 700.24 through the enrollee's current provider: 700.25 (1) for up to 120 days if the enrollee is engaged in a 700.26 current course of treatment for one or more of the following 700.27 conditions: 700.28 (i) an acute condition; 700.29 (ii) a life-threatening mental or physical illness; 700.30 (iii) pregnancy beyond the first trimester of pregnancy; 700.31 (iv) a physical or mental disability defined as an 700.32 inability to engage in one or more major life activities, 700.33 provided that the disability has lasted or can be expected to 700.34 last for at least one year, or can be expected to result in 700.35 death; or 700.36 (v) a disabling or chronic condition that is in an acute 701.1 phase; or 701.2 (2) for the rest of the enrollee's life if a physician 701.3 certifies that the enrollee has an expected lifetime of 180 days 701.4 or less. 701.5 For all requests for authorization under this paragraph, the 701.6 health plan company must grant the request for authorization 701.7 unless the enrollee does not meet the criteria provided in this 701.8 paragraph. 701.9 (b) The health plan company shall prepare a written plan 701.10 that provides a process for coverage determinations regarding 701.11 continuity of care of up to 120 days for new enrollees who 701.12 request continuity of care with their former provider, if the 701.13 new enrollee: 701.14 (1) is receiving culturally appropriate services and the 701.15 health plan company does not have a provider in its preferred 701.16 provider network with special expertise in the delivery of those 701.17 culturally appropriate services within the time and distance 701.18 requirements of section 62D.124, subdivision 1; or 701.19 (2) does not speak English and the health plan company does 701.20 not have a provider in its preferred provider network who can 701.21 communicate with the enrollee, either directly or through an 701.22 interpreter, within the time and distance requirements of 701.23 section 62D.124, subdivision 1. 701.24 The written plan must explain the criteria that will be used to 701.25 determine whether a need for continuity of care exists and how 701.26 it will be provided. 701.27(b)(c) This subdivision applies only to group coverage and 701.28 continuation and conversion coverage, and applies only to 701.29 changes in health plans made by the employer. 701.30 Subd. 2a. [LIMITATIONS.] (a) Subdivisions 1, 1a, 1b, and 2 701.31 apply only if the enrollee's health care provider agrees to: 701.32 (1) accept as payment in full the lesser of the health plan 701.33 company's reimbursement rate for in-network providers for the 701.34 same or similar service or the enrollee's health care provider's 701.35 regular fee for that service; 701.36 (2) adhere to the health plan company's preauthorization 702.1 requirements; and 702.2 (3) provide the health plan company with all necessary 702.3 medical information related to the care provided to the enrollee. 702.4 (b) Nothing in this section requires a health plan company 702.5 to provide coverage for a health care service or treatment that 702.6 is not covered under the enrollee's health plan. 702.7 Subd. 2b. [REQUEST FOR AUTHORIZATION.] The health plan 702.8 company may require medical records and other supporting 702.9 documentation to be submitted with the requests for 702.10 authorization made under subdivision 1, 1a, 1b, or 2. If the 702.11 authorization is denied, the health plan company must explain 702.12 the criteria it used to make its decision on the request for 702.13 authorization. If the authorization is granted, the health plan 702.14 company must explain how continuity of care will be provided. 702.15 Subd. 3. [DISCLOSURESDISCLOSURE.]The written plans702.16required under this section must be made available upon request702.17to enrollees or prospective enrolleesInformation regarding an 702.18 enrollee's rights under this section must be included in member 702.19 contracts or certificates of coverage and must be provided by a 702.20 health plan company upon request of an enrollee or prospective 702.21 enrollee. 702.22 Sec. 8. Minnesota Statutes 2000, section 62Q.58, is 702.23 amended to read: 702.24 62Q.58 [ACCESS TO SPECIALTY CARE.] 702.25 Subdivision 1. [STANDING REFERRAL.] A health plan company 702.26 shall establish a procedure by which an enrollee may apply 702.27 for and, if appropriate, receive a standing referral to a health 702.28 care provider who is a specialist if a referral to a specialist 702.29 is required for coverage. This procedure for a standing 702.30 referral must specify the necessarycriteria and conditions,702.31which must be met in order for an enrollee to obtain a standing702.32referralmanaged care review and approval an enrollee must 702.33 obtain before such a standing referral is permitted. 702.34 Subd. 1a. [MANDATORY STANDING REFERRAL.] (a) An enrollee 702.35 who requests a standing referral to a specialist qualified to 702.36 treat the specific condition described in clauses (1) to (5) 703.1 must be given a standing referral for visits to such a 703.2 specialist if benefits for such treatment are provided under the 703.3 health plan and the enrollee has any of the following conditions: 703.4 (1) a chronic health condition; 703.5 (2) a life-threatening mental or physical illness; 703.6 (3) pregnancy beyond the first trimester of pregnancy; 703.7 (4) a degenerative disease or disability; or 703.8 (5) any other condition or disease of sufficient 703.9 seriousness and complexity to require treatment by a specialist. 703.10 (b) Nothing in this section limits the application of 703.11 section 62Q.52 specifying direct access to obstetricians and 703.12 gynecologists. 703.13 (c) Paragraph (a) does not apply to health plans issued 703.14 under sections 43A.23 to 43A.31. 703.15 Subd. 2. [COORDINATION OF SERVICES.]A primary care703.16provider or primary care group shall remain responsible for703.17coordinating the care of an enrollee who has received a standing703.18referral to a specialist. The specialist shall not make any703.19secondary referrals related to primary care services without703.20prior approval by the primary care provider or primary care703.21group. However,An enrollee with a standing referral to a 703.22 specialist may request primary care services from that 703.23 specialist. The specialist, in agreement with the enrollee and 703.24 primary care provider or primary care group, may elect to 703.25 provide primary care services tothatthe enrollee, authorize 703.26 tests and services, and make secondary referrals according to 703.27 procedures established by the health plan company. The health 703.28 plan company may limit the primary care services, tests and 703.29 services, and secondary referrals authorized under this 703.30 subdivision to those that are related to the specific condition 703.31 or conditions for which the standing referral was made. 703.32 Subd. 3. [DISCLOSURE.] Information regarding referral 703.33 procedures must be included in member contracts or certificates 703.34 of coverage and must be provided to an enrollee or prospective 703.35 enrollee by a health plan company upon request. 703.36 Subd. 4. [REFERRAL.] (a) If a standing referral is 704.1 authorized under subdivision 1 or is mandatory under subdivision 704.2 1a, the health plan company must provide a referral to an 704.3 appropriate participating specialist who is reasonably available 704.4 and accessible to provide the treatment or to a nonparticipating 704.5 specialist if the health plan company does not have an 704.6 appropriate participating specialist who is reasonably available 704.7 and accessible to treat the enrollee's condition or disease. 704.8 (b) If an enrollee receives services from a 704.9 nonparticipating specialist because a participating specialist 704.10 is not available, services must be provided at no additional 704.11 cost to the enrollee beyond what the enrollee would otherwise 704.12 pay for services received from a participating specialist. 704.13 Sec. 9. [COVERAGE OF CLINICAL TRIALS.] 704.14 The commissioners of health and commerce shall, in 704.15 consultation with the commissioner of employee relations, 704.16 convene a work group to study health plan coverage of clinical 704.17 trials. The work group shall be made up of representatives of 704.18 consumers, patient advocates, health plan companies, purchasers, 704.19 providers, and other health care professionals involved in the 704.20 care and treatment of patients. The work group shall consider 704.21 definitions of routine patient costs, protocol-induced costs, 704.22 and high-quality clinical trials. The work group shall also 704.23 consider guidelines for voluntary agreements for health plan 704.24 coverage of routine patient costs incurred by patients 704.25 participating in high-quality clinical trials. The commissioner 704.26 shall submit the findings and the recommendations of the work 704.27 group to the chairs of the health policy and finance committees 704.28 in the senate and the house by January 15, 2002. 704.29 [EFFECTIVE DATE.] This section is effective the day 704.30 following final enactment. 704.31 Sec. 10. [QUALITY OF PATIENT CARE.] 704.32 The commissioner of health shall evaluate the feasibility 704.33 of collecting data on the quality of patient care provided in 704.34 hospitals, outpatient surgical centers, and other health care 704.35 facilities. In the evaluation, the commissioner shall examine 704.36 the appropriate roles of the public and private sectors and the 705.1 need for risk-adjusting data. The evaluation must consider 705.2 mechanisms to identify the quality of nursing care provided to 705.3 consumers by examining variables such as skin breakdown and 705.4 patient injuries. Any plan developed to collect data must also 705.5 address issues related to the release of the data in a useful 705.6 form to the public. The commissioner shall prepare and 705.7 distribute a written report of the evaluation by January 15, 705.8 2002. 705.9 Sec. 11. [EFFECTIVE DATE.] 705.10 Sections 1 and 3 are effective for violations committed on 705.11 or after August 1, 2001. Section 4 is effective beginning with 705.12 the report for the 2001 calendar year. Sections 2, 5, and 10 705.13 are effective the day following final enactment. Sections 7 and 705.14 8 are effective January 1, 2002, and apply to health plans 705.15 issued or renewed on or after that date. 705.16 ARTICLE 17 705.17 APPROPRIATIONS 705.18 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 705.19 The sums shown in the columns marked "APPROPRIATIONS" are 705.20 appropriated from the general fund, or any other fund named, to 705.21 the agencies and for the purposes specified in the following 705.22 sections of this article, to be available for the fiscal years 705.23 indicated for each purpose. The figures "2002" and "2003" where 705.24 used in this article, mean that the appropriation or 705.25 appropriations listed under them are available for the fiscal 705.26 year ending June 30, 2002, or June 30, 2003, respectively. 705.27 Where a dollar amount appears in parentheses, it means a 705.28 reduction of an appropriation. 705.29 SUMMARY BY FUND 705.30 APPROPRIATIONS BIENNIAL 705.31 2002 2003 TOTAL 705.32 General $3,082,223,000 $3,405,497,000 $6,487,720,000 705.33 State Government 705.34 Special Revenue 38,529,000 40,672,000 79,201,000 705.35 Health Care 705.36 Access 222,097,000 282,403,000 504,500,000 705.37 Federal TANF 301,748,000 293,939,000 595,687,000 706.1 Lottery Prize Fund 1,453,000 1,456,000 2,909,000 706.2 TOTAL $3,646,050,000 $4,023,967,000 $7,670,017,000 706.3 APPROPRIATIONS 706.4 Available for the Year 706.5 Ending June 30 706.6 2002 2003 706.7 Sec. 2. COMMISSIONER OF 706.8 HUMAN SERVICES 706.9 Subdivision 1. Total 706.10 Appropriation $3,466,506,000 $3,843,465,000 706.11 Summary by Fund 706.12 General 2,967,431,000 3,290,620,000 706.13 State Government 706.14 Special Revenue 520,000 534,000 706.15 Health Care 706.16 Access 211,354,000 272,916,000 706.17 Federal TANF 285,748,000 277,939,000 706.18 Lottery Cash Flow 1,453,000 1,456,000 706.19 [RECEIPTS FOR SYSTEMS PROJECTS.] 706.20 Appropriations and federal receipts for 706.21 information system projects for MAXIS, 706.22 PRISM, MMIS, and SSIS must be deposited 706.23 in the state system account authorized 706.24 in Minnesota Statutes, section 706.25 256.014. Money appropriated for 706.26 computer projects approved by the 706.27 Minnesota office of technology, funded 706.28 by the legislature, and approved by the 706.29 commissioner of finance may be 706.30 transferred from one project to another 706.31 and from development to operations as 706.32 the commissioner of human services 706.33 considers necessary. Any unexpended 706.34 balance in the appropriation for these 706.35 projects does not cancel but is 706.36 available for ongoing development and 706.37 operations. 706.38 [GIFTS.] Notwithstanding Minnesota 706.39 Statutes, chapter 7, the commissioner 706.40 may accept on behalf of the state 706.41 additional funding from sources other 706.42 than state funds for the purpose of 706.43 financing the cost of assistance 706.44 program grants or nongrant 706.45 administration. All additional funding 706.46 is appropriated to the commissioner for 706.47 use as designated by the grantor of 706.48 funding. 706.49 [SYSTEMS CONTINUITY.] In the event of 706.50 disruption of technical systems or 706.51 computer operations, the commissioner 706.52 may use available grant appropriations 706.53 to ensure continuity of payments for 706.54 maintaining the health, safety, and 706.55 well-being of clients served by 706.56 programs administered by the department 706.57 of human services. Grant funds must be 706.58 used in a manner consistent with the 707.1 original intent of the appropriation. 707.2 [SPECIAL REVENUE FUND INFORMATION.] On 707.3 December 1, 2001, and December 1, 2002, 707.4 the commissioner shall provide the 707.5 chairs of the house health and human 707.6 services finance committee and the 707.7 senate health, human services and 707.8 corrections budget division with 707.9 detailed fund balance information for 707.10 each special revenue fund account. 707.11 [FEDERAL ADMINISTRATIVE REIMBURSEMENT.] 707.12 Federal administrative reimbursement 707.13 resulting from MinnesotaCare outreach 707.14 grants and the Minnesota senior health 707.15 options project are appropriated to the 707.16 commissioner for these and other 707.17 activities related to improving access 707.18 to information and assistance, 707.19 simplifying the application and 707.20 enrollment process, and providing 707.21 information on any changes in program 707.22 eligibility. 707.23 [NONFEDERAL SHARE TRANSFERS.] The 707.24 nonfederal share of activities for 707.25 which federal administrative 707.26 reimbursement is appropriated to the 707.27 commissioner may be transferred to the 707.28 special revenue fund. 707.29 [TANF FUNDS APPROPRIATED TO OTHER 707.30 ENTITIES.] Any expenditures from the 707.31 TANF block grant shall be expended in 707.32 accordance with the requirements and 707.33 limitations of part A of title IV of 707.34 the Social Security Act, as amended, 707.35 and any other applicable federal 707.36 requirement or limitation. Prior to 707.37 any expenditure of these funds, the 707.38 commissioner shall assure that funds 707.39 are expended in compliance with the 707.40 requirements and limitations of federal 707.41 law and that any reporting requirements 707.42 of federal law are met. It shall be 707.43 the responsibility of any entity to 707.44 which these funds are appropriated to 707.45 implement a memorandum of understanding 707.46 with the commissioner that provides the 707.47 necessary assurance of compliance prior 707.48 to any expenditure of funds. The 707.49 commissioner shall receipt TANF funds 707.50 appropriated to other state agencies 707.51 and coordinate all related interagency 707.52 accounting transactions necessary to 707.53 implement these appropriations. 707.54 Unexpended TANF funds appropriated to 707.55 any state, local, or nonprofit entity 707.56 cancel at the end of the state fiscal 707.57 year unless appropriating language 707.58 permits otherwise. 707.59 [TANF FUNDS TRANSFERRED TO OTHER 707.60 FEDERAL GRANTS.] The commissioner must 707.61 authorize transfers from TANF to other 707.62 federal block grants so that funds are 707.63 available to meet the annual 707.64 expenditure needs as appropriated. 707.65 Transfers may be authorized prior to 707.66 the expenditure year with the agreement 708.1 of the receiving entity. Transferred 708.2 funds must be expended in the year for 708.3 which the funds were appropriated 708.4 unless appropriation language permits 708.5 otherwise. In accelerating transfer 708.6 authorizations, the commissioner must 708.7 aim to preserve the future potential 708.8 transfer capacity from TANF to other 708.9 block grants. 708.10 [TANF MAINTENANCE OF EFFORT.] (a) In 708.11 order to meet the basic maintenance of 708.12 effort (MOE) requirements of the TANF 708.13 block grant specified under Code of 708.14 Federal Regulations, title 45, section 708.15 263.1, the commissioner may only report 708.16 nonfederal money expended for allowable 708.17 activities listed in the following 708.18 clauses as TANF MOE expenditures: 708.19 (1) MFIP cash and food assistance 708.20 benefits under Minnesota Statutes, 708.21 chapter 256J; 708.22 (2) the child care assistance programs 708.23 under Minnesota Statutes, sections 708.24 119B.03 and 119B.05, and county child 708.25 care administrative costs under 708.26 Minnesota Statutes, section 119B.15; 708.27 (3) state and county MFIP 708.28 administrative costs under Minnesota 708.29 Statutes, chapters 256J and 256K; 708.30 (4) state, county, and tribal MFIP 708.31 employment services under Minnesota 708.32 Statutes, chapters 256J and 256K; 708.33 (5) expenditures made on behalf of 708.34 noncitizen MFIP recipients who qualify 708.35 for the medical assistance without 708.36 federal financial participation program 708.37 under Minnesota Statutes, section 708.38 256B.06, subdivision 4, paragraphs (d), 708.39 (e), and (j); 708.40 (6) the Minnesota Education Now and 708.41 Babies Later (MN ENABL) program under 708.42 Minnesota Statutes, section 145.9255; 708.43 and 708.44 (7) expenditures for family planning 708.45 activities under Minnesota Statutes, 708.46 section 145.925. 708.47 (b) The commissioner shall ensure that 708.48 sufficient qualified nonfederal 708.49 expenditures are made each year to meet 708.50 the state's TANF MOE requirements. For 708.51 the activities listed in paragraph (a), 708.52 clauses (2) to (7), the commissioner 708.53 may only report expenditures that are 708.54 excluded from the definition of 708.55 assistance under Code of Federal 708.56 Regulations, title 45, section 260.31. 708.57 (c) By August 31 of each year, the 708.58 commissioner shall make a preliminary 708.59 calculation to determine the likelihood 708.60 that the state will meet its annual 708.61 federal work participation requirement 709.1 under Code of Federal Regulations, 709.2 title 45, sections 261.21 and 261.23, 709.3 after adjustment for any caseload 709.4 reduction credit under Code of Federal 709.5 Regulations, title 45, section 261.41. 709.6 If the commissioner determines that the 709.7 state will meet its federal work 709.8 participation rate for the federal 709.9 fiscal year ending that September, the 709.10 commissioner may reduce the expenditure 709.11 under paragraph (a), clause (1), to the 709.12 extent allowed under Code of Federal 709.13 Regulations, title 45, section 709.14 263.1(a)(2). 709.15 (d) For fiscal years beginning with 709.16 state fiscal year 2003, the 709.17 commissioner shall assure that the 709.18 maintenance of effort used by the 709.19 commissioner of finance for the 709.20 February and November forecasts 709.21 required under Minnesota Statutes, 709.22 section 16A.103, contains expenditures 709.23 under paragraph (a), clause (1), equal 709.24 to at least 25 percent of the total 709.25 required under Code of Federal 709.26 Regulations, title 45, section 263.1. 709.27 (e) If nonfederal expenditures for the 709.28 programs and purposes listed in 709.29 paragraph (a) are insufficient to meet 709.30 the state's TANF MOE requirements, the 709.31 commissioner shall recommend additional 709.32 allowable sources of nonfederal 709.33 expenditures to the legislature, if the 709.34 legislature is or will be in session to 709.35 take action to specify additional 709.36 sources of nonfederal expenditures for 709.37 TANF MOE before a federal penalty is 709.38 imposed. The commissioner shall 709.39 otherwise provide notice to the 709.40 legislative commission on planning and 709.41 fiscal policy under paragraph (g). 709.42 (f) If the commissioner uses authority 709.43 granted under section 10, or similar 709.44 authority granted by a subsequent 709.45 legislature, to meet the state's TANF 709.46 MOE requirements in a reporting period, 709.47 the commissioner shall inform the 709.48 chairs of the appropriate legislative 709.49 committees about all transfers made 709.50 under that authority for this purpose. 709.51 (g) If the commissioner determines that 709.52 nonfederal expenditures under paragraph 709.53 (a) are insufficient to meet TANF MOE 709.54 expenditure requirements, and if the 709.55 legislature is not or will not be in 709.56 session to take timely action to avoid 709.57 a federal penalty, the commissioner may 709.58 report nonfederal expenditures from 709.59 other allowable sources as TANF MOE 709.60 expenditures after the requirements of 709.61 this paragraph are met. The 709.62 commissioner may report nonfederal 709.63 expenditures in addition to those 709.64 specified under paragraph (a) as 709.65 nonfederal TANF MOE expenditures, but 709.66 only ten days after the commissioner of 709.67 finance has first submitted the 710.1 commissioner's recommendations for 710.2 additional allowable sources of 710.3 nonfederal TANF MOE expenditures to the 710.4 members of the legislative commission 710.5 on planning and fiscal policy for their 710.6 review. 710.7 (h) The commissioner of finance shall 710.8 not incorporate any changes in federal 710.9 TANF expenditures or nonfederal 710.10 expenditures for TANF MOE that may 710.11 result from reporting additional 710.12 allowable sources of nonfederal TANF 710.13 MOE expenditures under the interim 710.14 procedures in paragraph (g) into the 710.15 February or November forecasts required 710.16 under Minnesota Statutes, section 710.17 16A.103, unless the commissioner of 710.18 finance has approved the additional 710.19 sources of expenditures under paragraph 710.20 (g). 710.21 (i) The provisions of Minnesota 710.22 Statutes, section 256.011, subdivision 710.23 3, which require that federal grants or 710.24 aids secured or obtained under that 710.25 subdivision be used to reduce any 710.26 direct appropriations provided by law, 710.27 do not apply if the grants or aids are 710.28 federal TANF funds. 710.29 (j) Notwithstanding section 13 of this 710.30 article, paragraph (a), clauses (1) to 710.31 (5), and paragraphs (b) to (j) expire 710.32 June 30, 2005. 710.33 [CAPITATION RATE INCREASE.] Of the 710.34 health care access fund appropriations 710.35 to the University of Minnesota in the 710.36 higher education omnibus appropriation 710.37 bill, $2,537,000 in fiscal year 2002 710.38 and $2,537,000 in fiscal year 2003 to 710.39 be used to increase the capitation 710.40 payments under Minnesota Statutes, 710.41 section 256B.69. Notwithstanding the 710.42 provisions of section 13, this 710.43 provision shall not expire. 710.44 Subd. 2. Agency Management 710.45 General 38,093,000 38,206,000 710.46 State Government 710.47 Special Revenue 403,000 415,000 710.48 Health Care 710.49 Access 3,631,000 3,673,000 710.50 Federal TANF 225,000 265,000 710.51 The amounts that may be spent from the 710.52 appropriation for each purpose are as 710.53 follows: 710.54 (a) Financial Operations 710.55 General 6,872,000 7,041,000 710.56 Health Care 710.57 Access 815,000 828,000 711.1 Federal TANF 225,000 265,000 711.2 (b) Legal & Regulation Operations 711.3 General 8,550,000 8,392,000 711.4 State Government 711.5 Special Revenue 403,000 415,000 711.6 Health Care 711.7 Access 239,000 244,000 711.8 (c) Management Operations 711.9 General 22,671,000 22,773,000 711.10 [CORE LICENSING ACTIVITIES.] Of the 711.11 general fund appropriation, $1,138,000 711.12 in fiscal year 2002 and $923,000 in 711.13 fiscal year 2003 is to support 14 new 711.14 licensor positions. Of this amount, 711.15 $72,000 in fiscal year 2002 and 711.16 $107,000 in fiscal year 2003 is to 711.17 cover maintenance and operational costs 711.18 for a new computer system, which will 711.19 provide public access to licensing 711.20 information. In order to receive 711.21 continued appropriations for these 711.22 purposes, by January 1, 2003, the 711.23 commissioner shall: 711.24 (1) reduce the average length of time 711.25 to complete investigations of licensing 711.26 complaints within 75 days; 711.27 (2) complete all licensing reviews 711.28 within the one-year and two-year 711.29 intervals set forth in statutes; and 711.30 (3) complete negative licensing action 711.31 decisions within 45 days of county 711.32 recommendations. 711.33 [UPDATING FEDERAL POVERTY GUIDELINES.] 711.34 Annual updates to the federal poverty 711.35 guidelines are effective each July 1, 711.36 following publication by the United 711.37 States Department of Health and Human 711.38 Services for health care programs under 711.39 Minnesota Statutes, chapters 256, 256B, 711.40 256D, and 256L. 711.41 Health Care 711.42 Access 2,577,000 2,601,000 711.43 Subd. 3. Administrative Reimbursement/ 711.44 Passthrough 711.45 Federal TANF 60,565,000 51,992,000 711.46 Subd. 4. Children's Services Grants 711.47 General 64,348,000 68,107,000 711.48 Federal TANF 6,290,000 6,290,000 711.49 [ADOPTION ASSISTANCE INCENTIVE GRANTS.] 711.50 Federal funds available during fiscal 711.51 year 2002 and fiscal year 2003, for 711.52 adoption incentive grants are 711.53 appropriated to the commissioner for 712.1 these purposes. 712.2 [FEDERAL CHILD WELFARE OUTCOMES 712.3 FUNDING.] The commissioner may seek and 712.4 expend federal funds to assist in 712.5 evaluating strategies to improve 712.6 outcomes for children in the child 712.7 welfare services system, including 712.8 reducing the disproportionate share of 712.9 minority youth in out-of-home care. 712.10 [ADOPTION ASSISTANCE AND RELATIVE 712.11 CUSTODY ASSISTANCE.] The commissioner 712.12 may transfer unencumbered appropriation 712.13 balances for adoption assistance and 712.14 relative custody assistance between 712.15 fiscal years and between programs. 712.16 [TANF TRANSFER TO SOCIAL SERVICES.] 712.17 $4,650,000 is appropriated to the 712.18 commissioner in fiscal year 2002 and in 712.19 fiscal year 2003 for purposes of 712.20 increasing services for families with 712.21 children whose incomes are at or below 712.22 200 percent of the federal poverty 712.23 guidelines. The commissioner shall 712.24 authorize a sufficient transfer of 712.25 funds from the state's federal TANF 712.26 block grant to the state's federal 712.27 social services block grant to meet 712.28 this appropriation. 712.29 [SOCIAL SERVICES BLOCK GRANT FUNDS FOR 712.30 CONCURRENT PERMANENCY PLANNING.] 712.31 Notwithstanding Minnesota Statutes, 712.32 section 256E.07, $4,650,000 in fiscal 712.33 year 2002 and $4,650,000 in fiscal year 712.34 2003 in social services block grant 712.35 funds allocated to the commissioner 712.36 under title XX of the Social Security 712.37 Act are available for distribution to 712.38 counties under the formula in Minnesota 712.39 Statutes, section 260C.213, for the 712.40 purposes of concurrent permanency 712.41 planning. 712.42 Subd. 5. Children's Services Management 712.43 General 3,845,000 5,724,000 712.44 [FEDERAL FINANCIAL PARTICIPATION 712.45 MAXIMIZATION FOR OUT-OF-HOME CARE.] The 712.46 commissioner of human services and the 712.47 commissioner of corrections shall 712.48 cooperate in efforts to maximize 712.49 federal financial participation in the 712.50 costs of providing out-of-home 712.51 placements for juveniles. 712.52 Subd. 6. Basic Health Care Grants 712.53 Summary by Fund 712.54 General 1,125,000,000 1,324,114,000 712.55 Health Care 712.56 Access 190,450,000 251,159,000 712.57 The amounts that may be spent from this 712.58 appropriation for each purpose are as 712.59 follows: 713.1 (a) MinnesotaCare Grants 713.2 Health Care 713.3 Access 188,900,000 250,409,000 713.4 [MINNESOTACARE FEDERAL RECEIPTS.] 713.5 Receipts received as a result of 713.6 federal participation pertaining to 713.7 administrative costs of the Minnesota 713.8 health care reform waiver shall be 713.9 deposited as nondedicated revenue in 713.10 the health care access fund. Receipts 713.11 received as a result of federal 713.12 participation pertaining to grants 713.13 shall be deposited in the federal fund 713.14 and shall offset health care access 713.15 funds for payments to providers. 713.16 [MINNESOTACARE FUNDING.] The 713.17 commissioner may expend money 713.18 appropriated from the health care 713.19 access fund for MinnesotaCare in either 713.20 fiscal year of the biennium. 713.21 [MINNESOTACARE PAYMENTS FOR PREGNANT 713.22 WOMEN AND CHILDREN UNDER THE AGE OF 713.23 TWO.] Payments for pregnant women and 713.24 children under the age of two who are 713.25 enrolled in the MinnesotaCare program 713.26 shall be paid from the health care 713.27 access fund effective January 1, 2003. 713.28 [DENTAL ACCESS GRANTS.] Of this 713.29 appropriation, $800,000 in fiscal year 713.30 2002 is to be distributed as dental 713.31 access grants in accordance with 713.32 Minnesota Statutes, section 256B.53. 713.33 If the amount appropriated is not used 713.34 within the fiscal year, the 713.35 commissioner of finance shall transfer 713.36 any remaining amount to the 713.37 commissioner of health to be 713.38 distributed as rural hospital capital 713.39 improvement grants for fiscal year 2003. 713.40 (b) MA Basic Health Care Grants - 713.41 Families and Children 713.42 General 440,097,000 523,911,000 713.43 [INDIAN HEALTH SERVICES FEDERAL MATCH.] 713.44 In the event the federal medical 713.45 assistance percentage rate increases to 713.46 100 percent for services provided as a 713.47 result of a referral by the federal 713.48 Indian health service or a tribal 713.49 provider, the commissioner is 713.50 authorized to increase the payment rate 713.51 for referrals by ten percent as an 713.52 incentive for the completion of 713.53 documentation required for increased 713.54 federal participation. Unspent state 713.55 medical assistance appropriations 713.56 resulting from the increase in the 713.57 federal medical assistance percentage 713.58 rate shall be transferred to the 713.59 appropriate account and are available 713.60 to the commissioner for covering the 713.61 costs of out-stationed health care 713.62 program eligibility services on 713.63 reservations. The base appropriation 714.1 for the 2004-2005 biennium for these 714.2 services must not exceed the state 714.3 medical assistance savings. These 714.4 actions are intended to improve access 714.5 to health care and assist in 714.6 eliminating disparities in health 714.7 status for American Indian people. 714.8 [IMMUNIZATION INFORMATION SERVICE.] Of 714.9 the general fund appropriation, 714.10 $500,000 the first year and $1,000,000 714.11 the second year is available to the 714.12 commissioner to support maintenance of 714.13 current registry activities related to 714.14 tracking medical assistance-eligible 714.15 children. Base funding for 714.16 immunization registries is reduced by 714.17 $250,000 per year. 714.18 (c) MA Basic Health Care Grants - 714.19 Elderly and Disabled 714.20 General 519,082,000 607,994,000 714.21 (d) General Assistance Medical Care 714.22 General 156,981,000 178,333,000 714.23 (e) Health Care Grants - Other Assistance 714.24 General 8,840,000 13,876,000 714.25 Health Care Access 1,550,000 750,000 714.26 [STOP-LOSS FUND ACCOUNT.] Of the 714.27 general fund appropriation, $149,000 in 714.28 fiscal year 2003 is to the commissioner 714.29 to be deposited in the stop-loss fund 714.30 account to be distributed in accordance 714.31 with Minnesota Statutes, section 714.32 256.956. 714.33 Subd. 7. Basic Health Care Management 714.34 General 21,578,000 15,049,000 714.35 Health Care 714.36 Access 15,940,000 16,735,000 714.37 The amounts that may be spent from this 714.38 appropriation for each purpose are as 714.39 follows: 714.40 (a) Health Care Policy Administration 714.41 General 2,916,000 3,076,000 714.42 Health Care 714.43 Access 578,000 595,000 714.44 [ENROLLMENT STUDY.] Of the general fund 714.45 appropriation, $100,000 in fiscal year 714.46 2003 is for the commissioner to develop 714.47 a report on the length of enrollment 714.48 and continuity of enrollment for 714.49 children enrolled in MinnesotaCare and 714.50 medical assistance and evaluate the 714.51 impact of the changes to eligibility in 714.52 these programs enacted in 2001. This 714.53 report shall be submitted by January 714.54 15, 2005, to the legislature and shall 715.1 be updated annually afterward 715.2 thereafter as necessary. 715.3 [DEDICATION OF FEDERAL MATCH.] Enhanced 715.4 federal match available for the use of 715.5 a professional review organization for 715.6 prior authorization and inpatient 715.7 admission certification shall be 715.8 dedicated to the commissioner for these 715.9 purposes. A portion of these funds 715.10 must be used for activities to decrease 715.11 unnecessary pharmaceutical costs in 715.12 medical assistance. 715.13 (b) Health Care Operations 715.14 General 18,662,000 11,973,000 715.15 Health Care 715.16 Access 15,362,000 16,140,000 715.17 [PREPAID MEDICAL PROGRAMS.] The 715.18 nonfederal share of the prepaid medical 715.19 assistance program fund, which has been 715.20 appropriated to fund county managed 715.21 care advocacy and enrollment operating 715.22 costs, shall be disbursed as grants 715.23 using either a reimbursement or block 715.24 grant mechanism and may also be 715.25 transferred between grants and nongrant 715.26 administration costs with approval of 715.27 the commissioner of finance. 715.28 Subd. 8. State-Operated Services 715.29 General 211,390,000 207,065,000 715.30 [MITIGATION RELATED TO STATE-OPERATED 715.31 SERVICES RESTRUCTURING.] Money 715.32 appropriated to finance mitigation 715.33 expenses related to restructuring 715.34 state-operated services programs and 715.35 administrative services may be 715.36 transferred between fiscal years within 715.37 the biennium. 715.38 [STATE-OPERATED SERVICES CHEMICAL 715.39 DEPENDENCY PROGRAMS.] When the 715.40 operations of the state-operated 715.41 services chemical dependency fund 715.42 created in Minnesota Statutes, section 715.43 246.18, subdivision 2, are impeded by 715.44 projected cash deficiencies resulting 715.45 from delays in the receipt of grants, 715.46 dedicated income, or other similar 715.47 receivables, and when the deficiencies 715.48 would be corrected within the budget 715.49 period involved, the commissioner of 715.50 finance may transfer general fund cash 715.51 reserves into this account as necessary 715.52 to meet cash demands. The cash flow 715.53 transfers must be returned to the 715.54 general fund in the fiscal year that 715.55 the transfer was made. Any interest 715.56 earned on general fund cash flow 715.57 transfers accrues to the general fund 715.58 and not the state-operated services 715.59 chemical dependency fund. 715.60 [STATE-OPERATED SERVICES 715.61 RESTRUCTURING.] For purposes of 716.1 restructuring state-operated services, 716.2 any state-operated services employee 716.3 whose position is to be eliminated 716.4 shall be afforded the options provided 716.5 in applicable collective bargaining 716.6 agreements. All salary and mitigation 716.7 allocations from fiscal year 2002 shall 716.8 be carried forward into fiscal year 716.9 2003. Provided there is no conflict 716.10 with any collective bargaining 716.11 agreement, any state-operated services 716.12 position reduction must only be 716.13 accomplished through mitigation, 716.14 attrition, transfer, and other measures 716.15 as provided in state or applicable 716.16 collective bargaining agreements and in 716.17 Minnesota Statutes, section 252.50, 716.18 subdivision 11, and not through layoff. 716.19 [REPAIRS AND BETTERMENTS.] The 716.20 commissioner may transfer unencumbered 716.21 appropriation balances between fiscal 716.22 years within the biennium for the state 716.23 residential facilities repairs and 716.24 betterments account and special 716.25 equipment. 716.26 [NAMES REQUIRED ON MONUMENTS.] (a) Of 716.27 this appropriation, $250,000 in fiscal 716.28 year 2002 is to the commissioner for 716.29 grants to community-based or statewide 716.30 organizations for the purpose of 716.31 purchasing and placing cemetery grave 716.32 markers or memorial monuments that 716.33 include the available names of 716.34 individuals at cemeteries located at 716.35 regional treatment centers operated or 716.36 formerly operated by the commissioner. 716.37 Individual monuments shall not be 716.38 placed if the family of the deceased 716.39 resident objects to the placement of 716.40 the monument. 716.41 (b) To be eligible for a grant, a 716.42 community-based or statewide 716.43 organization must include members of 716.44 local service or charitable 716.45 organizations, members of the business 716.46 community, persons with mental illness 716.47 or developmental disabilities, and to 716.48 the extent possible, family members of 716.49 deceased residents of the regional 716.50 treatment center, and present or former 716.51 employees of the regional treatment 716.52 center sites. 716.53 (c) Any unexpended portion of this 716.54 appropriation shall not cancel but 716.55 shall be available in fiscal year 2003 716.56 for these purposes. This is a one-time 716.57 appropriation and shall not become part 716.58 of the base level funding for the 716.59 2004-2005 biennium. 716.60 [BUILDING REMODELING.] The commissioner 716.61 shall use $400,000 from the 716.62 appropriation for repairs and 716.63 betterments to remodel building 6 at 716.64 the Brainerd regional human services 716.65 center to make the structure suitable 716.66 for school programs. The Brainerd 717.1 school district shall reimburse the 717.2 commissioner $200,000 in fiscal year 717.3 2002 and $200,000 in fiscal year 2003 717.4 through a lease agreement for these 717.5 remodeling costs. 717.6 Subd. 9. Continuing Care Grants 717.7 General 1,359,103,000 1,472,247,000 717.8 Lottery Prize Fund 1,308,000 1,308,000 717.9 The amounts that may be spent from this 717.10 appropriation for each purpose are as 717.11 follows: 717.12 (a) Community Social Services 717.13 Block Grants 717.14 48,715,000 49,690,000 717.15 [CSSA TRADITIONAL APPROPRIATION.] 717.16 Notwithstanding Minnesota Statutes, 717.17 section 256E.06, subdivisions 1 and 2, 717.18 the appropriations available under that 717.19 section in fiscal years 2002 and 2003 717.20 must be distributed to each county 717.21 proportionately to the aid received by 717.22 the county in calendar year 2000. 717.23 [SOCIAL SERVICES GRANT REDUCTION.] Any 717.24 reduction to social services 717.25 supplemental grants base budgets shall 717.26 be applied to funds awarded to counties 717.27 under Minnesota Statutes, section 717.28 256E.06, subdivision 2b, paragraph (b), 717.29 item 1. 717.30 (b) Aging Adult Service Grants 717.31 13,779,000 15,852,000 717.32 [AGING AND ADULT SERVICE GRANT 717.33 CARRYFORWARD AUTHORITY.] (a) Money 717.34 appropriated for Senior LinkAge line, 717.35 community services grants, and access 717.36 demonstration project grants shall be 717.37 used by the commissioner to maximize 717.38 federal reimbursement according to 717.39 federal law, rule, and regulation. 717.40 (b) Unexpended funds appropriated for 717.41 Senior LinkAge line, community services 717.42 grants, and access demonstration 717.43 project grants for fiscal year 2002 do 717.44 not cancel but are available to the 717.45 commissioner for these purposes for 717.46 fiscal year 2003. 717.47 [HOME-SHARING GRANTS.] Of this 717.48 appropriation, $225,000 in fiscal year 717.49 2002 and $400,000 in fiscal year 2003 717.50 is for the home-sharing grant program 717.51 under Minnesota Statutes, section 717.52 256.973. This appropriation shall 717.53 become part of the base level funding 717.54 for the 2004-2005 biennium. 717.55 [THE CENTER FOR VICTIMS OF TORTURE.] Of 717.56 the appropriation for fiscal year 2002, 717.57 $300,000 is for a grant to the center 718.1 for victims of torture. The grant is 718.2 to be used to conduct continuing 718.3 education and training of health care 718.4 and human service workers on how to 718.5 identify torture survivors, provide 718.6 appropriate care and make referrals, 718.7 and to establish a network of care 718.8 providers who will offer pro bono 718.9 services for survivors of politically 718.10 motivated torture. This is a one-time 718.11 appropriation requiring a one-to-one, 718.12 nonstate, in-kind match, and is 718.13 available until expended. 718.14 [PLANNING AND SERVICE DEVELOPMENT.] Of 718.15 this appropriation, $900,000 in fiscal 718.16 year 2002 and $1,100,000 in fiscal year 718.17 2003 is for distribution to county 718.18 boards and area agencies on aging for 718.19 planning and development of community 718.20 services under Minnesota Statutes, 718.21 section 256B.437, subdivision 2. 718.22 For fiscal year 2002, the commissioner 718.23 shall distribute $8,000 to each 718.24 county. Counties with more than 10,000 718.25 persons over age 65 shall receive a 718.26 distribution of an additional 42 cents 718.27 for each person over age 65. The 718.28 amount distributed to each area agency 718.29 on aging shall be $5,000. 718.30 For fiscal year 2003, the commissioner 718.31 shall distribute $10,000 to each 718.32 county. Counties with more than 10,000 718.33 persons over age 65 shall receive a 718.34 distribution of an additional 50 cents 718.35 for each person over age 65. The 718.36 amount distributed to each area agency 718.37 on aging shall be $5,000. 718.38 (c) Deaf and Hard-of-Hearing 718.39 Services Grants 718.40 1,953,000 1,785,000 718.41 [SERVICES TO DEAF PERSONS WITH MENTAL 718.42 ILLNESS.] (a) Of this appropriation, 718.43 $125,000 in fiscal year 2002 and 718.44 $60,000 in fiscal year 2003 is for a 718.45 grant to a nonprofit agency that 718.46 currently serves deaf and 718.47 hard-of-hearing adults with mental 718.48 illness through residential programs 718.49 and supportive housing outreach 718.50 activities. The grant must be used to 718.51 continue and maintain community support 718.52 services for deaf and hard-of-hearing 718.53 adults with mental illness who use or 718.54 wish to use sign language as their 718.55 primary means of communication. 718.56 (b) The grant for fiscal year 2003 718.57 shall be increased by $65,000 minus 718.58 earnings achieved by the grantee 718.59 through participation in the medical 718.60 assistance rehabilitation option for 718.61 persons with mental illness under 718.62 Minnesota Statutes, section 256B.0623. 718.63 The grant shall not be less than 718.64 $60,000. 719.1 (c) The base level funding for the 719.2 2004-2005 biennium shall be $125,000 719.3 minus earnings achieved by the grantee 719.4 through participation in the medical 719.5 assistance rehabilitation option for 719.6 persons with mental illness under 719.7 Minnesota Statutes, section 256B.0623. 719.8 [COMMISSION SERVING DEAF AND 719.9 HARD-OF-HEARING PEOPLE.] Of this 719.10 appropriation, $5,000 in fiscal year 719.11 2002 is to the commissioner for the 719.12 Minnesota commission serving deaf and 719.13 hard-of-hearing people to carry out the 719.14 duties under Minnesota Statutes, 719.15 section 256C.28. 719.16 (d) Mental Health Grants 719.17 General 50,571,000 52,407,000 719.18 Lottery Prize Fund 1,308,000 1,308,000 719.19 [TRANSFER TO DOER.] Of the general fund 719.20 appropriation, $265,000 in fiscal year 719.21 2003 is for a transfer to the 719.22 commissioner of employee relations for 719.23 costs associated with modifications in 719.24 the Mental Health Commitment Act. 719.25 [MENTAL HEALTH COUNSELING FOR FARM 719.26 FAMILIES.] Of the general fund 719.27 appropriation, $150,000 in fiscal year 719.28 2002 and $150,000 in fiscal year 2003 719.29 is to be transferred to the board of 719.30 trustees of the Minnesota state 719.31 colleges and universities for mental 719.32 health counseling support to farm 719.33 families and business operators through 719.34 the farm business management program at 719.35 Central Lakes College and Ridgewater 719.36 College. This appropriation is 719.37 available until June 30, 2003. This is 719.38 a one-time appropriation and shall not 719.39 be added to the base for the 2004-2005 719.40 biennium. 719.41 [COSTS ASSOCIATED WITH STATE INMATES 719.42 WITH MENTAL ILLNESS.] (a) Of the 719.43 general fund appropriation, $125,000 in 719.44 fiscal year 2002 and $185,000 in fiscal 719.45 year 2003 is for evaluation and support 719.46 staff to do discharge planning under 719.47 Minnesota Statutes, section 244.054, 719.48 for persons with serious and persistent 719.49 mental illness being discharged from 719.50 prison. These staff shall be employed 719.51 by the commissioner but assigned at the 719.52 direction of the commissioner of 719.53 corrections. 719.54 (b) Of the general fund appropriation, 719.55 the following amounts shall be 719.56 transferred to the commissioner of 719.57 corrections for the purposes indicated: 719.58 (1) $258,000 in fiscal year 2002 and 719.59 $258,000 in fiscal year 2003 for the 719.60 staff and travel costs associated with 719.61 discharge planning under Minnesota 719.62 Statutes, section 244.054, for persons 720.1 with serious and persistent mental 720.2 illness; and 720.3 (2) $24,000 in fiscal year 2002 and 720.4 $24,000 in fiscal year 2003 for the 720.5 cost of medications for state inmates 720.6 with serious and persistent mental 720.7 illness. 720.8 [COMPULSIVE GAMBLING.] Of the 720.9 appropriation from the lottery prize 720.10 fund to the commissioner for the 720.11 compulsive gambling treatment program 720.12 $150,000 in fiscal year 2002 and 720.13 $150,000 in fiscal year 2003 is for a 720.14 grant to a compulsive gambling council 720.15 located in St. Louis county. The 720.16 gambling council shall provide a 720.17 statewide compulsive gambling 720.18 prevention and education project for 720.19 adolescents. This is a one-time 720.20 appropriation and shall not become part 720.21 of the base appropriation for the 720.22 2004-2005 biennium. 720.23 The unencumbered balance of the 720.24 appropriation from the lottery prize 720.25 fund in the first year of the biennium 720.26 does not cancel but is available for 720.27 the second year. 720.28 (e) Medical Assistance Long-Term 720.29 Care Facilities 720.30 577,665,000 580,331,000 720.31 (f) Community Support Grants 720.32 12,875,000 13,097,000 720.33 [REGION 10 QUALITY ASSURANCE 720.34 COMMISSION.] (1) Of the appropriation 720.35 from the general fund for the biennium 720.36 ending June 30, 2003, $548,000 is to 720.37 the commissioner of human services to 720.38 be allocated to the region 10 quality 720.39 assurance commission for operating 720.40 costs of the alternative quality 720.41 assurance licensing project and for 720.42 grants to counties participating in 720.43 that project. 720.44 (2) $50,000 is appropriated from the 720.45 general fund to the commissioner of 720.46 human services for the biennium ending 720.47 June 30, 2003, for the region 10 720.48 quality assurance commission to conduct 720.49 the evaluation required under Minnesota 720.50 Statutes, section 256B.0951, 720.51 subdivision 9. 720.52 (3) $150,000 is appropriated from the 720.53 general fund to the commissioner of 720.54 human services for the biennium ending 720.55 June 30, 2003, for the commissioner to 720.56 conduct the project evaluation required 720.57 for the federal 1115 waiver of ICF/MR 720.58 regulations. 720.59 (g) Medical Assistance Long-Term 720.60 Care Waivers and Home Care 721.1 452,146,000 532,075,000 721.2 [NURSING FACILITY OPERATED BY THE RED 721.3 LAKE BAND OF CHIPPEWA INDIANS.] (1) The 721.4 medical assistance payment rates for 721.5 the 47-bed nursing facility operated by 721.6 the Red Lake Band of Chippewa Indians 721.7 must be calculated according to 721.8 allowable reimbursement costs under the 721.9 medical assistance program, as 721.10 specified in Minnesota Statutes, 721.11 section 246.50, and are subject to the 721.12 facility-specific Medicare upper limits. 721.13 (2) In addition, the commissioner shall 721.14 make available rate adjustments for the 721.15 biennium beginning July 1, 2001, on the 721.16 same basis as the adjustments provided 721.17 to nursing facilities under Minnesota 721.18 Statutes, section 256B.431. The 721.19 commissioner must use the facility's 721.20 final 2000 and 2001 Medicare cost 721.21 reports to calculate the adjustments. 721.22 This rate increase shall become part of 721.23 the facility's base rate for future 721.24 rate years. 721.25 [MORATORIUM EXCEPTIONS.] During each 721.26 year of the biennium beginning July 1, 721.27 2001, the commissioner of health may 721.28 approve moratorium exception projects 721.29 under Minnesota Statutes, section 721.30 144A.073, for which the full annualized 721.31 state share of medical assistance costs 721.32 does not exceed $2,000,000. 721.33 [LONG-TERM CARE CONSULTATION SERVICES.] 721.34 Effective July 1, 2001, the 721.35 preadmission screening program shall be 721.36 known as long-term care consultation 721.37 services. Payment to all counties 721.38 shall be established at the payment 721.39 amount in effect for preadmission 721.40 screening in fiscal year 2001, plus 721.41 $349,000 in fiscal year 2002 and 721.42 $510,000 in fiscal year 2003, 721.43 distributed between counties following 721.44 the proportionate distribution of the 721.45 fiscal year 2001 statewide payments. 721.46 (h) Alternative Care Grants 721.47 General 75,780,000 89,749,000 721.48 [ALTERNATIVE CARE TRANSFER.] Any money 721.49 allocated to the alternative care 721.50 program that is not spent for the 721.51 purposes indicated does not cancel but 721.52 shall be transferred to the medical 721.53 assistance account. 721.54 [ALTERNATIVE CARE APPROPRIATION.] The 721.55 commissioner may expend the money 721.56 appropriated for the alternative care 721.57 program for that purpose in either year 721.58 of the biennium. 721.59 (i) Group Residential Housing 721.60 General 79,261,000 87,356,000 722.1 (j) Chemical Dependency 722.2 Entitlement Grants 722.3 General 41,200,000 43,811,000 722.4 [FEDERAL SUBSTANCE ABUSE PREVENTION AND 722.5 TREATMENT BLOCK GRANT ALLOCATION.] The 722.6 commissioner shall allocate $10,000,000 722.7 from the federal substance abuse 722.8 prevention and treatment block grant 722.9 each year of the biennium ending June 722.10 30, 2003, to chemical dependency 722.11 services provided to persons eligible 722.12 under Minnesota Statutes, section 722.13 254B.04, subdivision 1, paragraph (a). 722.14 Beginning July 1, 2003, the 722.15 commissioner shall allocate $9,000,000 722.16 from the federal substance abuse 722.17 prevention and treatment block grant 722.18 each year of the biennium ending June 722.19 30, 2005, to chemical dependency 722.20 services provided to persons eligible 722.21 under Minnesota Statutes, section 722.22 254B.04, subdivision 1, paragraph (a). 722.23 Notwithstanding section 13, this rider 722.24 expires June 30, 2005. 722.25 (k) Chemical Dependency 722.26 Nonentitlement Grants 722.27 General 5,158,000 6,094,000 722.28 Subd. 10. Continuing Care Management 722.29 General 22,678,000 23,208,000 722.30 State Government 722.31 Special Revenue 117,000 119,000 722.32 Lottery Prize Fund 145,000 148,000 722.33 [DAY TRAINING TASK FORCE.] Of the 722.34 general fund appropriation, $100,000 in 722.35 fiscal year 2002 and $100,000 in fiscal 722.36 year 2003 is for the day training and 722.37 habilitation restructuring task force 722.38 to begin the planning and 722.39 implementation process. This 722.40 appropriation shall not become part of 722.41 base level funding for the biennium 722.42 beginning July 1, 2003. 722.43 [COUNTY INVOLVEMENT COSTS.] Of the 722.44 general fund appropriation, up to 722.45 $384,000 in fiscal year 2002 and up to 722.46 $514,000 in fiscal year 2003 is for the 722.47 commissioner to allocate to counties 722.48 for resident relocation costs resulting 722.49 from planned closures under Minnesota 722.50 Statutes, section 256B.437, and 722.51 resident relocations under Minnesota 722.52 Statutes, section 144A.161. Unexpended 722.53 funds for fiscal year 2002 do not 722.54 cancel but are available to the 722.55 commissioner for this purpose in fiscal 722.56 year 2003. 722.57 [RELOCATION AND DIVERSION FUNDING 722.58 CARRYFORWARD.] General fund 722.59 appropriations for administrative 722.60 activities related to relocating or 723.1 diverting persons with disabilities 723.2 under the age of 65 from institutional 723.3 settings are available for either year 723.4 of the biennium. 723.5 [STARTER GRANT.] In the event that the 723.6 commissioner receives federal grant 723.7 funds for a Real Choice System Change 723.8 Starter Grant from the Health Care 723.9 Financing Administration, the money is 723.10 appropriated to the commissioner to be 723.11 used for the purposes defined in the 723.12 federal application. This rider is 723.13 effective the day following final 723.14 enactment. 723.15 Subd. 11. Economic Support Grants 723.16 General 97,876,000 91,452,000 723.17 Federal TANF 216,175,000 218,449,000 723.18 The amounts that may be spent from this 723.19 appropriation for each purpose are as 723.20 follows: 723.21 (a) Assistance to Families Grants 723.22 General 34,195,000 25,142,000 723.23 Federal TANF 146,200,000 139,874,000 723.24 (b) Work Grants 723.25 General 9,844,000 9,844,000 723.26 Federal TANF 67,253,000 69,403,000 723.27 [LOCAL INTERVENTION GRANTS FOR 723.28 SELF-SUFFICIENCY CARRYFORWARD.] 723.29 Unexpended funds appropriated for local 723.30 intervention grants under Minnesota 723.31 Statutes, section 256J.625, for fiscal 723.32 year 2002 do not cancel but are 723.33 available to the commissioner for these 723.34 purposes in fiscal year 2003. 723.35 [SUPPORTED WORK.] $4,850,000 is 723.36 appropriated from the TANF fund to the 723.37 commissioner of human services for the 723.38 biennium ending June 30, 2003, to 723.39 counties and tribes that submit a plan 723.40 that describes the county's supported 723.41 work program under Minnesota Statutes, 723.42 section 256J.425, subdivision 4, clause 723.43 (v), and provides the number of 723.44 individuals to be served in the 723.45 supported work program. 723.46 Counties and tribes that submit a 723.47 supported work plan that is approved by 723.48 the commissioner shall receive an 723.49 allocation based on the average 723.50 proportion of the MFIP caseload that 723.51 has received MFIP assistance for 52 out 723.52 of the last 60 months, as sampled on 723.53 March 31, June 30, September 30, and 723.54 December 31 of the previous calendar 723.55 year, less the number of child-only 723.56 cases and cases where all the 723.57 caregivers are age 60 or over, provided 724.1 the county documents the need for 724.2 supported work. Two-parent cases, with 724.3 the exception of those with a caregiver 724.4 age 60 or over, will be multiplied by a 724.5 factor of two. Of the amount available 724.6 for supported work: 724.7 (1) $1,350,000 is allocated in fiscal 724.8 year 2002; and 724.9 (2) $3,500,000 is allocated in fiscal 724.10 years 2003 and 2004. 724.11 Unspent funds may be reallocated each 724.12 January based on the number of approved 724.13 supported work plans and need verified 724.14 by counties and tribes. 724.15 [MODIFICATION OF PRIOR TANF 724.16 APPROPRIATION.] Clauses (1) and (2) 724.17 apply to the appropriation in Laws 724.18 2000, chapter 488, article 8, section 724.19 2, subdivision 6, of $250,000 for 724.20 fiscal year 2001 in federal TANF funds 724.21 to the commissioner to contract with 724.22 the board of trustees of the Minnesota 724.23 state colleges and universities to 724.24 provide tuition waivers to employees of 724.25 health care and human services 724.26 providers that are members of 724.27 qualifying consortia operating under 724.28 Minnesota Statutes, sections 116L.10 to 724.29 116L.15: 724.30 (1) the appropriation shall not cancel 724.31 but shall be available until expended; 724.32 and 724.33 (2) the amendments made in this act to 724.34 the matching requirements of Minnesota 724.35 Statutes, chapter 116L, shall apply to 724.36 this appropriation. 724.37 [WELFARE-TO-WORK GRANTS.] Of the 724.38 federal TANF appropriation, $5,000,000 724.39 each year in fiscal year 2002 and 724.40 fiscal year 2003 is for welfare-to-work 724.41 programs administered by the 724.42 commissioner of economic security that 724.43 have utilized all of the federal 724.44 welfare-to-work funding received. The 724.45 commissioner of economic security shall 724.46 establish guidelines for distributing 724.47 the funds to local workforce service 724.48 areas based on current expenditures and 724.49 documented need and, by January 15, 724.50 2003, shall report to the chairs of the 724.51 house health and human services finance 724.52 committee and the senate health, human 724.53 services and corrections budget 724.54 division on the use of state and 724.55 federal funds appropriated for 724.56 welfare-to-work programs and the 724.57 effectiveness of such programs. This 724.58 is a one-time appropriation and shall 724.59 not be added to the base-level funding 724.60 for the 2003-2004 biennium. 724.61 (c) Economic Support Grants - 724.62 Other Assistance 725.1 General 2,514,000 4,145,000 725.2 Federal TANF 2,462,000 8,912,000 725.3 [TANF TRANSFER TO CHILD CARE AND 725.4 DEVELOPMENT BLOCK GRANT.] $1,462,000 in 725.5 fiscal year 2002 and $7,912,000 for 725.6 fiscal year 2003 is appropriated to the 725.7 commissioner of children, families, and 725.8 learning for the purposes of Minnesota 725.9 Statutes, section 119B.05. The 725.10 commissioner of human services shall 725.11 authorize a sufficient transfer of 725.12 funds from the state's federal TANF 725.13 block grant to the state's child care 725.14 and development fund block grant to 725.15 meet this appropriation. 725.16 [MINNESOTA FOOD ASSISTANCE PROGRAM.] Of 725.17 the general fund appropriation, 725.18 $1,214,000 in fiscal year 2003 is for 725.19 the Minnesota food assistance program. 725.20 (d) Child Support Enforcement 725.21 General 4,239,000 4,239,000 725.22 Federal TANF 260,000 260,000 725.23 [CHILD SUPPORT PAYMENT CENTER.] 725.24 Payments to the commissioner from other 725.25 governmental units, private 725.26 enterprises, and individuals for 725.27 services performed by the child support 725.28 payment center must be deposited in the 725.29 state systems account authorized under 725.30 Minnesota Statutes, section 256.014. 725.31 These payments are appropriated to the 725.32 commissioner for the operation of the 725.33 child support payment center or system, 725.34 according to Minnesota Statutes, 725.35 section 256.014. 725.36 (e) General Assistance 725.37 General 17,156,000 16,481,000 725.38 [GENERAL ASSISTANCE STANDARD.] The 725.39 commissioner shall set the monthly 725.40 standard of assistance for general 725.41 assistance units consisting of an adult 725.42 recipient who is childless and 725.43 unmarried or living apart from his or 725.44 her parents or a legal guardian at 725.45 $203. The commissioner may reduce this 725.46 amount in accordance with Laws 1997, 725.47 chapter 85, article 3, section 54. 725.48 (f) Minnesota Supplemental Aid 725.49 General 29,678,000 31,351,000 725.50 (g) Refugee Services 725.51 General 250,000 250,000 725.52 Subd. 12. Economic Support 725.53 Management 725.54 General 23,520,000 45,448,000 726.1 Health Care 726.2 Access 1,333,000 1,349,000 726.3 Federal TANF 2,493,000 943,000 726.4 The amounts that may be spent from this 726.5 appropriation for each purpose are as 726.6 follows: 726.7 (a) Economic Support Policy 726.8 Administration 726.9 General 8,464,000 7,704,000 726.10 Federal TANF 2,493,000 943,000 726.11 [FOOD STAMP ADMINISTRATIVE 726.12 REIMBURSEMENT.] The commissioner shall 726.13 reduce quarterly food stamp 726.14 administrative reimbursement to 726.15 counties in fiscal years 2002 and 2003 726.16 by the amount that the United States 726.17 Department of Health and Human Services 726.18 determines to be the county random 726.19 moment study share of the food stamp 726.20 adjustment under Public Law Number 726.21 105-185. The reductions shall be 726.22 allocated to each county in proportion 726.23 to each county's contribution, if any, 726.24 to the amount of the adjustment. Any 726.25 adjustment to medical assistance 726.26 administrative reimbursement that is 726.27 based on the United States Department 726.28 of Health and Human Services' 726.29 determinations under Public Law Number 726.30 105-185 shall be distributed to 726.31 counties in the same manner. 726.32 [EMPLOYMENT SERVICES TRACKING SYSTEM.] 726.33 Of the federal TANF appropriation, 726.34 $1,750,000 in fiscal year 2002 and 726.35 $200,000 in fiscal year 2003 are for 726.36 development of an employment tracking 726.37 system in collaboration with the 726.38 department of economic security. 726.39 Unexpended funds in fiscal year 2002 do 726.40 not cancel but are available to the 726.41 commissioner for these purposes in 726.42 fiscal year 2003. This is a one-time 726.43 appropriation and shall not be added to 726.44 the base-level funding for the 726.45 2004-2005 biennium. 726.46 [FINANCIAL INSTITUTION DATA MATCH AND 726.47 PAYMENT OF FEES.] The commissioner is 726.48 authorized to allocate up to $310,000 726.49 each year in fiscal year 2002 and 726.50 fiscal year 2003 from the PRISM special 726.51 revenue account to make payments to 726.52 financial institutions in exchange for 726.53 performing data matches between account 726.54 information held by financial 726.55 institutions and the public authority's 726.56 database of child support obligors as 726.57 authorized by Minnesota Statutes, 726.58 section 13B.06, subdivision 7. 726.59 (b) Economic Support Operations 726.60 General 15,056,000 37,744,000 727.1 Health Care 727.2 Access 1,333,000 1,349,000 727.3 [SPENDING AUTHORITY FOR FOOD STAMP 727.4 ENHANCED FUNDING.] In the event that 727.5 Minnesota qualifies for the United 727.6 States Department of Agriculture Food 727.7 and Nutrition Services Food Stamp 727.8 Program enhanced funding beginning in 727.9 federal fiscal year 1998, the funding 727.10 is appropriated to the commissioner. 727.11 The commissioner shall retain funds 727.12 from the enhanced funding in an amount 727.13 sufficient to fund the Minnesota Food 727.14 Assistance Program in state fiscal year 727.15 2002. Twenty-five percent of the 727.16 remaining balance shall be retained by 727.17 the commissioner, with the other 75 727.18 percent divided among the counties 727.19 according to a formula that takes into 727.20 account each county's impact on the 727.21 statewide food stamp error rate. 727.22 Sec. 3. COMMISSIONER OF HEALTH 727.23 Subdivision 1. Total 727.24 Appropriation 132,300,000 133,852,000 727.25 Summary by Fund 727.26 General 78,727,000 79,651,000 727.27 State Government 727.28 Special Revenue 26,830,000 28,714,000 727.29 Health Care 727.30 Access 10,743,000 9,487,000 727.31 Federal TANF 16,000,000 16,000,000 727.32 Subd. 2. Family and 727.33 Community Health 67,753,000 68,379,000 727.34 Summary by Fund 727.35 General 47,110,000 46,680,000 727.36 State Government 727.37 Special Revenue 961,000 1,987,000 727.38 Health Care 727.39 Access 3,682,000 3,712,000 727.40 Federal TANF 16,000,000 16,000,000 727.41 [HEALTH DISPARITIES.] Of the general 727.42 fund appropriation, $4,950,000 each 727.43 year is for reducing health 727.44 disparities. Of the amounts available: 727.45 (1) $1,400,000 each year is for 727.46 competitive grants under Minnesota 727.47 Statutes, section 145.928, subdivision 727.48 7, to eligible applicants to reduce 727.49 health disparities in infant mortality 727.50 rates and adult and child immunization 727.51 rates. 727.52 (2) $2,200,000 each year is for 727.53 competitive grants under Minnesota 727.54 Statutes, section 145.928, subdivision 728.1 8, to eligible applicants to reduce 728.2 health disparities in breast and 728.3 cervical cancer screening rates, 728.4 HIV/AIDS and sexually transmitted 728.5 infection rates, cardiovascular disease 728.6 rates, diabetes rates, and rates of 728.7 accidental injuries and violence. 728.8 (3) $500,000 each year is for grants to 728.9 tribal governments under Minnesota 728.10 Statutes, section 145.928, subdivision 728.11 10, to implement cultural interventions 728.12 to reduce health disparities. 728.13 (4) $500,000 each year is for state 728.14 administrative costs associated with 728.15 implementation of Minnesota Statutes, 728.16 section 145.928, subdivisions 1, 2, 3, 728.17 4, 5, 6, 7, 8, 10, 11, 12, and 13. 728.18 (5) $100,000 each year is for state 728.19 operations associated with 728.20 implementation of Minnesota Statutes, 728.21 section 145.928, subdivision 9. 728.22 (6) $250,000 each year is for grants 728.23 under Minnesota Statutes, section 728.24 145.928, subdivision 9, to community 728.25 health boards to improve access to 728.26 health screening and follow-up services 728.27 for foreign-born populations. 728.28 [MN ENABL.] Of the TANF appropriation, 728.29 $1,000,000 each year is for the MN 728.30 ENABL program. 728.31 [MN ENABL CARRYFORWARD.] Any unexpended 728.32 balance of the TANF funds appropriated 728.33 for MN ENABL in the first year of the 728.34 biennium does not cancel but is 728.35 available for the second year. 728.36 [TANF LOCAL PUBLIC HEALTH PROMOTION 728.37 PROGRAM.] Of the TANF appropriation, 728.38 $2,000,000 each year is appropriated to 728.39 the commissioner for the following 728.40 purposes: 728.41 (1) $1,900,000 each year is to be 728.42 distributed under Minnesota Statutes, 728.43 section 144.396, subdivision 7, for 728.44 local public health promotion and 728.45 protection related to high risk 728.46 behaviors by youth; and 728.47 (2) $100,000 each year is for state 728.48 administration for evaluation and 728.49 technical assistance activities related 728.50 to Minnesota Statutes, section 144.396, 728.51 subdivision 7. 728.52 [TANF LOCAL PUBLIC HEALTH PROMOTION 728.53 CARRYFORWARD.] Any unexpended balance 728.54 of the TANF funds appropriated for 728.55 local public health promotion and 728.56 protection in the first year of the 728.57 biennium does not cancel but is 728.58 available for the second year. 728.59 [INFANT MORTALITY REDUCTION.] Of the 728.60 TANF appropriation, $2,000,000 each 729.1 year is for grants under Minnesota 729.2 Statutes, section 145.928, subdivision 729.3 7, to reduce infant mortality. 729.4 [REDUCING INFANT MORTALITY 729.5 CARRYFORWARD.] Any unexpended balance 729.6 of the TANF funds appropriated for 729.7 reducing infant mortality in the first 729.8 year of the biennium does not cancel 729.9 but is available for the second year. 729.10 [HOME VISITING PROGRAM.] Of the TANF 729.11 appropriation, $4,000,000 each year is 729.12 for the home visiting program under 729.13 Minnesota Statutes, section 145A.17. 729.14 [POISON INFORMATION SYSTEM.] Of the 729.15 general fund appropriation, $1,360,000 729.16 each fiscal year is for poison control 729.17 system grants under Minnesota Statutes, 729.18 section 145.93. This is a one-time 729.19 appropriation that shall not become 729.20 part of base-level funding in 2004-2005. 729.21 [WIC TRANSFERS.] The general fund 729.22 appropriation for the women, infants, 729.23 and children (WIC) food supplement 729.24 program is available for either year of 729.25 the biennium. Transfers of these funds 729.26 between fiscal years must be either to 729.27 maximize federal funds or to minimize 729.28 fluctuations in the number of program 729.29 participants. 729.30 [MINNESOTA CHILDREN WITH SPECIAL HEALTH 729.31 NEEDS CARRYFORWARD.] General fund 729.32 appropriations for treatment services 729.33 in the services for Minnesota children 729.34 with special health needs program are 729.35 available for either year of the 729.36 biennium. 729.37 [HEALTH STATUS IMPROVEMENT GRANTS.] Of 729.38 the general fund appropriation, 729.39 $120,000 each year is to the 729.40 commissioner to award grants to improve 729.41 the quality of health care services 729.42 provided to children. Priority shall 729.43 be given to grant applications that: 729.44 (1) develop "best practices guidelines" 729.45 for primary and preventative health 729.46 care services to all children in 729.47 Minnesota, regardless of payor; 729.48 (2) design and implement 729.49 community-based education and 729.50 evaluation programs for physicians and 729.51 other direct care providers to 729.52 implement best practices guidelines; 729.53 and 729.54 (3) reduce disparities in access to 729.55 health care services and in health 729.56 status of Minnesota children. 729.57 [FAMILY HOME VISITING CARRYFORWARD.] 729.58 Any unexpended balance of the TANF 729.59 funds appropriated for family home 729.60 visiting in the first year of the 729.61 biennium does not cancel but is 730.1 available for the second year. 730.2 [SUICIDE PREVENTION.] Of the general 730.3 fund appropriation, $1,100,000 each 730.4 fiscal year is for suicide prevention 730.5 activities under Minnesota Statutes, 730.6 section 145.56. Of the amounts 730.7 available: 730.8 (1) $75,000 each fiscal year is for 730.9 refining, coordinating, and 730.10 implementing the suicide prevention 730.11 plan according to Minnesota Statutes, 730.12 section 145.56, subdivisions 1, 3, 4, 730.13 and 5. 730.14 (2) $1,025,000 each fiscal year is to 730.15 fund community-based programs under 730.16 Minnesota Statutes, section 145.56, 730.17 subdivision 2. 730.18 [RURAL HEALTH TECHNOLOGY DEMONSTRATION 730.19 PROJECT.] The commissioner may include 730.20 as an eligible activity through the 730.21 department's rural health grant 730.22 programs a demonstration project which 730.23 will model and pilot the introduction 730.24 of technologies designed to increase 730.25 rural hospital and clinics' vital 730.26 services, retain patients in their 730.27 local communities for treatment and 730.28 care, reduce outmigration of patients 730.29 to distant providers, and improve the 730.30 health and wellness of rural residents, 730.31 especially the elderly. 730.32 [ONE-TIME REDUCTION FOR FAMILY PLANNING 730.33 SPECIAL PROJECT GRANTS.] For fiscal 730.34 year 2003, base-level funding for the 730.35 Family Planning Special Project Grants 730.36 under Minnesota Statutes, section 730.37 145.925, shall be reduced by $690,000. 730.38 This reduction is contingent upon the 730.39 receipt of a federal 1115 waiver for a 730.40 medical assistance demonstration 730.41 project for family planning services. 730.42 Subd. 3. Access and Quality 730.43 Improvement 28,526,000 28,067,000 730.44 Summary by Fund 730.45 General 12,818,000 13,563,000 730.46 State Government 730.47 Special Revenue 8,647,000 8,729,000 730.48 Health Care 730.49 Access 7,061,000 5,775,000 730.50 [PURCHASING ALLIANCES.] Of the health 730.51 care access fund appropriation, 730.52 $200,000 the first year and $50,000 the 730.53 second year is for grants to 730.54 organizations developing health care 730.55 purchasing alliances established under 730.56 Minnesota Statutes, chapter 62T. Of 730.57 this appropriation, $50,000 the first 730.58 year is for a grant to the University 730.59 of Minnesota-Crookston to support the 730.60 northwest purchasing alliance; $50,000 731.1 the first year is for a grant to the 731.2 southwest regional development 731.3 commission to support the southwest 731.4 purchasing alliance; $50,000 the first 731.5 year is for a grant to the arrowhead 731.6 regional development commission to 731.7 support the development of a northeast 731.8 Minnesota purchasing alliance; and 731.9 $50,000 each year is for a grant to the 731.10 Brainerd lakes area chamber of commerce 731.11 education association to support the 731.12 north central purchasing alliance. The 731.13 state grants must be matched on a 731.14 one-to-one basis by nonstate funds. 731.15 This is a one-time appropriation and 731.16 shall not become part of the base-level 731.17 funding for the 2004-2005 biennium. 731.18 [SUPPLEMENTAL NURSING SERVICES AGENCY 731.19 REGISTRATION EFFECTIVE DATE.] 731.20 Notwithstanding the effective date of 731.21 Minnesota Statutes, sections 144A.71 to 731.22 144A.74, a supplemental nursing 731.23 services agency must register with the 731.24 commissioner not later than August 31, 731.25 2001. 731.26 [INITIAL MEDICARE CERTIFICATION COSTS.] 731.27 Of the appropriation from the state 731.28 government special revenue fund, 731.29 $135,000 each year is for initial 731.30 Medicare certification surveys. The 731.31 appropriation shall be recovered 731.32 through provider fees according to 731.33 Minnesota Statutes, section 144.122, 731.34 paragraph (e). Any unspent portion of 731.35 this appropriation shall be deposited 731.36 in the state government special revenue 731.37 fund. 731.38 [HEALTH CARE SAFETY NET.] (a) Of the 731.39 health care access fund appropriation, 731.40 $3,308,000 in the first year and 731.41 $2,120,000 in the second year is for a 731.42 grant program to provide rural hospital 731.43 capital improvement grants described in 731.44 Minnesota Statutes, section 144.148. 731.45 (b) The commissioner of finance shall 731.46 make base-level adjustments for fiscal 731.47 year 2004 funding in this program as 731.48 follows: 731.49 (1) reduce the health care access fund 731.50 base by $2,120,000; and 731.51 (2) increase the general fund base by 731.52 $2,120,000. 731.53 [HOME CARE PROVIDERS FEE WAIVER.] 731.54 Notwithstanding the provisions of 731.55 Minnesota Rules, chapter 4669, and 731.56 Minnesota Statutes, section 144A.4605, 731.57 subdivision 5, the commissioner of 731.58 health may, during the biennium 731.59 beginning July 1, 2001, waive license 731.60 fees for all home care providers who 731.61 hold a current license as of June 30, 731.62 2001, for the purpose of reducing 731.63 surplus home care fees in the state 731.64 government special revenue fund. 732.1 [RURAL AMBULANCE STUDY.] (a) The 732.2 commissioner shall direct the rural 732.3 health advisory committee to conduct a 732.4 study and make recommendations 732.5 regarding the challenges faced by rural 732.6 ambulance services related to: 732.7 personnel shortages for volunteer 732.8 ambulance services; personnel shortages 732.9 for full-time, paid ambulance services; 732.10 funding for ambulance operations; and 732.11 the impact on rural ambulance services 732.12 from changes in ambulance reimbursement 732.13 as a result of the federal Balanced 732.14 Budget Act of 1997, Public Law Number 732.15 105-33. 732.16 (b) The advisory committee may also 732.17 examine and make recommendations on: 732.18 (1) whether state law allows adequate 732.19 flexibility to address operational and 732.20 staffing problems encountered by rural 732.21 ambulance services; and 732.22 (2) whether current incentive programs, 732.23 such as the volunteer ambulance 732.24 recruitment program and state 732.25 reimbursement for volunteer training, 732.26 are adequate to ensure ambulance 732.27 service volunteers will be available in 732.28 rural areas. 732.29 (c) The advisory committee shall 732.30 identify existing state, regional, and 732.31 local resources supporting the 732.32 provision of local ambulance services 732.33 in rural areas. 732.34 (d) The advisory committee shall, if 732.35 appropriate, make recommendations for 732.36 addressing alternative delivery models 732.37 for rural volunteer ambulance 732.38 services. Such alternatives may 732.39 include, but are not limited to, 732.40 multiprovider service coalitions, 732.41 purchasing cooperatives, regional 732.42 response strategies, and different 732.43 utilization of first responder and 732.44 rescue squads. 732.45 (e) In conducting its study, the 732.46 advisory committee shall consult with 732.47 groups broadly representative of rural 732.48 health and emergency medical services. 732.49 Such groups may include: local elected 732.50 officials; ambulance and emergency 732.51 medical services associations; 732.52 hospitals and nursing homes; 732.53 physicians, nurses, and mid-level 732.54 practitioners; rural health groups; the 732.55 emergency medical services regulatory 732.56 board and regional emergency medical 732.57 services boards; and fire and sheriff's 732.58 departments. 732.59 (f) The advisory committee shall report 732.60 its findings and recommendations to the 732.61 commissioner by September 1, 2002. 732.62 (g) Data on an emergency medical 732.63 services provider organization, private 733.1 or nonprofit payor, or provider that 733.2 are collected and maintained as part of 733.3 this study are private data on 733.4 individuals or nonpublic data as 733.5 defined in Minnesota Statutes, section 733.6 13.02. 733.7 [LICENSE FEES.] Notwithstanding the 733.8 provisions of Minnesota Statutes, 733.9 sections 144.122, 144.53, and 144A.07, 733.10 a health care facility licensed under 733.11 the provisions of Minnesota Statutes, 733.12 chapter 144 or 144A, may submit the 733.13 required fee for licensure renewal in 733.14 quarterly installments. Any health 733.15 care facility requesting to pay the 733.16 renewal fees in quarterly payments 733.17 shall make the request at the time of 733.18 license renewal. Facilities licensed 733.19 under the provisions of Minnesota 733.20 Statutes, chapter 144, shall submit 733.21 quarterly payments by January 1, April 733.22 1, July 1, and October 1 of each year. 733.23 Nursing homes licensed under Minnesota 733.24 Statutes, chapter 144A, shall submit 733.25 the first quarterly payment with the 733.26 application for renewal, and the 733.27 remaining payments shall be submitted 733.28 at three-month intervals from the 733.29 license expiration date. The 733.30 commissioner of health can require full 733.31 payment of any outstanding balance if a 733.32 quarterly payment is late. Full 733.33 payment of the annual renewal fee will 733.34 be required in the event that the 733.35 facility is sold or ceases operation 733.36 during the licensure year. Failure to 733.37 pay the licensure fee is grounds for 733.38 the nonrenewal of the license. 733.39 Subd. 4. Health Protection 30,566,000 31,539,000 733.40 Summary by Fund 733.41 General 13,495,000 13,696,000 733.42 State Government 733.43 Special Revenue 17,071,000 17,843,000 733.44 [EMERGING HEALTH THREATS.] (a) Of the 733.45 general fund appropriation, $1,600,000 733.46 in the first year and $1,800,000 in the 733.47 second year are to increase the state 733.48 capacity to identify and respond to 733.49 emerging health threats. 733.50 (b) Of these amounts, $1,300,000 in the 733.51 first year and $1,500,000 in the second 733.52 year are to expand state laboratory 733.53 capacity to identify infectious disease 733.54 organisms, evaluate environmental 733.55 contaminants, develop new analytical 733.56 techniques, provide emergency response, 733.57 and support local government by 733.58 training health care system workers to 733.59 deal with biological and chemical 733.60 health threats. 733.61 (c) $300,000 each year is to train, 733.62 consult, and otherwise assist local 733.63 officials responding to clandestine 734.1 drug laboratories and minimizing health 734.2 risks to responders and the public. 734.3 [BASE FUNDING TRANSFER PROHIBITION.] 734.4 The proposal to transfer base funds 734.5 from grants to operations within the 734.6 health protection program shall not be 734.7 implemented. 734.8 [COMMUNITY HEALTH EDUCATION AND 734.9 PROMOTION PROGRAM ON FOOD SAFETY.] (a) 734.10 Of the general fund appropriation, 734.11 $200,000 in fiscal year 2002 is for a 734.12 grant to the city of Minneapolis to 734.13 establish a community-based health 734.14 education and promotion program on food 734.15 safety in the Latino, Somali, and 734.16 Southeast Asian communities. 734.17 (b) The program shall consist of direct 734.18 training of food industry operators and 734.19 workers on safe handling of food and 734.20 proper operation of food establishments 734.21 and a community consumer awareness 734.22 campaign to increase community 734.23 awareness of food safety and access to 734.24 food regulatory services. 734.25 (c) This is a one-time appropriation 734.26 and shall not become part of the base 734.27 level funding for the 2004-2005 734.28 biennium. 734.29 Subd. 5. Management and 734.30 Support Services 5,455,000 5,867,000 734.31 Summary by Fund 734.32 General 5,304,000 5,712,000 734.33 State Government 734.34 Special Revenue 151,000 155,000 734.35 Sec. 4. VETERANS NURSING 734.36 HOMES BOARD 30,948,000 30,030,000 734.37 [VETERANS HOMES SPECIAL REVENUE 734.38 ACCOUNT.] The general fund 734.39 appropriations made to the board may be 734.40 transferred to a veterans homes special 734.41 revenue account in the special revenue 734.42 fund in the same manner as other 734.43 receipts are deposited according to 734.44 Minnesota Statutes, section 198.34, and 734.45 are appropriated to the board for the 734.46 operation of board facilities and 734.47 programs. 734.48 [SETTING COST OF CARE.] The cost of 734.49 care for the domiciliary residents at 734.50 the Minneapolis veterans home for 734.51 fiscal year 2002 and fiscal year 2003 734.52 shall be calculated based on 100 734.53 percent occupancy. 734.54 [DEFICIENCY FUNDING.] Of the general 734.55 fund appropriation in fiscal year 2002, 734.56 $2,000,000 is available with the 734.57 approval of the commissioner of 734.58 finance. Approval of the commissioner 734.59 of finance is contingent upon review of 735.1 the board's submittal of a report 735.2 outlining the following: 735.3 (1) a long-term revenue outlook for the 735.4 homes; 735.5 (2) a review and recommendation of 735.6 alternative funding sources for the 735.7 homes' operations; and 735.8 (3) administrative and service options 735.9 to bring cost growth in line with 735.10 revenues. 735.11 Sec. 5. HEALTH-RELATED BOARDS 735.12 Subdivision 1. Total 735.13 Appropriation 11,179,000 11,424,000 735.14 [STATE GOVERNMENT SPECIAL REVENUE 735.15 FUND.] The appropriations in this 735.16 section are from the state government 735.17 special revenue fund. 735.18 [NO SPENDING IN EXCESS OF REVENUES.] 735.19 The commissioner of finance shall not 735.20 permit the allotment, encumbrance, or 735.21 expenditure of money appropriated in 735.22 this section in excess of the 735.23 anticipated biennial revenues or 735.24 accumulated surplus revenues from fees 735.25 collected by the boards. Neither this 735.26 provision nor Minnesota Statutes, 735.27 section 214.06, applies to transfers 735.28 from the general contingent account. 735.29 Subd. 2. Board of Chiropractic 735.30 Examiners 372,000 384,000 735.31 Subd. 3. Board of Dentistry 946,000 855,000 735.32 [EXPANDED DUTIES.] Of this 735.33 appropriation, $115,000 in fiscal year 735.34 2002 is to the board for the costs 735.35 associated with the expanded duties 735.36 relative to the regulation of dental 735.37 hygienists and foreign-trained 735.38 dentists. This is a one-time 735.39 appropriation and shall not become part 735.40 of the base level funding for the 735.41 2004-2005 biennium. 735.42 Subd. 4. Board of Dietetic 735.43 and Nutrition Practice 98,000 101,000 735.44 Subd. 5. Board of Marriage and 735.45 Family Therapy 114,000 118,000 735.46 [FEE INCREASE.] The board may increase 735.47 fees to meet the requirements of 735.48 Minnesota Statutes, section 214.06. 735.49 Subd. 6. Board of Medical 735.50 Practice 3,334,000 3,400,000 735.51 Subd. 7. Board of Nursing 2,769,000 2,902,000 735.52 [HEALTH PROFESSIONAL SERVICES 735.53 ACTIVITY.] Of these appropriations, 735.54 $515,000 the first year and $546,000 735.55 the second year are for the health 736.1 professional services activity. 736.2 [FEE INCREASE.] The board may increase 736.3 fees to meet the requirements of 736.4 Minnesota Statutes, section 214.06. 736.5 Subd. 8. Board of Nursing 736.6 Home Administrators 200,000 198,000 736.7 Subd. 9. Board of Optometry 93,000 96,000 736.8 Subd. 10. Board of Pharmacy 1,336,000 1,386,000 736.9 [ADMINISTRATIVE SERVICES UNIT.] Of this 736.10 appropriation, $354,000 the first year 736.11 and $359,000 the second year are for 736.12 the health boards administrative 736.13 services unit. The administrative 736.14 services unit may receive and expend 736.15 reimbursements for services performed 736.16 for other agencies. 736.17 Subd. 11. Board of Physical Therapy 191,000 197,000 736.18 Subd. 12. Board of Podiatry 53,000 45,000 736.19 Subd. 13. Board of Psychology 669,000 680,000 736.20 Subd. 14. Board of Social Work 846,000 873,000 736.21 Subd. 15. Board of Veterinary 736.22 Medicine 158,000 189,000 736.23 Sec. 6. EMERGENCY MEDICAL 736.24 SERVICES BOARD 2,770,000 2,775,000 736.25 [COMPREHENSIVE ADVANCED LIFE SUPPORT 736.26 EDUCATIONAL PROGRAM.] Of this 736.27 appropriation, $300,000 in fiscal year 736.28 2002 and $300,000 in fiscal year 2003 736.29 is to increase funding for the 736.30 comprehensive advanced life support 736.31 educational program under Minnesota 736.32 Statutes, section 144E.37. 736.33 [AUTOMATIC DEFIBRILLATOR STUDY.] Of 736.34 this appropriation, $32,000 in fiscal 736.35 year 2002 is to the board to study, in 736.36 consultation with the commissioner of 736.37 public safety, and report to the 736.38 legislature by December 15, 2002, 736.39 regarding the availability of automatic 736.40 defibrillators outside the seven-county 736.41 metropolitan area. The report shall 736.42 include recommendations to make these 736.43 devices accessible within a reasonable 736.44 distance through the nonmetropolitan 736.45 area, including recommendations for 736.46 funding their acquisition and 736.47 distribution. 736.48 Sec. 7. COUNCIL ON DISABILITY 692,000 714,000 736.49 Sec. 8. OMBUDSMAN FOR MENTAL 736.50 HEALTH AND MENTAL RETARDATION 1,419,000 1,462,000 736.51 Sec. 9. OMBUDSMAN 736.52 FOR FAMILIES 236,000 245,000 736.53 Sec. 10. TRANSFERS 737.1 Subdivision 1. Grants 737.2 The commissioner of human services, 737.3 with the approval of the commissioner 737.4 of finance, and after notification of 737.5 the chair of the senate health, human 737.6 services and corrections budget 737.7 division and the chair of the house 737.8 health and human services finance 737.9 committee, may transfer unencumbered 737.10 appropriation balances for the biennium 737.11 ending June 30, 2003, within fiscal 737.12 years among the MFIP, general 737.13 assistance, general assistance medical 737.14 care, medical assistance, Minnesota 737.15 supplemental aid, and group residential 737.16 housing programs, and the entitlement 737.17 portion of the chemical dependency 737.18 consolidated treatment fund, and 737.19 between fiscal years of the biennium. 737.20 Subd. 2. Administration 737.21 Positions, salary money, and nonsalary 737.22 administrative money may be transferred 737.23 within the departments of human 737.24 services and health and within the 737.25 programs operated by the veterans 737.26 nursing homes board as the 737.27 commissioners and the board consider 737.28 necessary, with the advance approval of 737.29 the commissioner of finance. The 737.30 commissioner or the board shall inform 737.31 the chairs of the house health and 737.32 human services finance committee and 737.33 the senate health, human services and 737.34 corrections budget division quarterly 737.35 about transfers made under this 737.36 provision. 737.37 Subd. 3. Prohibited Transfers 737.38 Grant money shall not be transferred to 737.39 operations within the departments of 737.40 human services and health and within 737.41 the programs operated by the veterans 737.42 nursing homes board without the 737.43 approval of the legislature. 737.44 Sec. 11. INDIRECT COSTS NOT TO 737.45 FUND PROGRAMS 737.46 The commissioners of health and of 737.47 human services shall not use indirect 737.48 cost allocations to pay for the 737.49 operational costs of any program for 737.50 which they are responsible. 737.51 Sec. 12. CARRYOVER LIMITATION 737.52 None of the appropriations in this 737.53 article which are allowed to be carried 737.54 forward from fiscal year 2002 to fiscal 737.55 year 2003 shall become part of the base 737.56 level funding for the 2004-2005 737.57 biennial budget, unless specifically 737.58 directed by the legislature. 737.59 Sec. 13. SUNSET OF UNCODIFIED LANGUAGE 737.60 All uncodified language contained in 738.1 this article expires on June 30, 2003, 738.2 unless a different expiration date is 738.3 explicit. 738.4 Sec. 14. REIMBURSEMENT TO LOCAL GOVERNMENTS 738.5 During the fiscal year beginning July 738.6 1, 2001, if a county or other local 738.7 unit of government advances money from 738.8 its own resources to carry out a 738.9 program under state law for which it is 738.10 authorized to spend money received from 738.11 a state agency, and the advance of 738.12 local money was made necessary because 738.13 of a delay in the appropriation of 738.14 state or federal money, the state 738.15 agency administering the program must 738.16 use the state or federal money, when it 738.17 becomes available, to reimburse the 738.18 local government for the advance of 738.19 local money to pay obligations that 738.20 would otherwise have been paid from the 738.21 state or federal money. 738.22 Sec. 15. RETROACTIVITY 738.23 A contract encumbered or a grant 738.24 awarded by the commissioners of health, 738.25 human services, or corrections before 738.26 September 1, 2001, may be made 738.27 retroactive to July 1, 2001. 738.28 Sec. 16. [246.141] [PROJECT LABOR.] 738.29 Wages for project labor may be paid by the commissioner out 738.30 of repairs and betterments money if the individual is to be 738.31 engaged in a construction project or a repair project of 738.32 short-term and nonrecurring nature. Compensation for project 738.33 labor shall be based on the prevailing wage rates, as defined in 738.34 section 177.42, subdivision 6. Project laborers are excluded 738.35 from the provisions of sections 43A.22 to 43A.30, and shall not 738.36 be eligible for state-paid insurance and benefits. 738.37 Sec. 17. [EFFECTIVE DATE.] 738.38 The provisions in this act are effective July 1, 2001, 738.39 unless a different effective date is specified. 738.40 ARTICLE 18 738.41 CRIMINAL JUSTICE 738.42 Section 1. [CRIMINAL JUSTICE APPROPRIATIONS.] 738.43 The sums shown in the columns marked "APPROPRIATIONS" are 738.44 appropriated from the general fund, or another fund named, to 738.45 the agencies and for the purposes specified in this act, to be 738.46 available for the fiscal years indicated for each purpose. The 738.47 figures "2002" and "2003" where used in this article, mean that 739.1 the appropriation or appropriations listed under them are 739.2 available for the year ending June 30, 2002, or June 30, 2003, 739.3 respectively. 739.4 SUMMARY BY FUND 739.5 2002 2003 TOTAL 739.6 General $ 413,000,000 $ 429,246,000 $ 842,246,000 739.7 Special Revenue $ 1,389,000 $ 1,242,000 $ 2,631,000 739.8 TOTAL $ 414,389,000 $ 430,488,000 $ 844,877,000 739.9 APPROPRIATIONS 739.10 Available for the Year 739.11 Ending June 30 739.12 2002 2003 739.13 Sec. 2. BOARD OF PUBLIC DEFENSE 739.14 Subdivision 1. Total 739.15 Appropriation 50,723,000 54,709,000 739.16 [APPROPRIATIONS FOR PROGRAMS.] The 739.17 amounts that may be spent from this 739.18 appropriation for each program are 739.19 specified in the following subdivisions. 739.20 [TRANSCRIPT COSTS.] During the biennium 739.21 ending June 30, 2003, the state public 739.22 defender may, with the approval of the 739.23 commissioner of finance, transfer funds 739.24 for transcript costs from the office of 739.25 administrative services to the state 739.26 public defender. 739.27 [PROHIBITION ON USE OF FUNDS FOR 739.28 CERTAIN LAWSUITS.] None of this 739.29 appropriation shall be used to pay for 739.30 lawsuits against public agencies or 739.31 public officials to change social or 739.32 public policy. 739.33 [PROHIBITION ON USE OF FUNDS FOR 739.34 LOBBYING.] None of this appropriation 739.35 shall be used to pay an employee solely 739.36 to provide lobbying services or 739.37 legislative advocacy or to serve solely 739.38 as a legislative liaison. 739.39 [PUBLIC DEFENSE CORPORATIONS.] The 739.40 board of public defense shall continue 739.41 to fund the existing public defense 739.42 corporations under Minnesota Statutes, 739.43 section 611.216. 739.44 Subd. 2. State Public Defender 739.45 3,450,000 3,734,000 739.46 Subd. 3. Administrative Services 739.47 Office 739.48 2,167,000 2,543,000 739.49 Subd. 4. District Public Defense 739.50 45,106,000 48,432,000 740.1 [COSTS ASSOCIATED WITH FELONY-LEVEL 740.2 PENALTY FOR IMPAIRED DRIVING.] $125,000 740.3 the second year is for costs associated 740.4 with increased trials and appeals due 740.5 to the felony-level driving while 740.6 impaired penalty. 740.7 Sec. 3. CORRECTIONS 740.8 Subdivision 1. Total 740.9 Appropriation 362,820,000 374,682,000 740.10 Summary by Fund 740.11 General 361,431,000 373,440,000 740.12 Special Revenue 1,389,000 1,242,000 740.13 [APPROPRIATIONS FOR PROGRAMS.] The 740.14 amounts that may be spent from this 740.15 appropriation for each program are 740.16 specified in the following subdivisions. 740.17 [UNENCUMBERED BALANCES.] Any 740.18 unencumbered balances remaining in the 740.19 first year do not cancel but are 740.20 available for the second year of the 740.21 biennium. 740.22 [TRANSFER OF POSITIONS AND 740.23 ADMINISTRATIVE MONEY.] Positions and 740.24 administrative money may be transferred 740.25 within the department of corrections as 740.26 the commissioner considers necessary, 740.27 upon the advance approval of the 740.28 commissioner of finance. 740.29 [TRANSFER OF SALARY FUNDS.] For the 740.30 biennium ending June 30, 2003, the 740.31 commissioner of corrections may, with 740.32 the approval of the commissioner of 740.33 finance, transfer funds to or from 740.34 salaries. 740.35 [CONTRACTS WITH PRIVATE CORPORATIONS.] 740.36 During the biennium ending June 30, 740.37 2003, the commissioner may enter into 740.38 contracts with private corporations or 740.39 governmental units of the state of 740.40 Minnesota to house adult offenders 740.41 committed to the commissioner of 740.42 corrections. Every effort shall be 740.43 made to house individuals committed to 740.44 the commissioner of corrections in 740.45 Minnesota correctional facilities. 740.46 [REDUCTION IN SERVICES OR STAFFING.] 740.47 During the biennium ending June 30, 740.48 2003, if it is necessary to reduce 740.49 services or staffing within a 740.50 correctional facility, the commissioner 740.51 or the commissioner's designee shall 740.52 meet with affected exclusive 740.53 representatives. The commissioner 740.54 shall make every reasonable effort to 740.55 retain correctional officer and prison 740.56 industry employees should reductions be 740.57 necessary. 740.58 Subd. 2. Correctional Institutions 741.1 Summary by Fund 741.2 2002 2003 741.3 General 225,365,000 232,584,000 741.4 Special Revenue 932,000 785,000 741.5 [CONTRACTS FOR BEDS AT RUSH CITY.] If 741.6 the commissioner contracts with other 741.7 states, local units of government, or 741.8 the federal government to rent beds in 741.9 the Rush City correctional facility, 741.10 the commissioner shall charge a per 741.11 diem under the contract, to the extent 741.12 possible, that is equal to or greater 741.13 than the per diem cost of housing 741.14 Minnesota inmates in the facility. The 741.15 per diem cost for housing inmates of 741.16 other states, local units of 741.17 government, or the federal government 741.18 at this facility shall be based on the 741.19 assumption that the facility is at or 741.20 near capacity. Notwithstanding any 741.21 laws to the contrary, the commissioner 741.22 may use the per diem appropriation to 741.23 operate the state correctional 741.24 institutions. 741.25 [FAITH-BASED PRERELEASE PROGRAM.] 741.26 $100,000 the first year and $100,000 741.27 the second year are for: (1) 741.28 developing a request for proposals from 741.29 vendors to privately operate a 741.30 partially publicly funded, faith-based 741.31 prerelease program with a community 741.32 reintegration component at a 741.33 correctional facility with a custody 741.34 level of less than four; and (2) 741.35 implementing the program. The 741.36 commissioner shall issue the request 741.37 for proposals by November 1, 2001, and 741.38 shall select a vendor to begin 741.39 operating the program by January 1, 741.40 2002. 741.41 In order to receive the appropriation, 741.42 the commissioner must obtain an equal 741.43 share of matching grants from the 741.44 federal government or private sources. 741.45 Both financial and in-kind resources 741.46 can serve to fulfill the match 741.47 requirement. 741.48 [PER DIEM REDUCTION PLAN.] The 741.49 commissioner may use any cost savings 741.50 generated through the implementation of 741.51 a per diem reduction plan for capital 741.52 improvements, which will contribute to 741.53 further per diem reductions at adult 741.54 correctional facilities. 741.55 [PRISON HEALTH CARE COMMISSION.] The 741.56 commissioner of corrections may 741.57 establish a prison health care 741.58 commission to develop an inmate health 741.59 care plan to be provided to offenders 741.60 under the custody of the department. 741.61 The purpose of the prison health care 741.62 commission shall be to specify the 741.63 level of health care services to be 742.1 provided to offenders and to define and 742.2 develop a detailed list of diagnoses 742.3 and treatments that will be provided 742.4 within the resources appropriated to 742.5 the department of corrections for 742.6 offender health care. The department 742.7 of corrections shall use this list to 742.8 manage health care priorities to ensure 742.9 the availability of life-saving 742.10 treatments and maintain an acceptable 742.11 level of health care services for all 742.12 offenders within appropriated resources. 742.13 If established, the prison health care 742.14 commission shall be comprised of the 742.15 following members: 742.16 (1) the commissioner of the department 742.17 of corrections, who will act as the 742.18 chair of the commission; 742.19 (2) the medical director of the 742.20 department of corrections; 742.21 (3) two members of the legislature 742.22 appointed by the governor; 742.23 (4) a representative of the department 742.24 of human services; and 742.25 (5) two wardens of Minnesota 742.26 correctional facilities. 742.27 If a prison health care commission is 742.28 established, an interagency workgroup 742.29 consisting of representatives of the 742.30 departments of health, commerce, human 742.31 services, and corrections shall provide 742.32 technical assistance to the prison 742.33 health care commission. 742.34 If established, the prison health care 742.35 commission shall provide a report to 742.36 the governor and the chairs and ranking 742.37 minority members of the house and 742.38 senate committees and divisions having 742.39 jurisdiction over crime prevention and 742.40 judiciary finance that recommends and 742.41 explains a hierarchy of health services 742.42 that represents the comparative 742.43 benefits of each service to the entire 742.44 population to be served. The report 742.45 must be submitted within 12 months of 742.46 the commission's formation date. 742.47 [BED IMPACT OF FELONY-LEVEL PENALTY FOR 742.48 IMPAIRED DRIVING.] $2,137,000 the 742.49 second year is for increased costs due 742.50 to the bed impact of the felony-level 742.51 driving while impaired penalty. 742.52 Subd. 3. Juvenile Services 742.53 13,984,000 14,283,000 742.54 [JUVENILE FEMALE FUNDING AND 742.55 PROGRAMMING.] In order to maximize 742.56 federal IV-E funding for juvenile 742.57 females committed to the commissioner 742.58 of corrections, the department of 742.59 corrections shall make necessary 743.1 changes to the juvenile females 743.2 facility and program in order to be in 743.3 compliance with IV-E guidelines and 743.4 requirements. All new IV-E funds 743.5 generated by eligible juvenile females 743.6 committed to the commissioner or placed 743.7 in the department of corrections 743.8 program for juvenile females shall be 743.9 deposited in the general fund. 743.10 Subd. 4. Community Services 743.11 Summary by Fund 743.12 General 109,252,000 113,488,000 743.13 Special Revenue 150,000 150,000 743.14 [SUPERVISION OF FELONY-LEVEL OFFENDERS 743.15 IN NON-CCA COUNTIES.] $410,000 the 743.16 first year and $550,000 the second year 743.17 are for probation and supervised 743.18 release services. This appropriation 743.19 shall be used solely for the purpose of 743.20 hiring new probation officers for 743.21 supervision of felony-level offenders 743.22 in noncommunity corrections act 743.23 counties. 743.24 [COUNTY PROBATION OFFICER 743.25 REIMBURSEMENTS.] $831,000 the first 743.26 year and $1,100,000 the second year are 743.27 for county probation officer 743.28 reimbursements to bring the state's 743.29 funding to 50 percent of the cost of 743.30 providing these services. Those funds 743.31 in excess of the state's 50 percent 743.32 contribution are for the purpose of 743.33 hiring new probation officers for 743.34 supervision of juvenile and 743.35 misdemeanant offenders in these 743.36 counties. 743.37 [COMMUNITY CORRECTIONS ACT SUBSIDY 743.38 FUNDING.] $7,500,000 the first year and 743.39 $7,500,000 the second year are for an 743.40 increase in community corrections act 743.41 subsidy funding to be distributed 743.42 according to the community corrections 743.43 aid formula in Minnesota Statutes, 743.44 section 401.10. In fiscal year 2002, 743.45 the commissioner shall distribute the 743.46 same amount of money to the Hennepin 743.47 county community corrections agency, 743.48 the Ramsey county community corrections 743.49 agency, the Anoka county community 743.50 corrections agency, the Arrowhead 743.51 community corrections agency, the 743.52 Dodge-Fillmore-Olmsted community 743.53 corrections agency, and the tri-county 743.54 (Polk, Norman, and Red Lake) community 743.55 corrections agency as was distributed 743.56 in fiscal year 2001 for productive day 743.57 initiative programs. The legislature 743.58 intends that those programs receiving 743.59 this money shall be funded by the 743.60 counties beginning with the fiscal year 743.61 starting July 1, 2002. The commissioner 743.62 of corrections may not make these 743.63 distributions for productive day 743.64 initiative programs, unless the program 744.1 has submitted to the commissioner a 744.2 self-sufficiency plan detailing how the 744.3 program will operate without a state 744.4 appropriation after July 1, 2002. 744.5 [INCREASED SUPERVISION OF ADULT SEX 744.6 OFFENDERS.] $1,731,000 the first year 744.7 and $2,000,000 the second year are for 744.8 enhanced supervision of adult felony 744.9 sex offenders by employing additional 744.10 probation officers to reduce the 744.11 caseloads of probation officers 744.12 supervising sex offenders on probation 744.13 or supervised release and/or to provide 744.14 job training and placement and 744.15 treatment for these offenders. 744.16 Of this appropriation, $150,000 each 744.17 year is for a grant to a multicounty 744.18 community corrections agency to 744.19 continue to provide increased 744.20 supervision of and treatment to sex 744.21 offenders who are on probation, 744.22 intensive community supervision, 744.23 supervised release, or intensive 744.24 supervised release. This grant must be 744.25 used to maintain the number of 744.26 offenders supervised by officers with 744.27 specialized caseloads to an average of 744.28 35 offenders. This appropriation shall 744.29 become part of the base budget of the 744.30 department of corrections for an annual 744.31 grant to the multicounty community 744.32 corrections agency for this purpose. 744.33 The grant recipient must report by 744.34 January 15, 2004, to the house and 744.35 senate committees with jurisdiction 744.36 over criminal justice policy and 744.37 funding on the outcomes of the program, 744.38 including comparative recidivism rates. 744.39 The commissioner shall distribute the 744.40 remaining funds with 25 percent of the 744.41 money appropriated to non-Community 744.42 Corrections Act counties and 75 percent 744.43 appropriated to Community Corrections 744.44 Act counties. The commissioner shall 744.45 distribute the appropriation to 744.46 Community Corrections Act counties 744.47 according to the formula contained in 744.48 Minnesota Statutes, section 401.10. 744.49 Each Community Corrections Act 744.50 jurisdiction and the department's 744.51 probation and supervised release unit 744.52 shall submit to the commissioner an 744.53 analysis of need along with a plan to 744.54 meet these needs and reduce adult 744.55 felony sex offender caseloads and/or 744.56 provide the job training and placement 744.57 and treatment for these offenders. 744.58 Upon approval of the plans, the 744.59 non-Community Corrections Act portion 744.60 of these funds shall be appropriated to 744.61 the department and the distribution 744.62 shall be based on statewide need. The 744.63 Community Corrections Act funds shall 744.64 be disbursed as grants to each 744.65 Community Corrections Act 744.66 jurisdiction. These appropriations may 744.67 not be used to supplant existing state 744.68 or county probation officer positions. 745.1 [RESTORATIVE JUSTICE PROGRAMS.] 745.2 $300,000 the first year and $300,000 745.3 the second year are for grants related 745.4 to restorative justice programs as 745.5 defined in Minnesota Statutes, section 745.6 611A.775. Grant awards must be 745.7 allocated in a balanced manner among 745.8 rural, suburban, and urban 745.9 organizations operating restorative 745.10 justice programs. Preference must be 745.11 given to organizations or programs that: 745.12 (1) are currently operating and have 745.13 had successful results; 745.14 (2) are community-based; and 745.15 (3) are supported by both private and 745.16 public funding. 745.17 [JUVENILE RESIDENTIAL TREATMENT 745.18 GRANTS.] $5,208,000 the first year and 745.19 $8,000,000 the second year are for 745.20 juvenile residential treatment grants. 745.21 [STUDY ON EXTENDED JURISDICTION 745.22 JUVENILES.] $40,000 the first year is a 745.23 one-time appropriation for a grant to 745.24 the Institute on Criminal Justice, 745.25 University of Minnesota Law School, to 745.26 be used to study the sanctions imposed 745.27 by judges on extended jurisdiction 745.28 juveniles whose juvenile court 745.29 disposition is revoked. The study must 745.30 include, at a minimum, the following 745.31 information on these offenders: 745.32 (1) the offense for which the offender 745.33 originally was convicted as an extended 745.34 jurisdiction juvenile; 745.35 (2) the provisions of the juvenile 745.36 disposition and the adult criminal 745.37 sentence originally imposed by the 745.38 sentencing court; 745.39 (3) the reason why the juvenile 745.40 disposition was revoked; 745.41 (4) if the offender's stayed prison 745.42 sentence was executed, the duration of 745.43 the executed sentence; and 745.44 (5) if the offender's stayed prison 745.45 sentence was not executed, the adult 745.46 criminal sanctions that were imposed as 745.47 a condition of the stayed sentence 745.48 including, but not limited to, jail 745.49 time, restitution, fine, probation, 745.50 home detention, and treatment. If 745.51 possible, the study shall include a 745.52 comparison of the adult criminal 745.53 sanctions imposed on revoked extended 745.54 jurisdiction juvenile offenders with 745.55 the criminal sanctions imposed on 745.56 similarly-situated adult criminal 745.57 offenders at the time of their initial 745.58 sentencing. 745.59 The institute must present its findings 745.60 to the chairs and ranking minority 746.1 members of the house and senate 746.2 committees having jurisdiction over 746.3 criminal justice funding and policy by 746.4 November 15, 2001. 746.5 [STUDY ON FELONY-LEVEL PENALTY FOR 746.6 DRIVING WHILE IMPAIRED.] $20,000 the 746.7 first year is a one-time appropriation 746.8 for a grant to the Institute on 746.9 Criminal Justice, University of 746.10 Minnesota Law School, to be used to 746.11 formulate a research plan for 746.12 evaluating the implementation and 746.13 impact of a law authorizing a felony 746.14 penalty for repeat impaired driving 746.15 offenders. The research plan shall 746.16 outline the steps needed to conduct a 746.17 rigorous evaluation that addresses both 746.18 the impact of a felony DWI law on 746.19 reoffense rates and its fiscal impact 746.20 on the criminal justice system. The 746.21 plan also must estimate the cost of 746.22 conducting the evaluation. 746.23 At a minimum, the institute must: 746.24 (1) identify and convene an advisory 746.25 group to assist in identifying 746.26 pertinent data sources and outline 746.27 strategies for accessing these sources; 746.28 (2) estimate the number of cases on 746.29 which data would need to be collected 746.30 so that statistical analysis could be 746.31 performed on both a baseline population 746.32 of offenders sentenced before the 746.33 effective date of the felony penalty 746.34 and a population of offenders sentenced 746.35 to a felony-level penalty; 746.36 (3) outline a sampling methodology to 746.37 ensure that all ten judicial districts 746.38 are adequately represented in the 746.39 sample; 746.40 (4) identify practitioners at the 746.41 judicial district level to serve as 746.42 contacts for research staff and to 746.43 answer questions about programmatic 746.44 costs; 746.45 (5) identify the process for manually 746.46 collecting, from individual judicial 746.47 districts, information on sentences 746.48 imposed on the populations of offenders 746.49 being studied; 746.50 (6) establish specific criteria 746.51 delineating how to assess the fiscal 746.52 impact of the felony DWI statute; and 746.53 (7) recommend a time frame within which 746.54 the evaluation study could be completed. 746.55 The institute must submit the research 746.56 plan to the chairs and ranking minority 746.57 members of the house and senate 746.58 committees having jurisdiction over 746.59 criminal justice funding and policy by 746.60 December 15, 2001. 747.1 [BUDGET REDUCTION; EXTENDED 747.2 JURISDICTION JUVENILE GRANTS.] A 747.3 $1,400,000 reduction each year in the 747.4 base budget appropriation for community 747.5 services must be directed to reductions 747.6 in extended jurisdiction juvenile 747.7 grants. 747.8 [EXTENDED JURISDICTION JUVENILE 747.9 GRANTS.] The commissioner of 747.10 corrections may grant to counties up to 747.11 $9,500 per extended jurisdiction 747.12 juvenile offender each year. 747.13 [COMMUNITY PRESERVATION UNIT MISSION.] 747.14 The commissioner of corrections must 747.15 rename the community preservation unit 747.16 consistent with a revised mission for 747.17 the unit that focuses on working with 747.18 minority communities on post-release 747.19 services, reentry, or other similar 747.20 matters. This mission must be 747.21 consistent with the department of 747.22 corrections' overall mission. By 747.23 September 1, 2001, the commissioner of 747.24 corrections must report to the chairs 747.25 and ranking minority members of the 747.26 house and senate committees with 747.27 jurisdiction over criminal justice 747.28 policy and funding on the unit's new 747.29 name, mission, and how this mission 747.30 fits with the department of 747.31 corrections' overall mission. The 747.32 community preservation unit and its 747.33 successor must not award or administer 747.34 grants until its new mission has been 747.35 implemented and the commissioner has 747.36 reported to the legislature. 747.37 [BUDGET REDUCTION; COMMUNITY 747.38 PRESERVATION UNIT.] An $85,000 747.39 reduction the first year must be 747.40 directed at cuts to the community 747.41 preservation unit and its successor. 747.42 [COMMUNITY SUPERVISION COSTS RELATED TO 747.43 FELONY-LEVEL DRIVING WHILE IMPAIRED 747.44 OFFENSE.] $197,000 the second year is 747.45 for increased community supervision 747.46 costs due to the felony-level driving 747.47 while impaired penalty. 747.48 Subd. 5. Management Services 747.49 Summary by Fund 747.50 General 12,830,000 13,085,000 747.51 Special Revenue 307,000 307,000 747.52 [CENTRAL OFFICE EFFICIENCY INITIATIVE.] 747.53 The commissioner must develop a plan to 747.54 improve the efficiency of the central 747.55 office. In part, the commissioner must 747.56 consider reductions in personnel levels 747.57 and the consolidation of functions. By 747.58 January 15, 2002, the commissioner must 747.59 report to the chairs and ranking 747.60 minority members of the senate and 747.61 house committees and divisions having 747.62 jurisdiction over criminal justice 748.1 funding on a central office efficiency 748.2 plan and what changes, if any, have 748.3 been initiated. The report may be 748.4 combined with the report on per diem 748.5 reductions. 748.6 Sec. 4. CORRECTIONS OMBUDSMAN 323,000 336,000 748.7 Sec. 5. SENTENCING 748.8 GUIDELINES COMMISSION 523,000 550,000 748.9 [SALARY INCREASE FOR EXECUTIVE 748.10 DIRECTOR.] Up to $10,000 the first year 748.11 and $20,000 the second year may be used 748.12 to increase the salary of the executive 748.13 director of the sentencing guidelines 748.14 commission. 748.15 [SEARCH FOR EXECUTIVE DIRECTOR.] Any 748.16 search conducted to fill the position 748.17 of executive director of the sentencing 748.18 guidelines commission shall be done on 748.19 a statewide basis. 748.20 Sec. 6. PUBLIC SAFETY -0- 84,000 748.21 [TRIAL SUPPORT COSTS FOR FELONY-LEVEL 748.22 PENALTY FOR IMPAIRED DRIVING.] $84,000 748.23 the second year is for increased costs 748.24 associated with providing trial support 748.25 due to the felony-level driving while 748.26 impaired penalty. 748.27 Sec. 7. ATTORNEY GENERAL -0- 127,000 748.28 [COSTS ASSOCIATED WITH FELONY-LEVEL 748.29 DRIVING WHILE IMPAIRED PENALTY.] 748.30 $127,000 the second year is for costs 748.31 associated with increased appeals due 748.32 to the felony-level driving while 748.33 impaired penalty. 748.34 Sec. 8. Minnesota Statutes 2000, section 15A.083, 748.35 subdivision 4, is amended to read: 748.36 Subd. 4. [RANGES FOR OTHER JUDICIAL POSITIONS.] Salaries 748.37 or salary ranges are provided for the following positions in the 748.38 judicial branch of government. The appointing authority of any 748.39 position for which a salary range has been provided shall fix 748.40 the individual salary within the prescribed range, considering 748.41 the qualifications and overall performance of the employee. The 748.42 supreme court shall set the salary of the state court 748.43 administrator and the salaries of district court 748.44 administrators. The salary of the state court administrator or 748.45 a district court administrator may not exceed the salary of a 748.46 district court judge. If district court administrators die, the 748.47 amounts of their unpaid salaries for the months in which their 748.48 deaths occur must be paid to their estates. The salary of the 749.1 state public defendermust be 95 percent of the salary of the749.2attorney generalshall be fixed by the state board of public 749.3 defense but must not exceed the salary of a district court judge. 749.4 Salary or Range 749.5 Effective 749.6 July 1, 1994 749.7 Board on judicial standards 749.8 executive director $44,000-60,000 749.9 Sec. 9. Minnesota Statutes 2000, section 241.272, 749.10 subdivision 6, is amended to read: 749.11 Subd. 6. [USE OF FEES.] Excluding correctional fees 749.12 collected from offenders supervised by department agents under 749.13 the authority of section 244.19, subdivision 1, paragraph (a), 749.14 clause (3), all correctional fees collected under this section 749.15 go to the general fund. Fees collected by agents under the 749.16 authority of section 244.19, subdivision 1, paragraph (a), 749.17 clause (3), shall go to the county treasurer in the county where 749.18 supervision is provided. These fees may only be used in 749.19 accordance with section 244.18, subdivision 6. 749.20 Sec. 10. Minnesota Statutes 2000, section 241.32, is 749.21 amended by adding a subdivision to read: 749.22 Subd. 4. [EMERGENCY HOUSING RENTAL AGREEMENTS.] The 749.23 commissioner of corrections may enter into rental agreements per 749.24 industry standards for emergency housing for inmates. 749.25 Sec. 11. Minnesota Statutes 2000, section 241.45, is 749.26 amended to read: 749.27 241.45 [PUBLICATION OF RECOMMENDATIONS; REPORTS.] 749.28 Subdivision 1. The ombudsman may publish conclusions and 749.29 suggestions by transmitting them to the office of the governor. 749.30 Before announcing a conclusion or recommendation that expressly 749.31 or impliedly criticizes an administrative agency, or any person, 749.32 the ombudsman shall consult with that agency or person. When 749.33 publishing an opinion adverse to an administrative agency, or 749.34 any person, the ombudsman shall include in such publication any 749.35 statement of reasonable length made to the ombudsman by that 749.36 agency or person in defense or mitigation of the action. 750.1 Subd. 2. In addition to whatever reports the ombudsman may 750.2 make on an ad hoc basis, the ombudsman shallbienniallyat the 750.3 end of each year report to the governor concerning the exercise 750.4 of the ombudsman's functions during the precedingbiennium750.5 year. The biennial report is due on or before the beginning of750.6the legislative session following the end of the biennium. 750.7 Sec. 12. Minnesota Statutes 2000, section 242.192, is 750.8 amended to read: 750.9 242.192 [CHARGES TO COUNTIES.] 750.10 (a) Until June 30,20012002, the commissioner shall charge 750.11 counties or other appropriate jurisdictions 65 percent of the 750.12 per diem cost of confinement, excluding educational costs and 750.13 nonbillable service, of juveniles at the Minnesota correctional 750.14 facility-Red Wing and of juvenile females committed to the 750.15 commissioner of corrections. This charge applies to juveniles 750.16 committed to the commissioner of corrections and juveniles 750.17 admitted to the Minnesota correctional facility-Red Wing under 750.18 established admissions criteria. This charge applies to both 750.19 counties that participate in the Community Corrections Act and 750.20 those that do not. The commissioner shall determine the per 750.21 diem cost of confinement based on projected population, pricing 750.22 incentives, market conditions, and the requirement that expense 750.23 and revenue balance out over a period of two years. All money 750.24 received under this section must be deposited in the state 750.25 treasury and credited to the general fund. 750.26 (b) Until June 30,20012002, the department of corrections 750.27 shall be responsible for 35 percent of the per diem cost of 750.28 confinement described in this section. 750.29 Sec. 13. Minnesota Statutes 2000, section 243.51, 750.30 subdivision 1, is amended to read: 750.31 Subdivision 1. [CONTRACTING WITH OTHER STATES AND FEDERAL 750.32 GOVERNMENT.] The commissioner of corrections is hereby 750.33 authorized to contract with agencies and bureaus of the United 750.34 States and with the proper officials of other states or a county 750.35 of this state for the custody, care, subsistence, education, 750.36 treatment and training of persons convicted of criminal offenses 751.1 constituting felonies in the courts of this state, the United 751.2 States, or other states of the United States. Such contracts 751.3 shall provide for reimbursing the state of Minnesota for all 751.4 costs or other expenses involved, and, to the extent possible, 751.5 require payment to the department of corrections of a per diem 751.6 amount that is substantially equal to or greater than the per 751.7 diem for the cost of housing Minnesota inmates at the same 751.8 facility. This per diem cost shall be based on the assumption 751.9 that the facility is at or near capacity. Any prisoner 751.10 transferred to the state of Minnesota pursuant to this 751.11 subdivision shall be subject to the terms and conditions of the 751.12 prisoner's original sentence as if the prisoner were serving the 751.13 same within the confines of the state in which the conviction 751.14 and sentence was had or in the custody of the United States. 751.15 Nothing herein shall deprive such inmate of the right to parole 751.16 or the rights to legal process in the courts of this state. 751.17 Sec. 14. Minnesota Statutes 2000, section 243.51, 751.18 subdivision 3, is amended to read: 751.19 Subd. 3. [TEMPORARY DETENTION.] The commissioner of 751.20 corrections is authorized to contract with agencies and bureaus 751.21 of the United States and with the appropriate officials of any 751.22 other state or county of this state for the temporary detention 751.23 of any person in custody pursuant to any process issued under 751.24 the authority of the United States, other states of the United 751.25 States, or the district courts of this state. The contract 751.26 shall provide for reimbursement to the state of Minnesota for 751.27 all costs and expenses involved, and, to the extent possible, 751.28 require payment to the department of corrections of a per diem 751.29 amount that is substantially equal to or greater than the per 751.30 diem for the cost of housing Minnesota inmates at the same 751.31 facility. This per diem cost shall be based on the assumption 751.32 that the facility is at or near capacity. 751.33 Sec. 15. Minnesota Statutes 2000, section 357.021, 751.34 subdivision 6, is amended to read: 751.35 Subd. 6. [SURCHARGES ON CRIMINAL AND TRAFFIC OFFENDERS.] 751.36 (a) The court shall impose and the court administrator shall 752.1 collect a$25$35 surcharge on every person convicted of any 752.2 felony, gross misdemeanor, misdemeanor, or petty misdemeanor 752.3 offense, other than a violation of a law or ordinance relating 752.4 to vehicle parking. The surcharge shall be imposed whether or 752.5 not the person is sentenced to imprisonment or the sentence is 752.6 stayed. 752.7 (b) If the court fails to impose a surcharge as required by 752.8 this subdivision, the court administrator shall show the 752.9 imposition of the$25surcharge, collect the surcharge and 752.10 correct the record. 752.11 (c) The court may not waive payment of the surcharge 752.12 required under this subdivision. Upon a showing of indigency or 752.13 undue hardship upon the convicted person or the convicted 752.14 person's immediate family, the sentencing court may authorize 752.15 payment of the surcharge in installments. 752.16 (d) The court administrator or other entity collecting a 752.17 surcharge shall forward it to the state treasurer. 752.18 (e) If the convicted person is sentenced to imprisonment 752.19 and has not paid the surcharge before the term of imprisonment 752.20 begins, the chief executive officer of the correctional facility 752.21 in which the convicted person is incarcerated shall collect the 752.22 surcharge from any earnings the inmate accrues from work 752.23 performed in the facility or while on conditional release. The 752.24 chief executive officer shall forward the amount collected to 752.25 the state treasurer. 752.26 Sec. 16. Minnesota Statutes 2000, section 357.021, 752.27 subdivision 7, is amended to read: 752.28 Subd. 7. [DISBURSEMENT OF SURCHARGES BY STATE TREASURER.] 752.29 (a) Except as provided in paragraphs (b) and (c), the state 752.30 treasurer shall disburse surcharges received under subdivision 6 752.31 and section 97A.065, subdivision 2, as follows: 752.32 (1) one percentof the surchargeshall be credited to the 752.33 game and fish fund to provide peace officer training for 752.34 employees of the department of natural resources who are 752.35 licensed under sections 626.84 to 626.863, and who possess peace 752.36 officer authority for the purpose of enforcing game and fish 753.1 laws; 753.2 (2) 39 percentof the surchargeshall be credited to the 753.3 peace officers training account in the special revenue fund; and 753.4 (3) 60 percentof the surchargeshall be credited to the 753.5 general fund. 753.6 (b) The state treasurer shall credit $3 of each surcharge 753.7 received under subdivision 6 and section 97A.065, subdivision 2, 753.8 to a criminal justice special projects account in the special 753.9 revenue fund. This account is available for appropriation to 753.10 the commissioner of public safety for grants to law enforcement 753.11 agencies and for other purposes authorized by the legislature. 753.12 (c) In addition to any amounts credited under paragraph 753.13 (a), the state treasurer shall credit $7 of each surcharge 753.14 received under subdivision 6 and section 97A.065, subdivision 2, 753.15 to the general fund. 753.16 Sec. 17. [LEGISLATIVE RECOMMENDATIONS; STATE POLICY PLAN.] 753.17 By December 1, 2001, the commissioner of corrections must 753.18 submit legislative recommendations to the chairs and ranking 753.19 minority members of the house and senate committees having 753.20 jurisdiction over criminal justice policy and funding regarding 753.21 the impact of entering into, or not entering into, the updated 753.22 interstate compact on adult offenders, as proposed by the 753.23 council of state governments. The commissioner must consult 753.24 with other professionals in the corrections field and must 753.25 consult with states that both have and have not entered into the 753.26 compact. The commissioner must develop a plan for state policy 753.27 in regard to handling interstate transfers of adult offenders. 753.28 The commissioner must be prepared to act on and implement the 753.29 recommendations and plan in 2002. In developing the legislative 753.30 recommendations and state policy plan, the commissioner must 753.31 consider fiscal impacts. Any costs associated with developing 753.32 the legislative recommendations and state policy plan under this 753.33 section must be absorbed within the commissioner's current 753.34 budget. 753.35 Sec. 18. Minnesota Statutes 2000, section 611.23, is 753.36 amended to read: 754.1 611.23 [OFFICE OF STATE PUBLIC DEFENDER; APPOINTMENT; 754.2 SALARY.] 754.3 The state public defender is responsible to the state board 754.4 of public defense. The state public defender shall be appointed 754.5 by the state board of public defense for a term of four years, 754.6 except as otherwise provided in this section, and until a 754.7 successor is appointed and qualified. The state public defender 754.8 shall be a full-time qualified attorney, licensed to practice 754.9 law in this state, serve in the unclassified service of the 754.10 state, and be removed only for cause by the appointing 754.11 authority. Vacancies in the office shall be filled by the 754.12 appointing authority for the unexpired term. The salary of the 754.13 state public defender shall be fixed by the state board of 754.14 public defense but must not exceed the salary ofthe chief754.15deputy attorney generala district court judge. Terms of the 754.16 state public defender shall commence on July 1. The state 754.17 public defender shall devote full time to the performance of 754.18 duties and shall not engage in the general practice of law. 754.19 Sec. 19. [INSTRUCTION TO REVISOR; LEGISLATIVE INTENT.] 754.20 The surcharge increase contained in Minnesota Statutes, 754.21 section 357.021, in this act supersedes any other increases to 754.22 the surcharge enacted in the 2001 First Special Session. 754.23 Sec. 20. [USE OF BRYNE GRANT FUNDS FOR RESTORATIVE JUSTICE 754.24 GRANTS.] 754.25 In fiscal years 2002 and 2003, the commissioner of public 754.26 safety shall use the same amount of federal Bryne grant funds 754.27 for grants to restorative justice programs as was used in fiscal 754.28 year 2001. 754.29 Sec. 21. [STUDY ON OMBUDSMAN FOR CORRECTIONS.] 754.30 The office of the governor, in consultation with the 754.31 department of administration, shall conduct a study of various 754.32 models to deliver the services provided by the ombudsman for 754.33 corrections, including the effects of privatizing certain 754.34 functions of the ombudsman for corrections. The office must 754.35 report its finding and recommendations to the chairs and ranking 754.36 minority members of the senate and house committees responsible 755.1 for corrections policy and finance by February 1, 2002. 755.2 Sec. 22. [EFFECTIVE DATE.] 755.3 The provisions of this article are effective July 1, 2001. 755.4 ARTICLE 19 755.5 FELONY DRIVING WHILE IMPAIRED 755.6 Section 1. [62Q.137] [COVERAGE FOR CHEMICAL DEPENDENCY 755.7 TREATMENT PROVIDED BY THE DEPARTMENT OF CORRECTIONS.] 755.8 (a) Any health plan that provides coverage for chemical 755.9 dependency treatment must cover chemical dependency treatment 755.10 provided to an enrollee by the department of corrections while 755.11 the enrollee is committed to the custody of the commissioner of 755.12 corrections following a conviction for a first-degree driving 755.13 while impaired offense under section 169A.24 if: (1) a court of 755.14 competent jurisdiction makes a preliminary determination based 755.15 on a chemical use assessment conducted under section 169A.70 755.16 that treatment may be appropriate and includes this 755.17 determination as part of the sentencing order; and (2) the 755.18 department of corrections makes a determination based on a 755.19 chemical assessment conducted while the individual is in the 755.20 custody of the department that treatment is appropriate. 755.21 Treatment provided by the department of corrections that meets 755.22 the requirements of this section shall not be subject to a 755.23 separate medical necessity determination under the health plan 755.24 company's utilization review procedures. 755.25 (b) The health plan company must be given a copy of the 755.26 court's preliminary determination and supporting documents and 755.27 the assessment conducted by the department of corrections. 755.28 (c) Payment rates for treatment provided by the department 755.29 of corrections shall not exceed the lowest rate for outpatient 755.30 chemical dependency treatment paid by the health plan company to 755.31 a participating provider of the health plan company. 755.32 (d) For purposes of this section, chemical dependency 755.33 treatment means all covered services that are intended to treat 755.34 chemical dependency and that are covered by the enrollee's 755.35 health plan or by law. 755.36 Sec. 2. Minnesota Statutes 2000, section 169A.07, is 756.1 amended to read: 756.2 169A.07 [FIRST-TIME DWI VIOLATOR; OFF-ROAD RECREATIONAL 756.3 VEHICLE OR MOTORBOAT.] 756.4 A person who violates section 169A.20 (driving while 756.5 impaired) while using an off-road recreational vehicle or 756.6 motorboat and who does not have a qualified prior impaired 756.7 driving incident is subject only to the criminal penalty 756.8 provided in section 169A.25 (first-degreesecond-degree driving 756.9 while impaired), 169A.26 (second-degreethird-degree driving 756.10 while impaired), or 169A.27 (third-degreefourth-degree driving 756.11 while impaired); and loss of operating privileges as provided in 756.12 section 84.91, subdivision 1 (operation of snowmobiles or 756.13 all-terrain vehicles by persons under the influence of alcohol 756.14 or controlled substances), or 86B.331, subdivision 1 (operation 756.15 of motorboats while using alcohol or with a physical or mental 756.16 disability), whichever is applicable. The person is not subject 756.17 to the provisions of section 169A.275, subdivision 5, 756.18 (submission to the level of care recommended in chemical use 756.19 assessment for repeat offenders and offenders with alcohol 756.20 concentration of 0.20 or more); 169A.277 (long-term monitoring); 756.21 169A.285 (penalty assessment); 169A.44 (conditional release); 756.22 169A.54 (impaired driving convictions and adjudications; 756.23 administrative penalties); or 169A.54, subdivision 11 (chemical 756.24 use assessment); the license revocation sanctions of sections 756.25 169A.50 to 169A.53 (implied consent law); or the plate 756.26 impoundment provisions of section 169A.60 (administrative 756.27 impoundment of plates). 756.28 Sec. 3. Minnesota Statutes 2000, section 169A.20, 756.29 subdivision 3, is amended to read: 756.30 Subd. 3. [SENTENCE.] A person who violates this section 756.31 may be sentenced as provided in section 169A.24 (first-degree 756.32 driving while impaired), 169A.25 (first-degreesecond-degree 756.33 driving while impaired), 169A.26 (second-degreethird-degree 756.34 driving while impaired), or 169A.27 (third-degreefourth-degree 756.35 driving while impaired). 756.36 Sec. 4. [169A.24] [FIRST-DEGREE DRIVING WHILE IMPAIRED.] 757.1 Subdivision 1. [DEGREE DESCRIBED.] A person who violates 757.2 section 169A.20 (driving while impaired) is guilty of 757.3 first-degree driving while impaired if the person: 757.4 (1) commits the violation within ten years of the first of 757.5 three or more qualified prior impaired driving incidents; or 757.6 (2) has previously been convicted of a felony under this 757.7 section. 757.8 Subd. 2. [CRIMINAL PENALTY.] A person who commits 757.9 first-degree driving while impaired is guilty of a felony and 757.10 may be sentenced to imprisonment for not more than seven years, 757.11 or to payment of a fine of not more than $14,000, or both. The 757.12 person is subject to the mandatory penalties described in 757.13 section 169A.276 (mandatory penalties; felony violations). 757.14 Sec. 5. Minnesota Statutes 2000, section 169A.25, is 757.15 amended to read: 757.16 169A.25 [FIRST-DEGREESECOND-DEGREE DRIVING WHILE 757.17 IMPAIRED.] 757.18 Subdivision 1. [DEGREE DESCRIBED.] A person who violates 757.19 section 169A.20 (driving while impaired) is guilty of 757.20first-degreesecond-degree driving while impaired if two or more 757.21 aggravating factors were present when the violation was 757.22 committed. 757.23 Subd. 2. [CRIMINAL PENALTY.]First-degreeSecond-degree 757.24 driving while impaired is a gross misdemeanor. The mandatory 757.25 penalties described in section 169A.275 and the long-term 757.26 monitoring described in section 169A.277 may be applicable. 757.27 Sec. 6. Minnesota Statutes 2000, section 169A.26, is 757.28 amended to read: 757.29 169A.26 [SECOND-DEGREETHIRD-DEGREE DRIVING WHILE 757.30 IMPAIRED.] 757.31 Subdivision 1. [DEGREE DESCRIBED.] A person who violates 757.32 section 169A.20 (driving while impaired) is guilty of 757.33second-degreethird-degree driving while impaired if one 757.34 aggravating factor was present when the violation was committed. 757.35 Subd. 2. [CRIMINAL PENALTY.]Second-degreeThird-degree 757.36 driving while impaired is a gross misdemeanor. The mandatory 758.1 penalties described in section 169A.275 and the long-term 758.2 monitoring described in section 169A.277 may be applicable. 758.3 Sec. 7. Minnesota Statutes 2000, section 169A.27, is 758.4 amended to read: 758.5 169A.27 [THIRD-DEGREEFOURTH-DEGREE DRIVING WHILE 758.6 IMPAIRED.] 758.7 Subdivision 1. [DEGREE DESCRIBED.] A person who violates 758.8 section 169A.20 (driving while impaired) is guilty of 758.9third-degreefourth-degree driving while impaired. 758.10 Subd. 2. [CRIMINAL PENALTY.]Third-degreeFourth-degree 758.11 driving while impaired is a misdemeanor. 758.12 Sec. 8. Minnesota Statutes 2000, section 169A.275, is 758.13 amended to read: 758.14 169A.275 [MANDATORY PENALTIES; NONFELONY VIOLATIONS.] 758.15 Subdivision 1. [SECOND OFFENSE.] (a) The court shall 758.16 sentence a person who is convicted of a violation of section 758.17 169A.20 (driving while impaired) within ten years of a qualified 758.18 prior impaired driving incident to either: 758.19 (1) a minimum of 30 days of incarceration, at least 48 758.20 hours of which must be served consecutively in a local 758.21 correctional facility; or 758.22 (2) eight hours of community work service for each day less 758.23 than 30 days that the person is ordered to serve in a local 758.24 correctional facility. 758.25 Notwithstanding section 609.135 (stay of imposition or execution 758.26 of sentence), the penalties in this paragraph must be executed, 758.27 unless the court departs from the mandatory minimum sentence 758.28 under paragraph (b) or (c). 758.29 (b) Prior to sentencing, the prosecutor may file a motion 758.30 to have a defendant described in paragraph (a) sentenced without 758.31 regard to the mandatory minimum sentence established by that 758.32 paragraph. The motion must be accompanied by a statement on the 758.33 record of the reasons for it. When presented with the 758.34 prosecutor's motion and if it finds that substantial mitigating 758.35 factors exist, the court shall sentence the defendant without 758.36 regard to the mandatory minimum sentence established by 759.1 paragraph (a). 759.2 (c) The court may, on its own motion, sentence a defendant 759.3 described in paragraph (a) without regard to the mandatory 759.4 minimum sentence established by that paragraph if it finds that 759.5 substantial mitigating factors exist and if its sentencing 759.6 departure is accompanied by a statement on the record of the 759.7 reasons for it. The court also may sentence the defendant 759.8 without regard to the mandatory minimum sentence established by 759.9 paragraph (a) if the defendant is sentenced to probation and 759.10 ordered to participate in a program established under section 759.11 169A.74 (pilot programs of intensive probation for repeat DWI 759.12 offenders). 759.13 (d) When any portion of the sentence required by paragraph 759.14 (a) is not executed, the court should impose a sentence that is 759.15 proportional to the extent of the offender's prior criminal and 759.16 moving traffic violation record. Any sentence required under 759.17 paragraph (a) must include a mandatory sentence that is not 759.18 subject to suspension or a stay of imposition or execution, and 759.19 that includes incarceration for not less than 48 consecutive 759.20 hours or at least 80 hours of community work service. 759.21 Subd. 2. [THIRD OFFENSE.] (a) The court shall sentence a 759.22 person who is convicted of a violation of section 169A.20 759.23 (driving while impaired) within ten years of the first of two 759.24 qualified prior impaired driving incidents to either: 759.25 (1) a minimum of 90 days of incarceration, at least 30 days 759.26 of which must be served consecutively in a local correctional 759.27 facility; or 759.28 (2) a program of intensive supervision of the type 759.29 described in section 169A.74 (pilot programs of intensive 759.30 probation for repeat DWI offenders) that requires the person to 759.31 consecutively serve at least six days in a local correctional 759.32 facility. 759.33 (b) The court may order that the person serve not more than 759.34 60 days of the minimum penalty under paragraph (a), clause (1), 759.35 on home detention or in an intensive probation program described 759.36 in section 169A.74. 760.1 (c) Notwithstanding section 609.135, the penalties in this 760.2 subdivision must be imposed and executed. 760.3 Subd. 3. [FOURTH OFFENSE.] (a) Unless the court commits 760.4 the person to the custody of the commissioner of corrections as 760.5 provided in section 169A.276 (mandatory penalties; felony 760.6 violations), the court shall sentence a person who is convicted 760.7 of a violation of section 169A.20 (driving while impaired) 760.8 within ten years of the first of three qualified prior impaired 760.9 driving incidents to either: 760.10 (1) a minimum of 180 days of incarceration, at least 30 760.11 days of which must be served consecutively in a local 760.12 correctional facility; or 760.13 (2) a program of intensive supervision of the type 760.14 described in section 169A.74 (pilot programs of intensive 760.15 probation for repeat DWI offenders) that requires the person to 760.16 consecutively serve at least six days in a local correctional 760.17 facility. 760.18 (b) The court may order that the person serve not more than 760.19 150 days of the minimum penalty under paragraph (a), clause (1), 760.20 on home detention or in an intensive probation program described 760.21 in section 169A.74. Notwithstanding section 609.135, the 760.22 penalties in this subdivision must be imposed and executed. 760.23 Subd. 4. [FIFTH OFFENSE OR MORE.] (a) Unless the court 760.24 commits the person to the custody of the commissioner of 760.25 corrections as provided in section 169A.276 (mandatory 760.26 penalties; felony violations), the court shall sentence a person 760.27 who is convicted of a violation of section 169A.20 (driving 760.28 while impaired) within ten years of the first of four or more 760.29 qualified prior impaired driving incidents to either: 760.30 (1) a minimum of one year of incarceration, at least 60 760.31 days of which must be served consecutively in a local 760.32 correctional facility; or 760.33 (2) a program of intensive supervision of the type 760.34 described in section 169A.74 (pilot programs of intensive 760.35 probation for repeat DWI offenders) that requires the person to 760.36 consecutively serve at least six days in a local correctional 761.1 facility. 761.2 (b) The court may order that the person serve the remainder 761.3 of the minimum penalty under paragraph (a), clause (1), on 761.4 intensive probation using an electronic monitoring system or, if 761.5 such a system is unavailable, on home detention. 761.6 Notwithstanding section 609.135, the penalties in this 761.7 subdivision must be imposed and executed. 761.8 Subd. 5. [LEVEL OF CARE RECOMMENDED IN CHEMICAL USE 761.9 ASSESSMENT.] Unless the court commits the person to the custody 761.10 of the commissioner of corrections as provided in section 761.11 169A.276 (mandatory penalties; felony violations), in addition 761.12 to other penalties required under this section, the court shall 761.13 order a person to submit to the level of care recommended in the 761.14 chemical use assessment conducted under section 169A.70 (alcohol 761.15 safety program; chemical use assessments) if the person is 761.16 convicted of violating section 169A.20 (driving while impaired) 761.17 while having an alcohol concentration of 0.20 or more as 761.18 measured at the time, or within two hours of the time, of the 761.19 offense or if the violation occurs within ten years of one or 761.20 more qualified prior impaired driving incidents. 761.21 Sec. 9. [169A.276] [MANDATORY PENALTIES; FELONY 761.22 VIOLATIONS.] 761.23 Subdivision 1. [MANDATORY PRISON SENTENCE.] (a) The court 761.24 shall sentence a person who is convicted of a violation of 761.25 section 169A.20 (driving while impaired) under the circumstances 761.26 described in section 169A.24 (first-degree driving while 761.27 impaired) to imprisonment for not less than three years. In 761.28 addition, the court may order the person to pay a fine of not 761.29 more than $14,000. 761.30 (b) The court may stay execution of this mandatory sentence 761.31 as provided in subdivision 2 (stay of mandatory sentence), but 761.32 may not stay imposition or adjudication of the sentence or 761.33 impose a sentence that has a duration of less than three years. 761.34 (c) An offender committed to the custody of the 761.35 commissioner of corrections under this subdivision, is not 761.36 eligible for release as provided in section 241.26, 244.065, 762.1 244.12, or 244.17, unless the offender has successfully 762.2 completed a chemical dependency treatment program while in 762.3 prison. 762.4 (d) Notwithstanding the statutory maximum sentence provided 762.5 in section 169A.24 (first-degree driving while impaired), when 762.6 the court commits a person to the custody of the commissioner of 762.7 corrections under this subdivision, it shall provide that after 762.8 the person has been released from prison the commissioner shall 762.9 place the person on conditional release for five years. The 762.10 commissioner shall impose any conditions of release that the 762.11 commissioner deems appropriate including, but not limited to, 762.12 successful completion of an intensive probation program as 762.13 described in section 169A.74 (pilot programs of intensive 762.14 probation for repeat DWI offenders). If the person fails to 762.15 comply with any condition of release, the commissioner may 762.16 revoke the person's conditional release and order the person to 762.17 serve all or part of the remaining portion of the conditional 762.18 release term in prison. The commissioner may not dismiss the 762.19 person from supervision before the conditional release term 762.20 expires. Except as otherwise provided in this section, 762.21 conditional release is governed by provisions relating to 762.22 supervised release. The failure of a court to direct the 762.23 commissioner of corrections to place the person on conditional 762.24 release, as required in this paragraph, does not affect the 762.25 applicability of the conditional release provisions to the 762.26 person. 762.27 (e) The commissioner shall require persons placed on 762.28 supervised or conditional release under this subdivision to pay 762.29 as much of the costs of the supervision as possible. The 762.30 commissioner shall develop appropriate standards for this. 762.31 Subd. 2. [STAY OF MANDATORY SENTENCE.] The provisions of 762.32 sections 169A.275 (mandatory penalties; nonfelony violations), 762.33 subdivision 3 or 4, and subdivision 5, and 169A.283 (stay of 762.34 execution of sentence), apply if the court stays execution of 762.35 the sentence under subdivision 1 (mandatory prison sentence). 762.36 In addition, the provisions of section 169A.277 (long-term 763.1 monitoring) may apply. 763.2 Subd. 3. [DRIVER'S LICENSE REVOCATION; NO STAY PERMITTED.] 763.3 The court may not stay the execution of the driver's license 763.4 revocation provisions of section 169A.54 (impaired driving 763.5 convictions and adjudications; administrative penalties). 763.6 Sec. 10. Minnesota Statutes 2000, section 169A.283, 763.7 subdivision 1, is amended to read: 763.8 Subdivision 1. [STAY AUTHORIZED.] Except as otherwise 763.9 provided insectionsections 169A.275 (mandatory penalties; 763.10 nonfelony violations) and 169A.276 (mandatory penalties; felony 763.11 violations), when a court sentences a person convicted of a 763.12 violation of section 169A.20 (driving while impaired), the court 763.13 may stay execution of the criminal sentence described in section 763.14169A.25169A.24 (first-degree driving while impaired),169A.26763.15 169A.25 (second-degree driving while impaired),or 169A.27763.16 169A.26 (third-degree driving while impaired), or 169A.27 763.17 (fourth-degree driving while impaired) on the condition that the 763.18 convicted person submit to the level of care recommended in the 763.19 chemical use assessment report required under section 169A.70 763.20 (alcohol safety programs; chemical use assessments). If the 763.21 court does not order a level of care in accordance with the 763.22 assessment report recommendation as a condition of a stay of 763.23 execution, it shall state on the record its reasons for not 763.24 following the assessment report recommendation. 763.25 Sec. 11. Minnesota Statutes 2000, section 169A.40, 763.26 subdivision 3, is amended to read: 763.27 Subd. 3. [FIRST-DEGREE AND SECOND-DEGREE DWI OFFENDERS; 763.28 CUSTODIAL ARREST.] Notwithstanding rule 6.01 of the Rules of 763.29 Criminal Procedure, a peace officer acting without a warrant who 763.30 has decided to proceed with the prosecution of a person for 763.31 violating section 169A.20 (driving while impaired), shall arrest 763.32 and take the person into custody if the officer has reason to 763.33 believe the violation occurred under the circumstances described 763.34 in section 169A.24 (first-degree driving while impaired) or 763.35 169A.25 (first-degreesecond-degree driving while impaired). 763.36 The person shall be detained until the person's first court 764.1 appearance. 764.2 Sec. 12. Minnesota Statutes 2000, section 169A.63, 764.3 subdivision 1, is amended to read: 764.4 Subdivision 1. [DEFINITIONS.] (a) As used in this section, 764.5 the following terms have the meanings given them. 764.6 (b) "Appropriate agency" means a law enforcement agency 764.7 that has the authority to make an arrest for a violation of a 764.8 designated offense or to require a test under section 169A.51 764.9 (chemical tests for intoxication). 764.10 (c) "Designated license revocation" includes a license 764.11 revocation under section 169A.52 (license revocation for test 764.12 failure or refusal) or a license disqualification under section 764.13 171.165 (commercial driver's license disqualification) resulting 764.14 from a violation of section 169A.52; within ten years of the 764.15 first of two or more qualified prior impaired driving incidents. 764.16 (d) "Designated offense" includes: 764.17 (1) a violation of section 169A.20 (driving while impaired) 764.18 under the circumstances described in section 169A.24 764.19 (first-degree driving while impaired) or 169A.25 (first-degree764.20 second-degree driving while impaired); or 764.21 (2) a violation of section 169A.20 or an ordinance in 764.22 conformity with it: 764.23 (i) by a person whose driver's license or driving 764.24 privileges have been canceled as inimical to public safety under 764.25 section 171.04, subdivision 1, clause (10); or 764.26 (ii) by a person who is subject to a restriction on the 764.27 person's driver's license under section 171.09 (commissioner's 764.28 license restrictions), which provides that the person may not 764.29 use or consume any amount of alcohol or a controlled substance. 764.30 (e) "Motor vehicle" and "vehicle" do not include a vehicle 764.31 which is stolen or taken in violation of the law. 764.32 (f) "Owner" means the registered owner of the motor vehicle 764.33 according to records of the department of public safety and 764.34 includes a lessee of a motor vehicle if the lease agreement has 764.35 a term of 180 days or more. 764.36 (g) "Prosecuting authority" means the attorney in the 765.1 jurisdiction in which the designated offense occurred who is 765.2 responsible for prosecuting violations of a designated offense. 765.3 Sec. 13. Minnesota Statutes 2000, section 171.29, 765.4 subdivision 2, is amended to read: 765.5 Subd. 2. [FEES, ALLOCATION.] (a) A person whose driver's 765.6 license has been revoked as provided in subdivision 1, except 765.7 under section 169A.52 or 169A.54, shall pay a $30 fee before the 765.8 driver's license is reinstated. 765.9 (b) A person whose driver's license has been revoked as 765.10 provided in subdivision 1 under section 169A.52 or 169A.54 shall 765.11 pay a $250 fee plus a $40 surcharge before the driver's license 765.12 is reinstated. Beginning July 1, 2002, the surcharge is $145. 765.13 Beginning July 1, 2003, the surcharge is $380. The $250 fee is 765.14 to be credited as follows: 765.15 (1) Twenty percent must be credited to the trunk highway 765.16 fund. 765.17 (2) Fifty-five percent must be credited to the general fund. 765.18 (3) Eight percent must be credited to a separate account to 765.19 be known as the bureau of criminal apprehension account. Money 765.20 in this account may be appropriated to the commissioner of 765.21 public safety and the appropriated amount must be apportioned 80 765.22 percent for laboratory costs and 20 percent for carrying out the 765.23 provisions of section 299C.065. 765.24 (4) Twelve percent must be credited to a separate account 765.25 to be known as the alcohol-impaired driver education account. 765.26 Money in the account is appropriated as follows: 765.27 (i) the first $200,000 in a fiscal year to the commissioner 765.28 of children, families, and learning for programs for elementary 765.29 and secondary school students; and 765.30 (ii) the remainder credited in a fiscal year to the 765.31 commissioner of transportation to be spent as grants to the 765.32 Minnesota highway safety center at St. Cloud State University 765.33 for programs relating to alcohol and highway safety education in 765.34 elementary and secondary schools. 765.35 (5) Five percent must be credited to a separate account to 765.36 be known as the traumatic brain injury and spinal cord injury 766.1 account. The money in the account is annually appropriated to 766.2 the commissioner of health to be used as follows: 35 percent 766.3 for a contract with a qualified community-based organization to 766.4 provide information, resources, and support to assist persons 766.5 with traumatic brain injury and their families to access 766.6 services, and 65 percent to maintain the traumatic brain injury 766.7 and spinal cord injury registry created in section 144.662. For 766.8 the purposes of this clause, a "qualified community-based 766.9 organization" is a private, not-for-profit organization of 766.10 consumers of traumatic brain injury services and their family 766.11 members. The organization must be registered with the United 766.12 States Internal Revenue Service under section 501(c)(3) as a 766.13 tax-exempt organization and must have as its purposes: 766.14 (i) the promotion of public, family, survivor, and 766.15 professional awareness of the incidence and consequences of 766.16 traumatic brain injury; 766.17 (ii) the provision of a network of support for persons with 766.18 traumatic brain injury, their families, and friends; 766.19 (iii) the development and support of programs and services 766.20 to prevent traumatic brain injury; 766.21 (iv) the establishment of education programs for persons 766.22 with traumatic brain injury; and 766.23 (v) the empowerment of persons with traumatic brain injury 766.24 through participation in its governance. 766.25 No patient's name, identifying information or identifiable 766.26 medical data will be disclosed to the organization without the 766.27 informed voluntary written consent of the patient or patient's 766.28 guardian, or if the patient is a minor, of the parent or 766.29 guardian of the patient. 766.30 (c) The$40surcharge must be credited to a separate 766.31 account to be known as the remote electronic alcohol monitoring 766.32 program account. The commissioner shall transfer the balance of 766.33 this account to the commissioner of finance on a monthly basis 766.34 for deposit in the general fund. 766.35 (d) When these fees are collected by a licensing agent, 766.36 appointed under section 171.061, a handling charge is imposed in 767.1 the amount specified under section 171.061, subdivision 4. The 767.2 reinstatement fees and surcharge must be deposited in an 767.3 approved state depository as directed under section 171.061, 767.4 subdivision 4. 767.5 Sec. 14. [SUPERVISION LEVEL.] 767.6 Nothing in this article requires a different level of 767.7 supervision for offenders than is currently required by law. 767.8 Sec. 15. [FELONY DWI STUDY.] 767.9 By January 15, 2004, and each year thereafter through 767.10 January 15, 2007, the commissioner of corrections must report to 767.11 the chairs and ranking minority members of the house and senate 767.12 committees having jurisdiction over criminal justice and 767.13 judiciary finance issues on the implementation and effects of 767.14 the felony level driving while impaired offense. The report 767.15 must include the following information on felony level driving 767.16 while impaired offenses: 767.17 (1) the number of persons convicted; 767.18 (2) the number of trials taken to verdict, separating out 767.19 cases tried to a judge versus cases tried to a jury, and the 767.20 number of convictions for each; 767.21 (3) the number of offenders incarcerated locally and the 767.22 term of incarceration; 767.23 (4) the number placed on probation and the length of the 767.24 probation; 767.25 (5) the number for whom probation is revoked, the reasons 767.26 for revocation, and the consequences imposed; 767.27 (6) the number given an executed prison sentence upon 767.28 conviction and the length of the sentence; 767.29 (7) the number given an executed prison sentence upon 767.30 revocation of probation and the length of sentence; 767.31 (8) the number who successfully complete treatment in 767.32 prison; 767.33 (9) the number placed on intensive supervision following 767.34 release from incarceration; 767.35 (10) the number who violate supervised release and the 767.36 consequences imposed; and 768.1 (11) any other information the commissioner deems relevant 768.2 to estimating future costs. 768.3 Sec. 16. [REPORT ON INSURANCE COVERAGE.] 768.4 By February 1, 2004, the commissioner of corrections shall 768.5 report to the chairs of the senate and house committees with 768.6 jurisdiction over criminal justice funding on the number of 768.7 cases in which a felony DWI offender had private health 768.8 insurance coverage for chemical dependency treatment, and the 768.9 results of the commissioner's attempts to obtain coverage for 768.10 this treatment under Minnesota Statutes, section 62Q.137. 768.11 Sec. 17. [EFFECTIVE DATE.] 768.12 Sections 1 to 12 and 14 to 16 are effective August 1, 2002, 768.13 and apply to crimes committed on or after that date. However, 768.14 violations occurring before August 1, 2002, that are listed in 768.15 Minnesota Statutes, section 169A.03, subdivisions 20 and 21, are 768.16 considered qualified prior impaired driving incidents for 768.17 purposes of this act. Section 13 is effective July 1, 2001.